Deck 25: Musculoskeletal Function

Question 1

A patient is being dismissed from the emergency department with an arm cast.What statement by the patient indicates more teaching is needed?

A)"I will keep the cast clean and dry."
B)"I will wiggle my thumb and fingers often."
C)"I will elevate my arm on two pillows."
D)"I can use a hanger to scratch under the cast."

Answer 1

"I can use a hanger to scratch under the cast."

Question 2

An older adult is diagnosed with rheumatoid arthritis.When discussing exercise with the patient,the nurse makes the greatest positive impact on the patient's quality of life when stating:

A)"Exercising will be important to the flexibility of your joints."
B)"It seems to help if you have someone to exercise with."
C)"I'll provide you with a list of gyms where you can exercise."
D)"Let's discuss ways for you to exercise your joints."

Answer 2

"Let's discuss ways for you to exercise your joints."

Question 3

To best identify a risk for injury in an older adult patient,the nurse assesses for:

A)decreased muscle mass in the legs.
B)history of falls.
C)hyperextension of the spine.
D)decreased bone density.

Answer 3

history of falls.

Question 4

A nurse is caring for the older patient who had knee replacement surgery 8 days ago.What assessment by the nurse is most important?

A)Determining whether the patient has sensation to the foot
B)Asking the patient to rate his or her current pain.
C)Observing the incision site for redness or drainage.
D)Monitoring the calf circumference on the affected side

Question 5

An older adult patient has been admitted to the hospital with suspected Paget disease.What clinical manifestation will help the nurse differentiate Paget disease from other types of musculoskeletal diseases?

A)Red,swollen upper and lower extremity joints
B)Pain on awakening that subsides with activity
C)Ataxia or mild hearing loss
D)Back deformity in the absence of pain

Question 6

A patient has polymyalgia rheumatica.When teaching about medications,what information does the nurse provide?

A)"Take the full dose of antibiotics even if you are feeling better."
B)"You need to remain upright 1 hour after taking the medication."
C)"Stay away from large crowds and avoid people who are sick."
D)"Do not drink alcohol while taking this medication."

Question 7

The nurse is assisting a 65-year-old female patient with planning an exercise program to prevent osteoporosis.The nurse shows an understanding of appropriate exercise when stating:

A)"The local gym offers aerobics for seniors on Tuesday and Thursday evenings."
B)"Bicycling along the park's 2-mile trail twice a week would be ideal."
C)"Do you have a friend who would walk with you for 30 to 60 minutes?"
D)"Are you aware that rowing is an excellent exercise for strengthening bone?"

Question 8

After a below-the-knee amputation,a patient has disturbed body image.What action by the patient indicates movement toward resolution of this diagnosis?

A)The patient names his stump "Pete."
B)The patient attends physical therapy.
C)The patient begins to change dressings.
D)The patient asks questions about prosthetics.

Question 9

A patient's chart contains an assessment of tophi and podagra.What medication does the nurse plan to educate the patient on?

A)Allopurinol (Zyloprim)
B)Colchicine (Colcrys)
C)Levadopa-carbidopa (Sinemet)
D)Ibuprofen (Motrin)

Question 10

The nurse caring for an older patient diagnosed with spinal stenosis encourages the patient to notify her physician if she experiences:

A)sharp pain when turning her neck side-to-side.
B)stabbing pain in her lower back.
C)a cramping sensation in her feet.
D)a burning sensation in either one or both legs.

Question 11

An older adult patient who has experienced a left knee replacement asks the nurse,"When will I be back to normal?" The nurse responds that:

A)"What did the surgeon tell you about function after the surgery?"
B)"Normal means different things to different people."
C)"You should be back to normal after 6 to 8 weeks."
D)"Surgery will improve your mobility but I'm not sure about being normal."

Question 12

A patient had hip replacement surgery.What intervention is most appropriate to prevent dislocation?

A)Instruct staff to use a fracture pan when the patient needs to toilet.
B)Administer ordered pain medication prior to turning.
C)Elevate the patient's knee on the affected side with a pillow.
D)Apply an abduction splint while the patient is in bed.

Question 13

A patient has onychomycosis.The nurse should anticipate educating the patient on which of the following drugs?

A)Clotrimazole (Lotrimin)
B)Terbinafine (Lamisil)
C)Itraconazole (Sporanox)
D)Methylprednisolone (Solu-Medrol)

Question 14

An older patient is in the family practice clinic reporting increasing joint pain,anorexia,and low-grade fever.The patient has a history of osteoarthritis.What action by the nurse is best?

A)Document the findings on the patient's chart.
B)Assess for joint deformities and nodules.
C)Tell the provider the patient needs more pain medicine.
D)Encourage the patient to ask for physical therapy.

Question 15

A nurse works in a long-term care facility where many of the residents have osteoporosis.For which resident would alendronate (Fosamax)be contraindicated?

A)A patient on a continuous tube feeding
B)A wheelchair-bound patient
C)A patient over the age of 85
D)A male patient

Question 16

A patient has just arrived in the postanesthesia care unit after a below-the-knee amputation.What assessment takes priority?

A)Surgical dressing
B)Level of pain
C)Pulse and blood pressure
D)Airway

Question 17

The nurse is caring for an older adult patient prescribed allopurinol (Zyloprim).What action by the nurse is best?

A)Offering fresh,cold water frequently during the day
B)Monitoring temperature every 4 hours
C)Ensuring sufficient protein intake
D)Assessing for depression symptoms daily

Question 18

An older confused patient is recovering from a stage IV sacral pressure ulcer.The nurse shows an understanding of this patient's risk for developing osteomyelitis by:

A)adhering to sterile technique when changing the wound's dressing.
B)assessing and documenting the patient's vital signs regularly.
C)managing the patient's antibiotic therapy as prescribed.
D)ensuring that the patient's diet includes sufficient protein.

Question 19

An older adult patient has been casted for a fractured left wrist.Which action by the nurse takes priority?

A)Assessing capillary refill in the nail beds of the fingers of the left hand.
B)Instructing the patient on how to effectively rate pain on the pain scale.
C)Teaching the patient to wrap the cast in plastic when the patient showers.
D)Providing the patient with a protein-enriched milkshake as a bedtime snack.

Question 20

A patient is scheduled to have a lower extremity amputation.What action by the nurse takes priority?

A)Discuss stump management and prostheses.
B)Ensure informed consent is on the chart.
C)Determine the patient's goal for pain control.
D)Administer the preoperative antibiotic.

Question 21

The nurse conducting a community-screening event for osteoporosis knows that which woman is at highest risk?

A)A slender 84-year-old Asian who smokes
B)A heavy set 65-year-old Caucasian
C)A 75-year-old taking a steroid "burst"
D)A 68-year-old African American who consumes one drink a day

Question 22

The nurse working with older adults knows which facts about age-related musculoskeletal changes? (Select all that apply. )

A)Muscle mass decreases,causing atrophy.
B)Myocytes are replaced by fibrous tissue.
C)Vertebral spaces enlarge with fluid retention.
D)Posture and gait change,leading to fall risk.
E)Men become bowlegged and waddle.

Question 23

To assess for osteoarthritis in an older adult patient,the nurse asks which of the following questions? (Select all that apply. )

A)"Do you have pain in your finger joints?"
B)"Do your knees crackle when you bend down?"
C)"Does you get dizzy when you turn your head?"
D)"Does it hurt when you get up from a chair?"
E)"Does your back creak when you bend over?"