Deck 37: A Person-Centred Approach to Assessing the Musculoskeletal System

Question 1

A 62-year-old female is scheduled to have a DEXA exam as a screening tool. What is the most likely reason that the test has been ordered? To:

A)evaluate bone mineral density.
B)assess for bone cancer.
C)screen for osteomyelitis.
D)check for fractures.

Answer 1

evaluate bone mineral density.

Question 2

What should be included in teaching the person about an electromyogram (EMG)? (Select all that apply.)

A)The test measures electrical activity of skeletal muscles at rest and during contraction.
B)Do not take any medication prior to this test without the doctor's approval.
C)The test measures electrical conduction along nerve pathways.
D)Do not consume caffeine for 3 hours before the test.

Answer 2

The test measures electrical activity of skeletal muscles at rest and during contraction.
Do not take any medication prior to this test without the doctor's approval.
Do not consume caffeine for 3 hours before the test.

Question 3

A person is seen in the clinic for a high blood uric acid level. What should this client be monitored for?

A)Bone cancer.
B)Paget's disease.
C)Gout.
D)Muscular dystrophy.

Answer 3

Muscular dystrophy.

Question 4

Put the following techniques of a musculoskeletal examination in the proper sequence.
1) Assess muscle mass by first inspecting for obvious increase or decrease in size.
2) Inspect and palpate the bones for any obvious deformity or changes in size, shape, or a painful response.
3) Measure the extremities for length and circumference, and compare limbs bilaterally.
4) Assess gait and posture.

Question 5

A person is about to have a magnetic resonance imaging (MRI)to diagnose a soft tissue abnormality of the lower leg. The nurse should immediately notify the doctor about which of the following? The person:

A)did not eat breakfast due to earlier nausea.
B)has a pacemaker.
C)has sleep apnea.
D)has a history of hypotension.

Question 6

During assessment when is a person's gait considered to be normal? If:

A)the gait is smooth and steady without limping.
B)the gait is slow and deliberate, as if the person is gingerly pulling one side up to meet the other.
C)the gait is jerky and quick, indicating the person has excellent motor control.
D)the person does not stumble, run into objects, or fall.

Question 7

When would a bone scan most likely be ordered for a person? When:

A)osteosarcoma is suspected.
B)a person complains of a new onset of pain in the area of the bone.
C)a muscle mass near the bone is suspected.
D)lab tests indicate a normal serum calcium level.

Question 8

A person comes to the Emergency Department complaining of right knee pain after being knocked down while playing basketball. The exam reveals the person experiences difficulty when stepping down on the right leg due to acute pain around the knee and slight swelling of the right knee. Initially, what does the nurse expect? The person will be:

A)sent home with instructions to rest and to apply an icepack for one week.
B)admitted to the hospital and seen by an orthopaedic specialist.
C)scheduled to see an orthopaedic specialist and a tentative appointment for a magnetic resonance imaging (MRI)scan.
D)admitted to the hospital and scheduled for an arthroscopy.

Question 9

How should the nurse prepare a person for an Electromyogram test? By:

A)doing no special preparation.
B)instructing the person not to drink fluids containing caffeine 3 hours before the test.
C)medicating the person with a muscle relaxant.
D)initiating a peripheral IV in the right arm.

Question 10

The nurse assesses a person and finds that a grating sound is present when a joint is bent and straightened. What is the appropriate medical term to describe this finding?

A)Bursitis.
B)Crepitation.
C)Synovitis.
D)Grinding.

Question 11

Why is alkaline phosphatase (ALP)assessed in people experiencing musculoskeletal disorders and diseases? To:

A)identify bone diseases.
B)determine phosphorus levels.
C)diagnose and monitor the treatment of gout.
D)establish true calcium levels.

Question 12

Creatine kinase (CK)is evaluated in persons who are suspected of having which condition?

A)Osteoarthritis.
B)Bone tumours.
C)Muscle trauma.
D)Gout.

Question 13

A young adult is seen in the clinic complaining of pain in the left wrist. There is no deformity of the wrist, the left radial pulse is strong, and there is no history of a fall or injury. What does the nurse expect to see ordered?

A)An x-ray of the arm to ensure there is no injury present.
B)Lab work to assess both serum calcium and serum phosphorus levels.
C)Rest and comfort measures for several days unless pain worsens.
D)A computerised tomography (CT)scan of the wrist to check for soft tissue injury.

Question 14

The nurse is assessing the person's spine and the assessment includes an abnormal finding. To conduct further assessment, what should the nurse ask the person to do?

A)Lie down on their abdomen so the nurse can look at the spine more carefully.
B)Stand, bend back slowly, then to the right and left while the nurse looks from the back.
C)Bend over, stand upright, and stretch both arms over the head.
D)Sit, then stand, as the nurse observes the person from the front.

Question 15

What is an age-related change in the musculoskeletal system of an older person?

A)Pain when ambulating due to increased bone mass.
B)Decreased bone mass and calcium absorption, which lead to an increased risk of fractures.
C)Vertebrae lengthen and thin, which leads to increased bone production.
D)Difficulty with dexterity after age 50.

Question 16

A person is ordered to be on bed rest for two months. What will happen to the person's bones? They will:

A)be affected positively by the rest and be stronger as a result.
B)increase their osteoblastic activity to promote bone deposition.
C)not be affected significantly by the bed rest.
D)undergo increased osteoclast activity and bone breakdown.

Question 17

A person is seen in the doctor's office following several tests. The test results include elevated blood calcium, elevated alkaline phosphatase, elevated phosphorus, normal creatine kinase, and increased uptake of the radioisotope on bone scan. What is the most likely diagnosis?

A)Osteoarthritis.
B)Osteomyelitis.
C)Osteoporosis.
D)Bone cancer.

Question 18

The nurse is teaching about an endoscopic examination of the interior surfaces of a joint during which both diagnosis and surgery can be accomplished. What is a correct name for this technique?

A)Arthrocentesis.
B)Arthroscopy.
C)Menisectomy.
D)Arthrogenesis.

Question 19

The person is recovering from orthopaedic surgery on a fractured arm. The nurse realises that for musculoskeletal function, what type of muscle is needed?

A)Smooth.
B)Cardiac.
C)Nonstriated.
D)Skeletal.

Question 20

The person's right femur was fractured and repaired at the diaphysis. When teaching, the person asks the nurse to explain the diaphysis. What is the nurse's best response? 1)_______

A)'Short bones like the femur are cuboid, spongy bones are called the diaphysis.'
B)'Flat bones like the femur are disc-shaped and are called the diaphysis.'
C)'Irregular bones like the femur are plates of compact bone that are also called the diaphysis.'
D)'Long bones like the femur have a mid-portion or shaft that is also called the diaphysis.'