Deck 22: Musculoskeletal System

Question 1

Of the 33 vertebrae in the spinal column,there are:
1)5 lumbar.
2)5 thoracic.
3)7 sacral.
4)12 cervical.

Answer 1

1
There are 7 cervical,12 thoracic,5 lumbar,5 sacral,and 3 to 4 coccygeal vertebrae.

Question 2

During an interview,a patient states,"I can feel this bump on the top of both of my shoulders-it doesn't hurt but I am curious about what it might be." The nurse should tell her:
1)"That is your subacromial bursa."
2)"That is your acromion process."
3)"That is your glenohumeral joint."
4)"That is the greater tubercle of your humerus."

Answer 2

2
The bump of the scapula's acromion process is felt at the very top of the shoulder.

Question 3

A woman who is 8 months pregnant comments that she has noticed a change in posture and is having lower back pain.The nurse tells her that during pregnancy women have a posture shift to compensate for the enlarging fetus.This shift in posture is known as:
1)lordosis.
2)scoliosis.
3)ankylosis.
4)kyphosis.

Answer 3

1
Lordosis compensates for the enlarging fetus,which would shift the center of balance forward.This shift in balance in turn creates strain on the low back muscles,felt as low back pain during late pregnancy by some women.

Question 4

Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are called:
1)bursa.
2)tendons.
3)cartilage.
4)ligaments.

Question 5

An imaginary line connecting the highest point on each iliac crest would cross:
1)the first sacral vertebra.
2)the fourth lumbar vertebra.
3)the seventh cervical vertebra.
4)the twelfth thoracic vertebra.

Question 6

A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth.The nurse knows that for her to move her hand to her mouth,she must perform the following movement:
1)flexion.
2)abduction.
3)adduction.
4)extension.

Question 7

The nurse is explaining to a patient that there are "shock absorbers" in his back to cushion the spine and to help it move.The nurse is referring to his:
1)costal facets.
2)nucleus pulposus.
3)vertebral foramen.
4)intervertebral discs.

Question 8

The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler.The nurse knows that bones increase in width or diameter by deposition of new bony tissue around the shafts.The nurse also knows that lengthening occurs at the:
1)bursa.
2)calcaneus.
3)epiphyses.
4)tuberosities.

Question 9

To palpate the temporomandibular joint,the nurse's fingers should be placed in the depression:
1)distal to the helix of the ear.
2)proximal to the helix of the ear.
3)anterior to the tragus of the ear.
4)posterior to the tragus of the ear.

Question 10

An 85-year-old patient comments during his annual physical that he seems to be getting shorter as he ages.The nurse should explain that decreased height occurs with aging because:
1)long bones tend to shorten with age.
2)of the shortening of the vertebral column.
3)there is a significant loss of subcutaneous fat.
4)there is a thickening of the intervertebral discs.

Question 11

The functional units of the musculoskeletal system are the:
1)joints.
2)bones.
3)muscles.
4)tendons.

Question 12

A patient is being assessed for range of joint movement.The nurse asks him to move his arm in toward the center of his body.This movement is called:
1)flexion.
2)abduction.
3)adduction.
4)extension.

Question 13

The knee joint is the articulation of the femur,the tibia,and the:
1)fibula.
2)radius.
3)patella.
4)humerus.

Question 14

A patient is visiting the clinic for an evaluation of a swollen,painful knuckle.The nurse notices that the knuckle above his ring on the left hand is swollen and he is unable to remove his wedding ring.This joint is called the:
1)interphalangeal joint.
2)tarsometatarsal joint.
3)metacarpophalangeal joint.
4)talocalcaneonavicular joint.

Question 15

The nurse is checking the range of motion in a patient's knee and knows that the knee is capable of the following movements:
1)flexion and extension.
2)supination and pronation.
3)circumduction.
4)inversion and eversion.

Question 16

The articulation of the mandible and the temporal bone is known as the:
1)intervertebral foramen.
2)condyle of the mandible.
3)temporomandibular joint.
4)zygomatic arch of the temporal bone.

Question 17

The nurse notices that a woman in an exercise class is unable to jump rope.The nurse knows that to jump rope,one's shoulder has to be capable of:
1)inversion.
2)supination.
3)protraction.
4)circumduction.

Question 18

The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury.The nurse knows that a rotator cuff injury involves:
1)nucleus pulposus.
2)the articular process.
3)the medial epicondyle.
4)the glenohumeral joint.

Question 19

Hematopoiesis takes place in the:
1)liver.
2)spleen.
3)kidneys.
4)bone marrow.

Question 20

A patient has been diagnosed with osteoporosis and asks the nurse,"What is osteoporosis?" The nurse knows that osteoporosis can be defined as:
1)loss of bone matrix.
2)loss of bone density.
3)new,weaker bone growth.
4)increased phagocytic activity.

Question 21

A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months.Which response by the nurse is appropriate?
1)"If these symptoms persist,you may need arthroscopic surgery."
2)"You are experiencing degeneration of your knee,which may not resolve."
3)"Your disease is due to repeated stress on the patellar tendon.It is usually self-limited,and your symptoms should resolve with rest."
4)"Increasing your activity and performing knee-strengthening exercises will help to decrease the inflammation and maintain mobility in the knee."

Question 22

The nurse knows that the incidence of osteoporosis is greatest in which group?
1)Black men
2)Black women
3)White women
4)American Indian men

Question 23

A patient is complaining of pain in his joints that is worse in the morning,is better after he has moved around for awhile,and then gets worse again if he sits for long periods of time.The nurse suspects that he may have:
1)tendinitis.
2)osteoarthritis.
3)rheumatoid arthritis.
4)intermittent claudication.

Question 24

During a neonatal examination,the nurse notes that the newborn infant has six toes.This finding is documented as:
1)unidactyly.
2)syndactyly.
3)polydactyly.
4)multidactyly.

Question 25

When assessing muscle strength,the nurse observes that a patient has complete range of motion against gravity with full resistance.What should the nurse record using a 0 to 5+ scale?
1)2+
2)3+
3)4+
4)5+

Question 26

A 68-year-old woman has come in for an assessment of her rheumatoid arthritis,and the nurse notes raised,firm,nontender nodules at the olecranon bursa and along the ulna.These nodules are most commonly diagnosed as:
1)epicondylitis.
2)gouty arthritis.
3)olecranon bursitis.
4)subcutaneous nodules.

Question 27

The nurse has completed the musculoskeletal examination of a patient's knee and has found a positive bulge sign.The nurse suspects:
1)irregular bony margins.
2)soft tissue swelling in the joint.
3)swelling from fluid in the epicondyle.
4)swelling from fluid in the suprapatellar pouch.

Question 28

A 28-year-old jogger comes to the sports clinic complaining of increased foot problems while running.The nurse knows that a possible cause of this could be:
1)twenty-four vertebrae.
2)a missing peroneus teritus.
3)convex anterior curvature of the femur.
4)a second toe that is longer than the great toe.

Question 29

A patient's annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine;however,this curvature disappears with forward bending.The nurse knows that this abnormality of the spine would be called:
1)structural scoliosis.
2)functional scoliosis.
3)herniated nucleus pulposus.
4)dislocated nucleus pulposus.

Question 30

A professional tennis player comes into the clinic complaining of a sore elbow.The nurse suspects that he has tenderness at the:
1)olecranon bursa.
2)annular ligament.
3)base of the radius.
4)medial and lateral epicondyle.

Question 31

A 40-year-old man has come into the clinic with complaints of "extreme tenderness in my toes." The nurse notes that his toes are slightly swollen,reddened,and warm to the touch.His complaints would suggest:
1)osteoporosis.
2)acute gout.
3)ankylosing spondylitis.
4)degenerative joint disease.

Question 32

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen's test.To perform this test,the nurse will instruct the patient to:
1)dorsiflex the foot.
2)plantarflex the foot.
3)hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.
4)hyperextend the wrists with the palmar surface of both hands touching and wait for 60 seconds.

Question 33

A woman who has had rheumatoid arthritis for years is starting to notice that her fingers are drifting to the side.The nurse knows that this condition is commonly referred to as:
1)radial drift.
2)ulnar deviation.
3)swan neck deformity.
4)Dupuytren's contracture.

Question 34

A patient states,"I can hear a crunching or grating sound when I kneel." She also states "it is very difficult to get out of bed in the morning because of stiffness and pain in my joints." The nurse suspects that the sound she hears is:
1)crepitation.
2)a bone spur.
3)a loose tendon.
4)fluid in the knee joint.

Question 35

A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms;the nurse suspects:
1)crepitation.
2)rotator cuff lesions.
3)dislocated shoulder.
4)rheumatoid arthritis.

Question 36

A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her hands.The nurse knows that changes associated with rheumatoid arthritis include:
1)Heberden's nodes.
2)Bouchard's nodules.
3)swan-neck deformities.
4)Dupuytren's contractures.

Question 37

The nurse is examining a 3-month-old infant.While holding the thumbs on the infant's inner mid thighs and the fingers outside on the hips,touching the greater trochanter,the nurse adducts the legs until the nurse's thumbs touch and then abducts the legs until the infant's knees touch the table.The nurse does not note any "clunking" sounds and is confident to record a:
1)positive Allis.
2)negative Allis.
3)positive Ortolani.
4)negative Ortolani.

Question 38

During an examination,the nurse asks a patient to bend forward from the waist and notes that the patient has lateral tilting.When his leg is raised straight up,he complains of a pain going down his buttock into his leg.The nurse suspects:
1)scoliosis.
2)meniscus tear.
3)herniated nucleus pulposus.
4)spasm of paravertebral muscles.

Question 39

An 80-year-old woman is visiting the clinic for a checkup.The nurse is observing for motor dysfunction in her hip and would have her:
1)internally rotate her hip while she is sitting.
2)abduct her hip while she is lying on her back.
3)adduct her hip while she is lying on her back.
4)externally rotate her hip while she is standing.

Question 40

A mother brings her newborn baby boy in for a checkup;she tells the nurse that he doesn't seem to be moving his right arm as much as his left and that he seems to have pain when she lifts him up under the arms.The nurse suspects a fractured clavicle and would observe for:
1)a negative Allis sign.
2)a positive Ortolani sign.
3)limited range of motion during the Moro reflex.
4)limited range of motion during LaSegue's reflex.

Question 41

The nurse is planning to measure a patient's angles of joint flexion and will use which instrument?
1)Caliper
2)Protracter
3)Goniometer
4)Measuring tape

Question 42

The nurse should use which test to check for large amounts of fluid around the patella?
1)Ballottement
2)Tinel's sign
3)Phalen's test
4)McMurray's test

Question 43

The nurse is assessing a 1-week-old infant and testing his muscle strength.The nurse lifts the infant with hands under the axillae and notes that the infant starts to "slip" between the hands.The nurse should:
1)suspect a fractured clavicle.
2)consider that the infant may have a deformity of the spine.
3)suspect that the infant may have weakness of the shoulder muscles.
4)consider this a normal finding because the musculature of an infant this age is undeveloped.

Question 44

The nurse is assessing the joints of a woman who has stated,"I have a long family history of arthritis,and my joints hurt." The nurse suspects that she has osteoarthritis.Which of the following are symptoms of osteoarthritis? Select all that apply.
1)Symmetric
2)Asymmetric
3)Pain with motion of affected joints
4)Affected joints swollen with hard,bony protuberances
5)Affected joints may have heat,redness,and swelling.

Question 45

A man who has had gout for several years comes to the clinic with a "problem with my toe." On examination,the nurse notes the presence of hard,painless nodules over the great toe;one had burst open with a chalky discharge.This finding is known as:
1)a callus.
2)a plantar wart.
3)tenosynovitis.
4)tophi.

Question 46

The nurse knows that another term for "knock knees" is:
1)genu varum.
2)genu valgum.
3)pes planus.
4)metatarsus adductus.

Question 47

The nurse is examining a 6-month-old baby and places the baby's feet flat on the table and flexes his knees up.The nurse notes that the right knee is significantly lower than the left.Which of the following is true of this finding?
1)This is a positive Allis sign and suggests hip dislocation.
2)The infant probably has a dislocated patella on the right.
3)This is a normal finding for the Allis test for an infant of this age.
4)The infant should return to the clinic in 2 weeks to see if this has changed.

Question 48

When performing a musculoskeletal assessment,the nurse knows that the correct approach for the examination should be:
1)proximal to distal.
2)distal to proximal.
3)posterior to anterior.
4)anterior to posterior.