Question 1

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

Accepted Answer

Normally this manoeuvre feels smooth and has no sound.With a positive Ortolani sign,a "clunk" will be heard and felt as the head of the femur pops back into place.

Question 2

A young swimmer comes to the sports clinic complaining of a very sore shoulder.He was running at the pool,slipped on some wet concrete,and tried to catch himself with his outstretched hand.He landed on this hand,and has not been able to move his shoulder since.The nurse suspects:

Accepted Answer

Dislocated shoulder occurs with trauma involving abduction,extension,and external rotation (e.g. ,falling on an outstretched arm or diving into a pool).

Question 3

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:

Accepted Answer

Rotator cuff lesions may cause limited range of motion and pain and muscle spasm during abduction,whereas forward flexion stays fairly normal.

Question 4

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:

Accepted Answer

Acute gout occurs primarily in men over 40 years of age.Clinical findings consist of redness,swelling,heat,and extreme tenderness.Gout is a metabolic disorder of disturbed purine metabolism,associated with elevated serum uric acid.

Question 5

During a neonatal examination,the nurse notes that the newborn infant has six toes.This finding is documented as:

Accepted Answer

Polydactyly is the presence of extra fingers or toes.

Question 6

A patient is complaining of pain in his joints that is worse in the morning,is better after he has moved around for a while,and then gets worse again if he sits for long periods of time.The nurse suspects that he may have:

Accepted Answer

Rheumatoid arthritis is worse in the morning when arising.Movement increases most joint pain,except in rheumatoid arthritis,in which movement decreases pain.

Question 7

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:

Accepted Answer

Postural changes are evident with aging;decreased height is most noticeable and is due to shortening of the vertebral column.Long bones do not shorten with age.

Question 8

A patient has been diagnosed with osteoporosis and asks the nurse,"What is osteoporosis?" The nurse knows that osteoporosis can be defined as:

Accepted Answer

Osteoporosis is the loss of bone mass.

Question 9

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen test.To perform this test,the nurse will instruct the patient to:

Accepted Answer

For the Phalen test,the person should hold both hands back to back while flexing the wrists 90 degrees.Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.The Phalen test reproduces numbness and burning in a person with carpal tunnel syndrome.

Question 10

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:

Accepted Answer

Changes in the hands caused by chronic rheumatoid arthritis include swan-neck and boutonniere deformities.Heberden's nodes and Bouchard's nodes are associated with osteoarthritis.

Question 11

The nurse knows that the incidence of osteoporosis is greatest in which group?

Accepted Answer

The incidence of osteoporosis is lowest in males of African descent and highest in females of European descent.

Question 12

An 80-year-old woman is visiting the clinic for a checkup.The nurse is observing for motor dysfunction in the woman's hip and would have her:

Accepted Answer

Limitation of abduction of the hip while supine is the most common motion dysfunction found in hip disease.

Question 13

During an examination,the nurse asks a patient to bend forward from the waist and notes that the patient has lateral tilting.When one of his legs is raised straight up,he complains of a pain going down the buttock into the leg.The nurse suspects:

Accepted Answer

Lateral tilting and sciatic pain with straight-leg raising are findings that occur with a herniated nucleus pulposus.

Question 14

A professional tennis player comes into the clinic complaining of a sore elbow.The nurse suspects that he has tenderness at the:

Accepted Answer

Epicondyle,the head of the radius,and tendons are common sites of inflammation and local tenderness,or "tennis elbow."

Question 15

A teenage girl is complaining of pain in her left wrist.She had been playing basketball and fell,landing on her left hand.The nurse examines her hand and would expect a fracture if the girl complains:

Accepted Answer

A fracture causes sharp pain that increases with movement.

Question 16

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:

Accepted Answer

Fingers drift to the ulnar side because of stretching of the articular capsule and muscle imbalance caused by chronic rheumatoid arthritis.

Question 17

A mother brings her newborn male infant 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:

Accepted Answer

For a fractured clavicle,observe for limited arm range of motion and unilateral response to the Moro reflex.

Question 18

The nurse has completed the musculoskeletal examination of a patient's knee and has found a positive bulge sign.The nurse suspects:

Accepted Answer

For swelling in the suprapatellar pouch,the bulge sign confirms the presence of fluid.

Question 19

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:

Accepted Answer

Subcutaneous nodules that are raised,firm,and nontender occur with rheumatoid arthritis in the olecranon bursa and along the extensor surface of the ulna.

Question 20

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 the patient hears is:

Accepted Answer

Crepitation is an audible and palpable crunching or grating sound that accompanies movement and occurs when articular surfaces in the joints are roughened,as with rheumatoid arthritis.

Quiz 24: Musculoskeletal System