Question 1

The nurse is collecting data for a patient's health history as part of the musculoskeletal system assessment.What should the nurse include when collecting this data? (Select all that apply.)

Accepted Answer

The patient's history should include diet history to determine if calcium and vitamin D intake are adequate,occupation and activities including sports and other physical activities,risk factors for musculoskeletal problems and family history of musculoskeletal problems to detect hereditary factors.C.Cardiovascular and respiratory problems are not a part of the health history for the musculoskeletal system.

Question 2

The daughter of an older female patient with osteoporosis asks what she can do to prevent the development of the disorder as she ages.What should the nurse suggest to the daughter?

Accepted Answer

The bone loss from osteoporosis can be offset by weight-bearing physical exercise which stimulates bone matrix deposition,increasing bone density.A.Keeping body weight low does not necessarily reduce the risk of developing osteoporosis.B.Increasing the oral intake of calcium should be determined by the daughter's primary care provider.C.Water aerobic activities are not weight-bearing and will not prevent the development of osteoporosis.

Question 3

A patient with a neurological illness has lost the function of opposing muscle antagonists.What should the nurse expect to assess in this patient?

Accepted Answer

There are approximately 700 skeletal muscles in the body.The general type of arrangement is the agonist with opposing antagonists and the cooperative synergists.Without synergism,maintaining balance would be difficult.A.B.Without synergism having fine motor control for writing or talking would be difficult if not impossible.D.Gag and corneal reflexes are not contingent upon the function of opposing muscle antagonists.

Question 4

The nurse is explaining muscle function to a group of high school students during Health Class.In which order should the nurse discuss the neuromuscular junction? Place the steps 1 through 6 in order.

Accepted Answer

The neuron releases the neurotransmitter,acetylcholine (Ach),which signals muscle contraction.An action potential travels along the motor neuron,reaching the synaptic end bulb.Acetylcholine is exocytosed into the synaptic cleft and bonds with receptors on the motor end plate.An action potential initiates and travels along the sarcolemma and into the transverse tubules,transferring to the sarcoplasmic reticulum.Calcium ions released from the sarcoplasmic reticulum bond to troponin of the thin filament,exposing bonding sites on actin for myosin heads.Myosin of the thick filament attaches and pulls the thin filament,shortening the sarcomeres and thus the muscle fiber.

Question 5

A patient recovering from a biopsy of the right femur had pain medication 1 hour ago.Which symptom should the nurse report and closely monitor in this patient? (Select all that apply.)

Accepted Answer

The nurse inspects the biopsy site for bleeding,swelling,and hematoma formation.Increased pain that is unresponsive to analgesic medication may indicate bleeding in the soft tissue.A.This is a normal body temperature.C.This is a normal capillary refill.E.Full range of motion is an expected finding.

Question 6

A patient is diagnosed with fractured thoracic vertebrae from a motor vehicle crash.Which other structure should the nurse suspect may have been damaged during this accident?

Accepted Answer

The thoracic vertebrae articulate with the posterior ends of the ribs.A.C.D.The liver,heart,and lungs are protected by the thoracic cage.

Question 7

A patient was an unrestrained passenger in a motor vehicle accident and hit the windshield.The patient's leg was also fractured.Which areas should be included in a patient's neurovascular checks? (Select all that apply.)

Accepted Answer

Neurovascular checks for an extremity include movement,sensation (numbness/tingling),presence of pulses,skin temperature,color,and capillary refill.D,E,F.Orientation,pupil reaction,and level of consciousness are neurological checks that are done to monitor the central nervous system.

Question 8

A patient with diabetes mellitus is scheduled for an arthroscopy of the right knee at 0800.What should be included in nursing preoperative care for this patient? (Select all that apply.)

Accepted Answer

The nurse should witness signature on the surgical consent,maintain NPO status,and check the blood glucose level.C.The patient is to take nothing by mouth.D.E.The physician is responsible for completing these actions.

Question 9

The nurse is assessing capillary refill time for a patient with a fractured tibia and fibula.Which refill time should the nurse report to the physician?

Accepted Answer

When assessing a patient with a fractured tibia and fibula,the nurse should report to the physician if the capillary refill time is greater than 3 to 5 seconds,as it can indicate circulatory compromise.A.B.C.These are all normal capillary refill times.

Question 10

The nurse is admitting an 88-year-old woman to an extended care facility.Which findings should the nurse consider as normal age-related changes of the patient's musculoskeletal system? (Select all that apply.)

Accepted Answer

Common age-related changes include decreased height due to smaller intervertebral spaces; joint pain and stiffness are associated with articular cartilage wear; and limb weakness because muscle strength declines with age as protein synthesis decreases.D.Small shuffling steps may be seen with Parkinson's disease.B.S-shaped curve is usually related to scoliosis.

Question 11

A patient is experiencing a tendon that is torn from a moveable bone.What should the nurse observe when collecting data on the patient's musculoskeletal system?

Accepted Answer

A muscle usually has at least two tendons,each attached to a different bone.The more stationary muscle attachment is called its origin; the more movable attachment is the insertion.The muscle itself crosses the joint formed by the two bones to which it is attached,and when the muscle contracts,it pulls on the insertion moving the bone in a particular direction.The muscle causing this particular action is termed the agonist.If the movable muscle is torn,the joint will not be able to be moved.B.C.These movements would necessitate the movable tendon to be intact and attached.D.Crepitus and palpable nodules occur within a joint and not at the site of muscle insertion into a bone.

Question 12

The mother of a 6-year-old child is concerned that the child is not going to be tall like other family members.What should the nurse explain as influencing the growth of bone? (Select all that apply.)

Accepted Answer

The growth of bone from fetal life until final adult height depends on many factors.Vitamin D is essential for the efficient absorption of calcium and phosphorus in the small intestine.Vitamins A and C are required for the production process of bone matrix.GH increases mitosis and protein synthesis.A.Insulin is essential for the efficient use of glucose to provide energy.B.Thyroxine stimulates osteoblasts and also increases energy production.If a child is lacking any of these hormones,growth is slower and the child may not reach his or her genetic potential for height.

Question 13

A patient in a motor vehicle crash has injuries to bones of the appendicular skeleton.Which bones should the nurse expect to support when caring for this patient? (Select all that apply.)

Accepted Answer

The appendicular skeleton consists of long bones including the femur and humerus.A.C.D.The axial skeleton consists of the skull,hyoid,and rib cage.

Quiz 45: Musculoskeletal Function and Assessment