Deck 53: Coordinating Care for Patients With Musculoskeletal Disorders

Question 1

The nurse provides education to a patient who is diagnosed with scoliosis and scheduled for surgical correction. Which patient statement indicates the need for additional teaching regarding postoperative care?
1)"I am at risk for fractures because of my condition."
2)"I must wear my brace at all times after surgery."
3)"I will apply cold packs to assist with pain management."
4)"I can drink a glass of wine each evening to help me relax.""

Answer 1

4

Question 2

The nurse correlates which mechanism of action for the administration of parathyroid hormone in the patient with osteoporosis?
1)Inhibits osteoclastic activity
2)Increases calcium absorption in the gastrointestinal tract
3)Protects against gonadotropin-releasing hormone agonist related to bone loss
4)Promotes calcium phosphate absorption in the bone

Answer 2

3

Question 3

Which statement by the patient receiving prednisone for muscular dystrophy (MD) indicates the need for further teaching?
1)"This medication may increase my appetite."
2)"This medication will decrease the loss of muscle mass."
3)"This medication will permanently stop the progression of my MD."
4)"This medication works by decreasing inflammation."

Answer 3

3

Question 4

Which interdisciplinary team member does the nurse consult regarding the proper use of a continuous passive motion (CPM) machine in the patient recovering from total hip replacement surgery?
1)Nurse manager
2)Physical therapist
3)Orthopedic surgeon
4)Occupational therapist

Question 5

The nurse is evaluating dietary teaching provided to a patient recovering from osteomyelitis. Which meal choice indicates that additional teaching is required?
1)Green salad, meat loaf, brown rice, and broccoli
2)Caesar's salad, pork loin slices, sauerkraut, baked potato, and sautéed carrots
3)Tossed salad, spaghetti with marinara sauce, Italian bread, and creamed spinach
4)Iceberg lettuce wedge, baked chicken breast, parsley red potatoes, and green beans

Question 6

The nurse provides education to a patient regarding treatment for plantar fasciitis. Which patient statement indicates a need for additional teaching?
1)"I will wear foot padding to help with the pain while I sleep."
2)"I will wear a splint at night to stretch my calf and arch my foot."
3)"I will need to have some physical therapy to address this condition."
4)"I will take the prescribed anti-inflammatories to help my condition."

Question 7

A middle-aged person with scoliosis asks why exercises are prescribed when the pain is already severe. How should the nurse respond to this patient?
1)"Exercise will stop the pain caused by the deformity."
2)"Exercise decreases bone density allowing the bones to straighten."
3)"Exercise can reverse and prevent the progression of the spinal deformity."
4)"Exercise helps with weight management, which is a major reason for the problem."

Question 8

The nurse provides education to a patient who is diagnosed with osteoporosis and prescribed ibandronate (Boniva). Which patient statement indicates the need for additional teaching?
1)"I will take my medication with food."
2)"I will take the medication once a month."
3)"My doctor told me that the medication may cause heartburn."
4)"My doctor told me that I can receive the medication by IV every 3 months."

Question 9

The nurse determines which patient is at highest risk for the development of osteoporosis?
1)48-year old Hispanic female with a body mass index (BMI) of 35 and a history of hyperparathyroidism
2)52-year old African American male with history of inflammatory bowel disease
3)55-year old Caucasian patient with a BMI of 17 and history of hyperthyroidism
4)60-year old Asian male who works as a tailor

Question 10

A patient with Duchenne muscular dystrophy has significant muscle damage. What is the primary reason for this destruction?
1)Elevated stores of body fat
2)Lack of protein responsible for muscle repair
3)Breakdown of collagen
4)Decreased protein synthesis

Question 11

A patient returns to the clinic for an evaluation 2 weeks after total hip replacement. Which statement by the patient indicates the need for further teaching?
1)"My daughter helps me put on my elastic stockings every morning."
2)"Even though I use my walker, I still have a limp."
3)"Now that I am stronger, I no longer need to use the raised toilet seat."
4)"Each day I try to increase my walking time by 10 minutes."

Question 12

The nurse correlates the mechanism of action of which medication to the treatment of a patient diagnosed with muscular dystrophy (MD)?
1)Cortisol
2)Antiplatelet therapy
3)Gabapentin
4)Opioids

Question 13

Which statement by the patient with suspected osteomyelitis indicates that teaching was effective?
1)"Osteomyelitis increases my risk of bone cancer."
2)"I will have to be on antibiotics for about 7 to 14 days."
3)"This can be cured with radiation therapy."
4)"A bone biopsy is the best way to diagnose this disease."

Question 14

Which patient statement indicates the need for additional teaching for the patient being discharged after total knee placement (TKR)?
1)"Narcotics may cause constipation, so I will increase my water intake."
2)"I will use an electric razor while I am on the blood thinners after surgery."
3)"I will report pain, tenderness, or warmth in my calf to my doctor immediately."
4)"I need to increase my intake of green, leafy vegetables to aid healing."

Question 15

In providing care to a patient diagnosed with osteoporosis, the nurse correlates which pathophysiological mechanisms to this disease process?
1)Osteoclasts break down bone with acids and enzymes.
2)Osteoclastic activity is greater than osteoblastic activity.
3)Osteoblastic activity is greater than osteoclastic activity.
4)Osteoblasts synthesize and add minerals to the bony matrix.

Question 16

The nurse prepares the patient with suspected osteoporosis for which diagnostic test?
1)Magnetic resonance imaging (MRI)
2)Computed tomography (CT) scan
3)Bone scan
4)Dual-energy x-ray absorptiometry (DEXA) scan

Question 17

The nurse monitors for which clinical manifestation in the patient diagnosed with Paget's disease?
1)Bone deformity
2)Joint stiffness
3)Muscle atrophy
4)Hyperreactive reflexes

Question 18

In caring for a patient with severe hip pain the patient is diagnosed with osteoarthritis (OA), what does the nurse teach the patient about this disease process?
1)"OA causes an overgrowth of cartilage in the joints."
2)"OA causes joint fluid to become bluish-white in color."
3)"OA causes a decrease in joint fluid that affects the cartilage."
4)"OA causes a build of fluid in the joints, hindering movement."

Question 19

A patient is prescribed alendronate (Fosamax). What instruction does the nurse provide to the patient about this medication?
1)Take at bedtime.
2)Take with a full meal.
3)Take on an empty stomach.
4)Take 2 hours after breakfast.

Question 20

A patient is admitted for an evaluation for suspected muscular dystrophy. Of the diagnostic studies prescribed, the nurse correlates which test is the gold standard to diagnose this disorder?
1)Bone scan
2)Computed tomography
3)Electromyography
4)Muscle biopsy

Question 21

The nurse correlates which laboratory results in the patient diagnosed with metastatic bone cancer? Select all that apply.
1)Decreased serum calcium
2)Increased serum alkaline phosphatase
3)Increased serum lactate dehydrogenase (LD)
4)Increased erythrocyte sedimentation rate (ESR)
5)Increased serum aspartate aminotransferase (AST)

Question 22

The nurse presents information about total joint replacement to new clinical staff. Which clinical conditions does the nurse include in the presentation as those that are indications for this procedure? Select all that apply.
1)Osteoporosis
2)Osteoarthritis
3)Rheumatoid arthritis
4)Systemic lupus erythematosus
5)Avascular necrosis of the femoral head

Question 23

The nurse monitors for which clinical manifestations in the patient being evaluated for scoliosis? Select all that apply.
1)Even gait
2)Uneven waist
3)Paresthesias in the hands
4)Lateral curve of the spine
5)Uneven hem line at the knees

Question 24

The nurse correlates which findings in a 40-year-old patient's health history as secondary risk factors for osteoporosis? Select all that apply.
1)Cigarette smoking
2)Corticosteroid therapy for more than 3 months
3)Inflammatory bowel disease
4)Premature menopause
5)Sedentary lifestyle

Question 25

The nurse monitors for which laboratory results in the patient diagnosed with muscular dystrophy (MD)? Select all that apply.
1)Increased alanine transaminase (ALT)
2)Increased blood urea nitrogen (BUN)
3)Increased creatine kinase (CK)
4)Increased glucose
5)Increased lactate dehydrogenase (LD)

Question 26

What factors in a 50-year-old patient's history increase the risk for development of lumbar scoliosis? Select all that apply.
1)Body mass index 31.4
2)Drinks two alcoholic beverages one to two times per week
3)Smokes one pack a day of cigarettes
4)Volunteers as a substance abuse counselor
5)Employed as a factory worker

Question 27

The nurse monitors for which clinical manifestations in the patient diagnosed with bone cancer?
1)Limp
2)Muscle atrophy
3)Skin discoloration
4)Dependent edema

Question 28

In planning a teaching session for the patient with osteoarthritis (OA), the nurse focuses on which conservative therapies for this health problem? Select all that apply.
1)Weight management
2)Steroidal therapy
3)Activity modification
4)Joint replacement surgery
5)Glucosamine and chondroitin

Question 29

The nurse monitors for which clinical manifestations of osteomyelitis in the patient recovering from hip replacement surgery? Select all that apply.
1)Fever
2)Bone deformity
3)Pain unrelieved by rest
4)Progressive muscle weakness
5)Tenderness and warmth at the surgical site

Question 30

The nurse prepares the patient diagnosed with a primary bone tumor for which treatment first?
1)Surgery
2)Amputation
3)Radiotherapy
4)Chemotherapy