Deck 45: Musculoskeletal Function and Assessment

Question 1

The nurse is collecting data for a patient who is reporting pain in the hand joints.What question should the nurse ask to determine the quality of the pain?

A) "Does the pain move?"
B) "How does the pain feel?"
C) "Did an event cause the pain?"
D) "How would you rate the pain?"

Answer 1

"How does the pain feel?"

Question 2

An older adult visiting a wellness clinic reports joint stiffness in the morning.What should the nurse respond to this patient?

A) "The stiffness is due to decreased moisture in joint bones."
B) "As we age, the cartilage in joints gets rough, causing stiffness."
C) "The fluid in your joints gets thinner as you age, so your joints get stiff."
D) "The body makes extra synovial fluid as we age, and that makes joints stiff."

Answer 2

"As we age, the cartilage in joints gets rough, causing stiffness."

Question 3

The nurse is reinforcing teaching for a patient who has severe arthritis and is having an x-ray.Which patient statement indicates teaching has been effective?

A) "The table is hard and cold."
B) "I may move during the x-ray."
C) "A soft mattress covers the table."
D) "I may lie in a position of comfort."

Answer 3

"The table is hard and cold."

Question 4

A patient recovering from a bone biopsy of the left leg has pain unrelieved by morphine 5 mg intramuscularly given 1.5 hours ago.The morphine is prescribed for every 3 hours.What should the nurse do?

A) Elevate the extremity.
B) Repeat morphine now.
C) Notify the charge nurse.
D) Administer morphine in 30 minutes.

Question 5

The nurse is gathering functional data on a patient with rheumatoid arthritis.Which of these areas should be included?

A) Ability to dress
B) Muscular build
C) Nutritional status
D) Height and weight

Question 6

The nurse is collecting data for a patient who is reporting pain in the left wrist.What question should the nurse use to address the region of the pain?

A) "Is the pain mild?"
B) "Where is the pain?"
C) "Does the pain move?"
D) "How does the pain feel?"

Question 7

The nurse is collecting data for a patient with osteoporosis.Which serum calcium result indicates the typical changes that occur in serum calcium levels with osteoporosis?

A) 6.5 mg/dL
B) 8.9 mg/dL
C) 9.7 mg/dL
D) 11.2 mg/dL

Question 8

The nurse,who is inspecting the knee of a patient who fell and reports stiffness,hears a grating sound with knee movement.How should the nurse document this finding?

A) Arthritis
B) Crepitus
C) Synovitis
D) Inflammation

Question 9

The nurse is caring for a patient scheduled for an arthrography.What should the nurse explain to the patient about pain expectations during the procedure?

A) "There is no pain during the procedure."
B) "There is pain while the x-ray is taken."
C) "There is temporary pain during dye injection."
D) "The procedure will be uncomfortable until it is completed."

Question 10

The nurse is caring for a patient with a suspected bone tumor.Which serum laboratory result indicates to the nurse that this health problem is present?

A) Decreased calcium
B) Increased magnesium
C) Increased creatine kinase
D) Elevated alkaline phosphatase

Question 11

The nurse is collecting data for a patient who is reporting pain in the left knee.What question should the nurse ask to address radiation of the pain?

A) "Is the pain intense?"
B) "Is the pain burning?"
C) "Does the pain move?"
D) "How would you describe the pain?"

Question 12

A patient scheduled for a magnetic resonance imaging (MRI)scan of the abdomen and pelvis asks how the machine takes a picture.What should the nurse respond to the patient?

A) "Magnetic fields create an image."
B) "Sound waves bounce off your organs to create the picture."
C) "Heat energy from the molecules of your body is detected to create a picture."
D) "X-rays from multiple angles are passed simultaneously to get a three-dimensional image."

Question 13

The nurse is caring for a patient who is to have a needle biopsy of a tumor in the right calf.Which patient statement indicates correct understanding of the teaching?

A) "I will need a few stitches."
B) "I will need a spinal anesthetic."
C) "The biopsy is usually taken with fluoroscopy."
D) "The biopsy will be used to determine if this is a cancerous tumor."

Question 14

The nurse is collecting data on a patient with a crushing injury to the lower extremities.
Which serum creatine kinase (CK)result should the nurse review and report to the physician?

A) CK-MB
B) CK-MM
C) CK-BB
D) CK1

Question 15

The nurse is caring for a patient 1 hour after a diagnostic arthroscopy of the right knee.Which activity should the nurse implement?

A) Strict bedrest
B) Straight-leg raises
C) No weight-bearing on right leg for 3 days
D) Partial weight-bearing on left leg for 1 week

Question 16

The nurse is reinforcing teaching provided to a patient scheduled for an arthrocentesis.Which patient statement indicates understanding of the planned procedure?

A) "They will use a small camera to look inside the joint."
B) "They will inject dye that shows up on a special camera."
C) "I'll be in a closed tube while they take pictures of my arm."
D) "A needle will be used to draw off some fluid from my elbow."

Question 17

The nurse is collecting data for a patient who is reporting pain in the right hip.Which question should the nurse ask to determine the severity of the pain?

A) "Is the pain burning?"
B) "Is the pain throbbing?"
C) "Does the pain radiate or move around?"
D) "What number rating would you give your pain on a scale from 0 to 10?"

Question 18

A patient is suspected as having a fractured skull.When explaining this pathology to the patient,how should the nurse describe the joints between the cranial bones?

A) Pivot
B) Saddle
C) Gliding
D) Sutures

Question 19

The nurse is caring for a patient who had a bone biopsy on the right leg.Which activity should the nurse implement?

A) Ambulate twice daily.
B) Monitor site of biopsy for bleeding.
C) Perform hourly passive range of motion.
D) Perform active range of motion every 2 hours.

Question 20

A patient is experiencing sacroiliac joint pain after falling.Which structure within the vertebral column should the nurse suspect is injured in this patient?

A) Axis
B) Atlas
C) Sacrum
D) Coccyx

Question 21

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.)

A) Diet history
B) Occupation and activities
C) Cardiovascular and respiratory problems
D) Risk factors for musculoskeletal problems
E) Family history of musculoskeletal problems

Question 22

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?

A) Keep body weight low.
B) Increase oral intake of calcium.
C) Engage in water aerobic activities.
D) Engage in weight-bearing exercises.

Question 23

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

A) Steady cursive handwriting
B) Perfect diction when talking
C) Inability to maintain balance
D) Intact gag and corneal reflexes

Question 24

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.

A)___ Neuron releases acetylcholine.
B)___ Myosin shortens the sarcomeres and pulls the muscle fiber.
C)___ Calcium from the sarcoplasmic reticulum bonds to myosin heads.
D)___ Action potential travels down motor neuron to the synaptic end bulb.
E)___ Action potential travels into the transverse tubules to the sarcoplasmic reticulum.
F)___ Acetylcholine crosses into the synaptic cleft and bonds with receptors on motor end plate.

Question 25

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.)

A) Temperature 98.4°F
B) Hematoma formation
C) Capillary refill of 3 seconds
D) Pain reported as 7 on a 0-to-10 scale
E) Range of motion of the ankle and knee present

Question 26

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?

A) Ribs
B) Liver
C) Heart
D) Lungs

Question 27

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.)

A) Pulses
B) Sensation
C) Movement
D) Orientation
E) Pupil reaction
F) Level of consciousness

Question 28

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.)

A) Maintaining NPO (nothing by mouth) status
B) Obtaining blood glucose
C) Providing a liquid breakfast
D) Explaining the anesthetic agents
E) Reviewing the surgical procedure
F) Witnessing signature on surgical consent

Question 29

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?

A) 2 seconds
B) 3 seconds
C) 5 seconds
D) 7 seconds

Question 30

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.)

A) Limb weakness
B) S-shaped curve to back.
C) Loss of 2 inches in height
D) Walks with small, shuffling steps.
E) Mild pain experiencing in the hands during the morning hours

Question 31

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?

A) Inability to move the joint
B) Hyperflexion of the joint
C) Hyperextension of the joint
D) Crepitus and palpable nodules

Question 32

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.)

A) Reduced levels of insulin
B) Limited amounts of thyroxine
C) Adequate intake of vitamin D
D) Production of growth hormone
E) Adequate intake of vitamins A and C

Question 33

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.)

A) Skull
B) Femur
C) Hyoid
D) Rib cage
E) Humerus