Deck 37: Musculoskeletal Trauma

Question 1

What are the modifiable risk factors for vertebral compression fracture? Select all that apply.
1)Estrogen deficiency
2)Presence of dementia
3)Bilateral ovariectomy
4)Susceptibility to falling
5)Presence of osteoporosis

Answer 1

1, 5

Question 2

The nurse is providing care for a client with nonunion at the site of a fracture in a lower extremity. After 12 weeks of monitoring, the fracture site shows no signs of healing. Which prescription does the nurse anticipate from the health-care provider?
1)IV antibiotic therapy
2)Physical therapy to maintain function
3)Surgery to debride dead bone tissue
4)Placement of a bone graft at the site

Answer 2

4

Question 3

The nurse is preparing to discharge a client to a rehabilitation facility after a total hip replacement because of a hip fracture. Which summary of the client's hospitalization best indicates adequate nursing care?
1)Lack of infection
2)Decreasing levels of pain
3)Obtained mobility with a walker
4)Absence of pulmonary complications

Answer 3

4

Question 4

When assessing a client's muscle strength using the Lovett scale, the nurse finds the client has no joint motion with palpable contraction of the muscle. Which grade does the nurse assign to the client based on this finding?
1)Fair
2)Poor
3)Good
4)Trace

Question 5

Which are signs and symptoms of musculoskeletal trauma? Select all that apply.
1)Edema
2)Paresthesia
3)Joint clicking
4)Joint swelling
5)Gait disturbance

Question 6

For which reason is a dual energy x-ray absorptiometry scan used for a client with a musculoskeletal disorder?
1)It detects soft tissue abnormalities.
2)It identifies stress fractures and bony metastases.
3)It determines mechanical derangement of the knee joint.
4)It visualizes the bone mineral density (BMD) of the hip and vertebrae.

Question 7

The nurse finds that a client with a musculoskeletal disorder has pain in the malleolar zone. The client is also unable to bear weight for more than four steps. Which does the nurse expect the health-care provider to prescribe?
1)Foot x-ray
2)Ankle x-ray
3)Hawkins test
4)Apprehension test

Question 8

While teaching a group of student nurses about different types of fractures, the nursing instructor says, "This fracture is characterized by the crushing of cancellous bone." Which type of fracture is the nursing instructor describing?
1)Complete
2)Transverse
3)Comminuted
4)Compression

Question 9

The registered nurse is evaluating the performance of a student nurse performing a valgus stress test on a client whose leg is slightly abducted. Which intervention does the registered nurse correct before it can be performed by the student nurse?
1)Placing one hand at the lateral aspect of the knee joint
2)Placing one hand at the medial aspect of the distal tibia
3)Applying valgus stress with the knee at 30 degrees of flexion
4)Applying valgus stress with the knee at 90 degrees of flexion

Question 10

While assessing a client with a musculoskeletal disorder, the nurse abducts the client's arm to 90 degrees and places anteriorly directed force on the posterior humeral head from behind. Which test is the nurse performing?
1)Hawkins test
2)Relocation test
3)Apprehension test
4)Neer impingement test

Question 11

The nurse is providing care for a client with a lower extremity fracture immobilized by a cast. Which complication does the nurse identify if assessment reveals tissue ischemia, functional impairment, and pain level disproportionate to the injury?
1)Horner syndrome
2)Cauda equina syndrome
3)Compartment syndrome
4)Carpal tunnel syndrome

Question 12

In order to maintain a high level of understanding about skeletal muscles, the nurse reviews anatomy and physiology concepts. Which recall of information indicates the effectiveness of the nurse's review?
1)The thick filaments of sarcomeres are made up of a protein called actin.
2)The thin filaments of sarcomeres are made up of a protein called myosin.
3)The fascicles contain 10 to 30 muscle fibers encased in connective tissue called epimysium.
4)The individual muscle fibers of skeletal muscle are arranged in bundles called fascicles.

Question 13

After assessing a client with a musculoskeletal disorder, the nurse concludes that the client has skeletal injuries. Which characteristics observed in the client support the nurse's conclusion? Select all that apply.
1)Spasm
2)Crepitus
3)Numbness
4)Clumsiness
5)Tingling sensation

Question 14

Which are the common predisposing factors that cause cervical strain? Select all that apply.
1)Bruxism
2)Abnormal posture
3)Lifting heavy objects
4)Motor vehicle accidents
5)Fall on a supinated forearm

Question 15

Place the events associated with fracture healing in the order they occur. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Remodeling
2) Callus formation
3) Lamellar bone deposition
4) Granulation tissue formation
5) Fracture and inflammatory phase

Question 16

The nurse is assisting the health-care provider while performing some specific maneuvers in a client with a knee injury. The health-care provider stabilizes the client's distal femur with one hand, grasps the proximal tibia with the other hand, and then attempts to sublux the tibia anteriorly. Which maneuver is the health-care provider performing?
1)Lachman test
2)McMurray test
3)Valgus stress test
4)Anterior drawer test

Question 17

When assessing a client with a musculoskeletal disorder, the nurse finds lack of sensation in the dermatome areas of the lower extremity L
1)Anticoagulant therapy
2)IV injection of muscle relaxants
3)X-ray and dual energy x-ray absorptiometry scan of the spine
4)Anteroposterior and lateral x-rays of the lumbar spine
5) The nurse suspects lumbar sprain/strain. Which does the nurse expect the health-care provider to prescribe in this situation?