Deck 36: Chronic Musculoskeletal Disorders

Question 1

The nurse should expect to assess which finding in a patient with intervertebral disc degeneration?

A) Back and leg pain relieved by sitting
B) Pain in the back that spreads to the buttocks
C) Back pain that spreads to the neck
D) Back pain with numbness and tingling of the fingers

Answer 1

Pain in the back that spreads to the buttocks

Question 2

Which statement indicates to the nurse that the patient with lower back pain due to intervertebral disc degeneration does not understand the goal of physical therapy?

A) "Physical therapy will help strengthen my core muscles."
B) "Electrical stimulation may be used to relieve my back pain."
C) "Physical therapy can reverse the disc degeneration."
D) "Physical therapy will help strengthen back muscles weakened by bedrest."

Answer 2

"Physical therapy can reverse the disc degeneration."

Question 3

When assessing a patient with a herniated disc in the lumbar region, the nurse would expect to find:

A) lower extremity paralysis.
B) urinary incontinence.
C) neck and shoulder pain radiating to hands.
D) burning pain that radiates from the buttocks to the leg.

Answer 3

burning pain that radiates from the buttocks to the leg.

Question 4

Which priority intervention should the nurse anticipate in the patient admitted with cauda equine syndrome?

A) Prepare patient for urgent surgery.
B) Place the patient on complete bedrest.
C) Obtain equipment for skin traction.
D) Obtain a physical therapy consult.

Question 5

When preparing a patient for a discectomy, the nurse explains that this procedure:

A) removes the lamina to enlarge the spinal canal.
B) removes all or part of the herniated disc.
C) joins vertebrae together to prevent motion between the vertebra.
D) vaporizes the tissue in the disc.

Question 6

How should the nurse respond when a 28-weeks-pregnant woman asks if she will need surgery after her baby is born to relieve the constant back pain she has been experiencing?

A) "That depends, did you have a herniated disc before pregnancy?"
B) "It's a possibility, have you seen a surgeon?"
C) "Most often, back pain goes away after delivery."
D) "Stay off your feet as much as possible and rest in bed."

Question 7

Which statement is typical of data collected on a patient with mild spinal stenosis?

A) "Flexing my lower back relieves the pain."
B) "Twisting side to side relieves the pain."
C) "I sometimes experience loss of bladder control."
D) "I have difficulty wiggling my toes."

Question 8

The nurse notices that a pregnant woman has an exaggerated concavity of her spine. The nurse documents this as:

A) kyphosis.
B) lordosis.
C) scoliosis.
D) rotoscoliosis.

Question 9

When a baby is born with congenital scoliosis, the nurse should also assess for problems with which other organs?

A) Heart and lungs
B) Liver and kidneys
C) Heart and kidneys
D) Lungs and liver

Question 10

The school nurse is screening middle-school students for scoliosis and notes that one student has a curve of 15 degrees. The nurse tells the parents that their child has:

A) prescoliosis.
B) mild scoliosis.
C) moderate scoliosis.
D) severe scoliosis.

Question 11

To perform scoliosis screening using the Adam forward bend test, what action does the nurse take?

A) The nurse asks the child to bend forward at the waist.
B) The nurse asks the child to cross arms over the chest.
C) The nurse stands at the child's side to exam the spine.
D) The nurse stands at the child's head to examine the spine.

Question 12

Which finding should the nurse expect when assessing a patient with osteoarthritis?

A) Pain that worsens with activity, relieved at rest
B) Warm swollen joints
C) Anorexia and weight loss
D) Low grade fever

Question 13

When preparing a community program on joint disease, the nurse recognizes that which group is most at risk for rheumatoid arthritis?

A) Women between 40 and 60 years of age
B) Men between 40 and 60 years of age
C) Women between 20 and 40 years of age
D) Men between 20 and 40 years of age

Question 14

Which laboratory values would the nurse expect to find in a patient with rheumatoid arthritis (RA)?

A) Negative rheumatoid factor
B) Low C-reactive protein
C) Low erythrocyte sedimentation rate
D) Antibodies to cyclic citrullinated peptide (anti-CCP)

Question 15

A patient with rheumatoid arthritis tells the nurse that the physician told him he has Felty syndrome and asks the nurse what it means. Which of the following conditions does the nurse include in her description of this syndrome?

A) Low grade fever, weight loss, anorexia
B) Vasculitis, pericarditis, pneumonitis
C) Enlarged spleen, neutropenia, anemia
D) Symmetric polyarticular joint swelling, joint redness, joint tenderness

Question 16

Which assessment findings in a 7-year-old child suggests a diagnosis of psoriatic arthritis?

A) Pain that started in the hips, knees, heels, or great toe followed later on by spine pain
B) Red, scaly skin; pitted and yellowed toenails; joint pain
C) Arthritis symptoms, intestinal inflammation
D) Pain in the lower legs

Question 17

Which statement by a female patient with osteopenia indicates that more teaching about risk factors is needed?

A) "I need to take calcium and vitamin D."
B) "Because exercise is good for me, I will try swimming."
C) "I need to stop smoking."
D) "I should stop drinking cola beverages."

Question 18

Which statement by a patient with Paget disease indicates that the nurse needs to reinforce teaching?

A) "Bisphosphonates and calcitonin will help strengthen the bone."
B) "Exercise may cause fractures."
C) "I will need to take calcium and vitamin D supplements."
D) "I need to maintain a healthy body weight.

Question 19

The nurse is teaching the parents of a child with scoliosis about the disorder. What would the nurse explain is the recommended treatment for a 15-degree curve of the spine?

A) "Spinal fusion will be needed after the child has stopped growing to correct the curve."
B) "A brace will need to be worn to straighten the spine."
C) "All that is needed for this degree of curvature is physical therapy."
D) "Surgery for placement of a rod may be needed if the spinal curvature worsens."

Question 20

The nurse anticipates that a patient experiencing neuropathic pain caused by lumbar disc herniation may be treated with:

A) Nonsteroidal anti-inflammatory drugs, which are specific for neuropathic pain
B) Opioids for moderate pain
C) Tramadol (Ultram) for mild pain
D) Gabapentin (Neurontin), which is specific for neuropathic pain