Deck 37: Musculoskeletal Trauma

Question 1

The nurse is assisting the primary care provider while performing some specific maneuvers in a client with a knee injury. The primary 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 primary care provider performing?
1) Lachman test
2) McMurray test
3) Valgus stress test
4) Anterior drawer test

Answer 1

1

Question 2

The nurse is performing a physical examination on a client with a suspected musculoskeletal disorder. What is the first nursing intervention during the examination?
1) Testing sensation using perception
2) Measuring muscle girth for symmetry
3) Evaluating peripheral vascular integrity
4) Assessing general appearance, contour, and symmetry

Answer 2

4

Question 3

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

Answer 3

3

Question 4

When assessing a client with a musculoskeletal disorder, the nurse finds lack of sensation in the dermatome areas of the lower extremity L5. The nurse suspects lumbar sprain /strain. What does the nurse expect the primary care provider to order in this situation?
1) Anticoagulant therapy
2) Intravenous injection of muscle relaxants
3) X-ray and dual energy x-ray absorptiometry scan of the spine
4) Complete blood count with erythrocyte sedimentation rate and C-reactive protein

Question 5

The nursing instructor is teaching a group of student nurses about skeletal muscles. Which statement by a student nurse indicates effective learning?
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 6

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 four steps. What does the nurse expect the primary health-care provider to order in this situation?
1) Foot x-ray
2) Ankle x-ray
3) Hawkins test
4) Apprehension test
Exhibit

Question 7

The nurse is evaluating the performance of a student nurse while caring for a client with an ankle sprain. Which intervention of the student nurse does the nursing instructor correct while providing care to the client?
1) Administering analgesics
2) Checking dorsalis pedis pulse
3) Checking posterior tibial pulse
4) Keeping the ankle below the heart

Question 8

The registered nurse is evaluating the performance of student nurse performing a valgus stress test on a client whose leg is slightly abducted. Which intervention of the student nurse does the registered nurse correct?
1) Placing one hand at the lateral aspect of the knee joint
2) Placing the 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 9

A client presents with a swollen left thigh and a lower extremity that appears shortened. The primary care provider orders an arteriogram. What is the client's most likely condition?
1) Ulnar nerve injury
2) Femur shaft fracture
3) Tibia/fibula fracture
4) Brachial plexus injury

Question 10

Which cervical root is associated with forearm pronation and supination?
1) C5
2) C6
3) C7
4) C8

Question 11

A client complains of pain and immobility of the wrist. On assessment, the nurse finds decreased range of motion (ROM), edema, and ecchymosis of the distal radius. The primary health-care provider recommends a neurovascular exam for confirmation. What does the nurse infer from these findings?
1) The client has a Smith fracture.
2) The client has a Colles fracture.
3) The client has a clavicle fracture.
4) The client has a green stick fracture.

Question 12

What is the most commonly dislocated joint in the body?
1) Hip
2) Wrist
3) Shoulder
4) Vertebrae

Question 13

Which musculoskeletal disorder is also called adhesive capsulitis?
1) Bursitis
2) Plantar fasciitis
3) Frozen shoulder
4) Carpel tunnel syndrome

Question 14

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

Question 15

The nurse is reviewing the medical records of four clients. Which client's medical record indicates the need to perform the McMurray test to assess the condition?
1) Client 1
2) Client 2
3) Client 3
4) Client 4

Question 16

The nurse is caring for four clients diagnosed with different musculoskeletal disorders. Which client requires treatment with calcitonin, calcium or vitamin D supplements, analgesics, and muscle relaxants?
1) Client 1
2) Client 2
3) Client 3
4) Client 4

Question 17

While teaching a group of student nurses about various musculoskeletal disorders, the nurse states, "This syndrome occurs when tissue pressure exceeds perfusion pressure in a closed anatomic space." Which syndrome is the nurse describing?
1) Horner syndrome
2) Cauda equine syndrome
3) Compartment syndrome
4) Carpel tunnel syndrome

Question 18

Why 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.
4) It visualizes the bone mineral density (BMD) of the hip and lumbar vertebrae.

Question 19

When obtaining the health history of a client with a suspected musculoskeletal disorder, why does the nurse ask the client about travel destinations within the past year?
1) To check if the client has osteoporosis
2) To check if the client has recent allergies
3) To identify the loading forces involved
4) To evaluate for exposure to Lyme disease

Question 20

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 21

Place the events associated with fracture healing in the order they occur. (Enter the letter of each step in the proper sequence, do not use commas or spaces.)
A. Remodeling
B. Callus formation
C. Lamellar bone deposition
D. Granulation tissue formation
E. Fracture and inflammatory phase

Question 22

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

Question 23

What are the signs and symptoms of musculoskeletal trauma?
1) Edema
2) Paresthesia
3) Joint clicking
4) Joint swelling
5) Gait disturbance

Question 24

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

Question 25

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