Deck 48: Nursing Management of the Patient With Musculoskeletal Disorders

Question 1

While assessing a patient's left knee for range of motion, the nurse hears clicking. The patient says that at times the knee "locks." The nurse would conduct additional assessment for which condition?

A) Rheumatoid arthritis
B) Fluid in the knee
C) Dislocation
D) Damage to the meniscus

Answer 1

Damage to the meniscus

Question 2

The nurse wishes to test opposition ability in the patient's thumb. How would the nurse instruct the patient?

A) "Touch each one of your fingertips with your thumb."
B) "Move your thumb across your palm away from the rest of your fingers."
C) "Move your thumb across your palm and touch your fifth finger."
D) "Move your thumb anteriorly away from the palm and then back."

Answer 2

"Touch each one of your fingertips with your thumb."

Question 3

The nurse rates a patient's biceps muscle strength at 3. Another nurse reading this rating would expect the patient's best movement of the muscle to be at which functional level?

A) Passive ROM
B) Active ROM with gravity and moderate weakness
C) Complete active ROM with minimal weakness
D) Complete ROM with no weakness

Answer 3

Active ROM with gravity and moderate weakness

Question 4

A patient tells the nurse that she is "tired of having leg pain" because it "gets in the way" of enjoying the activities that she wants to do with her family. What is the nurse's best response?

A) "How does your family react when you are having the pain and can't participate in activities?"
B) "At least you are able to do regular activities around the house."
C) "Everyone has some degree of pain every day, and I'm sure your family understands."
D) "But you are still working, so you are productive."

Question 5

A patient is newly diagnosed with arthritis of the cervical vertebrae. The nurse plans to assess which type of joint?

A) Spheroidal
B) Synovial
C) Fibrous
D) Cartilaginous

Question 6

The nurse is assessing an older adult's musculoskeletal system. The nurse would evaluate that which findings represent normal age-related changes? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Slightly reduced ROM of the shoulder
B) Slower gait
C) Redness and crepitus of the knee joint
D) Inability to abduct the thumb
E) Asymmetry of the pelvis

Question 7

During a physical assessment, the patient walks to the door of the examination room as the nurse watches the patient switch the weight on the feet. The nurse would document assessment of which part of the musculoskeletal status?

A) Knee extension
B) Second-phase gait
C) Hip flexion
D) First-phase gait

Question 8

The nurse assesses that a patient is unable to completely straighten the right arm. The nurse conducts additional assessment for which condition?

A) Muscle atrophy
B) The presence of nodules
C) Gout
D) Muscle fasciculation

Question 9

The nurse is assessing a patient who complains of numbness and tingling in the hands. When the patient bends the wrist downward and presses the backs of the hands together, there is numbness and tingling in the wrists and fingers. The nurse would conduct additional assessment for which condition?

A) Arthritis
B) Dislocation
C) Fracture
D) Carpel tunnel syndrome

Question 10

A patient tells the nurse that he has had increasing difficulty bending his knees to pick objects up from the floor since he got a desk job about 10 months ago. The nurse suspects that the patient's loss of knee and hip range of motion would be due to which condition?

A) Gout
B) Muscle spasms
C) Pain
D) Atrophy

Question 11

The nurse asks the patient to shrug the shoulders while the nurse applies pressure to keep the shoulders from moving. The nurse would document the results of this test as indicating strength of which muscle?

A) Sternocleidomastoid
B) Triceps
C) Biceps
D) Trapezius

Question 12

A patient is complaining of a fever and a "stiff neck." Upon assessment, the patient is unable to rotate the neck. The nurse would conduct additional assessment for which condition?

A) Gout
B) Cervical vertebrae fracture
C) Infectious process
D) Arthritis

Question 13

During assessment of a patient's knee, the nurse tests for the bulge sign. Which technique is the nurse using?

A) The nurse is tapping lightly over the nerve running next to the patella.
B) The nurse strokes the medial aspect of the knee upward and observes for changes.
C) The nurse feels for a fluid wave while moving the patella up and against the femur.
D) The nurse places a thumb and finger on either side of the patella and assesses for fluid in the spaces next to the patella.

Question 14

A patient tells the nurse that he has damaged cartilage in his knee. How should the nurse respond to this information?

A) "It will take a few months for the damage to heal."
B) "That is considered a strain and will heal itself in a few weeks."
C) "Exercise will increase the healing time for the cartilage."
D) "Did the doctor talk with you about treatment options?"

Question 15

The nurse assessing a patient's musculoskeletal status notes that the left shoulder does not have its normal curvature and fullness. The nurse would conduct additional assessment for which disorder?

A) Scoliosis
B) Arthritis
C) Rotator cuff tear
D) Dislocation

Question 16

The nurse is preparing to conduct a history on a patient being seen for hip pain and reduced range of motion. For which purpose does the nurse conduct this history?

A) To determine if the patient needs assistive devices
B) To evaluate the degree of pain the patient is experiencing
C) To determine the patient's level of function so care can be planned
D) To allow the patient to talk about symptoms

Question 17

The nurse has just begun testing range of motion in a patient's right knee when the patient says, "That really hurts." Which interventions should be implemented? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Continue to try to achieve normal ROM.
B) Stop the test on that joint.
C) Massage the knee for 20 minutes.
D) Call the health care provider.
E) Test ROM in the left knee and compare findings.

Question 18

A patient provides the nurse with a list of current medications and adds that she takes glucosamine every day. The nurse would document this information in which part of the health history?

A) Biographical data
B) Chief complaint
C) Past medical history
D) Social history

Question 19

While assessing a patient's hands, the nurse notes that the patient is unable to fully extend the ring or fifth finger. The nurse would suspect which condition?

A) Dupuytren's contracture
B) Bouchard's nodes
C) Swan neck deformity
D) Heberden's nodes

Question 20

A patient recovering from hip replacement surgery is prescribed a pillow between the legs. The nurse explains that the pillow will facilitate which positioning?

A) Adduction
B) Abduction
C) Extension
D) Flexion

Question 21

When assessing a 68 year-old female patient, the nurse notes an exaggerated curvature of the thoracic spine when the patient bends at the waist. How would the nurse evaluate this finding?

A) It represents kyphosis and is a common curvature in older patients.
B) It represents kyphosis, for which emergency surgery is indicated.
C) It is called scoliosis and is a normal curvature in the elderly.
D) This is an expected finding in all women.

Question 22

The patient with an old knee injury says, "I think I have water on my knee again." The nurse would prepare to conduct which tests to assess for that finding? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Ballottement
B) Bulge sign
C) Phalen's test
D) Thomas test
E) Heberden's sign

Question 23

The nurse is assessing a patient's gait. Which findings would the nurse consider normal? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The patient walks with a wide base of support.
B) The arms swing according to gait phase.
C) The patient shuffles when walking.
D) The gait is jerky, with quick movements.
E) The patient holds the arms out from the body in slight extension.

Question 24

The nurse wishes to assess the anatomic snuffbox of a patient's wrist. Which instruction should the nurse provide?

A) "Place your hand palm-up on the table."
B) "Make a tight fist as I palpate your wrist."
C) "Extend your thumb fully to the side."
D) "Flex your wrist as much as possible."

Question 25

The nurse is assessing a patient's ability to internally rotate the shoulders. Which direction would the nurse provide?

A) "Place your hands behind your lower back."
B) "Raise your arms to shoulder level."
C) "Place both your hands behind your neck with your elbows out to the side."
D) "Raise your arms above your head with your palms facing each other."

Question 26

The nurse determines that a patient has pain when turning the hand palm down and then palm up. Which documentation is appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Pain on forearm supination
B) Cannot extend hand without pain
C) Pain on circumduction of the forearm
D) Pain on pronation of the hand
E) Unable to circumduct the forearm

Question 27

A 70-year-old woman is diagnosed with a pathologic fracture of the fibula. The nurse would assess for which most common condition?

A) Elder abuse
B) Osteoporosis
C) An unreported fall or injury
D) Cancer of the bone

Question 28

During an assessment of the feet, the nurse asks the patient to sit, feet dangling, and point the toes toward the nose. The nurse is assessing which movement?

A) Plantar flexion
B) Dorsiflexion
C) Eversion
D) Inversion

Question 29

The nurse determines that a patient's shoulder muscle strength is normal when it is graded as _______ or better.

Question 30

The nurse plans to use a goniometer during assessment of a patient's musculoskeletal system. Which technique should the nurse use? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Document the angle of the joint in range of degrees.
B) Place the fulcrum of the goniometer on the joint.
C) Place the movable arm of the goniometer on the stationary part of the joint.
D) Place the stationary arm of the goniometer on the part of the limb that will not move.
E) Move the patient's arm through the normal full range of motion.