Deck 26: Common Musculoskeletal Concerns

Question 1

A nurse plans for the discharge of a 75-year-old patient who has the diagnosis of osteoporosis. Which of these actions would the nurse consider first?

A) Avoid stressful situations.
B) Schedule an annual DXA/DEXA scan.
C) Remove clutter from the floors of the home.
D) Encourage consumption of a high-protein diet.

Answer 1

Remove clutter from the floors of the home.

Question 2

A nurse is interviewing an older woman who is a new patient in an outpatient medical clinic. Which of the following findings by the nurse is considered a risk factor for osteoporosis?

A) The woman is obese and has hip pain with ambulation.
B) The woman drinks three glasses of skim milk daily.
C) The woman eats three to five servings of shrimp and liver per week.
D) The woman has been taking corticosteroids for 10 years because of chronic pulmonary disease.

Answer 2

The woman has been taking corticosteroids for 10 years because of chronic pulmonary disease.

Question 3

Which of the following manifestations would a nurse expect in a 70-year-old patient who has the diagnosis of osteoarthritis?

A) Swan neck deformity of the hand
B) Subluxation of the fingers
C) Heberden's nodes on the distal phalanges
D) Enlarged great toe

Answer 3

Heberden's nodes on the distal phalanges

Question 4

After first managing the pain being experienced by the client with gout, the treatment focuses on:

A) strengthening the affected joints through a controlled exercise plan.
B) minimizing joint disfigurement by using therapeutic splinting.
C) preventing systemic involvement by altering the client's diet.
D) managing chronic pain by taking regular doses of salicylates.

Question 5

Kyphosis in the older adult can be a result of which of the following?

A) Osteoarthritis
B) Rheumatoid arthritis
C) Osteoporosis
D) Gout

Question 6

A nurse is teaching an older adult who is experiencing an acute attack of gout. Which of the following should the nurse include in the teaching? (Select all that apply.)

A) Rest the joint during the acute gout attack.
B) Take acetylsalicylic acid (aspirin, or ASA) to relieve pain.
C) Increase fluid intake to 2 L/day.
D) Avoid foods high in purine.
E) Avoid alcoholic beverages.

Question 7

A nurse is teaching an older adult who is experiencing an acute attack of gout. Which of the following should the nurse include in the teaching?

A) Avoid foods high in purine.
B) Encourage the patient to take in 1 L of fluid daily.
C) Consume one glass of red wine daily.
D) Recommend that the patient eat 12-16 ounces of foods high in protein such as red meat.

Question 8

A nursing student is preparing a presentation on arthritis. The nursing student knows that differences between osteoarthritis (OA) and rheumatoid arthritis (RA) include that: (Select all that apply.)

A) both OA and RA have an acute onset in older adults.
B) OA is a localized process, whereas RA may be systemic.
C) OA usually impacts distal interphalangeal joints; RA impacts proximal interphalangeal joints.
D) both OA and RA present with joint stiffness lasting 20-30 minutes after rest.
E) initial treatment of both OA and RA is usually nonpharmacological using heat or exercise.

Question 9

A nurse is teaching a group of 65-year-old patients about reducing the risk of osteoarthritis. Which of the following would the nurse discuss as a modifiable risk factor for osteoarthritis? (Select all that apply.)

A) Female sex
B) History of joint injuries
C) Advancing age
D) Drinking one cup of regular coffee a day
E) Obesity

Question 10

A patient is diagnosed with osteoporosis. Which statements should the nurse include when teaching the client about the disease? (Select all that apply.)

A) Osteoporosis is common in females after menopause.
B) Osteoporosis is a degenerative disease characterized by a decrease in bone density.
C) The disease is congenital, caused by poor dietary intake of dairy products.
D) Osteoporosis can cause pain and injury.
E) Passive range of motion can prevent osteoporosis.

Question 11

A nurse is planning an educational session on osteoporosis to be given at a senior center. Which of the following should be discussed as preventive measures for osteoporosis?

A) Following a diet with adequate amounts of calcium and vitamin D
B) Increasing the intake of beverages containing phosphorus
C) Having a yearly dual-energy X-ray absorptiometry DXA (or DEXA) scan
D) Including isometric exercise for at least 30 minutes three times per week