Deck 66: Nursing Management: Musculoskeletal Problems

Question 1

While working in a gerontology clinic,the nurse sees older adult women on a long-term basis.What is an assessment finding that alerts the nurse to the presence of osteoporosis in a patient?

A) The presence of bowed legs
B) Measurable loss of height
C) Poor appetite and aversion to dairy products
D) The development of unstable,wide-gait ambulation

Answer 1

Measurable loss of height

Question 2

Which statement by a patient who is scheduled for an above-the-knee amputation for treatment of osteosarcoma of the right tibia indicates that patient teaching is needed?

A) "I wish that I did not have to have chemotherapy after this surgery."
B) "I do not mind the surgery because it will finally cure the cancer."
C) "I know that I will need a lot of physiotherapy after surgery."
D) "I will use the patient-controlled analgesia to help control my pain level after surgery."

Answer 2

"I do not mind the surgery because it will finally cure the cancer."

Question 3

Following a laminectomy with a spinal fusion,a patient reports numbness and tingling of the right lower leg.What is the first nursing action?

A) Report the patient's complaint to the surgeon.
B) Check the vital signs for indications of hemorrhage.
C) Turn the patient to the side to relieve pressure on the operative area.
D) Compare these findings with preoperative assessments of neuromuscular symptoms.

Answer 3

Compare these findings with preoperative assessments of neuromuscular symptoms.

Question 4

A 43-year-old truck driver who is responsible for loading and unloading the business machines he transports has a history of chronic back pain.Following teaching regarding care of his back,the nurse determines that the patient understands management of his condition when he makes which of the following responses?

A) "I plan to start doing sit-ups and leg lifts to strengthen the muscles of my back."
B) "I will try to sleep with my hips and knees extended to prevent back strain."
C) "I can tell my boss that I need to change to a job where I can work at a desk."
D) "I will keep my back straight when I need to lift anything higher than my waist."

Question 5

A 58-year-old woman who has been menopausal for 5 years is diagnosed with osteoporosis following densitometry testing.The woman has been concerned about her risk for osteoporosis because her mother has the condition.In teaching the woman about her osteoporosis,what should the nurse explain?

A) With a family history of osteoporosis,bone resorption cannot be prevented or slowed.
B) Estrogen replacement therapy must be started to prevent rapid progression of her osteoporosis.
C) Continuous,low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
D) Even with a family history of osteoporosis,the calcium loss from bones can be slowed by increased calcium intake and exercise.

Question 6

A patient has chronic osteomyelitis of his femur,which he is managing at home with self-administration of IV antibiotics.On a home visit,the nurse identifies the nursing diagnosis of ineffective therapeutic regimen management when the nurse makes which of the following observations?

A) The patient is unable to plantar-flex the foot on the affected side.
B) The patient uses crutches to avoid weight bearing on the affected leg.
C) The patient takes and records the oral temperature twice a day.
D) The patient is irritable and frustrated with the length of treatment required.

Question 7

The nurse identifies a nursing diagnosis of pain related to muscle spasms for a patient with acute low back pain associated with acute lumbosacral strain.What is an appropriate nursing intervention for this problem to teach to the patient?

A) Gently perform range-of-motion exercises of the lower extremities.
B) Place a small pillow under the upper back to gently flex the lumbar spine.
C) Rest in bed with the head of the bed elevated 20 degrees,and flex the knees.
D) Elevate the head of the bed on blocks,and lie with the feet firmly against the foot of the bed.

Question 8

A patient with an open fracture of the left tibia with major soft tissue damage underwent surgical reduction and fixation of the tibia with debridement of nonviable tissue and drain placement in the damaged soft tissue.During the postoperative period,the nurse suspects the development of osteomyelitis on finding which of the following data?

A) Fever with chills and night sweats
B) Light-yellow drainage from the wound
C) Pain on movement of the affected limb
D) Muscle spasms around the affected bone

Question 9

A patient is hospitalized for initiation of regional antibiotic perfusion for chronic osteomyelitis of the right femur.Which intervention will be included in the plan of care?

A) Frequent weight-bearing exercise
B) Immobilization of the right leg
C) Avoiding administration of nonsteroidal anti-inflammatory drugs
D) Supporting the right leg in a flexed position

Question 10

Which of the following is a major risk factor for osteoporosis?

A) Age under 65 years
B) Fragility fracture experienced in adulthood
C) Hypergonadism
D) Hyperparathyroidism

Question 11

Which reflex is affected in a patient with a disc herniation at the level of L3?

A) None
B) Patellar
C) Achilles
D) Deep-tendon reflex

Question 12

Which of the following foods would the nurse recommend to the patient as having the highest amount of calcium per serving,to increase the patient's nutritional intake of calcium?

A) Yogourt
B) Whole milk
C) Shrimp
D) Salmon

Question 13

A patient complains that he has a sore foot.Upon assessment,the nurse notes a localized thickening area of skin where the patient indicates that the pain is located.Based upon this assessment,which of the following is the most likely cause of the patient's pain?

A) Corn
B) Soft corn
C) Callus
D) Plantar wart

Question 14

A patient with a herniated intravertebral disc undergoes a laminectomy and discectomy.Following the surgery,how should the nurse position the patient on his side?

A) By placing a pillow between the patient's legs and turning his body as a unit
B) By turning the patient's head and shoulders and then his hips,keeping him centred in the bed
C) By having the patient turn himself to the side by grasping the siderails and pulling himself over
D) By elevating the head of the bed 30 degrees and having the patient extend his legs while turning to the side

Question 15

Which foot disorder does the patient have when there is an elevation of the longitudinal arch of the foot,resulting from contracture of the plantar fascia?

A) Hallux valgus
B) Morton's neuroma
C) Pes cavus
D) Pes planus

Question 16

A patient is being discharged after 2 weeks of intravenous (IV)antibiotic therapy for acute osteomyelitis in the left leg.Which information will be included in the discharge teaching?

A) The reason for taking oral antibiotics for 7 to 10 days after discharge
B) The need for daily aerobic exercise to help maintain muscle strength
C) How to monitor and care for the long-term IV catheter site
D) How to apply warm packs safely to the leg to reduce pain

Question 17

After teaching a patient with a bunion about how to prevent further problems,the nurse will determine that more teaching is needed if the patient says which of the following?

A) "I will wear soft slippers whenever possible."
B) "I will throw away my high-heeled shoes."
C) "I will use the bunion pad to relieve the pain."
D) "I will take ibuprofen when I need it."