Question 1

The nurse observes an exaggerated lumbar curve while inspecting the spine of a client. Which term should the nurse use when documenting the finding?

Accepted Answer

Lordosis refers to an exaggerated inward curve of the lumbar spine, which is what the nurse observed.

Question 2

The nurse assesses a client with tenderness and stiffness in the wrist and elbow. The client reports that their discomfort is worsened with activity. Which condition should the nurse suspect?

Accepted Answer

Osteoarthritis is characterized by joint pain that worsens with activity and improves with rest, which matches the client's symptoms of tenderness and stiffness in the wrist and elbow that worsen with activity.

Question 3

Which instructions should the nurse provide a client to assess the lateral flexion? Select all that apply.

Accepted Answer

Lateral flexion involves bending to the side. B assesses lateral flexion of the neck, and C assesses lateral flexion of the trunk.

Question 4

Which degree of wrist movement is an expected finding when assessing extension?

Accepted Answer

Normal wrist extension is approximately 70 degrees. This range allows for the back of the hand to move towards the forearm.

Question 5

The nurse is preparing to assess the posterior spine of a client. Which landmark should the nurse use to determine symmetry?

Accepted Answer

The iliac crests are used as a landmark to assess symmetry of the posterior spine because they are at the same level on both sides of the body, making it easier to identify any asymmetry.

Question 6

The nurse is caring for a client with a right femur fracture. Which category of bone should the nurse identify the femur as when discussing the fracture with the client?

Accepted Answer

The femur is classified as a long bone due to its elongated shape and the role it plays in supporting the weight of the body and facilitating movement.

Question 7

The nurse notes swelling and tenderness of the olecranon process during the palpation. Which condition should the nurse suspect?

Accepted Answer

The answer of The nurse notes swelling and tenderness of...

Question 8

When assessing the strength of a client's upper extremities, a full range of motion against gravity with moderate resistance is noted. Which should the nurse document the finding as?

Accepted Answer

When a client demonstrates a full range of motion against gravity with moderate resistance, it is indicative of "Good" strength. This grading is part of a commonly used scale to assess muscle strength, where "Normal" would indicate full range of motion against gravity with full resistance.

Question 9

The school nurse is assessing adolescent females for scoliosis. Which area of the spine does the nurse plan to assess?

Accepted Answer

Scoliosis is most commonly assessed in the thoracic region of the spine, as this is where abnormal lateral curvature is most often observed in adolescents.

Question 10

The nurse asks the client to point their toes up towards their nose during an examination of the lower extremities. Which type of movement is the nurse assessing?

Accepted Answer

Pointing the toes up towards the nose is an example of dorsiflexion, which involves decreasing the angle between the dorsum (top) of the foot and the shin.

Question 11

A client tells the nurse they feel numbness and tingling in their hands after they were instructed to bend their wrist downward and press their hands together. Which condition should the nurse suspect?

Accepted Answer

The client's symptoms after performing the maneuver (bending the wrist downward and pressing the hands together) suggest they are experiencing Phalen's sign, which is a diagnostic indicator of Carpal Tunnel Syndrome. This condition is characterized by numbness and tingling in the hands due to median nerve compression at the wrist.

Question 12

The nurse is preparing to perform the bulge test on a client's left knee. When performing the test, which area of the knee should the nurse assess for bulging?

Accepted Answer

The answer of The nurse is preparing to perform the...

Question 13

The nurse is preparing to assess a client's spine for abnormalities. Which instruction should the nurse provide the client?

Accepted Answer

CTo assess a client's spine for abnormalities, the nurse should observe the client's spine in various positions to identify any curvature, misalignment, or limited range of motion. Option B involves standing and moving in ways that allow for observation of the spine's alignment and flexibility from the back. Option C involves bending, standing tall, and stretching, which also allows for a comprehensive view of the spine's condition and range of motion. These actions help in identifying issues such as scoliosis, kyphosis, or lordosis.

Question 14

A client comes to the emergency department (ED)complaining of a painful injury to the right knee received while playing basketball. Which examination techniques will the nurse include during the physical assessment of this client? Select all that apply.

Accepted Answer

Inspection is used to visually assess for swelling, bruising, or deformity. Palpation helps identify tenderness, warmth, or fluid accumulation. Bulge sign testing is specific for detecting fluid in the knee joint. Auscultation and percussion are not typically used for knee injuries.

Question 15

The client is recovering from the surgical repaid of a fractured arm. When discussing the effects of the fracture with the client, which skeletal bone functions should the nurse include in the teaching? Select all that apply.

Accepted Answer

The answer of The client is recovering from the surgical...

Question 16

The nurse assessing a client experiencing pain in their right foot observes swelling and inflammation of the foot and deviation of the big toe from the midline associated with crowding of the remaining toes. Which condition does the nurse suspect?

Accepted Answer

The symptoms described, including swelling and inflammation of the foot along with deviation of the big toe from the midline and crowding of the remaining toes, are characteristic of a bunion. A bunion is a bony bump that forms on the joint at the base of the big toe.

Question 17

The nurse is caring for a client with a knee injury. When documenting this injury in the medical record, the nurse identifies the knee as which type of joint?

Accepted Answer

The knee is classified as a hinge joint because it allows for flexion and extension in one plane, similar to the movement of a door hinge.

Question 18

The nurse notes a round mass on the back of a client's wrist. Which question should the nurse ask the client?

Accepted Answer

A round mass on the back of a client's wrist is most commonly associated with a ganglion cyst. Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of your wrists or hands. Rheumatoid arthritis, osteoarthritis, and carpal tunnel syndrome are not typically characterized by the presence of a round mass on the wrist.

Question 19

The nurse is assessing a client with the inability to move their fourth and fifth fingers. The nurse notes severe flexion in both of the affected fingers but no complaints of pain during palpation. Based on this data, which diagnosis should the nurse suspect?

Accepted Answer

Dupuytren contracture is characterized by the inability to straighten the fingers due to thickening and shortening of the palmar fascia, leading to severe flexion of the affected fingers, commonly the fourth and fifth fingers, without pain on palpation.

Question 20

The nurse notes there is a grating sound in a client's joint when they bend and straighten it. Which terminology should the nurse use when documenting this finding?

Accepted Answer

Crepitation refers to the grating, crackling, or popping sounds and sensations experienced under the skin and joints or a crackling sensation due to the presence of air in the subcutaneous tissue. This term is specifically used to describe the sound heard in joint movements that suggest the presence of air in soft tissues or the rubbing of roughened surfaces.

Quiz 23: Musculoskeletal System