Question 1

Which information in a 67-year-old woman's health history will alert the nurse to the need for a more focused assessment of the musculoskeletal system?

Accepted Answer

A family history of height loss with aging may indicate osteoporosis,and the nurse should perform a more thorough assessment of the patient's current height and other risk factors for osteoporosis.A sprained ankle during adolescence does not place the patient at increased current risk for musculoskeletal problems.A family history of tuberculosis is not a risk factor.Occasional nonsteroidal antiinflammatory drug (NSAID)use does not indicate any increased musculoskeletal risk.

Question 2

The nurse who notes that a 59-year-old female patient has lost 1 inch in height over the past 2 years will plan to teach the patient about

Accepted Answer

The decreased height and the patient's age suggest that the patient may have osteoporosis and that bone density testing is needed.Discography,MRI,and myelography are typically done for patients with current symptoms caused by musculoskeletal dysfunction and are not the initial diagnostic tests for osteoporosis.

Question 3

A 72-year-old patient with kyphosis is scheduled for dual-energy x-ray absorptiometry (DXA)testing.The nurse will plan to

Accepted Answer

DXA testing is painless and noninvasive.No IV access is necessary.Contrast medium is not used.Because the procedure is painless,no antianxiety medications are required.

Question 4

Which medication information will the nurse identify as a concern for a patient's musculoskeletal status?

Accepted Answer

Frequent or chronic corticosteroid use may lead to skeletal problems such as avascular necrosis and osteoporosis.The use of HT and calcium supplements will help prevent osteoporosis.NSAID use does not increase the risk for musculoskeletal problems.

Question 5

A patient has a new order for magnetic resonance imaging (MRI)to evaluate for left femur osteomyelitis after a hip replacement surgery.Which information indicates that the nurse should consult with the health care provider before scheduling the MRI?

Accepted Answer

Patients with permanent pacemakers cannot have MRI because of the force exerted by the magnetic field on metal objects.An open MRI will not cause claustrophobia.The patient will need to be instructed to remove the hearing aid before the MRI,but this does not require consultation with the health care provider.Because contrast medium will not be used,shellfish allergy is not a contraindication to MRI.

Question 6

A patient with left knee pain is diagnosed with bursitis.The nurse will explain that bursitis is an inflammation of

Accepted Answer

Bursae are fluid-filled sacs that cushion joints and bony prominences.Fibrocartilage is a solid tissue that cushions some joints.Bursae are a specific type of connective tissue.The synovial membrane lines many joints but is not a bursa.

Question 7

Which nursing action is correct when performing the straight-leg raising test for an ambulatory patient with back pain?

Accepted Answer

When performing the straight leg-raising test,the patient is in the supine position and the nurse passively lifts the patient's legs to a 60-degree angle.The other actions would not be correct for this test.

Question 8

The nurse finds that a patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light resistance.The nurse should document the patient's muscle strength as level

Accepted Answer

A level 3 indicates that the patient is unable to move against resistance but can move against gravity.Level 1 indicates minimal muscle contraction,level 2 indicates that the arm can move when gravity is eliminated,and level 4 indicates active movement with some resistance.

Question 9

Which finding from a patient's right knee arthrocentesis will be of concern to the nurse?

Accepted Answer

The presence of purulent fluid suggests a possible joint infection.Normal synovial fluid is scant in amount and pale yellow/straw-colored.

Question 10

A 42-year-old male patient complains of shoulder pain when the nurse moves his arm behind the back.Which question should the nurse ask?

Accepted Answer

The patient's pain will make it more difficult to accomplish tasks like putting on a shirt or jacket.This pain should not affect the patient's ability to feed himself or use the toilet because these tasks do not involve moving the arm behind the patient.The arm will not usually be positioned behind the patient during sleeping.

Question 11

Which information obtained during the nurse's assessment of a 30-year-old patient's nutritional-metabolic pattern may indicate the risk for musculoskeletal problems?

Accepted Answer

The patient's height and weight indicate obesity,which places stress on weight-bearing joints.The use of whole milk,avoiding fruits and vegetables,and use of a daily multivitamin are not risk factors for musculoskeletal problems.

Question 12

Which action can the nurse delegate to unlicensed assistive personnel (UAP)who are working in the orthopedic clinic?

Accepted Answer

Drawing blood specimens is a common skill performed by UAP in clinic settings.The other actions are assessments and require registered nurse (RN)-level judgment and critical thinking.

Question 13

The nurse notes crackling sounds and a grating sensation with palpation of an older patient's elbow.How will this finding be documented?

Accepted Answer

Crackling sounds and a grating sensation that accompany movement are described as crepitus or crepitation.Torticollis is a twisting of the neck to one side,subluxation is a partial dislocation of the joint,and epicondylitis is an inflammation of the elbow that causes a dull ache that increases with movement.

Question 14

After completing the health history,the nurse assessing the musculoskeletal system will begin by

Accepted Answer

The usual technique in the physical assessment is to begin with inspection.Abnormalities in muscle mass or configuration will allow the nurse to perform a more focused assessment of abnormal areas.The other assessments are also included in the assessment but are usually done after inspection.

Question 15

Which finding is of highest priority when the nurse is planning care for a 77-year-old patient seen in the outpatient clinic?

Accepted Answer

A history of falls requires further assessment and development of fall prevention strategies.The other changes are more typical of bone and joint changes associated with normal aging.

Quiz 62: Nursing Assessment: Musculoskeletal System