Question 1

A health-conscious young adult female asks the nurse what diagnostic test might help predict the likelihood for developing osteoporosis. With which diagnostic test should respond?

Accepted Answer

Dual energy x-ray absorptiometry (DEXA) is the gold standard for measuring bone density and can help predict the likelihood for developing osteoporosis. Arthroscopy is a diagnostic test for joint problems, EMG for nerve and muscle function, and SSEP for neurological disorders.

Question 2

The nurse is planning to determine whether a patient has fluid in the knee. What should the nurse use to make this assessment?

Accepted Answer

A,B

Question 3

The nurse is assessing an older patient's musculoskeletal status. What should the nurse consider as normal findings for this patient?

Accepted Answer

Decreased bone mass and minerals, atrophied muscle fibers, and decreased range of motion are normal age-related changes in the musculoskeletal system of older adults.

Question 4

The nurse wants to determine if a patient is experiencing carpel tunnel syndrome. Which test should the nurse use to make this assessment?

Accepted Answer

Phalen's test is used to assess for carpal tunnel syndrome. The patient holds their wrists flexed for one minute, and if they experience tingling or numbness in their fingers, it suggests carpal tunnel syndrome. The bulge sign test is used to assess for fluid accumulation in the knee joint, ballottement is used to assess for patellar effusion or swelling, and Thomas test is used to assess for hip flexion contracture.

Question 5

The patient's right femur was fractured and repaired at the diaphysis. When discussing the repair, the patient asks the nurse to explain the diaphysis. How should the nurse respond?

Accepted Answer

The diaphysis is the mid-portion or shaft of long bones like the femur.

Question 6

A patient complains of pain in the jaw, swelling, and the inability to open the mouth without pain. Where should the nurse palpate when assessing this patient?

Accepted Answer

The answer of A patient complains of pain in the...

Question 7

While conducting range of motion with an older patient, the patient begins to cry and states, "My knee hurts when you do that!" Which interventions should be implemented at this time?

Accepted Answer

The answer of While conducting range of motion with an...

Question 8

The nurse would document "unable to assess" for which patient in relation to performing Phalen's test?

Accepted Answer

Phalen's test is used to diagnose carpal tunnel syndrome and involves flexing the wrists. A patient with an above-the-elbow amputation cannot perform this test due to the absence of the lower arm and hand, making it impossible to assess.

Question 9

The nurse is reviewing data collected during the assessment of an older female. What should the nurse identify as being a normal age-related change?

Accepted Answer

The answer of The nurse is reviewing data collected during...

Question 10

The nurse is preparing to assess a patient's musculoskeletal status. In which order should the nurse perform the techniques of this examination? 
A) Assess joints for swelling, pain, redness, warmth, crepitus, and range of motion (ROM). 
B) Inspect and palpate the bones for any obvious deformity or changes in size, shape, or a painful response. 
C) Measure the extremities for length and circumference, and compare limbs bilaterally. 
D) Assess gait and posture.

Accepted Answer

The answer of The nurse is preparing to assess a...

Question 11

In which order should the nurse assess a patient complaining of pain in both knees? Place in order of priority. 
A) measurement of muscle mass 
B) range of motion 
C) inspection 
D) palpation
E) non of the above

Accepted Answer

The answer of In which order should the nurse assess...

Question 12

A patient is recovering from orthopedic surgery on a fractured arm. The nurse realizes that for musculoskeletal function, what type of muscle is needed?

Accepted Answer

The type of muscle needed for musculoskeletal function is skeletal muscle, as this type of muscle is responsible for movement and stability of the bones and joints. Cardiac muscle is only found in the heart and smooth muscle is found in the organs and digestive system. A combination of skeletal and smooth muscle is not necessary for musculoskeletal function.

Question 13

The nurse is reviewing assigned patients who are scheduled for an MRI. Which patient should the nurse identify as being able to safely undergo an MRI diagnostic test?

Accepted Answer

Patients with open wounds can safely undergo an MRI because MRI safety concerns primarily involve metallic objects or electronic devices within the body that can be affected by the MRI's magnetic field. Pacemakers, shrapnel, and external hardware could pose risks due to the strong magnetic fields used in MRI, potentially causing movement of metallic objects or malfunctioning of electronic devices.

Question 14

A patient is scheduled for an electromyelogram (EMG). What should the nurse instruct the patient about this diagnostic test?

Accepted Answer

The answer of A patient is scheduled for an electromyelogram...

Question 15

The nurse assessing a 68-year-old female patient notes an exaggerated curvature of the thoracic spine when the patient bends at the waist. With which alteration does the nurse recognize this finding to be consistent?

Accepted Answer

The exaggerated curvature of the thoracic spine when the patient bends at the waist is consistent with kyphosis, which is a common curvature in older patients, especially in women. Scoliosis is an abnormal lateral curvature of the spine, and lordosis is an accentuated lumbar curve, neither of which is consistent with the described finding. Surgery may be considered for severe cases of kyphosis but is not indicated based on the provided information.

Question 16

The patient is ordered to be on bed rest for two months. The nurse realizes that the patient's bones will

Accepted Answer

Bed rest for extended periods of time can lead to increased osteoclast activity and bone resorption, which may result in bone loss and increased risk of fractures. This can be particularly problematic for individuals who already have low bone density or osteoporosis. To mitigate these negative effects, patients on bed rest should be encouraged to perform weight-bearing exercises as tolerated and consume adequate amounts of calcium and vitamin D.

Question 17

The nurse is instructing a patient about preparations needed for an electromyogram. Which patient statement indicates that further teaching is required?

Accepted Answer

Flexaril (cyclobenzaprine) is a muscle relaxant that can interfere with the results of the electromyogram. The patient should not take this medication before the test unless specifically instructed to do so by their healthcare provider. The other statements indicate an understanding of the preparation instructions.

Question 18

The height of a female patient has decreased 1 inch over the last year. The patient is concerned and asks the nurse, "What is happening to me?" How should the nurse respond to the patient?

Accepted Answer

The nurse should provide the patient with accurate information regarding the cause of height loss. Option A is inaccurate and may cause the patient to become complacent about their health. Option B is dismissive and minimizes the patient's concerns. Option D also provides limited information and does not empower the patient to take action or self-advocate.

Question 19

A patient recovering from a total hip replacement develops a fever and redness at the surgical site. What should the nurse consider first when assessing this patient?

Accepted Answer

Fever and redness at the surgical site are signs of infection, which could lead to osteomyelitis. This is the most pressing concern and requires immediate attention. The other options are not relevant in this situation.

Question 20

A patient is seen in the clinic for chronic low blood calcium. What effect will this have on bone health?

Accepted Answer

When blood calcium levels are low, the hormone parathyroid hormone (PTH) is released to stimulate osteoclasts (cells that break down bone tissue) to release calcium into the bloodstream. This causes bone resorption, or breakdown, which leads to a decrease in bone density and an increased risk of fractures.

Quiz 38: Assessing the Musculoskeletal System