Deck 40: Musculoskeletal System

Question 1

A client who has a cast on the right arm develops severe pain unrelieved by the prescribed narcotic analgesic.The nurse also notes sluggish capillary refill,weak pulses,and numbness below the casted limb.The nurse should suspect the client has developed which fracture complication?

A)ankylosis
B)compartment syndrome
C)fat embolism
D)infection

Answer 1

compartment syndrome

Question 2

The client is referred to a branch of medicine that deals with the prevention or correction of disorders and diseases of the musculoskeletal system.The physician will be a member of which branch of medicine?

A)immunity
B)orthopedics
C)oncology
D)neurology

Answer 2

orthopedics

Question 3

Which aspect should be included when teaching a client about cast care?

A)Cover the outside of the cast with a plastic bag to prevent soiling.
B)Use a hair dryer on the low setting to hasten cast drying.
C)The heat felt during cast application is normal and should subside in 10 to 15 minutes.
D)Keep the cast on a flat,firm surface until completely dry.

Answer 3

The heat felt during cast application is normal and should subside in 10 to 15 minutes.

Question 4

A client has a severe sprain of the right ankle.Immediate treatment would include which of the following?

A)rest,ice,compression,and elevation
B)elevation and application of heat
C)application of a cast
D)brace or elastic bandage and aspirin

Question 5

Compartment syndrome is treated by removing the cast or dressing and:

A)performing a fasciotomy
B)administrating antibiotics
C)doing physical therapy
D)elevating the affected limb higher than the heart,and applying ice packs

Question 6

What is the MOST important concern of the nurse caring for a client with decreased range of motion and ambulatory ability?

A)prevention of contractures
B)assessing crepitus
C)diagnosing locomotion disorders
D)assessing synarthrosis

Question 7

Treatment of the client who had a fat embolism from a fracture consists of bed rest,oxygen,and:

A)traction
B)intravenous (IV)fluids
C)surgery
D)passive exercises of all nonaffected joints

Question 8

In addition to maintaining body alignment,the main objective of all health professionals caring for orthopedic clients is to:

A)preserve muscle tone and continue joint motion
B)prevent injury and provide immediate treatment
C)correct deformities
D)repair hereditary problems

Question 9

A client who sustained a fractured femur from an auto accident is placed in traction.The client complains of severe pain,dyspnea,and restlessness,and the nurse's assessment indicates cyanosis,shock,and petechiae over the neck,upper arms,and chest.The nurse should suspect the client has developed which fracture complication?

A)compartment syndrome
B)fat embolism
C)infection
D)nonunion

Question 10

Complications resulting from fracture may include which of these?

A)pulmonary edema
B)fat embolism
C)osteoporosis
D)pulmonary embolism

Question 11

When assessing a client who has a musculoskeletal disorder,on which of these aspects should the nurse focus?

A)client's medical history
B)client's specific muscle or joint disorders
C)client's functional abilities
D)client's basic bone structure

Question 12

In comparison to other types of fractures,a client who has sustained a compound fracture stands a greater chance of developing which complication?

A)compartment syndrome
B)fat embolism
C)infection
D)nonunion

Question 13

For a client who has a fractured tibia,where will a cast be applied?

A)above the ankle to below the knee
B)to the ankle and knee
C)to the ankle,knee,and hip
D)to the knee and hip

Question 14

What is the major disadvantage of open reduction internal fixation (ORIF)?

A)client rejection of implanted device
B)introducing infection into the bone
C)permanent damage to the central nervous system
D)potential for incomplete repair of the fracture

Question 15

Modalities for treatment of a fracture may include open or closed reduction,casts,and:

A)parenteral calcium administration
B)compartmentalization
C)fibrinogen administration
D)traction

Question 16

A client develops a severe muscle strain with a complete rupture.Which of these treatment approaches will be taken?

A)ice packs for 20- to 30-minute periods during the first 24 hours after the injury
B)heat as necessary to promote comfort
C)rest and immobilization
D)surgical repair

Question 17

Client education for crutch walking for the client with a full left leg cast includes which of the following?

A)The tripod position is the basic stance.
B)Place crutch tips 12 to 15 inches in front of and lateral to the client's foot.
C)Change crutch tips frequently.
D)Place weight equally on the axilla pieces when moving the affected leg.

Question 18

Which of these statements BEST describes scoliosis?

A)exaggeration of the lumbar spine curvature
B)grating sensation or sound heard upon joint movement
C)increased roundness of the thoracic spinal curve
D)lateral curving deviation of the spine

Question 19

A nurse is performing a neurovascular assessment on a client who has just had a long leg cast applied.In addition to checking the client's extremity for pain and paresthesia,the nurse must assess for:

A)restlessness
B)sleep patterns
C)pulselessness
D)dietary intake

Question 20

The health care provider orders a window to be cut over the abdomen of a client in a hip spica cast for which of these purposes?

A)to dress a wound
B)to observe the skin
C)to relieve pressure from abdominal distention
D)to take a pulse

Question 21

Medical treatment for bursitis of the elbow would include joint rest and which of the following?

A)administration of salicylates and NSAIDs
B)injection of saline into the bursa
C)continuous warm compresses
D)surgical debridement of the bursa

Question 22

Which of these statements should the nurse make to the client who had a right total knee replacement?

A)"You will ambulate with assistance the day after surgery."
B)"You will be standing at the bedside on the evening of surgery."
C)"You will stay in the hospital for 10 days."
D)"You will keep the right leg in a dependent position when sitting up in a chair."

Question 23

A client is diagnosed with temporomandibular joint dysfunction (TMJ)syndrome.Medical management would consist of which of the following?

A)orthodontics to close gaps in teeth
B)antibiotics and narcotic analgesics
C)regular chewing exercises
D)moist heat and cold therapy

Question 24

A checkout clerk at a grocery store develops numbness,pain,and impaired mobility of the fingers of the dominant left hand.The nurse should suspect the client has developed which of these conditions?

A)carpal tunnel syndrome
B)bursitis
C)osteoarthritis
D)osteoporosis

Question 25

Medical treatment of carpal tunnel syndrome includes all of the following.Which would be initiated FIRST?

A)administration of narcotic analgesics
B)application of immobilizing splints
C)injection of cortisone into the carpal tunnel
D)surgery to relieve pressure on the nerve

Question 26

A client who has severe and prolonged osteoporosis may experience loss of:

A)height
B)joint function
C)muscle mass
D)weight

Question 27

Teaching for a client who has osteoporosis should emphasize which of the following?

A)a diet high in vitamin C
B)narcotic analgesics as ordered
C)regular exercise
D)supplemental oxygen

Question 28

A client has a left total hip replacement.In which of these positions should the nurse place the operative hip?

A)abduction and extension
B)abduction and flexion
C)adduction and extension
D)adduction and flexion

Question 29

The nurse is aware that pin care for a client with an external fixation should include which of the following? (Select all that apply. )

A)Use a new gauze pad over all pins.
B)Do not remove any crust from around the pin site.
C)Report an increase in fever to 101.5 degrees Fahrenheit.
D)Remove drainage from pin site.
E)Monitor for redness,swelling,purulent drainage,or pain.

Question 30

A client develops a red macule at the site of a deer tick bite,a rash with round rings around the site,headache,neck stiffness,and pain.The nurse should suspect the client has developed which of these conditions?

A)gout
B)Lyme disease
C)polymyositis
D)rheumatoid arthritis

Question 31

What is the cause of gout?

A)ineffective purine metabolism
B)joint overuse,resulting in "wear and tear"
C)diminished mineral and protein matrix components of the bone
D)inflammation of the bone and bone marrow due to pathogenic bacteria

Question 32

A client has a closed below-the-knee amputation of the left leg.The nurse recognizes the client will be scheduled to spend some time in the prone position each day to:

A)increase muscle strength of the thigh muscles
B)prevent contractures of the hip
C)prevent edema of the stump
D)prevent thrombophlebitis

Question 33

What is the MOST common cause of osteomyelitis?

A)upper respiratory infection
B)infection from open fractures
C)infected teeth or tonsils
D)closed fractures

Question 34

Which of these medications will be prescribed to relieve pain for the client who has osteoarthritis?

A)aspirin or NSAIDs
B)steroids
C)narcotics
D)muscle relaxants

Question 35

Client teaching for the client with osteoarthritis would emphasize which of the following?

A)minimizing rest periods during the day
B)splinting the affected joints
C)applying heat as needed for comfort
D)taking aspirin or NSAIDs around the clock

Question 36

Teaching for the client with gout would include avoiding foods high in purine,such as:

A)asparagus
B)broccoli
C)spinach
D)potatoes

Question 37

A client is experiencing a condition involving an increase in the porosity of bone.It is often called the "silent disease" and goes untreated.This condition is:

A)Lyme disease
B)osteoarthritis
C)osteoporosis
D)rheumatoid arthritis

Question 38

A client has been diagnosed with an autoimmune inflammatory disease that involves the synovium of the joints and is potentially disabling.The nurse is aware that this client is experiencing:

A)bursitis
B)Lyme disease
C)osteoarthritis
D)rheumatoid arthritis

Question 39

Which of the following medications are approved for the prevention and treatment of osteoporosis in postmenopausal women and in men? (Select all that apply. )

A)alendronate sodium (Fosamax)
B)estrogen
C)calcitonin (Fortical/Miacalcin)
D)teriparatide (Forteo)
E)ibandronate (Boniva)
F)risedronate (Actonel)

Question 40

Slow progressive degeneration of joint articular cartilage results in which condition?

A)bursitis
B)Lyme disease
C)osteoarthritis
D)rheumatoid arthritis