Deck 38: Assessing the Musculoskeletal System

Question 1

Which of the following Select all that apply.

A)"How has having this condition affected your relationship with others?"
B)"Describe your usual activities for a 24-hour period."
C)"Has having this condition created stress for you?"
D)"Have you had any physical therapy or other treatments for your condition?"
E)"Do you take any herbal supplements for musculoskeletal problems?"

Answer 1

"Have you had any physical therapy or other treatments for your condition?"
"Do you take any herbal supplements for musculoskeletal problems?"

Question 2

The height of a female patient has decreased ? inch over the last year. The patient is concerned and asks the nurse, "What is happening to me?" The most therapeutic response by the nurse would be which of the following?

A)"Everybody gets shorter as they get older."
B)"There is no need to worry; you only lost ? inch since last year.You probably won't lose much more than that."
C)"There can be several causes for the loss of height, but as we age, bone mass decreases and the spinal column shortens."
D)"There could be something wrong so you should discuss it with your physician."

Answer 2

"There can be several causes for the loss of height, but as we age, bone mass decreases and the spinal column shortens."

Question 3

The nurse asks a patient experiencing debilitating rheumatoid arthritis how the condition makes them feel about himself. The nurse is assessing what type of functional health pattern?

A)self-perception-self-concept
B)role-relationships
C)coping-stress
D)value-belief

Answer 3

self-perception-self-concept

Question 4

The nurse, reviewing data collected during the assessment of an elderly female, would identify which of the following as being normal age-related changes? Select all that apply.

A)height decreased ? inch in 2 years
B)complains of frequent cramping of lower extremities
C)1 cm nodule palpated in right foot
D)decreased range of motion in right and left hips
E)lateral curvature of the spine

Question 5

The nurse, instructing a patient about preparations needed for an electromyogram, would determine that further instruction is needed when the patient makes which of the following statements?

A)"I will not smoke any cigarettes up to three hours before the test."
B)"It will be alright to have a glass of water before the test."
C)"I can take my Flexaril before having my test so that my back won't hurt"
D)"I can take my lisinopril the night before my test for my blood pressure."

Question 6

A patient is being discharged after being treated for a fracture. Which of the following assessments would ensure safety in the patient's home environment?

A)safe walking path and no scatter rugs in the home environment
B)location of furniture to aid with ambulation
C)proper functioning of device used for cooking
D)presence of small rug in front of bathroom sink to reduce risk of slipping on water

Question 7

A patient is diagnosed with Ellis-van Creveld syndrome. Which of the following will the nurse most likely assess in this patient? Select all that apply.

A)height 3'6"
B)extra digit on both hands
C)wrist deformity's bilaterally
D)muscle spasms
E)decayed teeth

Question 8

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?
Click on the correct area on the image.

Question 9

The nurse, assessing a 68 year-old female patient, notes an exaggerated curvature of the thoracic spine when the patient bends at the waist. The nurse realizes that this finding is consistent with which of the following?

A)kyphosis and is a common curvature in older patients
B)kyphosis and the patient will have to have surgical correction of the deformity
C)scoliosis and is a normal curvature in the elderly
D)lordosis and is common in elderly patients

Question 10

The nurse, assessing a Native American patient diagnosed with rheumatoid arthritis, asks how cultural beliefs or practices affect how the patient feels and cares about the condition. The nurse is assessing what type of functional health pattern?

A)cognitive-perceptual
B)value-belief
C)self-perception-Self-concept
D)coping-stress

Question 11

The nurse is assessing an elderly patient. Which of the following would be considered normal findings for this patient? Select all that apply.

A)decreased bone mass and minerals
B)increased calcium reabsorption
C)muscle fibers atrophy
D)vertebrae elongate
E)decreased range of motion

Question 12

While performing range of motion exercises with an elderly patient, the patient begins to cry and states, "My knee hurts when you do that!" Which interventions should be implemented at this time? Select all that apply.

A)Continue with the exercise regimen.
B)Stop ROM immediately in that extremity.
C)Massage the knee for 20 minutes.
D)Call the physician.
E)Have the patient complete the exercise alone.

Question 13

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

A)arthroscopy
B)an electromyogram (EMG)
C)somatosensory evoked potential (SSEP)
D)dual energy x-ray absorptiometry (DEXA)

Question 14

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

A)development of osteomyelitis
B)subacute osteoporosis
C)pathological fracture
D)undiagnosed osteitis deformans

Question 15

A priority nursing diagnosis for a patient diagnosed with amyotrophic lateral sclerosis (ALS) would be which of the following?

A)Imblanced Nutrition: Less than Body Requirements
B)Deficient Fluid Volume
C)Risk for Activity Intolerance
D)Impaired Gas Exchange

Question 16

The nurse asks a patient diagnosed with severe osteoporosis how the condition has interfered with his ability to work. The nurse is assessing what type of functional health pattern?

A)value-belief
B)cognitive-perceptual
C)activity-exercise
D)role-relationships

Question 17

The nurse asks a patient if she ingests over-the-counter medications, herbal supplements, or nutritional supplements for any type of problems with her bones or muscles. The nurse is assessing what type of functional health pattern?

A)activity-exercise
B)self-perception-self-concept
C)health perception-health management
D)cognitive-perceptual

Question 18

The nurse would document "unable to assess" for which of the following patients in relation to performing Phalen's test?

A)a patient with a long leg cast
B)a patient with an above-the-elbow amputation
C)a patient wearing compression stockings
D)a patient with osteoarthritis of the hips

Question 19

In which order should the nurse assess a patient complaining of pain in both knees? Place in order of priority. Click and drag the options below to move them up or down.

A)measurement of muscle mass
B)range of motion
C)inspection
D)palpation

Question 20

Which of the following patients could safely undergo an MRI diagnostic test?

A)a patient with a pacemaker for three years
B)a patient with shrapnel from a military assault
C)a patient with an open abdominal wound
D)a patient with external hardware following a fracture repair

Question 21

When caring for older adults, the nurse realizes that an age-related change in the musculoskeletal system is which of the following?

A)difficulty with dexterity after age 50
B)vertebrae lengthen and thin, which leads to increased bone production
C)decreased bone mass and calcium absorption, which lead to a chance for fractures
D)pain when ambulating due to increased bone mass and minerals

Question 22

A patient is seen in the physician's office following several tests. The test results include elevated blood calcium, elevated alkaline phosphatase, elevated phosphorus, normal creatine kinase, and increased uptake of the radioisotope on bone scan. The nurse realizes that the most likely diagnosis is which of the following?

A)bone spurs
B)rheumatoid arthritis
C)osteoporosis
D)bone cancer

Question 23

A patient's gait is considered normal during assessment if Select all that apply.

A)the patient does not stumble, run into objects, or fall.
B)the gait is smooth and steady without limping.
C)the gait is slow and deliberate as if the patient is gingerly pulling one side up to meet the other.
D)the gait is jerky and quick, which indicates the patient has excellent motor control.
E)the posture is upright and straight, and the gait is smooth.

Question 24

Teaching the patient about an electromyelogram (EMG) should include which of the following? Select all that apply.

A)Do not smoke for several hours before the test.
B)Do not take any medication prior to this test without physician approval.
C)The test measures nerve conduction along pathways.
D)The test measures electrical activity of skeletal muscles at rest.
E)Fluids containing caffeine are permitted prior to the test.

Question 25

In patients who are experiencing musculoskeletal disorders and diseases, alkaline phosphatase (ALP) is assessed to which of the following?

A)establish true calcium levels
B)evaluate the presence of bone diseases
C)determine phosphorus levels
D)diagnose muscle trauma

Question 26

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

A)Bone resorption will be triggered in order to increase serum calcium levels.
B)Bone production will occur in order to help increase the blood calcium.
C)Bones will not be affected because the calcium is low in the blood.
D)Bones will pull the needed calcium from other body structures.

Question 27

The patient is about to have a magnetic resonance imaging (MRI) to diagnose a soft tissue abnormality of the lower leg. The nurse should immediately notify the physician about which of the following?

A)The patient has a concern about what will be found on the MRI.
B)The patient has a pacemaker.
C)The patient has a history of hypertension.
D)The patient did not eat breakfast due to earlier nausea.

Question 28

The nurse should prepare the patient for standard x-rays of an arm by which of the following?

A)Initiating a peripheral IV in the opposite arm.
B)Finding out the patient's allergies.
C)Doing no special preparation.
D)Cleansing the arm with antibacterial cleanser.

Question 29

A patient is seen in the clinic complaining of pain in the left wrist. There is no deformity of the wrist, the left radial pulse is strong, and there is no history of a fall or injury. What does the nurse expect to see ordered?

A)an x-ray of both arms to ensure there is no injury present
B)rest and comfort measures for several days unless pain worsens
C)lab work to assess calcium and phosphorus levels
D)a computerized tomography (CT) scan of the wrist to check for soft tissue injury

Question 30

Put the following techniques of a musculoskeletal examination in the proper sequence. Click and drag the options below to move them up or down.

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.

Question 31

A patient comes to the emergency department complaining of right knee pain after being knocked down while playing basketball. The exam reveals the patient experiences difficulty when stepping down on the right leg due to acute pain around the knee and slight swelling of the right knee. Initially, the nurse expects that

A)the patient will be sent home with instructions to use ice for one week.
B)the patient will be admitted to the hospital and seen by an orthopedic specialist.
C)the patient will be scheduled to see an orthopedic physician and a tentative appointment for a magnetic resonance imaging (MRI) scan.
D)the patient will be admitted to the hospital and scheduled for exploratory surgery.

Question 32

The nurse is teaching about an endoscopic examination of the interior surfaces of a joint during which surgery and diagnosis can also be accomplished. What is a correct name for this technique?

A)arthrocentesis
B)arthroscopy
C)atherogenesis
D)arthrodesis

Question 33

Creatine kinase (CK) is evaluated in patients who are suspected of having which of the following?

A)juvenile rheumatoid arthritis
B)gout
C)muscle disease
D)bone tumors

Question 34

Which of the following assessments are used to determine the presence of larger amounts of fluid in the knee? Select all that apply.

A)ballottement
B)bulge sign
C)Phalen's test
D)Thomas test
E)increased fluid causing a tapping sound

Question 35

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

A)not be affected by the bed rest.
B)undergo increased osteoclast activity and bone resorption.
C)increase their osteoblastic activity to promote ossification.
D)be affected positively by the rest and be stronger as a result.

Question 36

The patient's right femur was fractured and repaired at the diaphysis. When teaching, the patient asks the nurse to explain the diaphysis. The nurse's best response is which of the following?

A)"Short bones like the femur are cuboid, spongy bone that, in medical terms, are called the diaphysis."
B)"Irregular bones like the femur are plates of compact bone that are also called the diaphysis."
C)"Flat bones like the femur are disc-shaped and, in medical terms, are called the diaphysis."
D)"Long bones like the femur have a mid-portion or shaft that is also called the diaphysis."

Question 37

A 62-year-old female patient is scheduled to have a DEXA exam as a screening tool. The most likely reason that the test has been ordered is which of the following?

A)to check for fractures
B)to check the degree of osteoporosis
C)to screen for osteomyelitis
D)to evaluate bone cancer

Question 38

To determine if a patient is experiencing carpal tunnel syndrome, the nurse would perform which of the following assessment tests?

A)bulge sign
B)ballottement
C)Phalen's test
D)Thomas test

Question 39

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

A)cardiac
B)smooth
C)skeletal
D)a combination of skeletal and smooth

Question 40

A bone scan would most likely be ordered for a patient when

A)bone cancer is suspected.
B)a muscle mass near the bone is suspected.
C)a patient complains of new onset pain in the area of the bone.
D)lab tests indicate normal calcium.

Question 41

The patient complains of pain and clicking in the right knee. The nurse will use what test to assess the patient? Mark an "X" on the correct figure.
Click on the correct area on the image.