Question 1

The nurse is assessing the joints of a woman who has stated,"I have a long family history of arthritis,and my joints hurt." The nurse suspects that she has osteoarthritis.Which of these are symptoms of osteoarthritis? Select all that apply.

Accepted Answer

In osteoarthritis,asymmetric joint involvement commonly affects hands,knees,hips,and lumbar and cervical segments of the spine.Affected joints have stiffness,swelling with hard bony protuberances,pain with motion,and limitation of motion.The other options reflect signs of rheumatoid arthritis.

Question 2

The nurse should use which test to check for large amounts of fluid around the patella?

Accepted Answer

Ballottement of the patella is reliable when larger amounts of fluid are present.The Tinel's sign and the Phalen's test are used to check for carpal tunnel syndrome.The McMurray's test is used to test the knee for a torn meniscus.

Question 3

A patient tells the nurse that "all my life I've been called 'knock knees.'" The nurse knows that another term for "knock knees" is:

Accepted Answer

Genu valgum is also known as "knock knees" and is present when there is more than 2.5 cm between the medial malleoli when the knees are together.

Question 4

A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her fingers.The nurse will assess for signs of what problems?

Accepted Answer

Changes in the fingers caused by chronic rheumatoid arthritis include swan neck and boutonniere deformities.Heberden's nodes and Bouchard's nodules are associated with osteoarthritis.Dupuytren's contractures occur because of chronic hyperplasia of the palmar fascia and causes contractures of the digits (see Table 22-4).

Question 5

When performing a musculoskeletal assessment,the nurse knows that the correct approach for the examination should be:

Accepted Answer

The musculoskeletal assessment should be done in an orderly approach,head to toe,proximal to distal,from the midline outward.The other options are not correct.

Question 6

The nurse is assessing a 1-week-old infant and is testing his muscle strength.The nurse lifts the infant with hands under the axillae and notices that the infant starts to "slip" between the hands.The nurse should:

Accepted Answer

An infant who starts to "slip" between the nurse's hands shows weakness of the shoulder muscles.An infant with normal muscle strength wedges securely between the nurse's hands.The other responses are not correct.

Question 7

A patient's annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine;however,this curvature disappears with forward bending.The nurse knows that this abnormality of the spine is called:

Accepted Answer

Functional scoliosis is flexible;it is apparent with standing and disappears with forward bending.Structural scoliosis is fixed;the curvature shows both when standing and when bending forward.See Table 22-7 for description of herniated nucleus pulposus.These findings are not indicative of a dislocated hip.

Question 8

The nurse is examining a 2-month-old infant and notices asymmetry of the infant's gluteal folds.The nurse should assess for other signs of what disorder?

Accepted Answer

Unequal gluteal folds may accompany hip dislocation after 2 to 3 months of age,but some asymmetry may occur in healthy children.Further assessment is needed.The other responses are not correct.

Question 9

A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months.Which response by the nurse is appropriate?

Accepted Answer

Osgood-Schlatter disease is painful swelling of the tibial tubercle just below the knee.It is most likely due to repeated stress on the patellar tendon.It is usually self-limited,occurring during rapid growth and most often in males.The symptoms resolve with rest.The other responses are not appropriate.

Question 10

A man who has had gout for several years comes to the clinic with a problem with his toe.On examination,the nurse notices the presence of hard,painless nodules over the great toe;one has burst open with a chalky discharge.This finding is known as:

Accepted Answer

Tophi are collections of sodium urate crystals resulting from chronic gout in and around the joint that cause extreme swelling and joint deformity.They appear as hard,painless nodules (tophi)over the metatarsophalangeal joint of the first toe and they sometimes burst with a chalky discharge (See Table 22-6).See Table 22-6 for descriptions of the other conditions.

Question 11

The nurse is examining a 6-month-old infant and places the infant's feet flat on the table and flexes his knees up.The nurse notes that the right knee is significantly lower than the left.Which of these statements is true of this finding?

Accepted Answer

Finding one knee significantly lower than the other is a positive Allis sign and suggests hip dislocation.Normally the tops of the knees are at the same elevation.The other statements are not correct.

Question 12

When assessing muscle strength,the nurse observes that a patient has complete range of motion against gravity with full resistance.What Grade should the nurse record using a 0 to 5 point scale?

Accepted Answer

Complete range of motion against gravity is normal muscle strength and is recorded as Grade 5 muscle strength.

Question 13

A patient has been diagnosed with a ganglion cyst over the dorsum of his left wrist.He asks the nurse,"What is this thing?" The nurse's best answer would be,"It is:

Accepted Answer

A ganglionic cyst is a common benign tumor;it does not become malignant,and it does not need to be drained.It is not caused by chronic repetitive motion injury.

Quiz 22: Musculoskeletal System