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Pathophysiology-Musculoskeletal Final Prep

Terms in this set (74)

C
A clinician is preparing to teach about bone matrix. Which information should be included? The component of the bone matrix that gives bone tensile strength is: REF: p. 954

a. Calcium
b. Phosphate
c. Collagen
d. Magnesium
B
Which information indicates the nurse has a good understanding of osteoblasts? Once their initial function is complete, osteoblasts become: REF: p. 955

a. Osteoclasts
b. Osteocytes
c. Chondroblasts
d. Osteoids
A
Which information indicates the nurse understands osteocalcin? Osteocalcin is a: REF: p. 958

a. Glycoprotein
b. Hormone
c. Mineral
d. Vitamin
B
A clinician is preparing to discuss hydroxyapatite. Which information should be included? Hydroxyapatite in the bone matrix contains which of the following molecules in its crystalline structure? REF: p. 958

a. Calcium and magnesium
b. Calcium and phosphate
c. Phosphate and magnesium
d. Magnesium and hydrogen
A
Which information indicates the nursing student has a good understanding between compact bone and spongy bone? The major difference between compact bone and spongy bone is the: REF: p. 960

a. Organization of the structural elements
b. Location within the body
c. Activating chemicals in each
d. Types of minerals in the bone matrix
A
A staff member asks a nurse how blood gets to the bone. How should the nurse reply? Blood vessels penetrate to the inner structures of the bone via: REF: p. 960

a. Volkmann canals
b. Canaliculi
c. Sharpey fibers
d. Lamellae
C
A nurse is preparing to teach the staff about bones. Which information should the nurse include? After puberty, the epiphyseal plate calcifies, and the epiphysis and _____ merge. REF: p. 960
a. Epiphyseal line
b. Diaphyseal plate
c. Metaphysis
d. Articular cartilage
C
When a staff member asks how remodeling of bone occurs, what is the nurse's best response? Remodeling is done by clusters of bone cells called: REF: p. 961
a. Precursor stimulating cells
b. Osteoclastic cutting cones
c. Basic multicellular units
d. Haversian system cells
C
A nurse is discussing the different phases of bone remodeling. Which information should be included? Phase 2 of the bone remodeling cycle involves bone: REF: p. 962
a. Formation
b Activation
c. Resorption
d. Fracturing
D
When the physical therapist is describing a freely movable joint, which term should be used? REF: p. 963
a. Synarthrosis
b. Amphiarthrosis
c. Fibrous
d. Diarthrosis
B
A nurse recalls fibrous joints generally are: REF: p. 963
a. Rotating
b. Slightly movable
c. Freely movable
d. Calcified
C
Which of the following should the nurse include when discussing the different types of cartilaginous joints? REF: p. 964
a. Sutures and gomphosis
b. Syndesmosis and gomphosis
c. Symphysis and synchondrosis
d. Gomphosis and synchondrosis
C
Which statement indicates the nurse has a good understanding of joints? The joints between the teeth and the maxilla or mandible are examples of a: REF: p. 964
a. Symphysis
b. Diarthrosis
c. Gomphosis
d. Syndesmosis
B
A nurse recalls the elbow joint is an example of a(n): REF: p. 965
a. Amphiarthrosis
b. Diarthrosis
c. Synarthrosis
d. Symphysis
B
When a staff member asks where costal cartilage is located, how should the nurse respond? Between the: REF: p. 964
a. Vertebrae
b. Ribs and sternum
c. Sutures of the skull
d. Facial bones
C
The epimysium, perimysium, and endomysium are made of:
REF: p. 965
a. Bone
b. Epithelium
c. Fascia
d. Cartilage
D
Which layer forms the fascicles in skeletal muscle? REF: p. 967
a. Tendon sheath
b. Endomysium
c. Epimysium
d. Perimysium
C
When a staff member asks the nurse about the contractile unit of a muscle, how should the nurse reply? The contractile unit of a muscle cell is called the: REF: p. 968
a. Motor unit
b. Basement membrane
c. Myofibril
d. Ribosome
A
An isolated muscle is believed to be a type 1 fiber. Which of the following should be observed by the nurse when the muscle is stimulated? REF: p. 968

a. The muscle resists fatigue.
b. The muscle tires easily.
c. The muscle will not contract.
d. The muscle has no fascia.
B
An isolated muscle is believed to be a type II fiber. Which of the following should be observed by the nurse when the muscle is stimulated? REF: p. 969 | p. 972
a. The muscle has slow contraction speed.
b. The muscle is fatigued easily.
c. The muscle has a profuse capillary supply.
d. The muscle has no fascia.
C
When the nurse is using the term "sarcopenia," what is the nurse describing? It is the: REF: p. 974
a. Absence of muscle cells
b. Fatigue of muscle cells
c. Age-related loss in skeletal muscle
d. Muscles that are unable to contract
D
A nurse is preparing to teach about myofibrils. Which information should the nurse include? The structure of the contractile subunit of the myofibril is called the: REF: p. 968

a. Sarcoplasmic reticulum
b. Actin
c. Motor endplate
d. Sarcomere
C
While planning care for a patient with muscle problems, which information should the nurse remember? _____ ions directly control the contraction of muscles. REF: p. 972
a. Sodium
b. Potassium
c. Calcium
d. Magnesium
B
A patient has researched muscles on the internet. Which information indicates the patient has a good understanding? The molecule that prevents a muscle contraction from occurring when the muscle is at rest is: REF: p. 972
a. Calcium
b. Troponin-tropomyosin
c. Actin
d. Myosin
A
A nursing student wants to know during which stage actin binds to myosin. What is the nurse's best response? During: REF: p. 972
a. Coupling
b. Relaxation
c. Discharging
d. Excitation
C
When a patient asks what the fuel for skeletal muscle contraction is, how should the nurse respond? The main energy source or fuel for skeletal muscle contraction is: REF: p. 972
a. Calcium
b. Lactic acid
c. Adenosine triphosphate (ATP)
d. Actin
B
The nurse observed the patient's muscle contracted, but the limb did not move. How should the nurse chart this muscle contraction? REF: p. 973
a. Isotonic contraction
b. Isometric contraction
c. Eccentric contraction
d. Concentric contraction
D
A nurse recalls that when a muscle acts as the prime mover, it is called the: REF: p. 973

a. Flexor
b. Recruiter
c. Antagonist
d. Agonist
A,B,D
MULTIPLE RESPONSE

The nurse has a good understanding of bone matrix when he comments that the following molecules are part of the bone matrix? (Select all that apply.) REF: p. 955
a. Collagen fibers
b. Elastin fibers
c. Proteoglycans
d. Glycoproteins
e. Epithelial cells
B, C, D
MULTIPLE RESPONSE

Which information indicates the nurse has a good understanding of synovial joints? The synovial joints in the body include the (select all that apply): REF: p. 964
a. Syndesmosis type that connects two vertebrae
b. Spheroid type found in the shoulder
c. Hinge type found in the elbow
d. Gliding type found in the hand
e. Gomphosis joint in the mandible
A, B, C, D
MULTIPLE RESPONSE

The nursing student has a good understanding of glycoproteins when he states that the following glycoproteins are present in the bone? (Select all that apply.) REF: p. 958

a. Osteocalcin
b. Sialoprotein
c. Bone albumin
d. Alpha-glycoprotein
e. Collagen
A,C,D,E
MULTIPLE RESPONSE

A patient has researched compact bones on the Internet. Which information indicates the patient has a good understanding of compact bone? The structures present in compact bone include the (select all that apply): REF: p. 960
a. Haversian canals
b. Trabeculae
c. Canaliculi
d. Lamellae
e. Lacunae
A,B,C,D
MULTIPLE RESPONSE

Which information indicates the staff member has a good understanding of bone classifications? The shapes that represent bone classifications include (select all that apply): REF: p. 960

a. Long
b. Flat
c. Short
d. Irregular
e. Round
A,B,C
MULTIPLE RESPONSE

A nurse is preparing to teach about skeletal muscles. Which information should the nurse include? The terms used to describe skeletal muscle are (select all that apply): REF: p. 967
a. Voluntary
b. Striated
c. Extrafusal
d. Fibrotic
e. Epithelial
D
The incidence of fractures of the pelvis is highest in: REF: p. 978
a. Preadolescent boys
b. Adolescent boys
c. Adolescent girls
d. Older adults
B
A 65-year-old Hispanic female is admitted to the hospital with a pathologic, compound, transverse fracture of the femur. Which of the following statements best describes this type of fracture?
REF: p. 979
a. The fracture line is parallel to the bone.
b. The fracture line is straight across the bone.
c. The fracture line is perpendicular to the bone.
d. The fracture line is vertical to the shaft of the bone.
C
A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture? REF: p. 979
a. Fatigue fracture
b. Stress fracture
c. Pathologic fracture
d. Greenstick fracture
C
A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This is referred to as a what type of fracture? REF: p. 980
a. Comminuted
b. Greenstick
c. Fatigue
d. Compound
A
Transchondral fractures are most prevalent in: REF: p. 980
a. Adolescents
b. Older adults
c. Infants
d. Premenopausal females
B
35-year-old female suffers a broken clavicle following a motor vehicle accident. X-ray reveals that the bone surfaces in the joint partially lost contact with each other. This condition is called:
REF: p. 981
a. Dislocation
b. Subluxation
c. Distortion
d. Nonunion
A
A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. This condition is known as a: REF: p. 982
a. Sprain
b. Strain
c. Disunion
d. Subluxation
D
A 36-year-old male complains of pain and weakness in the elbow. He reports that he is a warehouse worker and lifts boxes daily. MRI reveals inflammation of the tendon where it attaches to bone. This condition is called: REF: p. 982
a. Periostitis
b. Muscle strain
c. Bursitis
d. Epicondylopathy
D
An important and useful clinical measure in the diagnosis of rhabdomyolysis is measurement of which laboratory value?
REF: p. 985
a. White blood cell count
b. Antinuclear antibodies
c. Aspartate aminotransferase
d. Creatine kinase (CK)
B
Which of the following clinical findings would be expected in the patient with rhabdomyolysis? REF: p. 984
a. Sweating
b. Dark urine
c. Yellow color to the skin
d. Lower extremity swelling
C
A 70-year-old female presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase in bone: REF: p. 988
a. Density
b. Formation
c. Resorption
d. Mineralization
B
A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is: REF: p. 989
a. Increased androgen levels
b. Decreased estrogen levels
c. Strenuous exercise
d. Excessive dietary calcium
C
A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for: REF: p. 989
a. Bone infections
b. Joint injuries
c. Pathologic bone fractures
d. Osteomalacia
D
An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with osteomalacia caused by: REF: p. 993
a. Collagen breakdown in the bone matrix
b. Excessive bone resorption
c. Crowding of bone marrow by excessive bone growth
d. Inadequate bone mineralization
C
A 56-year-old male was admitted to the hospital with a diagnosis of osteomalacia. History reveals that he takes anticonvulsants, underwent small bowel resection 3 years earlier, and suffers from chronic pancreatitis. What is the common link between these three factors and the development of osteomalacia? REF: p. 993
a. Impaired phosphate absorption
b. Increased calcium excretion
c. Vitamin D deficiency
d. Impaired vitamin C metabolism
B
A disorder similar to osteomalacia that occurs in growing bones of children is termed: REF: p. 993
a. Paget disease
b. Rickets
c. Osteomyelitis
d. Osteosarcoma
B
The cause of Paget disease is: REF: p. 994
a. Fluoride deficiency
b. Unknown at present
c. Excess vitamin A
d. Osteogenic sarcoma
A
A 70-year-old male presents with back pain, fever, and weight loss. He reports that he had a recent respiratory infection from which he thought he recovered. Tests revealed increased white blood cell count, and a diagnosis of endogenous osteomyelitis was made. The primary organism causing this condition is: REF: p. 995
a. Staphylococcus aureus
b. Salmonella
c. Mycobacterium
d. Haemophilus influenza
B
A 54-year-old female was recently diagnosed with degenerative joint disease. This condition is characterized by loss of:
REF: p. 996
a. The epiphyses
b. Articular cartilage
c. Synovial fluid
d. The joint capsule
C
A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA). Which of the following is the expected treatment of choice? REF: p. 1002
a. Nonsteroidal anti-inflammatory drugs (NSAIDs)
b. Gold salts
c. Methotrexate
d. Hydroxychloroquine
B
Researchers now believe that RA is: REF: p. 999
a. Curable with antiviral agents
b. An autoimmune disease
c. A complication of rheumatic fever
d. Related superficial joint injury
A
A 34-year-old female was recently diagnosed with RA. Physical examination revealed that inflammation started in the: REF: p. 999
a. Synovial membrane
b. Articular cartilage
c. Subchondral bone
d. Surrounding ligaments
A
A 21-year-old female presents with low back pain and stiffness that is alleviated by physical activity. She was diagnosed with ankylosing spondylitis (AS). The first joint to be affected would be the: REF: p. 1002
a. Sacroiliac
b. Carpal
c. Shoulder
d. Knee
A
Which of the following people is at highest risk for the development of gout? REF: p. 1005
a. Men aged 40 to 50 years
b. Premenopausal women
c. Male adolescents
d. Female children
C
A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. The symptoms he experienced are caused by the crystallization of _____ within the synovial fluid. REF: p. 1005
a. Purines
b. Pyrimidines
c. Uric acid
d. Acetic acid
C
A 46-year-old male presents with severe pain, redness, and tenderness in the right big toe. He was diagnosed with gouty arthritis. He is at risk for developing: REF: p. 1005
a. Cholelithiasis
b. Myocarditis
c. Renal stones
d. Liver failure
A
A 51-year-old male experienced severe acute gouty arthritis. Which of the following is the most common trigger for the symptoms? REF: p. 1005
a. Trauma
b. Anemia
c. High-fat foods
d. Lack of exercise
B
The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:
REF: p. 1007
a. Monarticular arthritis
b. Tophaceous gout
c. Asymptomatic hyperuricemia
d. Complicated gout
C
A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibers decreased, a condition referred to as: REF: p. 1008
a. Myodysplasia
b. Ischemic atrophy
c. Disuse atrophy
d. Deconditioning hypoplasia
D
Fibromyalgia is a chronic musculoskeletal disorder characterized by: REF: p. 1008
a. Pain resulting from joint and muscle inflammation
b. Muscle pain in the back and gastrointestinal symptoms
c. Neurologic pain in the skeletal muscles
d. Diffuse pain, fatigue, and tender points
A
Myotonia is characterized by: REF: p. 1010
a. Prolonged depolarization of muscle cell membranes
b. Absence of adenosine triphosphate (ATP) for muscle contraction
c. Delayed muscle contraction
d. Hyperactive reflexes
D
A 13-year-old female is admitted to the hospital for evaluation and treatment of an osteosarcoma in her left distal femur. Which statement best describes osteosarcoma? REF: p. 1015
a. Myelogenic, develops in red bone marrow only
b. Benign, develops in spongy bone tissue
c. Collagenic, originates in the periosteum
d. Osteogenic, most often develops in the bone marrow
A
A 60-year-old male presents with swelling and pain in the knee. CT reveals a tumor of spongy bone. His diagnosis would be:
REF: p. 1016
a. Chondrosarcoma
b. Rhabdomyoma
c. Rhabdomyosarcoma
d. Fibrosarcoma
C
The most common cause of toxic myopathy is: REF: p. 1012
a. Infection
b. A tumor
c. Alcoholism
d. Osteoporosis
C
35. A malignant tumor of striated muscle tissue origin is called: REF: p. 1013
a. Myelogenic tumor
b. Giant cell tumor
c. Rhabdomyosarcoma
d. Rhabdomyoma
A,B,C,D
MULTIPLE RESPONSE

A 35-year-old female presents with impaired motor function and visual disturbances. The diagnosis is Paget disease. What additional symptoms would be expected? (Select all that apply.)
REF: p. 994
a. Skull thickness
b. Dementia
c. Deafness
d. Headache
e. Hypertension
A,B,D,E
MULTIPLE RESPONSE

Signs and symptoms of subluxation include (select all that apply): REF: p. 982

a. Pain
b. Swelling
c. Hemorrhage
d. Limitation of movement
e. Joint deformity
A,B,D,E
MULTIPLE RESPONSE

A 29-year-old male was recently diagnosed with AS. He is interested in obtaining more information about his disease. Patient teaching would include which of the following? (Select all that apply.) REF: p. 1004
a. A diagnosis is made from history, physical examination, x-rays, and genetic analysis.
b. Inflammation of the fibrocartilage in cartilaginous joints results in the erosion of bone structure, scar tissue formation, and joint fusion.
c. The more common signs and symptoms of early disease include restricted joint movement and increased pain after physical activity.
d. The usual treatment includes anti-inflammatory and analgesic medications, exercises, and physical therapy.
e. The spine becomes bent forward as the normal convex curve of the lower spine diminishes.
A,B,C
MULTIPLE RESPONSE

The pattern of bone destruction indicative of an aggressive malignant tumor is known as J_____ pattern. (Select all that apply.)
REF: p. 1014

a. Moth-eaten
b. Permeative
c. Geographic
d. Radial
e. Selective
11
COMPLETION REF: p. 1008

To make a diagnosis of fibromyalgia, tenderness must be present in ____ of the 18 points necessary for diagnosis.
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