Upgrade to remove ads
Terms in this set (14)
A patient complains of pain during circumduction of the shoulder when the nurse moves the arm behind the patient. Which question should the nurse ask?
a. "Do you have difficulty in putting on a jacket?"
b. "Are you able to feed yourself without difficulty?"
c. "Are you able to sleep through the night without waking?"
d. "Do you ever have trouble lowering yourself to the toilet?"
The patient's pain will make it more difficult to accomplish tasks like putting on a shirt or
jacket. This pain should not affect the patient's ability to feed himself or herself or use
the toilet because these tasks do not involve moving the arm behind the patient. The arm
will not usually be positioned behind the patient during sleeping.
A patient with knee pain who is diagnosed with bursitis asks the nurse to explain just what bursitis is.
The nurse will respond that bursitis is an inflammation of
a. a small, fluid-filled sac found at many joints.
b. the synovial membrane that lines the joint area.
c. the fibrocartilage that acts as a shock absorber in the knee joint.
d. any connective tissue that is found supporting the joints of the body.
Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a
solid tissue that cushions some joints. Bursae are a specific type of connective tissue. The
synovial membrane lines many joints but is not a bursa.
When assessing a 64-year-old woman, the nurse notes that the patient has lost 1 inch in height since the previous visit 2 years ago.
The nurse will plan to teach the patient about
a. discography studies.
b. myelographic testing.
c. magnetic resonance imaging (MRI).
d. dual-energy x-ray absorptiometry (DEXA).
The decreased height and the patient's age suggest that the patient may have osteoporosis
and that bone density testing is needed. Discography, MRI, and myelography are
typically done for patients with current symptoms caused by musculoskeletal dysfunction
and are not the initial diagnostic tests for osteoporosis.
Which information in a 60-year-old woman's health history will alert the nurse to the need for a more focused assessment of the musculoskeletal system?
a. The patient experienced a sprained ankle at age 13.
b. The patient's mother became much shorter with aging.
c. The patient's father died of complications of miliary tuberculosis.
d. The patient reports taking ibuprofen (Advil) for occasional headaches.
A family history of height loss with aging may indicate osteoporosis, and the nurse
should perform a more thorough assessment of the patient's current height and other risk
factors for osteoporosis. A sprained ankle during adolescence does not place the patient at
increased current risk for musculoskeletal problems. A family history of tuberculosis is
not a risk factor. Occasional nonsteroidal anti-inflammatory drug (NSAID) use does not
indicate any increased musculoskeletal risk.
Which information obtained during the nurse's assessment of the patient's nutritionalmetabolic pattern may indicate the risk for musculoskeletal problems?
a. The patient takes a multivitamin daily.
b. The patient dislikes fruits and vegetables.
c. The patient is 5 ft 2 in and weighs 180 lb.
d. The patient prefers whole milk to nonfat milk.
The patient's height and weight indicate obesity, which places stress on weight-bearing
joints. The use of whole milk, avoiding fruits and vegetables, and use of a daily
multivitamin are not risk factors for musculoskeletal problems.
When the nurse is assessing a new patient in the clinic, which information about the patient's medications will be of most concern?
a. The patient takes a daily multivitamin and calcium supplement.
b. The patient has migraine headaches that are treated with nonsteroidal antiinflammatory
c. The patient has severe asthma and requires frequent therapy with oral steroids.
d. The patient takes hormone replacement therapy (HRT) to prevent "hot flashes."
Corticosteroid use may lead to skeletal problems such as avascular necrosis and
osteoporosis. The use of HRT and calcium supplements will help prevent osteoporosis.
NSAID use does not increase the risk for musculoskeletal problems.
While testing the patient's muscle strength, the nurse finds that the patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light
The nurse should document the patient's muscle strength as level
A level 3 indicates that the patient is unable to move against resistance but can move
against gravity. Level 1 indicates minimal muscle contraction, level 2 indicates that the
arm can move when gravity is eliminated, and level 4 indicates active movement with
When assessing the musculoskeletal system, the nurse's initial action will usually be to
a. feel for the presence of crepitus during joint movement.
b. have the patient move the extremities against resistance.
c. observe the patient's body build and muscle configuration.
d. check active and passive range of motion for the extremities.
The usual technique in the physical assessment is to begin with inspection. Abnormalities
in muscle mass or configuration will allow the nurse to perform a more focused
assessment of abnormal areas. The other assessments also are included in the assessment
but are usually done after inspection.
Which nursing action is correct when the nurse is assessing the straight-leg raising test for a patient with back pain?
a. Raise the patient's legs to a 60-degree angle from the bed.
b. Have the patient dangle the legs over the edge of the exam table.
c. Place the patient initially in the prone position on the bed or exam table.
d. Instruct the patient to elevate the legs while tightening the abdominal muscles.
When performing the straight leg-raising test, the patient is in the supine position and the
nurse passively lifts the patient's legs to a 60-degree angle. The other actions would not
be correct for this test.
A patient with kyphosis is scheduled for dual-energy x-ray absorptiometry (DEXA) testing.
The nurse will plan to
a. give an oral sedative.
b. start an intravenous line.
c. teach the patient about DEXA.
d. screen the patient for shellfish allergies.
DEXA testing is painless and noninvasive. No IV access is necessary. Contrast medium
is not used. Because the procedure is painless, no antianxiety medications are required.
A patient has a new order for magnetic resonance imaging (MRI) to evaluate for right femur osteomyelitis.
Which patient information indicates that the nurse should consult with the health care provider before scheduling the MRI?
a. The patient has a pacemaker.
b. The patient is claustrophobic.
c. The patient wears a hearing aid.
d. The patient is allergic to shellfish.
Patients with permanent pacemakers cannot have MRI because of the force exerted by
the magnetic field on metal objects. An open MRI will not cause claustrophobia. The
patient will need to be instructed to remove the hearing aid before the MRI, but this does
not require consultation with the health care provider. Since contrast medium will not be
used, shellfish allergy is not a contraindication to MRI.
When assessing the movement of a patient's elbow, the nurse notes crackling sounds and a grating sensation with palpation. How will this be documented?
Crackling sounds and a grating sensation that accompany movement are described as
crepitus or crepitation. Torticollis is a twisting of the neck to one side, subluxation is a
partial dislocation of the joint, and epicondylitis is an inflammation of the elbow that
causes a dull ache that increases with movement.
The nurse obtains this information when assessing a 74-year-old patient in the outpatient clinic.
Which finding is of highest priority when the nurse is planning care for the patient?
a. Symmetrical joint swelling of fingers
b. Decreased right knee range of motion
c. History of recent loss of balance and fall
d. Complaint of left hip aching when jogging
A history of falls requires further assessment and development of fall prevention
strategies. The other changes are more typical of bone and joint changes associated with
A patient is seen in the clinic complaining of knee pain following an arthroscopic procedure 7 days previously and the health care provider performs arthrocentesis.
Which finding will be of most concern to the nurse?
a. Scant thin fluid
b. Sanguineous fluid
c. Straw-colored fluid
d. Purulent appearing fluid
The presence of purulent fluid suggests a possible joint infection. Bloody fluid might be
expected after an arthroscopic procedure. Normal synovial fluid is scant in amount and
YOU MIGHT ALSO LIKE...
Chapter 62: Musculoskeletal System
Arthritis and Connective Tissue Disease
OTHER SETS BY THIS CREATOR
McGuire - Exam 1 Drugs
Mental Health Exam 3
Mental Health Exam 2
Mental Health Exam 2