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JarvisHA22MusculoskeletalSystem

Terms in this set (40)

During an assessment of the spine, the patient would be asked to:
A. adduct and extend
B. supinate, evert, and retract
C. extend, adduct, invert and rotate
D. flex, extend, abduct, and rotate
D. flex, extend, abduct, and rotate
Pronation and supination of the hand and forearm are the result of the articulation of the:
A. scapula and clavicle
B. radius and ulna
C. patella and condole of fibula
D. femur and acetabulum
B. radius and ulna
Anterior and posterior stability are provided to the knee joint by the:
A. medial and lateral menisci
B. patellar tendon and ligament
C. medial collateral ligament and quadriceps muscle
D. anterior and posterior cruciate ligaments
D. anterior and posterior cruciate ligaments
A 70-year-old woman has come for a health examination. Which of the following is a common age-related change in the curvature of the spinal column?
A. lordosis
B. scoliosis
C. kyphosis
D. lateral scoliosis
C. kyphosis
The timing of joint pain may assist the examiner in determining the cause. The joint pain associated with rheumatic fever would:
A. be worse in the morning
B. be worse later in the day
C. be worse in the morning but improve during the day
D. occur 10 to 14 days after an untreated sore throat
D. occur 10 to 14 days after an untreated sore throat
Examination of the shoulder includes four motions. These are:
A. forward flexion, internal rotation, abduction, and external rotation
B. abduction, adduction, pronation, and supination
C. circumduction, inversion, eversion, and rotation
D. elevation, retraction, protraction, and circumduction
A. forward flexion, internal rotation, abduction, and external rotation
The bulge sign is a test for:
A. swelling in the supra patellar pouch
B. carpal tunnel syndrome
C. Heberden's nodes
D. olecranon bursa inflammation
A. swelling in the supra patellar pouch
The examiner is going to measure the patient's legs for length discrepancy. The normal finding would be:
A. no difference in measurements
B. 0.5 cm difference
C. within 1 cm of each other
D. 2 cm difference
C. within 1 cm of each other
A 2-year-old child has been brought to the clinic for a health examination. A common finding would be:
A. kyphosis
B. lordosis
C. scoliosis
D. no deviation is normal
B. lordosis
Positive Phalen test and Tinel sign are seen in a patient with:
A. a torn meniscus
B. hallux valgus
C. carpal tunnel syndrome
D. tennis elbow
C. carpal tunnel syndrome
When assessing an infant, the examiner completes Ortolani maneuver by:
A. lifting the newborn and noting a C-shaped curvature of the spin
B. gently lifting and abducting the infant's flexed knees while palpating the greater trochanter with the fingers
C. comparing the height of the tops of the knees when the knees are flexed up
D. palpating the length of the clavicles
B. gently lifting and abducting the infant's flexed knees while palpating the greater trochanter with the fingers
In which of the following ethnic groups would you expect to see the lowest incidence of osteoporosis?
A. Blacks
B. Whites
C. Asians
D. Native Americans
A. Blacks
Heberden's and Bouchard's nodes are hard and nontender and are associated with:
A. osteoarthritis.
B. rheumatoid arthritis.
C. Dupuytren's contracture.
D. metacarpophalangeal bursitis.
A. osteoarthritis.
The divisions of the spinal vertebrae include which of the following?
A. Cervical, thoracic, and scaphoid
B. Scapular, clavicular, and lumbar
C. Thoracic, lumbar, and coccygeal
D. Cervical, lumbar, and iliac
C. Thoracic, lumbar, and coccygeal
Which of the following muscles may be congenitally absent in certain individuals?
A. Palmaris shortus
B. Palmaris longus
C. Peroneus secondus
D. Synovius membraneous
B. Palmaris longus
When testing for muscle strength, the examiner does which of the following?
A. Observes muscles for the degree of contraction when the individual lifts a heavy object
B. Applies an opposing force when the individual puts a joint in flexion or extension
C. Measures the degree of force that it takes to overcome joint flexion or extension
D. Measures the degree of flexion and extension with a goniometer
B. Applies an opposing force when the individual puts a joint in flexion or extension
The knee joint is the articulation of three bones, the:
A femur, fibula, and patella.
B. femur, radius, and olecranon process.
C. fibula, tibia, and patella.
D. femur, tibia, and patella.
D. femur, tibia, and patella.
When assessing an individual for the presence of a herniated nucleus pulposus, which of the following maneuvers would you ask the individual to perform?
A. Raise the legs straight while keeping the knee extended
B. Have the individual bend over and attempt to touch the ground while keeping the legs straight
C. Have the individual do a knee bend
D. Have the individual abduct and adduct the legs while keeping the knee extended
A. Raise the legs straight while keeping the knee extended
Crepitation is an audible sound that is produced by:
A. roughened articular surfaces moving over each other.
B. tendons or ligaments that slip over bones during motion.
C. joints that are stretched when placed in hyperflexion or hyperextension.
D. an inflamed bursa.
A. roughened articular surfaces moving over each other.
Bundles of muscle fibers that compose skeletal muscle are identified as:
A. fasciculi.
B. fasciculations.
C. ligaments.
D. tendons.
A. fasciculi.
Which of the following physiological processes takes place within the musculoskeletal system?
A. Hematopoiesis
B. Hemolysis
C. Hemoptysis
D. Hemianopsia
A. Hematopoiesis
The musculoskeletal system provides which of the following functions to the human body?
A. Protection and storage
B. Movement and elimination
C. Storage and control
D. Propulsion and preservation
A. Protection and storage
A 47-year-old client tells the nurse, "I don't want to develop osteoarthritis like both of my parents." Which of the following can the nurse instruct this client?
A. "Eating a well-balanced diet and regular exercise are the best defense."
B. "Over-the-counter analgesics will help prevent the progression of the disease."
C. "If your parents had the disease, you are at increased risk of developing the disease."
D. "Calcium supplements will prevent the disorder."
A. "Eating a well-balanced diet and regular exercise are the best defense."
A normal degenerative change associated with aging, osteoarthritis can contribute to decreased physical activity. A well-balanced diet and regular exercise help to slow the progression of this change.

The disorder is not related to genetics.

Calcium supplementation will not prevent the development of the disorder.

Over-the-counter analgesics will help with the pain associated with the disease, but will not prevent the progression of the disease.
When performing a straight-leg-raise test, the client complains of sharp pain in the lower back with radiation down one leg. What does this finding indicate?
A. The presence of arthritis in the lumbar spine
B. A herniated disk
C. The presence of synovitis
D. Inflammation of the hip joint
B. A herniated disk
If the client complains of sharp pain that begins in the lower back and radiates down the leg during the straight-leg-raise test, the nurse should record the distribution and severity of the pain and the degree of leg elevation at the time the pain occurs. Pain along the course of the sciatic nerve with the straight-leg-raise test may indicate a herniated disk.

Arthritis of the lumbar spine would not cause symptoms related to pressure on the sciatic nerve.

Inflammation of the hip joint, arthritis, causes localized pain at the hip and does not radiate down the leg.

Synovitis is an effusion within the synovium of the knee resulting in distention of the suprapatellar area and lateral aspects of the knee.
The nurse explains to Mrs. Barber that obese clients have an increased risk for arthritis in weight-bearing joints.
A. True
B. False
A. True
Obesity increases risk for arthritis in weight-bearing joints, therefore the nurse encourages the client to continue to watch her weight. The nurse should encourage the client to continue a regular exercise program according to age and ability to maintain or improve musculoskeletal function.
An eight-month-pregnant female client tells the nurse, "I am okay except I have a backache and I never had a backache before." Which of the following can the nurse instruct the client about this health concern?
A. "This is a normal occurrence and nothing to worry about."
B. "Back pain is often intensified during pregnancy in women who have a history of previous back pain."
C. "As your baby has grown, your center of gravity has shifted, putting pressure on the lower spine."
D. "Weakened abdominal muscles have caused your posture to change."
C. "As your baby has grown, your center of gravity has shifted, putting pressure on the lower spine."
As the pregnancy progresses, lordosis (an inward curvature of the lower spine-sway back) compensates for the enlarging fetus. The center of gravity shifts forward, which strains the lower spine, causing lower back pain.

Weakened abdominal muscles are not the cause of the lordosis.

The development of back pain is common; however, the nurse should not dismiss the client's concern by stating that "there is nothing to worry about."

A previous history of back pain may aggravate the situation; however, this woman does not have a previous history of back pain.
During the assessment of a two-month-old, the nurse flexes the infant's knees and compares the height of the knees. What does this maneuver assess?
A. Tibial torsion
B. Genu valgum
C. Genu varum
D. Allis' sign
D. Allis' sign
Allis' sign is used to detect unequal leg length, which could indicate congenital hip dislocation and should be assessed at every office visit until one year of age. The nurse is positioned at the infant's feet. With the infant supine, the nurse flexes the infant's knees, keeping the femurs aligned, and compares the height of the knees. An uneven height indicates unequal leg length.

Tibial torsion is a curving of the tibias.

Genu valgum (knock knees) is found typically after the age of four and identified when the child walks.

Genu varum (bowlegs) is identified in infants before they learn to walk.
A client is newly diagnosed with osteoarthritis of the spine. The nurse knows that this client has a disease process within the:
A. Synovial joints
B. Fibrous joints
C. Cartilaginous joints
D. Cervical bursae
C. Cartilaginous joints
With osteoarthritis the joint cartilage erodes and typically affects the spine, hips, and knees. Bones joined by cartilage, such as the vertebrae, are called cartilaginous joints.

Bones joined by fibrous tissue, such as the sutures joining the bones of the skull, are called fibrous joints.

Bones separated by a fluid-filled joint cavity are called synovial joints.
Synovial joints are reinforced and strengthened by ligaments. Ligaments are protected by small, synovial fluid-filled sacs called bursae.

Cervical bones do not have bursae.
When performing an assessment on an elderly client, the nurse notes that the client has kyphosis. Which of the following findings did the nurse observe in this client?
A. An exaggerated convex curve of the thoracic spine
B. Decreased bone density
C. A lateral curvature of the spine
D. An exaggerated inward curvature of the lower spine
A. An exaggerated convex curve of the thoracic spine
Kyphosis is an exaggeration of the normal convex curve of the thoracic spine. It may result from congenital abnormality, rheumatic conditions, compression fractures, or other disease processes including syphilis, tuberculosis, and rickets.

Scoliosis is a lateral curvature of the spine.

Lordosis is an exaggeration of the normal lumbar curve of the spine.

Osteoporosis occurs because of decreased bone density. The nurse is not able to observe this during an assessment.
The nurse is assessing a client with carpal tunnel syndrome. When the nurse percusses lightly over the median nerve, the client feels numbness, tingling, and pain along the median nerve. The nurse documents which of the following?
A. Positive thenar atrophy
B. A positive Phalen's test
C. A positive Dupuytren's contracture
D. A positive Tinel's sign
D. A positive Tinel's sign
A positive Tinel's sign is present if there is numbness, tingling, and pain along the median nerve when percussing lightly over the median nerve in each wrist. A positive Tinel's sign is often seen with carpal tunnel syndrome.

A positive Phalen's test is performed in individuals with carpal tunnel syndrome. The wrists are bent downward, pressing the backs of both hands together causing the flexion of the wrists to 90 degrees. Normally clients experience no symptoms with this maneuver. In individuals with carpal tunnel syndrome, this maneuver produces pain, tingling, and numbness that radiates to the arm, shoulder, or neck.

Dupuytren's contracture is not associated with carpal tunnel syndrome. With Dupuytren's contracture, the fourth and fifth fingers are flexed. This is a progressive, painless, inherited disorder that causes severe flexion in the affected fingers, is usually bilateral, and is more common in middle-aged and older males.

Atrophy of the thenar eminence is a common finding with carpal tunnel syndrome; however, it does not cause numbness and tingling.
The nurse is assessing the muscle strength of a client. The client had complete range of motion against gravity with full resistance. What would the nurse record using a 0-5 scale in this situation?
A. 4/5
B. 2/5
C. 5/5
D. 3/5
C. 5/5
Muscle strength is rated on a 0-5 scale (no muscle contraction-normal muscle strength). A rating of 5/5 is considered normal muscle strength, meaning that the client has full range of motion against gravity with full resistance.

2/5 muscle strength is full range of motion without gravity (passive motion).

A rating of 3/5 muscle strength is considered fair and means the client has full range of motion with gravity, but not against resistance.

4/5 muscle strength is documented if the client has full range of motion against gravity with moderate resistance.
A postoperative hip replacement client is prescribed a pillow between the legs. Which position will this pillow serve for the client?
A. Abduction
B. Flexion
C. Pronation
D. Adduction
A. Abduction
Abduction is movement of a limb away from the midline or median plane of the body, along the frontal plane.

Adduction is movement of a limb toward the midline. Pronation and supination refer only to the movements of the radius around the ulna.

In pronation, the palm moves to face downward.

Flexion is a bending movement that decreases the angle of the joint and brings the articulating bones closer together.
The nurse should encourage Mrs. Barber to spend the next several weeks enjoying a sedentary lifestyle because this lifestyle has been found to help clients with arthritis.
A. True
B. False
B. False
Recommend regular exercise according to age and ability to maintain or improve musculoskeletal function. Sedentary lifestyles increase the risk for musculoskeletal complications.
When the nurse assesses Mrs. Barber and finds out that she has had erythematous, hot, swollen, tender fingers and pain with movement, which of the following goals would be the most realistic?
A. The most important goal for Mrs. Barber is to be able to participate in a fast-paced aerobic exercise regimen several times a week.
B. The most important goal for Mrs. Barber is that she will not require any further medication for pain or discomfort associated with her symptoms.
C. The most important goal for Mrs. Barber would be to have an understanding of her disease process and have increased awareness of symptoms associated with arthritis.
D. The most important goal for Mrs. Barber would be to be free of any pain.
C. The most important goal for Mrs. Barber would be to have an understanding of her disease process and have increased awareness of symptoms associated with arthritis.
Increasing the client's awareness about her disease process will allow her to be able to cope with her disease with an understanding of of her symptoms.

This is probably not the most realistic goal for the client, considering how much pain she has been experiencing.

The nurse should set realistic goals for the client. Because the client has been experiencing a great deal of pain in the past few weeks, the nurse should use goals that are more realistic until she feels better.
During the musculoskeletal assessment of a female client, the nurse documents that the client has pain in the muscles and soft tissues around the head, neck, shoulders, and hips. Which of the following disorders do these findings suggest in the client?
A. Systemic lupus erythematosus
B. Gout
C. Fibromyalgia
D. Osteoarthritis
C. Fibromyalgia
Fibromyalgia, classified as a rheumatic disease, is characterized by pain in the muscles and soft tissues that support and surround joints. Pain is experienced in tender points of the head, neck, shoulders, and hips.

With osteoarthritis, the joint cartilage erodes, resulting in pain and stiffness primarily in the spine, knees, and hips.

Systemic lupus erythematosus (SLE) is an autoimmune disease that causes inflammation in joints and other body organs.

Gout is a type of arthritis caused by uric acid crystal deposits in the joints. The deposits cause inflammation, pain, and swelling in the joints, especially the great toe.
During the assessment of a client's shoulder joints, the client shrugs his shoulders and then complains of pain with abduction. What does this finding suggest to the nurse?
A. Osteoarthritis of the joint
B. Possible rotator cuff tear
C. Olecranon bursitis
D. A dislocated shoulder
B. Possible rotator cuff tear
In rotator cuff tears, the client is unable to perform abduction without lifting or shrugging the shoulder. This sign is accompanied by pain, tenderness, and muscle atrophy.

Olecranon bursitis occurs over the olecranon process of the elbow. It s caused by swelling of the bursa and results in swelling of the elbow.

A dislocation of a joint would result in obvious deformity of the area and an inability to move the joint.

Osteoarthritis of the joint causes generalized pain and stiffness of the area.
A client tells the nurse about upper thigh and hip pain when standing too long. Which of the following does this information suggest to the nurse?
A. The client may have some degenerative disease process within the hip.
B. The client may have lumbosacral nerve root irritation.
C. The client may have referred pain from another body region.
D. The client is experiencing paraesthesia.
A. The client may have some degenerative disease process within the hip.
Weight-bearing activities may increase the pain if the client has a degenerative disease of the hip, knees, or vertebrae.

Sensations of burning, tingling, or prickling (paraesthesia) may accompany compression of nerves and blood vessels in a particular body region.

Shoulder pain may be the result of referred pain such as a hiatal hernia or cardiac, gallbladder, and pleural conditions.

Lumbosacral nerve root irritation may cause pain to be felt in the leg.
During the focused musculoskeletal interview, the nurse learns that a client developed osteomyelitis after hip replacement surgery. What does this information suggest to the nurse?
A. The client is at risk for future episodes of bone infections.
B. The client may be more prone to develop osteomalacia.
C. The client is at risk for the development of fractures.
D. The client is more likely to develop osteoarthritis.
A. The client is at risk for future episodes of bone infections.
Osteomyelitis, an infection of the bone, frequently recurs in clients with a history of previous infections.

Individuals with osteomalacia (adult vitamin D deficiency) are more prone to develop multiple fractures of the bone.

The development of osteoarthritis is not related to osteomyelitis.

A previous history of osteomyelitis is not a risk factor for the development of fractures.
When performing an assessment on a client, the nurse notes that the client's great toe deviates laterally from the midline, crowding the other toes and causing marked enlargement of the joint. The nurse documents the presence of which of the following?
A. Hallus valgus
B. Hammertoe
C. Pes planus
D. Genu varum
A. Hallus valgus
Hallux valgus (bunion): The great toe deviates laterally from the midline, crowding the other toes. The metatarsophalangeal joint and bursa become enlarged and inflamed, causing a bunion.

Hammertoe occurs when there is flexion of the proximal interphalangeal joint of a toe, while the distal metatarsophalangeal joint hyperextends. A callus or corn frequently occurs on the surface of the flexed joint from external pressure.

Pes planus (flatfoot) occurs when the arch of the foot is flattened.

Genu varum is the term for bowlegs.
The nurse knows that arthritis affects more than 40% of the adult population.
A. True
B. False
B. False
According to Healthy People 2010, arthritis affects more than 20% of the adult population, instead of more than 40%.
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