NURSING 633 Week 14 – Musculoskeletal (MSK) Answers

Week 14 – Musculoskeletal (MSK) A school-age child falls off a swing and fractures the humerus close to the elbow joint. What is the most important assessment for this patient to evaluate possible complications of this injury? Salter-Harris classification Palpation for joint laxity Evaluation of pain with extension The presence of a spiral fracture A patient has symptoms of carpal tunnel syndrome. Which diagnostic tests will help confirm this disorder? (Select all that apply.) Erythrocyte sedimentation rate Plain radiographs Anti-nuclear antibody Electromyography Nerve conduction studies A 62-year-old female presents with atraumatic right knee pain. On exam, she has mildly swollen right knee that is not warm or tender to touch. She has negative McMurray test. Her x-ray demonstrates tibial femoral joint space narrowing and visualization of osteophytes. How should the nurse practitioner interpret the results of this x-ray? Age-related changes in the knee A Baker's cyst Gouty arthritis Osteoarthritis In the knee, joint space narrowing indicates a loss of articular cartilage and usually worsening osteoarthritis. Osteophytes formed in response to degeneration of cartilage and joints. The McMurray test is commonly used to assess joint motion and meniscal injury. A patient presents with right shoulder pain after an acute shoulder injury yesterday. He fell against a brick wall while working at his home. He reports pain that radiates into his upper arm. How should this be managed? Prescribe physical therapy for the patient Ordered x-ray of the right shoulder Rest, ice, and naproxen for one week Immobilize the right shoulder for 3 days And x-rays generally the initial test used to evaluate trauma that results in acute pain. An x-ray could demonstrate fracture. It would not be helpful for evaluation of most soft tissue injuries. No other intervention is appropriate until fracture and dislocation have been ruled out. An adolescent athlete has injured his ankle playing basketball. He has right ankle pain, ecchymosis, and significant edema, and he is unable to bear weight at the time of the clinical exam. Which diagnosis is least likely? Grade 3 sprain Grade 2 sprain Grade 1 sprain An avulsion fracture A grade 1 sprain results from minimal stretching or small tears in the ligament. There is mild tenderness and edema, and the patient is able to bear weight. A grade 2 sprain is more significant, the clinical signs are more severe stretching and tearing of ligament with moderate pain, edema, tenderness and ecchymosis. Weightbearing is painful but the patient is able to walk. A grade 3 sprain is the most severe, and involves complete tear of the ligament, there is joint instability, severe pain, edema, tenderness, ecchymosis, patients are unable to bear weight due to pain. An adult patient who has been taking high-dose corticosteroids reports a dull, aching pain in the groin and presents with a limp. What condition does the provider suspect, based on this history? Avascular necrosis of the femoral head