Test 4 Outline
1. Know the different types of fractures
A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for:
A. Osteomalacia
B. Pathologic bone fractures
C. Bone infections
D. Joint injuries
A 70-year old female with osteoporosis fractures her leg at a location of preexisting abnormality following a minor
fall. Which of the following best describes the fracture?
A. Pathologic fracture
B. Greenstick fracture
C. Fatigue fracture
D. Stress fracture
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 the location of this fracture?
A. Vertical to the bone shaft
B. Perpendicular across the bone
C. Parallel to the bone
D. Diagonally across the bone
A 32 year old obese male begins a jogging routine. A week after beginning, he fractured his leg. This is referred to
as what type of fracture?
A. Compound
B. Fatigue
C. Comminuted
D. Greenstick
Transchondral fractures are most prevalent in:
a. Adolescents
b. Older adults
c. Infants
d. Premenopausal females
A client is admitted to the hospital with a transverse fracture of the femur. Which statement best describes this
type of fracture?
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.
2. Know the difference between: dislocation, subluxation, distortion, Nonunion.
A 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
A. Dislocation
B. Subluxation
C. Distortion
D. Nonunion
3. Know the differences between: Sprain, Strain, Disunion, Subluxation
A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. This condition
is known as a:
a.Sprain
b.Strain
c.Disunion
d.Subluxation
4. What is rhabdomyolysis, the DX and S/Sx
An important and useful clinical measure in the diagnosis of rhabdomyolysis is measurement of which laboratory
value?
a.White blood cell count
b.Antinuclear antibodies
c.Aspartate aminotransferase
, d.Creatine kinase (CK)
Which of the following clinical findings would be expected in the patient with rhabdomyolysis?
a.Sweating
b.Dark urine
c.Yellow color to the skin
d.Lower extremity swelling
The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is
experiencing flushing, rash, pruritus, and urticaria. The patient’s heart rate is 120 beats per minute, and the blood
pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with:
a. allergic reaction.
b. red man syndrome.
c. rhabdomyolysis.
d. Stevens-Johnson syndrome.
5. Osteoporosis and fractures
A 70-year-old female presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase
in bone:
a.Density
b.Formation
c.Resorption
d.Mineralization
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:
a.Increased androgen levels
b.Decreased estrogen levels
c.Strenuous exercise
d.Excessive dietary calcium
6. What is Osteomalacia, s/sx. tx
An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with
osteomalacia caused by:
a.Collagen breakdown in the bone matrix
b.Excessive bone resorption
c.Crowding of bone marrow by excessive bone growth
d.Inadequate bone mineralization
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?
a.Impaired phosphate absorption
b.Increased calcium excretion
c.Vitamin D deficiency
d.Impaired vitamin C metabolism
A disorder similar to osteomalacia that occurs in growing bones of children is termed:
a.Paget disease
b.Rickets
c.Osteomyelitis
d.Osteosarcoma
Osteomalacia is a result of:
A) collagen breakdown in the bone matrix.
B) excessive bone resorption.
C) crowding of bone marrow by excessive bone
growth. D) inadequate bone mineralization.
7. What is osteomyelitis (causes), s/sx, dx, and treatment
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:
a.Staphylococcus aureus
b.Salmonella
, c.Mycobacterium
d.Haemophilus influenzae
8. What is osteoarthritis, causes, dx, tx
Osteoarthritis, a degenerative joint disease, is characterized by loss of:
a) the epiphyses.
b) articular cartilage.
c) synovial fluid.
d) the joint capsule.
A nurse is providing medication teaching for a patient who will begin taking diclofenac[Voltaren] gel for
osteoarthritis in both knees and elbows. Which statement by the patient indicates understanding of the teaching?
a. “Because this is a topical drug, liver toxicity will not occur.”
b. “I should cover areas where the gel is applied to protect them from sunlight.”
c. “I will apply equal amounts of gel to all affected areas.”
d. “The topical formulation has the same toxicity as the oral formulation.”
9. What is rheumatoid arthritis (RA) causes, dx, tx
A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA). Which of the following is the expected
treatment of choice?
a.Nonsteroidal anti-inflammatory drugs (NSAIDs)
b.Gold salts
c.Methotrexate
d.Hydroxychloroquine
Researchers now believe that RA is:
a.Curable with antiviral agents
b.An autoimmune disease
c.A complication of rheumatic fever
d.Related superficial joint injury
A 34-year-old female was recently diagnosed with RA. Physical examination revealed that inflammation started in
the:
a.Synovial membrane
b.Articular cartilage
c.Subchondral bone
d.Surrounding ligaments
A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin
glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information?
a. “By reducing inflammation, this drug will slow the progression of your disease.”
b. “Glucocorticoids are used as adjunctive therapy during acute flare-ups.”
c. “Oral glucocorticoids cause less toxicity than intra-articular injections.”
d. “You may resume running when the pain and swelling improve.”
A patient who has been diagnosed with rheumatoid arthritis (RA) for 1 month and has generalized symptoms is
taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) and an oral glucocorticoid. The provider has
ordered methotrexate [Rheumatrex]. The patient asks the nurse why methotrexate is necessary since pain and
swelling have been well controlled with the other medications. The nurse will tell the patient that:
a. a methotrexate regimen can reduce overall costs and side effects of treatment.
b. starting methotrexate early can help delay joint degeneration.
c. starting methotrexate now will help increase life expectancy.
d. with methotrexate, doses of NSAIDs can be reduced to less toxic levels
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis.The nurse will teach
this patient about the importance of:
a. having routine renal and hepatic function tests.
b. limiting folic acid consumption.
c. reporting alopecia and rash.
d. taking the medication on a daily basis.
A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently
taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient?
a. That an eye exam is necessary at the beginning of therapy with this drug
b. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine
1. Know the different types of fractures
A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for:
A. Osteomalacia
B. Pathologic bone fractures
C. Bone infections
D. Joint injuries
A 70-year old female with osteoporosis fractures her leg at a location of preexisting abnormality following a minor
fall. Which of the following best describes the fracture?
A. Pathologic fracture
B. Greenstick fracture
C. Fatigue fracture
D. Stress fracture
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 the location of this fracture?
A. Vertical to the bone shaft
B. Perpendicular across the bone
C. Parallel to the bone
D. Diagonally across the bone
A 32 year old obese male begins a jogging routine. A week after beginning, he fractured his leg. This is referred to
as what type of fracture?
A. Compound
B. Fatigue
C. Comminuted
D. Greenstick
Transchondral fractures are most prevalent in:
a. Adolescents
b. Older adults
c. Infants
d. Premenopausal females
A client is admitted to the hospital with a transverse fracture of the femur. Which statement best describes this
type of fracture?
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.
2. Know the difference between: dislocation, subluxation, distortion, Nonunion.
A 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
A. Dislocation
B. Subluxation
C. Distortion
D. Nonunion
3. Know the differences between: Sprain, Strain, Disunion, Subluxation
A 12-year-old female hurts her ankle while playing basketball. Tests reveal that she tore a ligament. This condition
is known as a:
a.Sprain
b.Strain
c.Disunion
d.Subluxation
4. What is rhabdomyolysis, the DX and S/Sx
An important and useful clinical measure in the diagnosis of rhabdomyolysis is measurement of which laboratory
value?
a.White blood cell count
b.Antinuclear antibodies
c.Aspartate aminotransferase
, d.Creatine kinase (CK)
Which of the following clinical findings would be expected in the patient with rhabdomyolysis?
a.Sweating
b.Dark urine
c.Yellow color to the skin
d.Lower extremity swelling
The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is
experiencing flushing, rash, pruritus, and urticaria. The patient’s heart rate is 120 beats per minute, and the blood
pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with:
a. allergic reaction.
b. red man syndrome.
c. rhabdomyolysis.
d. Stevens-Johnson syndrome.
5. Osteoporosis and fractures
A 70-year-old female presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase
in bone:
a.Density
b.Formation
c.Resorption
d.Mineralization
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:
a.Increased androgen levels
b.Decreased estrogen levels
c.Strenuous exercise
d.Excessive dietary calcium
6. What is Osteomalacia, s/sx. tx
An 80-year-old male presents with skeletal pain and tenderness, especially in the hips. He is diagnosed with
osteomalacia caused by:
a.Collagen breakdown in the bone matrix
b.Excessive bone resorption
c.Crowding of bone marrow by excessive bone growth
d.Inadequate bone mineralization
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?
a.Impaired phosphate absorption
b.Increased calcium excretion
c.Vitamin D deficiency
d.Impaired vitamin C metabolism
A disorder similar to osteomalacia that occurs in growing bones of children is termed:
a.Paget disease
b.Rickets
c.Osteomyelitis
d.Osteosarcoma
Osteomalacia is a result of:
A) collagen breakdown in the bone matrix.
B) excessive bone resorption.
C) crowding of bone marrow by excessive bone
growth. D) inadequate bone mineralization.
7. What is osteomyelitis (causes), s/sx, dx, and treatment
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:
a.Staphylococcus aureus
b.Salmonella
, c.Mycobacterium
d.Haemophilus influenzae
8. What is osteoarthritis, causes, dx, tx
Osteoarthritis, a degenerative joint disease, is characterized by loss of:
a) the epiphyses.
b) articular cartilage.
c) synovial fluid.
d) the joint capsule.
A nurse is providing medication teaching for a patient who will begin taking diclofenac[Voltaren] gel for
osteoarthritis in both knees and elbows. Which statement by the patient indicates understanding of the teaching?
a. “Because this is a topical drug, liver toxicity will not occur.”
b. “I should cover areas where the gel is applied to protect them from sunlight.”
c. “I will apply equal amounts of gel to all affected areas.”
d. “The topical formulation has the same toxicity as the oral formulation.”
9. What is rheumatoid arthritis (RA) causes, dx, tx
A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA). Which of the following is the expected
treatment of choice?
a.Nonsteroidal anti-inflammatory drugs (NSAIDs)
b.Gold salts
c.Methotrexate
d.Hydroxychloroquine
Researchers now believe that RA is:
a.Curable with antiviral agents
b.An autoimmune disease
c.A complication of rheumatic fever
d.Related superficial joint injury
A 34-year-old female was recently diagnosed with RA. Physical examination revealed that inflammation started in
the:
a.Synovial membrane
b.Articular cartilage
c.Subchondral bone
d.Surrounding ligaments
A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin
glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information?
a. “By reducing inflammation, this drug will slow the progression of your disease.”
b. “Glucocorticoids are used as adjunctive therapy during acute flare-ups.”
c. “Oral glucocorticoids cause less toxicity than intra-articular injections.”
d. “You may resume running when the pain and swelling improve.”
A patient who has been diagnosed with rheumatoid arthritis (RA) for 1 month and has generalized symptoms is
taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) and an oral glucocorticoid. The provider has
ordered methotrexate [Rheumatrex]. The patient asks the nurse why methotrexate is necessary since pain and
swelling have been well controlled with the other medications. The nurse will tell the patient that:
a. a methotrexate regimen can reduce overall costs and side effects of treatment.
b. starting methotrexate early can help delay joint degeneration.
c. starting methotrexate now will help increase life expectancy.
d. with methotrexate, doses of NSAIDs can be reduced to less toxic levels
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis.The nurse will teach
this patient about the importance of:
a. having routine renal and hepatic function tests.
b. limiting folic acid consumption.
c. reporting alopecia and rash.
d. taking the medication on a daily basis.
A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently
taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient?
a. That an eye exam is necessary at the beginning of therapy with this drug
b. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine
