RN Musculoskeletal system EAQ 2022

Why is Phalen’s test performed in a client? To diagnose atrophy To diagnose bone tumor To detect rotator cuff injuries To detect carpal tunnel syndrome A client injures an amphiarthrodial joint. Which joint did the client injure? Knee joint Pelvic joint Elbow joint Cranial joint A client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. What is the most appropriate nursing response? "Your primary healthcare provider must have forgotten to prescribe it." "Your condition is not severe enough to have physical therapy approved." "Your joints are still inflamed, and physical therapy can be harmful." "Physical therapy is not helpful for persons who suffer from RA." A nurse is providing postoperative teaching to a client who is scheduled to have an above-theknee amputation. The client will use crutches during the postoperative period. Which activity will prepare the client for crutch walking? Lifting weights Changing bed positions Caring for the residual limb Performing phantom limb exercises A nurse is caring for a client with a below-the-knee amputation. What should the nurse encourage the client to do to prepare the residual limb for a prosthesis? Abduct the residual limb when ambulating. Dangle the residual limb off the bed frequently. Soak the residual limb in warm water twice a day. Press the end of the residual limb against a pillow periodically. Which diagnostic study is used to investigate the cause of an inflamed joint and determines a client’s response to antiinflammatory drug therapy? Duplex venous Doppler Plethysmography Thermography Somatosensory evoked potential Which joint in the human body is an example of a condyloid joint? Wrist joint Elbow joint Shoulder joint Sacroiliac joint Non–weight bearing with crutches has been prescribed for a client with a leg injury. The nurse provides teaching before ambulation is begun. To facilitate walking with crutches, what is the most important activity the nurse should teach the client? Sit up in a chair to help strengthen back muscles. Keep the unaffected leg in extension and abduction. Exercise the triceps, finger flexors, and elbow extensors. Use a trapeze frequently to strengthen the biceps muscles. What is the nurse’s primary consideration when caring for a client with rheumatoid arthritis? Surgery Comfort Education Motivation Which ethnic group has a greater incidence of osteoporosis due to musculoskeletal differences? Irish Americans African Americans Chinese Americans Egyptian Americans The school nurse is attending to a student athlete who reports muscle pain after a practice session. Which should the nurse identify as a cause of this pain when providing instruction to the student? Lactic acid Acetoacetic acid Hydrochloric acid Beta-hydroxybutyric acid Which type of bone tumor is commonly seen in elderly clients? Endochroma Osteosarcoma Chondrosarcoma Osteochondroma Which is the first line treatment for Paget disease? Oral alendronate 1500 mg of calcium Intravenous pamidronate Intravenous zoledronic acid After an amputation of a limb, a client begins to experience extreme discomfort in the area where the limb once was. What is the nurse’s greatest concern at this time? Addressing the pain Reversing feelings of hopelessness Promoting mobility in the residual limb Acknowledging the grieving for the lost limb Which joint permits movement in any direction? Pivot joint Hinge joint Biaxial joint Ball-and-socket joint Which radiographic test is used to view the entire skeleton? Bone scan Gallium and thallium scan Computed tomography (CT) Magnetic resonance imaging (MRI) scan The primary healthcare provider prescribes one unit of packed red blood cells to be administered to the client who suffered a hip fracture. Several minutes after the start of the infusion, the client reports itching. Upon further assessment, the nurse observes hives on the client’s chest. Which action should the nurse take next? Call the primary healthcare provider to obtain a prescription for an antihistamine. Flush packed red blood cells with 5% dextrose and 0.45% normal saline. Slow down the rate of the infusion. Stop the transfusion immediately. Which term should the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? Osteopenia Osteomyelitis Osteomalacia Osteoarthritis Which diagnostic test is used for the direct visualization of ligaments, menisci, and articular surfaces of joints? Arthroscopy Muscle biopsy Ultrasonography Electromyography Which condition is characterized by infection of a client’s bone or bone marrow? Osteomalacia Osteomyelitis Herniated disc Spinal stenosis A home care nurse is visiting a client who had a below-the-knee amputation. Which client statement indicates to the nurse that further teaching is needed? "At night, I sleep with a pillow under my knees." "When I sit in a chair, I put my legs out straight on an ottoman." "I apply a firm, even bandage around the end of my affected leg every day." "I press the end of my affected leg against a soft surface several times during the day." Which diagnostic scan is used to detect diffuse or localized muscle weakness? Arthroscopy Radiography Myelography Electromyography When providing discharge teaching to a client who had a total hip replacement, what should the nurse instruct the client to avoid? Climbing stairs Stretching exercises Sitting in a low chair Lying prone for more than 15 minutes Which estrogen antagonist is specifically used to prevent and treat osteoporosis in postmenopausal women? Raloxifene Denosumab Alendronate Zoledronic acid The nurse is providing discharge teaching to a 30-year-old client who was hospitalized for exacerbation of rheumatoid arthritis. Which statement by the client indicates correct understanding of the treatment plan? "I will plan to rest in bed for the next 2 weeks." "I will only take my medications when I am having joint pain." "When I exercise, I will reduce the number of repetitions when I have pain." "When I get out of bed, I will push off with my fingers rather than the palms of my hands." Which musculoskeletal system change is associated in older adult clients? Decreased in height Decreased neck rigidity Increased fine-motor dexterity Increased range of motion (ROM) After surgery for a fractured hip, a client states, "I don’t remember when I have ever been so uncomfortable." What should the nurse’s initial response be? Notify the primary healthcare provider. Use distraction techniques. Medicate the client as prescribed. Perform a complete pain assessment. Which joint helps in the gliding movement of the wrist? Pivot joint Hinge joint Biaxial joint Ball and socket joint Which type of cast will the nurse be caring for in a child with a fractured femur? Cylinder Hip spica Prefabricated knee Robert Jones After becoming incontinent of urine, an older client is admitted to a nursing home. The client’s rheumatoid arthritis contributes to severely painful joints. Which need is the primaryconsideration in the care of this client? Control of pain Immobilization of joints Motivation and teaching Bladder training and control Which disorder of the foot is caused by continual pressure over bony prominences? Corn Plantar wart Hammer toe Hallux rigidus According to the common scale for grading muscle strength, what rating will be given to a client who can complete range of motion with some resistance? 1 2 3 4 Which hormone aids in regulating intestinal calcium and phosphorous absorption? Insulin Thyroxine Glucocorticoids Parathyroid hormone Which structure protects a client’s internal organs, supports blood cell production, and stores minerals? Joints Bones Muscles Cartilages A client who is receiving radiation therapy for bone cancer lives alone and works full time. What should the nurse encourage this client to do? Perform regularly scheduled aerobic activity daily. Take a leave of absence from work when receiving therapy. Include rest periods during the day while receiving radiation. Continue the activities usually performed before becoming ill. Which synovial joint movement is described as turning the sole outward away from the midline of the body? Pronation Eversion Adduction Supination Which nursing intervention prevents footdrop in a client with osteomyelitis? Elevating the foot with the use of pillows Consistently flexing the affected extremity Encouraging the client to change positions Neutral positioning of the foot with the use of a splint What is a goniometer used for? To assess range of motion To reduce phantom limb sensation To prevent hip flexion contractures To immobilize a joint during fracture Which hormone increases the rate of protein synthesis in a client? Estrogen Thyroxine Parathormone Vitamin D A client falls at home and is brought to the emergency department by family members. The client reports intercostal pain and is confused and disoriented. Which is the best way for the nurse to determine whether this behavior is new for the client? Interview the client to identify when the confusion started. Question the family members about the client’s usual behavior. Ask the primary healthcare provider when the confusion was noted first. Observe the client for a few hours before determining the onset of confusion. The nurse is preparing to initiate intravenous antibiotic therapy for a client who developed an infection along the incision after having a total knee replacement. Before starting the first dose of intravenous antibiotics, which task should the nurse ensure has been completed? Red blood cell count Wound culture Knee x-ray Urinalysis Which term should the nurse use to describe synovial joint movement that moves away from the midline of the body? Inversion Extension Pronation Abduction An older female client is seen in the primary healthcare provider’s office. Upon initial nursing assessment the nurse notes the client’s height has decreased by 1 inch (2.5 cm) since the last visit 1 year ago. The nurse knows that what is the mostlikely reason for this finding? The nurse was in error. Older adults are not active enough so they lose bone mass. Older adults have poor posture so they are shorter. Older adults may have osteoporosis-related height changes. Three days after a cast is applied to a client’s fractured tibia, the client reports that there is a burning pain over the ankle. The cast over the ankle feels warm to the touch, and the pain is not relieved when the client changes position. What is the nurse’s priority action? Obtain a prescription for an antibiotic. Report the client’s concern to the primary healthcare provider. Administer the prescribed medication for pain. Explain that this is typical after a cast is applied. A client with pain and paresthesia of the left leg is scheduled for an electromyogram. What should the nurse discuss with the client before the test is performed? Bed rest must be maintained after the procedure. The involved area will be shaved before the procedure. Needles will be inserted into the affected muscles during the test. Monitoring of the heart rate and rhythm will be done throughout the test. A client with a history of a herniated nucleus pulposus is scheduled for total hip replacement surgery. To prevent the most common complication associated with this type of surgery, the nurse should instruct the client to perform which activity? Straight-leg raises Buerger-Allen exercises Deep breathing and coughing Plantar flexion and dorsiflexion exercises A nurse is assessing a client with a cast to the extremity. Which assessment finding is the priority? Warmth Numbness Skin desquamation Generalized discomfort Which clinical manifestation can a client experience during a fat embolism syndrome (FES)? Nausea Dyspnea Orthopnea Paresthesia Which instrument is the nurse using in this image? Arthroscope Orthoses Goniometer External fixator Which treatment is beneficial for a client with muscle spasm? Thermotherapy Muscle massage Frequent position changes Muscle-strengthening exercise regimen The nurse is providing postoperative care to a client who had surgery in which a hip prosthesis was inserted. An abductor splint is in place. When should the nurse remove the splint? When the client gets up to sit in a chair If the client needs a change of position Once the client’s edema and pain have ceased During the client’s skin care and physical therapy A client has injured a short bone. Which is an example of a short bone? Tibia Femur Tarsals Humerus Which factor may cause a client neck pain? Headache Poor posture Low body weight Sedentary lifestyle A client sustains a fractured right femur after an automobile accident and is admitted to the hospital’s emergency department. Which assessment is the priority? Turn the client to the side-lying position. Take the client’s pedal pulse in the affected extremity. Instruct the client to wiggle the toes of the right foot. Ask the client if numbness or tingling is present in the right foot. A nurse performs full range-of-motion exercises on a client’s extremities. When putting an ankle through range-of-motion exercises, what must the nurse perform? Flexion, extension, and rotation Abduction, flexion, adduction, and extension Pronation, supination, rotation, and extension Dorsiflexion, plantar flexion, eversion, and inversion A client who had an above-the-knee amputation (AKA) has a pressure dressing on the end of the residual limb. The client asks, "Why do I have to have this tight dressing on my leg?" Which answer by the nurse is correct? "It decreases the swelling of the area." "It decreases the formation of scar tissue." "It prevents the formation of blood clots." "It reduces phantom limb pain." What are examples of a client’s flat bones? Select all that apply. Sacrum Scapula Sternum Humerus Mandible Which child is at the highest risk for blunt trauma associated with the indirect entry (hematogenous stage) of microorganisms? 8-year-old boy 10-year-old girl 13-year-old girl 14-year-old boy The nurse is caring for a client with rheumatoid arthritis. When should the nurse expect the client to experience the most pain and limited movement of the joints? After assistive exercise When the room is cool During the evening hours In the morning on awakening Which individual is at risk of developing carpal tunnel syndrome? Housekeeper Software engineer Healthcare worker Professional athlete Which diagnostic study is used to detect deep vein thrombosis in the client’s lower extremities? Thermography Plethysmography Duplex venous doppler Somatosensory evoked potential Which structure connects the client’s tibia to the femur at the knee joint? Fascia Bursae Tendons Ligaments A client who has paraplegia often loses calcium from the skeletal system. The nurse concludes that what factor contributes to calcium loss in this client? Decreased activity Inadequate fluid intake Decreased calcium intake Inadequate kidney function An x-ray film indicates that an older client has a fractured femur. The client asks the nurse, "Will I be able to walk again?" What is the best response by the nurse? "I have no idea because only time will tell." "You only broke a bone. It could have been worse." "You’ll walk again. This is a common issue in older people." "Tell me more about your concerns about being able to walk." While caring for a client with a second-degree left ankle sprain, a nurse raises the injured part above heart level. What is the reason behind this nursing intervention? To promote bone density To prevent further edema To reduce pain perception To increase muscle strength In the postanesthesia care unit after a below-the-knee amputation, a client begins crying after feeling for the affected lower leg. How should the nurse respond? Administer medication to induce sleep. Allow the client to ventilate feelings of loss. Provide time for privacy by leaving the room. Do not address the behavior until the client is more alert. A client with rheumatoid arthritis asks the nurse about ways to decrease morning stiffness. What should the nurse suggest? Wearing loose but warm clothing Planning a short rest break periodically Avoiding excessive physical stress and fatigue Taking a hot tub bath or shower in the morning Which joint in the client’s body is an example of a gliding joint? Wrist Elbow Shoulder Sacroiliac A client has had a below-the-knee amputation of the leg. What is important for the nurse to consider when providing postoperative care for a client who had an amputation of a lower extremity? Strict bed rest is maintained for at least several days. The residual limb should not be elevated for the first 24 hours. Hemorrhage rarely occurs during the early postoperative period. Primary healthcare providers usually change the dressing on the residual limb within 48 hours. A nurse is caring for a client who will have a below-the-knee amputation with an immediate postoperative prosthesis. The client asks the nurse the advantage of having an immediate prosthesis. What should the nurse explain is the advantage? Decreases phantom limb sensations Encourages a normal walking pattern Reduces the incidence of wound infection Allows for fitting of the prosthesis before discharge A client who is scheduled for a muscle biopsy tells the nurse, "They better give me a general anesthetic. I don’t want to feel anything." Which is the most therapeutic initial response by the nurse? "You seem to be worried about the test." "This test is done under local anesthesia." "Tell them when you have pain so they can take care of it." "You probably will not have pain so try not to think about it." A client with a distal femoral fracture has a long leg cast applied. Which important element of a discharge program should the nurse focus on when teaching crutch-walking? Establishing a schedule for pain medication Maintaining a fixed schedule of daily activities Modifying the home environment to prevent accidents Understanding that a more sedentary lifestyle is necessary While awaiting the biopsy report before removal of a bone tumor, the client reports being afraid of a diagnosis of cancer. How should the nurse respond? "Worrying is not going to help the situation." "Let’s wait until we hear what the biopsy report says." "It is very upsetting to have to wait for a biopsy report." "Operations are not performed unless there are no other options." A nurse is caring for a client who just had an above-the-knee amputation. Which is the key factor in assessing how the client will cope with the body image change? Extent of the change Suddenness of the change Obviousness of the change Personal perception of the change A registered nurse (RN) is giving home care instructions to a client who was treated for injuries due to a fall. Which statement made by the client indicates a need for correction? pA registered nurse (RN) is giving home care instructions to a client who was treated for injuries due to a fall. Which made by the client indicates a need for correction?/p "I should walk on scatter rugs at home." "I should drink 3000 mL of water every day." "I should eat fruits and vegetables six times a day." "I should exercise the joints above and below the cast daily." Which hormones are involved in building and maintaining healthy bone tissue? Select all that apply. Insulin Thyroxine Glucocorticoids Growth hormone Parathyroid hormone Which bursae are found between the client’s elbow and the skin? Olecranon Prepatellar Subacromial Trochanteric Which principle should the nurse consider when assisting a client with crutches to learn the fourpoint gait? Elbows should be kept in rigid extension. Most of the weight should be supported by axillae. The client must be able to bear weight on both legs. The affected extremity should be kept off the ground. The nurse is caring for a client who is 1 day postoperative for a left hip fracture repair. During the assessment, which finding should the nurse assess further? Pain at the surgical site Small amount of serosanguinous drainage Decreased range of motion to the left extremity Sudden shortness of breath A client returns from surgery after a right below-the-knee amputation with the residual limb elevated on a pillow to prevent edema. In which position should the nurse place the client after the first postoperative day? With the residual limb immobilized Turn client to prone position at least three times a day For short periods in the right side-lying position With the residual limb elevated for a total of three days X-ray films reveal that a client has closed fractures of the right femur and tibia. In addition, multiple soft-tissue contusions are present. Which action is most important for the nurse to take? Perform a neurovascular assessment of the extremity. Reassure the client that these injuries are not that serious. Gather equipment needed for the application of skeletal traction. Prepare the client for a surgical reduction of the injured extremity. A client with arthritis reports receiving several dietary suggestions over the years. Which recommendation for a daily diet should the nurse reinforce? Wheat germ and yeast Yogurt and blackstrap molasses Multiple vitamin supplements in large doses Adequate foods in a variety of different food groups Which factor does the nurse consider most likely contributes to the increased incidence of hip fractures in older adults? Carelessness Fragility of bone Sedentary existence Rheumatoid diseases A 90-year-old resident of a nursing home falls and fractures the proximal end of the right femur. The surgeon plans to reduce the fracture with an internal fixation device. What general fact about the older adult should the nurse consider when caring for this client? Aging causes a lower pain threshold. Physiologic coping defenses are reduced. Most confused states result from dementia. Older adults psychologically tolerate changes well. Which physiologic changes of the musculoskeletal system are related to aging? Select all that apply. Slowed movement Cartilage degeneration Increased bone density Increased range of motion Increased bone prominence What does grade 3 indicate according to the muscle-strength scale? Active movement against gravity and some resistance Active movement of body part with elimination of gravity Active movement against full resistance without evident fatigue Active movement against gravity only and not against resistance The x-ray report of a client shows the presence of a greenstick fracture. What is a greenstick fracture? A fracture with more than two fragments An incomplete fracture with one side bent A spontaneous fracture at the site of bone disease A fracture that extends across the longitudinal axis of the bone shaft Which type of joint is present in the client’s shoulders? Pivotal Saddle Condyloid Spheroidal A client reports burning sensation and sharp pain on the sole of a foot. Which condition does the nurse suspect in the client? Torticollis Pes planus Crepitation Plantar fasciitis Which term should the nurse use to describe a flat, poorly defined mass on the sole over a bony prominence caused by pressure? Plantar wart Callus Ingrown nail Hypertrophic ungual labium One week after an above-the-knee amputation, a client refuses to go to physical therapy and tells the nurse, "I’ll never be a whole person again!" What is the nurse’s best response? "You’re still the same person you’ve always been. Just relax." "You’ve lost a part of yourself. That must be very difficult for you." "You may feel that way, but I’m sure your family considers you a whole person." "You must go to physical therapy every day or you will develop muscle contractures." A client with terminal bone cancer is to receive 2 mg of hydromorphone intravenously (IV) every 4 hours as needed for severe breakthrough pain. The vial contains 10 mg/mL. When the client reports severe pain, how much solution of hydromorphone should the nurse administer? Record your answer using one decimal place. Include a leading zero if applicable. 0.2 During a follow-up visit, a nurse finds that flexion contractures have developed in a client with osteoarthritis (OA). Which factor may have led to this condition? Wearing shoes without insoles Elevating the legs 8 to 12 inches Using large pillows under the knees or head Placing a small pillow under the head in the supine position A client with an above-the-knee amputation asks why the residual limb needs to be wrapped with an elastic bandage. The nurse explains the purpose is to do what? Limit the formation of blood clots. Decrease the phantom limb sensation. Prevent hemorrhage and cover the incision. Support the soft tissue and minimize swelling. An older client experiences urinary frequency and nocturia. While ambulating, the client develops severe back pain and is found to have a vertebral compression fracture. When planning care, the nurse will focus interventions on which type of fracture? Collapse of vertebral bodies Demineralization of the spinal cord Wear and tear of the spinous processes Bulging of the spinal cord from the vertebra After an amputation, the client’s residual limb is bandaged snugly throughout the postoperative period. Which goal should the nurse identify as the primary reason for this intervention? Promoting shrinkage Preventing injury to the area Preventing suture line infection Promoting drainage of secretions A client had an above-the-knee amputation of the left leg because of trauma from a motor vehicle collision. The primary healthcare provider prescribes ambulation with crutches until the residual limb is healed and the client can be fitted with a prosthesis. What should be the nurse’s initial action? Demonstrate the swing-through crutch walking gait. Determine whether the client has ever used crutches before. Introduce the client to another client who is using crutches. Provide a pamphlet that has information about using crutches. A client sustains a back injury after falling 20 feet (6 m). In which position should the nurse place the client? Lateral position with a pillow between the knees Any position that reduces pain and is comfortable Supine position while not allowing the spine to flex Sitting position with a pillow placed in the small of the back The nurse is reviewing the blood test reports of a child whose blood sample was tested after receiving a general anesthetic. The nurse finds that the client has increased intracellular calcium levels. What medication would be beneficial to the client? Aspirin (Anacin) Naproxen (Aleve) Ibuprofen (Advil) Dantrolene (Dantrium) client with dementia is admitted with a fractured hip after a fall at home. The client’s family member witnessed the fall. Four hours after admission, the client’s blood pressure increases to a moderately severe hypertensive level. The client pulls on the bedclothes continuously. The client’s family member asks for pain medication for the client. What does the nurse concludes? The client has the need to go to the bathroom. The client may be in pain and unable to respond appropriately. The family member may be trying to keep the client overmedicated. The family member feels guilty about the fall and wants to keep the client pain free. A client with a fractured head of the right femur and osteoporosis is placed in Buck extension before surgical repair. What should the nurse do when caring for this client until surgery is performed? Remove the weights from the traction every 2 hours to promote comfort. Turn the client from side to side every 2 hours to prevent pressure on the coccyx. Raise the knee gatch on the bed every 2 hours to limit the shearing force of traction. Assess the circulation of the affected leg every 2 hours to ensure adequate tissue perfusion. To reduce a fracture of the hip, a client is placed in Buck traction before surgery. Because the client keeps slipping down in bed, increased countertraction is prescribed. What should the nurse do to increase countertraction? Add more weight to the traction. Elevate the head of the client’s bed. Use a slight Trendelenburg position. Apply a chest restraint around the client. A client with osteoporosis is prescribed raloxifene. What should the nurse monitor in the client? pA client with osteoporosis is raloxifene. What should the nurse monitor in the client?/p Check serum creatinine Monitor urinary calcium Monitor liver function tests Observe for anxiety and drowsiness While assessing the health of a 69-year-old client, the nurse finds an age-related change. Which finding in the client supports the nurse's conclusion? Big eyes, wide open Presence of facial hair A bruise on the elbow Walking with neck bent forward The medical history of a client with osteoporosis indicates renal calculi. Which medication would be contraindicated? Os-cal Raloxifene Ibandronate Zoledronic acid A nurse is caring for a client with rheumatoid arthritis. Based on the client’s diagnosis, the nurse should review the result of which laboratory test? Pancreatic lipase Bence Jones protein Antinuclear antibody Alkaline phosphatase A client had a cerebrovascular accident (also known as a "brain attack"), and bed rest is prescribed. What can the nurse use to best prevent footdrop in this client? Splints Blocks Cradles Sandbags A client with osteomyelitis has a slow rate of healing. Which factors can contribute to reduced healing in the client? Select all that apply. Diabetes Cataract Smoking Dermatitis Alcoholism A client returns to work as a carpenter after surgery for carpal tunnel syndrome of the right hand. What instructions should the nurse give to help prevent further problems with the hands when the client returns to work? "Avoid carrying tools with the arms." "Learn to hammer with the left hand." "Do stretching exercises during breaks." "Avoid power tools such as cordless screwdrivers." The nurse is caring for a client with a long leg cast. Which clinical findings indicate compromised circulation? Select all that apply. Foul odor Swelling of the toes Drain