Chapter 37, Musculoskeletal Trauma
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. For which reason is a dual energy x-ray absorptiometry scan used for a client with a musculoskeletal
disorder?
1.
It detects soft tissue abnormalities.
2.
It identifies stress fractures and bony metastases.
3.
It determines mechanical derangement of the knee joint.
4.
It visualizes the bone mineral density (BMD) of the hip and vertebrae.
2. While assessing a client with a musculoskeletal disorder, the nurse abducts the client’s arm to 90
degrees and places anteriorly directed force on the posterior humeral head from behind. Which test
is the nurse performing?
1.
Hawkins test
2.
Relocation test
3.
Apprehension test
4.
Neer impingement test
3. While teaching a group of student nurses about different types of fractures, the nursing instructor
says, “This fracture is characterized by the crushing of cancellous bone.” Which type of fracture
is the nursing instructor describing?
1.
Complete
2.
Transverse
3.
Comminuted
4.
Compression
4. When assessing a client’s muscle strength using the Lovett scale, the nurse finds the client has no
joint motion with palpable contraction of the muscle. Which grade does the nurse assign to the
client based on this finding?
1.
Fair
2.
Poor
3.
Good
4.
Trace
5. The nurse is providing care for a client with a bone fracture. Which cells does the nurse identify as
being involved in the healing of a bone?
1.
Osteoblasts
2.
Osteocytes
3.
Osteoclasts
4.
Osteoprogenitor cells
6. The nurse is reviewing the medical record of a client. Which physiological disorder does the nurse
recognize with a medical diagnosis of adhesive capsulitis?
1.
Bursitis
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Company
, 2.
Plantar fasciitis
3.
Frozen shoulder
4.
Carpal tunnel syndrome
7. The nurse is performing a physical examination on a client with a suspected musculoskeletal
disorder. Which is the first nursing intervention performed during the examination?
1.
Testing sensation using perception
2.
Measuring muscle girth for symmetry
3.
Evaluating peripheral vascular integrity
4.
Assessing general appearance, contour, and symmetry
8. A client reports pain and immobility of the wrist. On assessment, the nurse finds decreased range of
motion (ROM), edema, and ecchymosis of the distal radius. The health-care provider recommends
a neurovascular examination for confirmation. Which information does the nurse expect to infer
from these findings?
1.
The client has a Smith fracture.
2.
The client has a Colles fracture.
3.
The client has a clavicle fracture.
4.
The client has a greenstick fracture.
9. The nurse is providing client teaching about treatment needed for a grade 2 ankle sprain. Which type
of acute treatment does the nurse teach to the client?
1.
Rest, ice, compression, and elevation (RICE)
2.
Immobilization
3.
Protect, rest, ice, compression, and elevation (PRICE)
4.
Physical therapy
10. A client presents with a swollen left thigh and a lower extremity that appears shortened. Which is the
client’s most likely condition recognized by the nurse?
1.
Greenstick femur shaft fracture
2.
Impacted femur shaft fracture
3.
Incomplete femur shaft fracture
4.
Transverse femur shaft fracture
11. When assessing a client with a musculoskeletal disorder, the nurse finds lack of sensation in the
dermatome areas of the lower extremity L5. The nurse suspects lumbar sprain/strain. Which does
the nurse expect the health-care provider to prescribe in this situation?
1.
Anticoagulant therapy
2.
IV injection of muscle relaxants
3.
X-ray and dual energy x-ray absorptiometry scan of the spine
4.
Anteroposterior and lateral x-rays of the lumbar spine
12. The nurse is preparing to discharge a client to a rehabilitation facility after a total hip replacement
because of a hip fracture. Which summary of the client’s hospitalization best indicates adequate
nursing care?
1.
Lack of infection
2.
Decreasing levels of pain
Copyright © 2020 F. A. Davis
Company
, 3.
Obtained mobility with a walker
4.
Absence of pulmonary complications
13. The nurse is providing care for a client with a lower extremity fracture immobilized by a cast. Which
complication does the nurse identify if assessment reveals tissue ischemia, functional impairment,
and pain level disproportionate to the injury?
1.
Horner syndrome
2.
Cauda equina syndrome
3.
Compartment syndrome
4.
Carpal tunnel syndrome
14. In order to maintain a high level of understanding about skeletal muscles, the nurse reviews anatomy
and physiology concepts. Which recall of information indicates the effectiveness of the nurse’s
review?
1.
The thick filaments of sarcomeres are made up of a protein called actin.
2.
The thin filaments of sarcomeres are made up of a protein called myosin.
3.
The fascicles contain 10 to 30 muscle fibers encased in connective tissue called
epimysium.
4.
The individual muscle fibers of skeletal muscle are arranged in bundles called
fascicles.
15. The nurse is providing care for a client with nonunion at the site of a fracture in a lower extremity.
After 12 weeks of monitoring, the fracture site shows no signs of healing. Which prescription
does the nurse anticipate from the health-care provider?
1.
IV antibiotic therapy
2.
Physical therapy to maintain function
3.
Surgery to debride dead bone tissue
4.
Placement of a bone graft at the site
16. The registered nurse is evaluating the performance of a student nurse performing a valgus stress test
on a client whose leg is slightly abducted. Which intervention does the registered nurse correct
before it can be performed by the student nurse?
1.
Placing one hand at the lateral aspect of the knee joint
2.
Placing one hand at the medial aspect of the distal tibia
3.
Applying valgus stress with the knee at 30 degrees of flexion
4.
Applying valgus stress with the knee at 90 degrees of flexion
17. The nurse is assisting the health-care provider while performing some specific maneuvers in a client
with a knee injury. The health-care provider stabilizes the client’s distal femur with one hand,
grasps the proximal tibia with the other hand, and then attempts to sublux the tibia anteriorly.
Which maneuver is the health-care provider performing?
1.
Lachman test
2.
McMurray test
3.
Valgus stress test
4.
Anterior drawer test
Copyright © 2020 F. A. Davis
Company
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. For which reason is a dual energy x-ray absorptiometry scan used for a client with a musculoskeletal
disorder?
1.
It detects soft tissue abnormalities.
2.
It identifies stress fractures and bony metastases.
3.
It determines mechanical derangement of the knee joint.
4.
It visualizes the bone mineral density (BMD) of the hip and vertebrae.
2. While assessing a client with a musculoskeletal disorder, the nurse abducts the client’s arm to 90
degrees and places anteriorly directed force on the posterior humeral head from behind. Which test
is the nurse performing?
1.
Hawkins test
2.
Relocation test
3.
Apprehension test
4.
Neer impingement test
3. While teaching a group of student nurses about different types of fractures, the nursing instructor
says, “This fracture is characterized by the crushing of cancellous bone.” Which type of fracture
is the nursing instructor describing?
1.
Complete
2.
Transverse
3.
Comminuted
4.
Compression
4. When assessing a client’s muscle strength using the Lovett scale, the nurse finds the client has no
joint motion with palpable contraction of the muscle. Which grade does the nurse assign to the
client based on this finding?
1.
Fair
2.
Poor
3.
Good
4.
Trace
5. The nurse is providing care for a client with a bone fracture. Which cells does the nurse identify as
being involved in the healing of a bone?
1.
Osteoblasts
2.
Osteocytes
3.
Osteoclasts
4.
Osteoprogenitor cells
6. The nurse is reviewing the medical record of a client. Which physiological disorder does the nurse
recognize with a medical diagnosis of adhesive capsulitis?
1.
Bursitis
Copyright © 2020 F. A. Davis
Company
, 2.
Plantar fasciitis
3.
Frozen shoulder
4.
Carpal tunnel syndrome
7. The nurse is performing a physical examination on a client with a suspected musculoskeletal
disorder. Which is the first nursing intervention performed during the examination?
1.
Testing sensation using perception
2.
Measuring muscle girth for symmetry
3.
Evaluating peripheral vascular integrity
4.
Assessing general appearance, contour, and symmetry
8. A client reports pain and immobility of the wrist. On assessment, the nurse finds decreased range of
motion (ROM), edema, and ecchymosis of the distal radius. The health-care provider recommends
a neurovascular examination for confirmation. Which information does the nurse expect to infer
from these findings?
1.
The client has a Smith fracture.
2.
The client has a Colles fracture.
3.
The client has a clavicle fracture.
4.
The client has a greenstick fracture.
9. The nurse is providing client teaching about treatment needed for a grade 2 ankle sprain. Which type
of acute treatment does the nurse teach to the client?
1.
Rest, ice, compression, and elevation (RICE)
2.
Immobilization
3.
Protect, rest, ice, compression, and elevation (PRICE)
4.
Physical therapy
10. A client presents with a swollen left thigh and a lower extremity that appears shortened. Which is the
client’s most likely condition recognized by the nurse?
1.
Greenstick femur shaft fracture
2.
Impacted femur shaft fracture
3.
Incomplete femur shaft fracture
4.
Transverse femur shaft fracture
11. When assessing a client with a musculoskeletal disorder, the nurse finds lack of sensation in the
dermatome areas of the lower extremity L5. The nurse suspects lumbar sprain/strain. Which does
the nurse expect the health-care provider to prescribe in this situation?
1.
Anticoagulant therapy
2.
IV injection of muscle relaxants
3.
X-ray and dual energy x-ray absorptiometry scan of the spine
4.
Anteroposterior and lateral x-rays of the lumbar spine
12. The nurse is preparing to discharge a client to a rehabilitation facility after a total hip replacement
because of a hip fracture. Which summary of the client’s hospitalization best indicates adequate
nursing care?
1.
Lack of infection
2.
Decreasing levels of pain
Copyright © 2020 F. A. Davis
Company
, 3.
Obtained mobility with a walker
4.
Absence of pulmonary complications
13. The nurse is providing care for a client with a lower extremity fracture immobilized by a cast. Which
complication does the nurse identify if assessment reveals tissue ischemia, functional impairment,
and pain level disproportionate to the injury?
1.
Horner syndrome
2.
Cauda equina syndrome
3.
Compartment syndrome
4.
Carpal tunnel syndrome
14. In order to maintain a high level of understanding about skeletal muscles, the nurse reviews anatomy
and physiology concepts. Which recall of information indicates the effectiveness of the nurse’s
review?
1.
The thick filaments of sarcomeres are made up of a protein called actin.
2.
The thin filaments of sarcomeres are made up of a protein called myosin.
3.
The fascicles contain 10 to 30 muscle fibers encased in connective tissue called
epimysium.
4.
The individual muscle fibers of skeletal muscle are arranged in bundles called
fascicles.
15. The nurse is providing care for a client with nonunion at the site of a fracture in a lower extremity.
After 12 weeks of monitoring, the fracture site shows no signs of healing. Which prescription
does the nurse anticipate from the health-care provider?
1.
IV antibiotic therapy
2.
Physical therapy to maintain function
3.
Surgery to debride dead bone tissue
4.
Placement of a bone graft at the site
16. The registered nurse is evaluating the performance of a student nurse performing a valgus stress test
on a client whose leg is slightly abducted. Which intervention does the registered nurse correct
before it can be performed by the student nurse?
1.
Placing one hand at the lateral aspect of the knee joint
2.
Placing one hand at the medial aspect of the distal tibia
3.
Applying valgus stress with the knee at 30 degrees of flexion
4.
Applying valgus stress with the knee at 90 degrees of flexion
17. The nurse is assisting the health-care provider while performing some specific maneuvers in a client
with a knee injury. The health-care provider stabilizes the client’s distal femur with one hand,
grasps the proximal tibia with the other hand, and then attempts to sublux the tibia anteriorly.
Which maneuver is the health-care provider performing?
1.
Lachman test
2.
McMurray test
3.
Valgus stress test
4.
Anterior drawer test
Copyright © 2020 F. A. Davis
Company
