Chapter 38: Degenerative Diseases of the Musculoskeletal System
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A client is diagnosed with degenerative disc disorder (DDD). Which form of physical therapy does the nurse
anticipate the primary care provider will prescribe to reduce the movement of the spine and enhance the
healing process?
1. Braces
2. Massage
3. Electrotherapies
4. Heat and cold packs
____ 2. Which diagnostic test does the nurse expect the primary care provider to prescribe to confirm a diagnosis of
osteoporosis?
1. Electromyography (EMG)
2. Computed tomography (CT) scan
3. Magnetic resonance imaging (MRI) scan
4. Dual-energy x-ray absorptiometry (DEXA) scan
____ 3. The nurse is caring for a client whose bone mineral density is -2 based on a T-score value, which compares
the client’s bone mineral density to the mean for young adult women. Which condition does this score
indicate?
1. Osteomalacia
2. Osteopenia
3. Osteoporosis
4. Severe osteoporosis
____ 4. A client is diagnosed with osteomalacia and undergoes therapy to correct the vitamin D deficiency and
normalize phosphate levels. Which outcome indicates the successful completion of therapy?
1. The client does not experience any cervical back pain.
2. The client is able to walk up and down stairs comfortably.
3. The client does not report any numbness in the lower extremities.
4. The client reports normal bowel and bladder function.
____ 5. The nurse observes that an older client has a hunched back. Which disorder does the nurse suspect?
1. Osteoporosis
2. Osteomalacia
3. Osteoarthritis
4. Spinal stenosis
____ 6. Which diagnostic technique is used to diagnose rickets?
1. Electromyography (EMG)
2. Bone mineral density (BMD) examination
3. Magnetic resonance imaging (MRI) scan
4. Dual-energy x-ray absorptiometry (DEXA)
____ 7. A nursing instructor is teaching a group of nursing students the causes of spinal nerve impingement. Which
statement made by the student indicates the need for further teaching?
1. “Herniated discs may cause spinal nerve impingement.”
2. “Disc thickening may cause spinal nerve impingement.”
3. “Osteocyte formation may cause spinal nerve impingement.”
Copyright © 2016 F. A. Davis Company
, 4. “Compression of the disc may cause spinal nerve impingement.”
____ 8. Which statement is true regarding rheumatoid arthritis and osteoarthritis?
1. Rheumatoid arthritis is an autoimmune disease.
2. Osteoarthritis is mainly treated with methotrexate.
3. Osteoarthritis is less common than rheumatoid arthritis.
4. Rheumatoid arthritis affects mainly the proximal interphalangeal and distal
interphalangeal joints.
____ 9. The nursing instructor is teaching student nurses about the various fluids of the musculoskeletal system.
Which statement made by a student nurse indicates effective learning?
1. “Lubricin is a lubricating liquid present in a joint.”
2. “Synovial fluid is a protein that acts as a lubricant for the bone surfaces of a joint.”
3. “Chondrocytes synthesize proteoglycans fluid in the later stages of osteoarthritis.”
4. “Edematous fluid accumulated in a joint affected by osteoarthritis makes the joint
capsule less effective as a protector.”
____ 10. Which class of medications are contraindicated for a client with Cushing’s disease?
1. Glucocorticoids
2. Muscle relaxants
3. Calcium supplements
4. NSAIDs
____ 11. After assessing a client with spinal stenosis, the primary care provider orders immediate decompression
surgery. Which symptom in the client did the primary care provider likely observe?
1. Diminished bowel and bladder function
2. Severe lower back pain
3. Pain walking up and down stairs
4. Diminished Achilles reflexes
____ 12. Which condition in a client may cause cauda equina syndrome?
1. Celiac disease
2. Paget’s disease
3. Cushing’s disease
4. End-stage renal disease
____ 13. A nurse is caring for a client whose lumbar spinal nerve 4 (L4) is affected by degenerative disc disease
(DDD). Which condition does the nurse anticipate in the client?
1. Diminished patella reflex
2. Diminished Achilles reflex
3. Difficulty with dorsiflexion of the foot
4. Difficulty with plantarflexion of the foot
____ 14. The primary care provider recommends measuring the trabecular bone density in a client’s spine. Which
diagnostic test does the nurse expect the primary health care provider to prescribe?
1. X-ray
2. Electromyography (EMG)
3. Magnetic resonance imaging (MRI) scan
4. Quantitative computed tomography (QCT) scan
____ 15. The nurse is caring for a client who is receiving risedronate therapy. Which precautionary measure does the
nurse provide the client?
1. Take the medication with water.
Copyright © 2016 F. A. Davis Company
, 2. Take the medication in a sitting or upright position.
3. Both A and B.
4. None of the above.
____ 16. A nurse is caring for a client who has Bouchard’s nodes. Which joints does the nurse anticipate to be swollen
in this client?
1. Vertebral joints
2. Metacarpophalangeal joints
3. Distal interphalangeal joints
4. Proximal interphalangeal joints
____ 17. Which physiological process takes place more rapidly after an individual is 30 years of age?
1. Bone growth
2. Osteoblastic activity
3. Osteoclastic activity
4. All of the above
____ 18. The nurse is caring for a client with degenerative disc disease (DDD). Which outcome indicates effective
chiropractic therapy?
1. The client’s discs are realigned.
2. The client has diminished inflammation.
3. The client has decreased neuropathic pain.
4. The client has been relieved of pain caused by spinal nerve impingement.
____ 19. A client with osteoporosis was prescribed teriparatide therapy. Which outcome indicates the therapeutic effect
of the medication has been achieved?
1. Reduced pain
2. Fortification of the bone
3. Reduced inflammation
4. Strengthening of the bone
____ 20. The nursing instructor is teaching a group of student nurses about degenerative disc disease (DDD). Which
statement made by the student nurse indicates effective learning?
1. “Degenerative disc disease occurs only in the cervical region of the vertebral column.”
2. “Age-related degenerative changes in the intervertebral discs are the main causes of lower
back pain.”
3. “Males are more susceptible to lumbar degenerative disc disease.”
4. “Onset of lumbar degenerative disc disease occurs most often between the ages of 30 and
50.”
____ 21. Which hormone indirectly helps in the formation of bone by stimulating muscle growth?
1. Testosterone
2. Calcitriol
3. Calcitonin
4. Parathyroid hormone
____ 22. Why does the registered nurse instruct the parents of a young girl to reduce the use of sunblock and cover-ups
with their child?
1. Overuse of sunblock and cover-ups will inhibit the production of estrogen.
2. Absorption of calcium by the gastrointestinal tract is inhibited by the overuse of sunblock
and cover-ups.
3. The production of osteoblast cells is inhibited by the excessive use of sunblock and
cover-ups.
Copyright © 2016 F. A. Davis Company
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A client is diagnosed with degenerative disc disorder (DDD). Which form of physical therapy does the nurse
anticipate the primary care provider will prescribe to reduce the movement of the spine and enhance the
healing process?
1. Braces
2. Massage
3. Electrotherapies
4. Heat and cold packs
____ 2. Which diagnostic test does the nurse expect the primary care provider to prescribe to confirm a diagnosis of
osteoporosis?
1. Electromyography (EMG)
2. Computed tomography (CT) scan
3. Magnetic resonance imaging (MRI) scan
4. Dual-energy x-ray absorptiometry (DEXA) scan
____ 3. The nurse is caring for a client whose bone mineral density is -2 based on a T-score value, which compares
the client’s bone mineral density to the mean for young adult women. Which condition does this score
indicate?
1. Osteomalacia
2. Osteopenia
3. Osteoporosis
4. Severe osteoporosis
____ 4. A client is diagnosed with osteomalacia and undergoes therapy to correct the vitamin D deficiency and
normalize phosphate levels. Which outcome indicates the successful completion of therapy?
1. The client does not experience any cervical back pain.
2. The client is able to walk up and down stairs comfortably.
3. The client does not report any numbness in the lower extremities.
4. The client reports normal bowel and bladder function.
____ 5. The nurse observes that an older client has a hunched back. Which disorder does the nurse suspect?
1. Osteoporosis
2. Osteomalacia
3. Osteoarthritis
4. Spinal stenosis
____ 6. Which diagnostic technique is used to diagnose rickets?
1. Electromyography (EMG)
2. Bone mineral density (BMD) examination
3. Magnetic resonance imaging (MRI) scan
4. Dual-energy x-ray absorptiometry (DEXA)
____ 7. A nursing instructor is teaching a group of nursing students the causes of spinal nerve impingement. Which
statement made by the student indicates the need for further teaching?
1. “Herniated discs may cause spinal nerve impingement.”
2. “Disc thickening may cause spinal nerve impingement.”
3. “Osteocyte formation may cause spinal nerve impingement.”
Copyright © 2016 F. A. Davis Company
, 4. “Compression of the disc may cause spinal nerve impingement.”
____ 8. Which statement is true regarding rheumatoid arthritis and osteoarthritis?
1. Rheumatoid arthritis is an autoimmune disease.
2. Osteoarthritis is mainly treated with methotrexate.
3. Osteoarthritis is less common than rheumatoid arthritis.
4. Rheumatoid arthritis affects mainly the proximal interphalangeal and distal
interphalangeal joints.
____ 9. The nursing instructor is teaching student nurses about the various fluids of the musculoskeletal system.
Which statement made by a student nurse indicates effective learning?
1. “Lubricin is a lubricating liquid present in a joint.”
2. “Synovial fluid is a protein that acts as a lubricant for the bone surfaces of a joint.”
3. “Chondrocytes synthesize proteoglycans fluid in the later stages of osteoarthritis.”
4. “Edematous fluid accumulated in a joint affected by osteoarthritis makes the joint
capsule less effective as a protector.”
____ 10. Which class of medications are contraindicated for a client with Cushing’s disease?
1. Glucocorticoids
2. Muscle relaxants
3. Calcium supplements
4. NSAIDs
____ 11. After assessing a client with spinal stenosis, the primary care provider orders immediate decompression
surgery. Which symptom in the client did the primary care provider likely observe?
1. Diminished bowel and bladder function
2. Severe lower back pain
3. Pain walking up and down stairs
4. Diminished Achilles reflexes
____ 12. Which condition in a client may cause cauda equina syndrome?
1. Celiac disease
2. Paget’s disease
3. Cushing’s disease
4. End-stage renal disease
____ 13. A nurse is caring for a client whose lumbar spinal nerve 4 (L4) is affected by degenerative disc disease
(DDD). Which condition does the nurse anticipate in the client?
1. Diminished patella reflex
2. Diminished Achilles reflex
3. Difficulty with dorsiflexion of the foot
4. Difficulty with plantarflexion of the foot
____ 14. The primary care provider recommends measuring the trabecular bone density in a client’s spine. Which
diagnostic test does the nurse expect the primary health care provider to prescribe?
1. X-ray
2. Electromyography (EMG)
3. Magnetic resonance imaging (MRI) scan
4. Quantitative computed tomography (QCT) scan
____ 15. The nurse is caring for a client who is receiving risedronate therapy. Which precautionary measure does the
nurse provide the client?
1. Take the medication with water.
Copyright © 2016 F. A. Davis Company
, 2. Take the medication in a sitting or upright position.
3. Both A and B.
4. None of the above.
____ 16. A nurse is caring for a client who has Bouchard’s nodes. Which joints does the nurse anticipate to be swollen
in this client?
1. Vertebral joints
2. Metacarpophalangeal joints
3. Distal interphalangeal joints
4. Proximal interphalangeal joints
____ 17. Which physiological process takes place more rapidly after an individual is 30 years of age?
1. Bone growth
2. Osteoblastic activity
3. Osteoclastic activity
4. All of the above
____ 18. The nurse is caring for a client with degenerative disc disease (DDD). Which outcome indicates effective
chiropractic therapy?
1. The client’s discs are realigned.
2. The client has diminished inflammation.
3. The client has decreased neuropathic pain.
4. The client has been relieved of pain caused by spinal nerve impingement.
____ 19. A client with osteoporosis was prescribed teriparatide therapy. Which outcome indicates the therapeutic effect
of the medication has been achieved?
1. Reduced pain
2. Fortification of the bone
3. Reduced inflammation
4. Strengthening of the bone
____ 20. The nursing instructor is teaching a group of student nurses about degenerative disc disease (DDD). Which
statement made by the student nurse indicates effective learning?
1. “Degenerative disc disease occurs only in the cervical region of the vertebral column.”
2. “Age-related degenerative changes in the intervertebral discs are the main causes of lower
back pain.”
3. “Males are more susceptible to lumbar degenerative disc disease.”
4. “Onset of lumbar degenerative disc disease occurs most often between the ages of 30 and
50.”
____ 21. Which hormone indirectly helps in the formation of bone by stimulating muscle growth?
1. Testosterone
2. Calcitriol
3. Calcitonin
4. Parathyroid hormone
____ 22. Why does the registered nurse instruct the parents of a young girl to reduce the use of sunblock and cover-ups
with their child?
1. Overuse of sunblock and cover-ups will inhibit the production of estrogen.
2. Absorption of calcium by the gastrointestinal tract is inhibited by the overuse of sunblock
and cover-ups.
3. The production of osteoblast cells is inhibited by the excessive use of sunblock and
cover-ups.
Copyright © 2016 F. A. Davis Company
