Test Bank- Musculoskeletal
A patient with left knee pain is diagnosed with bursitis. The nurse will explain that
bursitis is an
inflammation of
a. the synovial membrane that lines the joint.
b. a small, fluid-filled sac found at some joints.
c. the fibrocartilage that acts as a shock absorber in the knee joint.
d. any connective tissue that is found supporting the joints of the body ANSWERANS: B
Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a
solid tissue that
cushions some joints. Bursae are a specific type of connective tissue. The synovial
membrane lines many joints
but is not a bursa.
The nurse who notes that a 59-year-old female patient has lost 1 inch in height over the
past 2 years will
plan to teach the patient about
Test Bank - Medical-Surgical Nursing: Assessment and Management of Clinical
Problems 10e 797
a. discography studies.
b. myelographic testing.
c. magnetic resonance imaging (MRI).
d. dual-energy x-ray absorptiometry (DXA). ANSWERANS: D
The decreased height and the patients age suggest that the patient may have
osteoporosis and that bone density
testing is needed. Discography, MRI, and myelography are typically done for patients
with current symptoms
caused by musculoskeletal dysfunction and are not the initial diagnostic tests for
osteoporosis
4. Which information in a 67-year-old womans health history will alert the nurse to the
need for a more
focused assessment of the musculoskeletal system?
a. The patient sprained her ankle at age 13.
b. The patients mother became shorter with aging.
c. The patient takes ibuprofen (Advil) for occasional headaches.
d. The patients father died of complications of miliary tuberculosis ANSWERANS: B
A family history of height loss with aging may indicate osteoporosis, and the nurse
should perform a more
thorough assessment of the patients current height and other risk factors for
osteoporosis. A sprained ankle
during adolescence does not place the patient at increased current risk for
musculoskeletal problems. A family
,history of tuberculosis is not a risk factor. Occasional nonsteroidal antiinflammatory drug
(NSAID) use does
not indicate any increased musculoskeletal risk.
5. Which information obtained during the nurses assessment of a 30-year-old patients
nutritional-metabolic
pattern may indicate the risk for musculoskeletal problems?
a. The patient takes a multivitamin daily.
b. The patient dislikes fruits and vegetables.
c. The patient is 5 ft 2 in and weighs 180 lb.
Test Bank - Medical-Surgical Nursing: Assessment and Management of Clinical
Problems 10e 798
d. The patient prefers whole milk to nonfat milk ANSWERANS: C
The patients height and weight indicate obesity, which places stress on weight-bearing
joints. The use of whole
milk, avoiding fruits and vegetables, and use of a daily multivitamin are not risk factors
for musculoskeletal
problems.
6. Which medication information will the nurse identify as a concern for a patients
musculoskeletal status?
a. The patient takes a daily multivitamin and calcium supplement.
b. The patient takes hormone therapy (HT) to prevent hot flashes.
c. The patient has severe asthma and requires frequent therapy with oral
corticosteroids.
d. The patient has migraine headaches treated with nonsteroidal antiinflammatory drugs
(NSAIDs). ANSWERANS: C
Frequent or chronic corticosteroid use may lead to skeletal problems such as avascular
necrosis and
osteoporosis. The use of HT and calcium supplements will help prevent osteoporosis.
NSAID use does not
increase the risk for musculoskeletal problems.
7. The nurse finds that a patient can flex the arms when no resistance is applied but is
unable to flex when the
nurse applies light resistance. The nurse should document the patients muscle strength
as level
a. 0.
b. 1.
c. 2.
d. 3. ANSWERANS: D
A level 3 indicates that the patient is unable to move against resistance but can move
against gravity. Level 1
indicates minimal muscle contraction, level 2 indicates that the arm can move when
gravity is eliminated, and
level 4 indicates active movement with some resistance
, 9. Which nursing action is correct when performing the straight-leg raising test for an
ambulatory patient with
back pain?
a. Raise the patients legs to a 60-degree angle from the bed.
b. Place the patient initially in the prone position on the exam table.
c. Have the patient dangle both legs over the edge of the exam table.
d. Instruct the patient to elevate the legs and tense the abdominal muscles.
ANSWERANS: A
When performing the straight leg-raising test, the patient is in the supine position and
the nurse passively lifts
the patients legs to a 60-degree angle. The other actions would not be correct for this
test
8. After completing the health history, the nurse assessing the musculoskeletal system
will begin by
a. having the patient move the extremities against resistance.
b. feeling for the presence of crepitus during joint movement.
c. observing the patients body build and muscle configuration.
d. checking active and passive range of motion for the extremities. ANSWERANS: C
The usual technique in the physical assessment is to begin with inspection.
Abnormalities in muscle mass or
configuration will allow the nurse to perform a more focused assessment of abnormal
areas. The other
assessments are also included in the assessment but are usually done after inspection.
10. A 72-year-old patient with kyphosis is scheduled for dual-energy x-ray
absorptiometry (DXA) testing. The
nurse will plan to
a. explain the procedure.
b. start an IV line for contrast medium injection.
c. give an oral sedative 60 to 90 minutes before the procedure.
Test Bank - Medical-Surgical Nursing: Assessment and Management of Clinical
Problems 10e 800
d. screen the patient for allergies to shellfish or iodine products. ANSWERANS: A
DXA testing is painless and noninvasive. No IV access is necessary. Contrast medium
is not used. Because the
procedure is painless, no antianxiety medications are required.
11. A patient has a new order for magnetic resonance imaging (MRI) to evaluate for left
femur osteomyelitis
after a hip replacement surgery. Which information indicates that the nurse should
consult with the health care
provider before scheduling the MRI?
a. The patient has a pacemaker.
b. The patient is claustrophobic.
A patient with left knee pain is diagnosed with bursitis. The nurse will explain that
bursitis is an
inflammation of
a. the synovial membrane that lines the joint.
b. a small, fluid-filled sac found at some joints.
c. the fibrocartilage that acts as a shock absorber in the knee joint.
d. any connective tissue that is found supporting the joints of the body ANSWERANS: B
Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a
solid tissue that
cushions some joints. Bursae are a specific type of connective tissue. The synovial
membrane lines many joints
but is not a bursa.
The nurse who notes that a 59-year-old female patient has lost 1 inch in height over the
past 2 years will
plan to teach the patient about
Test Bank - Medical-Surgical Nursing: Assessment and Management of Clinical
Problems 10e 797
a. discography studies.
b. myelographic testing.
c. magnetic resonance imaging (MRI).
d. dual-energy x-ray absorptiometry (DXA). ANSWERANS: D
The decreased height and the patients age suggest that the patient may have
osteoporosis and that bone density
testing is needed. Discography, MRI, and myelography are typically done for patients
with current symptoms
caused by musculoskeletal dysfunction and are not the initial diagnostic tests for
osteoporosis
4. Which information in a 67-year-old womans health history will alert the nurse to the
need for a more
focused assessment of the musculoskeletal system?
a. The patient sprained her ankle at age 13.
b. The patients mother became shorter with aging.
c. The patient takes ibuprofen (Advil) for occasional headaches.
d. The patients father died of complications of miliary tuberculosis ANSWERANS: B
A family history of height loss with aging may indicate osteoporosis, and the nurse
should perform a more
thorough assessment of the patients current height and other risk factors for
osteoporosis. A sprained ankle
during adolescence does not place the patient at increased current risk for
musculoskeletal problems. A family
,history of tuberculosis is not a risk factor. Occasional nonsteroidal antiinflammatory drug
(NSAID) use does
not indicate any increased musculoskeletal risk.
5. Which information obtained during the nurses assessment of a 30-year-old patients
nutritional-metabolic
pattern may indicate the risk for musculoskeletal problems?
a. The patient takes a multivitamin daily.
b. The patient dislikes fruits and vegetables.
c. The patient is 5 ft 2 in and weighs 180 lb.
Test Bank - Medical-Surgical Nursing: Assessment and Management of Clinical
Problems 10e 798
d. The patient prefers whole milk to nonfat milk ANSWERANS: C
The patients height and weight indicate obesity, which places stress on weight-bearing
joints. The use of whole
milk, avoiding fruits and vegetables, and use of a daily multivitamin are not risk factors
for musculoskeletal
problems.
6. Which medication information will the nurse identify as a concern for a patients
musculoskeletal status?
a. The patient takes a daily multivitamin and calcium supplement.
b. The patient takes hormone therapy (HT) to prevent hot flashes.
c. The patient has severe asthma and requires frequent therapy with oral
corticosteroids.
d. The patient has migraine headaches treated with nonsteroidal antiinflammatory drugs
(NSAIDs). ANSWERANS: C
Frequent or chronic corticosteroid use may lead to skeletal problems such as avascular
necrosis and
osteoporosis. The use of HT and calcium supplements will help prevent osteoporosis.
NSAID use does not
increase the risk for musculoskeletal problems.
7. The nurse finds that a patient can flex the arms when no resistance is applied but is
unable to flex when the
nurse applies light resistance. The nurse should document the patients muscle strength
as level
a. 0.
b. 1.
c. 2.
d. 3. ANSWERANS: D
A level 3 indicates that the patient is unable to move against resistance but can move
against gravity. Level 1
indicates minimal muscle contraction, level 2 indicates that the arm can move when
gravity is eliminated, and
level 4 indicates active movement with some resistance
, 9. Which nursing action is correct when performing the straight-leg raising test for an
ambulatory patient with
back pain?
a. Raise the patients legs to a 60-degree angle from the bed.
b. Place the patient initially in the prone position on the exam table.
c. Have the patient dangle both legs over the edge of the exam table.
d. Instruct the patient to elevate the legs and tense the abdominal muscles.
ANSWERANS: A
When performing the straight leg-raising test, the patient is in the supine position and
the nurse passively lifts
the patients legs to a 60-degree angle. The other actions would not be correct for this
test
8. After completing the health history, the nurse assessing the musculoskeletal system
will begin by
a. having the patient move the extremities against resistance.
b. feeling for the presence of crepitus during joint movement.
c. observing the patients body build and muscle configuration.
d. checking active and passive range of motion for the extremities. ANSWERANS: C
The usual technique in the physical assessment is to begin with inspection.
Abnormalities in muscle mass or
configuration will allow the nurse to perform a more focused assessment of abnormal
areas. The other
assessments are also included in the assessment but are usually done after inspection.
10. A 72-year-old patient with kyphosis is scheduled for dual-energy x-ray
absorptiometry (DXA) testing. The
nurse will plan to
a. explain the procedure.
b. start an IV line for contrast medium injection.
c. give an oral sedative 60 to 90 minutes before the procedure.
Test Bank - Medical-Surgical Nursing: Assessment and Management of Clinical
Problems 10e 800
d. screen the patient for allergies to shellfish or iodine products. ANSWERANS: A
DXA testing is painless and noninvasive. No IV access is necessary. Contrast medium
is not used. Because the
procedure is painless, no antianxiety medications are required.
11. A patient has a new order for magnetic resonance imaging (MRI) to evaluate for left
femur osteomyelitis
after a hip replacement surgery. Which information indicates that the nurse should
consult with the health care
provider before scheduling the MRI?
a. The patient has a pacemaker.
b. The patient is claustrophobic.
