Ch. 49 Assessment of the musculoskeletal system

Which ethnic group has the lowest risk for developing osteoporosis?
A. African American
B. European American
C. Asian American
D. Hispanic American

A. African American

Which pt is most likely to be at risk for osteoporosis related to cultural differences and nutritional intake?
A. Older African- American male who is a vegetarian
B. Young Chinese American female who has anorexia nervosa
C. Middle aged Native American fem

B. Young Chinese American female who has anorexia nervosa

Which pt has sustained a fracture of a bone that would normally fxn to protect vital organs?
A. Has tibia-fubula fracture that occurred during a skateboarding accident
B. Has sternal fracture secondary to being thrown from a motorcycle
C. Has a spiral fra

B. Has sternal fracture secondary to being thrown from a motorcycle

Which clinical manifestation typifies the priority concept for pts who have disorders of the musculoskeletal system?
A. Pain in the knee joint that worsens after jogging
B. Mild dehydration and dark urine after being in the sun
C. Exertional dyspnea after

A. Pain in the knee joint that worsens after jogging

Which clinical finding most strongly suggest that the pt is having dysfunction of the ms?
A. Oxygen saturation is low
B. Red cell count is low
C. Temperature is elevated
D. BP is elevated

B. Red cell count is low

A pt is at risk for a parathyroid hormone imbalance r/t a recent surgical procedure. Based on this info which blood level must the nurse monitor?
A. blood glucose
B. serum calcium
C. serum potassium
D. serum magnesium

B. serum calcium

Which food would be the best choice to supply a vitamin that plays a key role in bone health?
A. carrots
B. apples
C. milk
D. whole grain bread

C. milk

A nurse is caring for an adult pt with a recent increase in growth hormone that has resulted in acromegaly. In assessing this pt, what does the nurse expect to find?
A. bone and soft tissue deformalities
B. pain that increases when flexing joints
C. unusu

A. bone and soft tissue deformalities

What is an example of a pivot joint?
A. knee joint
B. radioulnar
C. shoulder joint
D. cranial area

B. radioulnar

A pt is experiencing inflammatory arthritis accompanied by synovitis. Based on the nurse's knowledge of A and P, which arthrodial joint is involved?
A. vertebral joint
B. cranial joint
C. pelvis joint
D. elbow joint

D. elbow joint

The nurse would ask the pt to perform extension and flexion to assess full range of motion for which joint?
A. Elbow joint
B. Pelvis area
C. Hip joint
D. Cervical area

A. Elbow joint

The nurse is assessing a pt's shoulder joint. what would be considered a normal finding?
A. pt can perform slight rotation and full flexion and extension
B. pt can freely move joint in any direction
C. pt has motion in one plane of flexion and extension
D

B. pt can freely move joint in any direction

A decrease in the body's vitamin D level can result in which disorder of the musculoskeletal system?
A. Acromegaly
B. Osteomalacia
C. Muscular dystrophy
D. Polymyositis

B. Osteomalacia

An athletic young adult man broke his leg several weeks ago and is now having his cast removed for the first time. Upon seeing the parents of his leg, he is stunned. What is the nurses best response to the patient surprise?
A. Don't worry, it looks crusty

D. Without regular exercise, muscles atrophy, strength can be restored with use

A 55-year-old woman with a small frame is aware of her increased risk for osteoporosis and loss of bone mass. She currently has no pain or loss of function. She asked the nurse to recommend an exercise design to counteract the risk. What does the nurse su

C. walking with arm weights

The nurse is assessing and order construction worker he tells the nurse that he developed osteoarthritis as a result of his work duties. Which joint is the nurse most likely to assess to detect this disorder?
A. knees and lumbar spine
B. Fingers and toes

A. Knees and lumbar spine

The nurse is assessing an older woman who has osteoporosis. Which assessment findings with the nurse expect? Select all that apply.
A. Swelling in the fingers and joints
B. Postural changes
C. Gait changes
D. Inability to bear weight
E. Muscle atrophy
F.

B. Postural changes
C. Gait changes
F. History of fractures

Which group has the greatest risk for trauma resulting in injuries to muscles and bones?
a. Order adult men as a result of occupational injuries
b. Young men as a result of motor vehicle accidents
c. Young women as a result of sports injuries
d. Children

B. Young men as a result of motor vehicle accidents

The nurse observes that the older adult has kyphosis. Which topic does the nurse like to address this assessment finding?
A. Isometric exercises
B. Weight bearing exercises
C. Proper body mechanics
D. Use of warm, moist heat

C. Proper body mechanics

The patient is a construction worker in his early 30s who is treated with oral antibiotics after stepping on a nail. The wound does not appear to be responding to anabiotic treatment as expected, despite the patients compliance. The nurse suspects the pat

D. Diabetes Mellitus

The nurse is that a patient has an elevated alkaline phosphatase (ALP). What is the clinical significance of this result?
A. The concentration of ALP increases with bone or liver damage
B. An increased AL P indicates progressive muscular dystrophy
C. And

A. The concentration of AARP it increases with bone or liver damage

Patient patient has an arthroscopy in the right leg. And assessing the patients neurovascular status of the extremity, what does the nurse evaluate? Select all that apply
A. Presents of pain
B. Gait and balance
C. distal pulses
D. Capillary refill
E. Sens

A. Presence of pain
C. Distal pulses
D. Capillary refill
E. sensation
F. temperature of skin

For which circumstances the nurse or rehabilitation therapist most likely to use a goniometer?
A. Older patient had knee surgery and is undergoing physical therapy.
B. Order patient is undergoing therapy to correct difficulties with balance and gait.
C. Y

A. Order patient had knee surgery and is undergoing physical therapy.

Which assessment finding of the musculoskeletal system indicates an abnormality?
A. Symmetry in the upper extremities an equal muscle mass.
B. Gait balance and smooth regular stride.
C. Flexion, extension, and rotation of the neck.
D. A position of three

D. Opposition of three or four fingers to the thumb

Which outcome statement indicates that calcitonin is performing its intended function?
A. Calcium level is within normal limits.
B. Muscle mass is improving with exercise.
C. Growth of healthy bones tissue is occurring. D. White cell blood count is within

A. Calcium level is within normal limits

The nurse is reviewing the laboratory results and sees that the patient has hypercalcemia. Which laboratory results as the nurse expect because of the inverse relationship to calcium?
A. Low level of sodium.
B. Low level of phosphorus.
C. How level of thy

B. Low level of phosphorus

Which hormones affect bone growth select all that apply
A. Glucocorticoid
B. renin
C. thyroxine.
D.Estrogens.
E. Androgens.
F.Catecholamines

A
c
d
e

Which laboratory result may indicate liver damage or metastatic cancer of the bone?
A. serum calcium 9.5 MG/DL
B. Aspartate Aminotransferase 15 units/L
C. Lactate dehydrogenase 185 units/L
D. alkaline phosphatase 140 units/L

D. Alkaline phosphatase 140 unit/L

Which substance affect bone growth and metabolism? Select all that apply
A. chloride
B. calcium
C. vitamin C
D. phosphorus
E. vitamin D
F. sodium

B
c
d
e

Patient reports pain in the lower ankle. Which question does the nurse asked to elicit relevant information about the patients musculoskeletal problem? select all that apply.
A. do you eat foods that supply iron and protein?
B. what seems to make the pain

B
c
e

The nurse is assessing a patient's posture and gait and noticed is that the patient has a lurch and shifts and shoulders from side to side while walking. What is the clinical significance of this finding?
A. muscles in the buttocks and or legs are too wea

A. Muscles in the buttocks and legs are too weak to allow weight change from one foot to another

In assessing a patient's functional ability and range of motion, the patient is unable to actively move a joint through the expected range of motion. Which technique does the nurse used to assess joint mobility?
A. Patient relaxes the muscles while the nu

B. Nurse holds one hand above and one hand below the joint and allows passive range of motion

What is the most common musculoskeletal assessment finding in patients who have abdominal obesity?
A. Scoliosis
B. Crepitus
C. Lordosis
D. Kyphosis

C. Lordosis

Which activity does the nurse asked a patient to perform when assessing range of motion in the patient's hands?
A. waive the hand as they were waving goodbye.
B. Grip the nurses hand as hard as possible. C. Rapidly move hands from palm up to palm down.
D.

D. Make a first and then oppose each finger to thumb

A patient has an effusion on the right knee. Which assessment findings does the nurse expect to assess and this patient?
A. limitations in movement and accompanying pain
B. Poor alignment as in genu Valgum
C. Crepitus and difficulty bearing weight
D. Obvi

A. Limitations in movement and accompanying pain

The nurse notices that an older patient has gait changes and decreased coordination and muscle strength. What is the priority goal for the shift?
A. Encourage mobility
B . prevent falls
C. increased strength
D. avoid worsening

B. Prevent falls

The nurse is reviewing laboratory results for a patient who was involved in the accident. There is no evidence of fracture or bone damage, but multiple soft tissue injuries were sustained. Which muscle enzymes are expected to be elevated because of the in

A
b
d
e
f

For which circumstance is the nurse most likely to use a Doppler during patient assessment?
A. Patient has progressed of decreased flexion and extension of the wrist related to a contracture.
B. blood pressure cannot be a team because patient has bilatera

C. Distill peripheral pulses of the affected extremity are difficult to locate and palpate

Which patient has the greatest risk for developing chronic osteomyelitis?
A. Stepped on a rusty nail 30 years ago.
B. Has recurrent diabetic foot ulcer.
C. Has osteopenia and is noncompliant with therapy.
D. performs heavy manual labor

B. Has reoccurring diabetic foot ulcer

The patient admits to drinking excessive alcohol. What additional assessment should the nurse perform to identify how the patients intake of alcohol may be interfering with musculoskeletal health?
A. performing neurological assessment.
B. Assess muscle st

C. Perform dietary assessment

Middle-age adult runs 5 miles every day.Which person has the greatest risk for developing a soft tissue injury
A. Middle-age adult runs 5 miles every day.
B. Older adult does water aerobics three times a week
C. teenager spent seven hours a day using a co

A. Middle-age adult runs 5 miles every day.

The nurse is caring for a patient who just had a bone biopsy. What is the priority nursing action?
A. Administer pain medication
B. Assess for bleeding
C. Review test results
D. Assess for infection

B. Assess for bleeding

The nurse hears a report that the patient has chronic muscle weakness in the upper extremities. Which question is the nurse most likely to ask the off going nurse?

C. How much assistance is required for activities of daily living

What instructions with the home health nurse to give to home health aide about assisting an older patient who has a shoulder injury?

Wash the patients hair