1. A client is having a myelography. What action by the nurse is most important?
a. Assess serum aspartate aminotransferase (AST) levels.
b. Ensure that informed consent is on the chart.
c. Position the client flat after the procedure.
d. Reinforce the dr
ANS: B
This diagnostic procedure is invasive and requires informed consent. The AST does not need to be assessed
prior to the procedure. The client is positioned with the head of the bed elevated after the test to keep the
contrast material out of the bra
2. A client is undergoing computed tomography (CT) of a joint. What action by the nurse is most important
before the test?
a. Administer sedation as prescribed.
b. Assess for seafood or iodine allergy.
c. Ensure that the client has no metal on the body.
d
ANS: B
Because CT uses iodine-based contrast material, the nurse assesses the client for allergies to iodine or seafood
(which often contains iodine). The other actions are not needed.
3. A client had an arthroscopy 1 hour ago on the left knee. The nurse finds the left lower leg to be pale and
cool, with 1+/4+ pedal pulses. What action by the nurse is best?
a. Assess the neurovascular status of the right leg.
b. Document the findings in
ANS: A
The nurse should compare findings of the two legs as these findings may be normal for the client. If a
difference is observed, the nurse notifies the provider. Documentation should occur after the nurse has all the
data. Elevating the left leg will
4. A hospitalized clients strength of the upper extremities is rated at 3. What does the nurse understand about
this clients ability to perform activities of daily living (ADLs)?
a. The client is able to perform ADLs but not lift some items.
b. No difficu
ANS: A
This rating indicates fair muscle strength with full range of motion against gravity but not resistance. The
client could complete ADLs independently unless they required lifting objects.
5. A client is distressed at body changes related to kyphosis. What response by the nurse is best?
a. Ask the client to explain more about these feelings.
b. Explain that these changes are irreversible.
c. Offer to help select clothes to hide the deformit
ANS: A
Assessment is the first step of the nursing process, and the nurse should begin by getting as much information
about the clients feelings as possible. Explaining that the changes are irreversible discounts the clients feelings.
Depending on the ext
6. The nurse knows that hematopoiesis occurs in what part of the musculoskeletal system?
a. Cancellous tissue
b. Collagen matrix
c. Red marrow
d. Yellow marrow
ANS: C
Hematopoiesis occurs in the red marrow, which is part of the cancellous tissues containing both types of bone
marrow.
7. A nurse is providing community education about preventing traumatic musculoskeletal injuries related to car
crashes. Which group does the nurse target as the priority for this education?
a. High school football team
b. High school homeroom class
c. Mid
ANS: A
Young men are at highest risk for musculoskeletal injury due to trauma, especially due to motor vehicle
crashes. The high school football team, with its roster of young males, is the priority group.
8. A school nurse is conducting scoliosis screening. In screening the client, what technique is most
appropriate?
a. Bending forward from the hips
b. Sitting upright with arms outstretched
c. Walking across the room and back
d. Walking with both eyes clos
ANS: A
To assess for scoliosis, a spinal deformity, the student should bend forward at the hips. Standing behind the
student, the nurse looks for a lateral curve in the spine. The other actions are not correct.
9. The clients chart indicates genu varum. What does the nurse understand this to mean?
a. Bow-legged
b. Fluid accumulation
c. Knock-kneed
d. Spinal curvature
ANS: A
Genu varum is a bow-legged deformity. A fluid accumulation is an effusion. Genu valgum is knock-kneed. A
spinal curvature could be kyphosis or lordosis.
10. The nurse is assessing four clients with musculoskeletal disorders. The nurse should assess the client with
which laboratory result first?
a. Serum alkaline phosphatase (ALP): 108 units/L
b. Serum aspartate aminotransferase (AST): 26 units/L
c. Serum
ANS: D
A normal serum phosphorus level is 3 to 4.5 mg/dL; a level of 2 mg/dL is low, and this client should be
assessed first. The values for serum ALP, AST, and calcium are all within normal ranges.
1. A nursing student studying the musculoskeletal system learns about important related hormones. What
information does the student learn? (Select all that apply.)
a. A lack of vitamin D can lead to rickets.
b. Calcitonin increases serum calcium levels.
c
ANS: A, C, D
Vitamin D is needed to absorb calcium and phosphorus. A deficiency of vitamin D can lead to rickets.
Estrogen stimulates osteoblastic activity. Parathyroid hormone stimulates osteoclastic activity. Calcitonin
decreases serum calcium levels wh
2. A student nurse learns about changes that occur to the musculoskeletal system due to aging. Which changes
does this include? (Select all that apply.)
a. Bone changes lead to potential safety risks.
b. Increased bone density leads to stiffness.
c. Osteo
ANS: A, C, E
Many age-related changes occur in the musculoskeletal system, including decreased bone density,
degeneration of cartilage, and some degree of muscle tissue atrophy. Osteoporosis, while common, is not
universal. Bone density decreases with age
3. An older clients serum calcium level is 8.7 mg/dL. What possible etiologies does the nurse consider for this
result? (Select all that apply.)
a. Good dietary intake of calcium and vitamin D
b. Normal age-related decrease in serum calcium
c. Possible oc
ANS: B, C
This slightly low calcium level could be an age-related decrease in serum calcium or could indicate a
metabolic bone disease such as osteoporosis or osteomalacia. A good dietary intake would be expected to
produce normal values. Metastatic cance
4. When assessing gait, what features does the nurse inspect? (Select all that apply.)
a. Balance
b. Ease of stride
c. Goniometer readings
d. Length of stride
e. Steadiness
ANS: A, B, D, E
To assess gait, look at balance, ease and length of stride, and steadiness. Goniometer readings assess flexion
and extension or joint range of motion.