Chapter 44 a Musculoskeletal Disorder Flashcards
What is the movement of an extremity away from the midline of the body called?
a. Abduction
b. Adduction
c. Flexion
d. Extension
a. Abduction
What is the large, fan-shaped muscle that covers the anterior chest from the sternum to the
proximal end of the humerus and acts on the joint of the shoulder to flex, adduct, androtate?
a. Serratus anterior
b. Intercostal
c. Transversus abdominis
d. Pectoralis major
d. Pectoralis major
Which instructions will the nurse reinforce for the patient before a magnetic resonance
imaging (MRI) procedure?
a. Void to completely empty the bladder.
b. Omit all citrus food for 12 hours before the procedure.
c. Remove all metal, such as jewelry, glasses, and hair clips.
d. Wear only cotton garments for the procedure.
c. Remove all metal, such as jewelry, glasses, and hair clips.
The nurse reinforces instructions for the patient who is to have a unicompartmental knee
replacement that which is a major advantage of this partial knee replacement?
a. the patient will be up and walking 2 to 3 hours after the operation.
b. the kneecap is completely removed.
c. the procedure is especially helpful in the treatment of rheumatoid arthritis (RA).
d. a small titanium disk replaces the worn cartilage.
a. the patient will be up and walking 2 to 3 hours after the operation.
A patient who has had a right below the knee amputation continues to complain of unpleasant sensation in the right foot. Which explanation will the nurse provide about this “phantom pain”?
a. It only exists in the mind.
b. It is a complication following an amputation and can be clarified by the surgeon.
c. It is related to the severed nerves that are still sending messages to the brain.
d. It occurs when the person becomes focused on the loss of the limb.
c. It is related to the severed nerves that are still sending messages to the brain.
The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours. The nurse understands that the correct nursing intervention
is to keep the legs in which position?
a. together so they do not separate while turning.
b. flexed to stabilize the prosthesis.
c. abducted so the prosthesis does not become dislocated.
d. adducted to prevent additional pain for the patient with turning.
c. abducted so the prosthesis does not become dislocated.
A patient has been casted to stabilize a fracture of the right radius and ulna. The nurse assesses a capillary refill of 5 seconds and cold fingers of the right hand. Which initial intervention should the nurse deploy?
a. Notify the charge nurse of a probable compartmentsyndrome.
b. Apply a warm compress to the fingers to relieve swelling.
c. Elevate the right hand to heart level to maintain arterial pressure.
d. Cut the cast off to release constriction.
c. Elevate the right hand to heart level to maintain arterial pressure.
A patient had an open reduction with internal fixation (ORIF) for a compound fracture of the left tibia and has been placed in a long leg cast. The findings by the nurse are: left foot warm/pink, pedal pulse weaker than right, capillary refill 3 seconds, and small 1 cm area of
blood on cast. Which action will the nurse take?
a. Notify charge nurse of impending compartment syndrome.
b. Document that all findings are within normal limits.
c. Inform charge nurse about probable hemorrhage.
d. Place warm compresses on left foot.
b. Document that all findings are within normal limits.
When a patient recovering from a fractured tibia asks what callus formation is, the nurse provides which explanation?
a. when blood vessels of the bone are compressed.
b. a part of the bone healing process after a fracture when new bone is being formed over the fracture site.
c. the formation of a clot over the fracture site.
d. when the hematoma becomes organized and a fibrin meshwork is formed.
b. a part of the bone healing process after a fracture when new bone is being formed over the fracture site.
Which patient statement indicates the need for additional teaching for a patient with rheumatoid arthritis who is taking meloxicam?
a. “I am keeping a daily record of my blood pressure.”
b. “I take aspirin before I go to bed.”
c. “I know I can take meloxicam with or without regard to meals.”
d. “I weigh every day so I will be aware of any weight gain.”
b. “I take aspirin before I go to bed.”
Which should the nurse expect to see in the plan of care for a patient following a myelogram in which water-soluble dye was used?
a. Position in a semi-Fowler’s position for 8 hours
b. Place patient flat on back to compress puncture site.
c. Ambulate for brief periods to lessen postmyelogram headache.
d. Limit fluids to increase absorption of the dye.
a. Position in a semi-Fowler’s position for 8 hours
Which finding would delay a computed tomography (CT)scan?
a. Patient’s allergy to shellfish or iodine
b. Patient has a suspected tumor
c. Patient’s allergy to milk products
d. Patient’s gluten intolerance
a. Patient’s allergy to shellfish or iodine
Forty-eight hours after a patient sustained a fractured femur in a car accident, the nurse notes the patient has a pulse of 110, respirations at 25, labored respirations and crackles in
both lung fields. The nurse immediately reports to the charge nurse the probability of which
disorder?
a. impending pneumonia.
b. atelectasis.
c. fat embolism.
d. anxiety attack.
c. fat embolism.
Which is the priority nursing intervention for a patient experiencing a fat embolism?
a. Administer oxygen
b. Increase intravenous fluids.
c. Administer analgesic medication
d. Notify the charge nurse
a. Administer oxygen
A patient, age 68, has experienced an intertrochanteric fracture of the right hip. Before surgery, to provide support and comfort, an immobilizing device of which type is applied?
a. Thomas ring
b. Bryant traction
c. Russell traction
d. Buck traction
d. Buck traction
Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease?
a. Leafy green vegetables
b. Foods high in sodium
c. Tea and coffee
d. Vitamin A
a. Leafy green vegetables
Which instruction will the nurse reinforce for a patient who is taking alendronate?
a. Take drug with any meal.
b. Take drug first thing in the morning.
c. Drink at least 5 oz of milk before taking drug.
d. Take drug with an antacid to avoid heartburn.
b. Take drug first thing in the morning.
The patient has been diagnosed as having gouty arthritis. The patient asks the nurse to explain the cause of the inflammation of the great toe. Which is the appropriate nursing response?
a. “You have calcium oxalate deposits that are seen in gouty arthritis.”
b. “The inflammation is from small accumulations of uric acid crystals, which are called tophi.”
c. “The small nodules are not related to the arthritis condition.”
d. “You have fat deposits that are common with gouty arthritis.”
b. “The inflammation is from small accumulations of uric acid crystals, which are called tophi.”
When the patient with rheumatoid arthritis reports not liking daily exercise, the nurse encouragingly reminds the patient that exercise has which benefit?
a. Keeping the joints from “freezing.”
b. Ensuring longer and better sleep.
c. Stimulating joints when done vigorously
d. When performed weekly, having greater benefits.
a. Keeping the joints from “freezing.”
The nurse clarifies to a patient who is being evaluated for possible rheumatoid arthritis that the elevated erythrocyte sedimentation rate (ESR) indicates the presence of which process?
a. A chronic infection
b. Poor protein intake
c. Increased inflammatory reaction in the body.
d. A poor immune response to amicroorganism
c. Increased inflammatory reaction in the body.
Which instructions should the nurse reinforce for the patient before the initiation of the hydroxychloroquine to treat joint inflammation from systemic lupus erythematosus(SLE)?
a. Report mouth ulcerations.
b. Get a chest x-ray.
c. Get an eye examination.
d. Take prophylaxis for malaria.
c. Get an eye examination.
Which action should the nurse take when a patient with osteomyelitis of the right forearm is admitted with an open wound that is draining?
a. Enforce a low-calorie diet.
b. Initiate drainage and secretion precautions.
c. Frequently do passive ROM on the elbow.
d. Ambulate several times daily.
b. Initiate drainage and secretion precautions.
A 16-year-old male patient presents in the emergency room with a pathologic fracture of the left femur and complains of pain on weight-bearing. These are common indicators of which
disorder?
a. osteogenic sarcoma.
b. osteoporosis.
c. rheumatoid arthritis.
d. osteochondroma.
a. osteogenic sarcoma.
The 14-year-old boy who is scheduled for left leg amputation says to the nurse, “What in the world am I going to do with only one leg?” Which is the nurse’s therapeutic response?
a. “ This is a tough thing to go through”
b. “With a prosthesis, you will be as good as new.”
c. “It is way too early to be concerned about that now.”
d. “When my brother had his leg removed, he did great!”
a. “ This is a tough thing to go through”
