Lewis Chapter 64: Musculoskeletal System Flashcards
What are the bone cells that function in the breakdown of bone tissue (resorption) called?
a. Osteoids
b. Osteocytes
c. Osteoclasts
d. Osteoblasts
C.
To prevent muscle atrophy, the nurse teaches the client with a leg immobilized in traction to perform which of the following manoeuvres?
a. Flexion contractions
b. Isotonic contractions
c. Isometric contractions
d. Extension contractions
C.
A client with bursitis of the shoulder asks the nurse what the bursa does. What does the nurse tell the client about the function of the bursa?
a. Bursae connect bone to bone.
b. Bursae separate muscle from muscle.
c. Bursae lubricate joints with synovial fluid.
d. Bursae relieve friction between moving parts.
D,
While the nurse is obtaining subjective assessment data related to the musculoskeletal system, which of the following conditions requires the nurse to ask about family history?
a. Osteomyelitis
b. Osteomalacia
c. Low back pain
d. Rheumatoid arthritis
D.
When a nurse grades muscle strength with a score of 2, what does that indicate?
a. Active movement against gravity
b. A barely detectable flicker of contraction
c. Active movement with elimination of gravity
d. Active movement against full resistance without evident fatigue
C.
Which of the following is a normal finding in the assessment of the musculoskeletal system?
a. Muscle strength of 4
b. A lateral curvature of the spine
c. Angulation of bone toward midline
d. Full range of motion of all joints without pain
D.
The nurse is admitting a patient who has been diagnosed with cellulitis and probable osteomyelitis. The patient has just received an injection of radioisotope at 0900 hours before a bone scan. Which of the following times should the nurse anticipate having to take the patient for the bone scan?
A. 0930 hours
B. 1000 hours
C. 1100 hours
D. 1300 hours
C. 1100 hours
A technologist usually administers a calculated dose of a radioisotope two hours before a bone scan. If the patient was injected at 0900 hours, the procedure should be done at 1100 hours.
The nurse is preparing a patient for a bone scan. Which of the following information should the nurse include in the teaching plan for this procedure?
A. Two additional follow-up scans will be required.
B. There will be only mild pain associated with the procedure.
C. The procedure takes approximately 15–30 minutes to complete.
D. The patient will be asked to drink increased fluids after the procedure.
D. The patient will be asked to drink increased fluids after the procedure.
Patients are asked to drink increased fluids after the procedure to aid in excretion of the radioisotope, if not contraindicated by another condition.
Which of the following medications require that the nurse complete a thorough musculoskeletal assessment as an important component of patient care?
A. Corticosteroids
B. Antiplatelet aggregators
C. Alpha-adrenergic blockers
D. Calcium-channel blockers
A. Corticosteroids
Corticosteroids are associated with avascular necrosis and decreased bone and muscle mass. Alpha-adrenergic blockers, calcium-channel blockers, and antiplatelet aggregators are not commonly implicated in damage to the musculoskeletal system.
The nurse is assessing a patient in the outpatient clinic who has a longstanding history of rheumatoid arthritis and indicates increasing stiffness in the right knee that has culminated in complete fixation of the joint. Which of the following problems would the nurse document based upon the patient symptoms?
A. Atrophy
B. Ankylosis
C. Crepitation
D. Contracture
B. Ankylosis
Ankylosis is stiffness or fixation of a joint, whereas contracture is reduced movement as a consequence of fibrosis. Atrophy is a flabby appearance of muscle leading to decreased function and tone. Crepitation (crepitus) is a grating or crackling sound that accompanies movement.
The nurse is performing a musculoskeletal assessment of an older person whose mobility has been progressively decreasing in recent months. How should the nurse best assess the patient’s range of motion (ROM) in the affected leg?
A. Perform passive range of motion (ROM), asking the patient to report any pain.
B. Ask the patient to lift progressive weights with the affected leg.
C. Observe the patient’s unassisted range of motion (ROM) in the affected leg.
D. Move both of the patient’s legs from a supine position to full flexion.
C. Observe the patient’s unassisted range of motion (ROM) in the affected leg.
Passive range of motion (ROM) should be performed with extreme caution, and may be best avoided when assessing patients of advanced age. Observing the patient’s active ROM is more accurate and safer than asking the patient to lift weights with their legs.
Which statement describes the process of bone remodeling in aging?
A. Bone reabsorption increases and bone formation decreases
B. Bone formation increases and bone reabsorption increases
C. Loss of water from joints contribute to arthritis and stiff joints
D. Joints and limbs become more flexible
A. Bone reabsorption increases and bone formation decreases
The bone remodeling process changes as adults age. Bone resorption increases and bone formation decreases. This causes a loss of bone density and can lead to osteopenia and osteoporosis.
Which action would the nurse take to best assess the range of motion (ROM) in the affected leg for an older person whose mobility has been progressively decreasing in recent months?
A. Perform passive range of motion (ROM), asking the patient to report any pain.
B. Ask the patient to lift progressive weights with the affected leg.
C. Observe the patient’s unassisted range of motion (ROM) in the affected leg.
D. Move both of the patient’s legs from a supine position to full flexion.
C. Observe the patient’s unassisted range of motion (ROM) in the affected leg.
Observing the patient’s active ROM is more accurate and safer than asking the patient to lift weights with their legs. A valuable assessment method is to compare the range of motion of one extremity with the range of motion on the opposite side.
Which statement describes full muscle strength when a nurse is grading the strength of individual muscles?
A. Active movement of body part with elimination of gravity
B. Active movement against gravity only and not against resistance
C. Active movement against full resistance without evident fatigue
D. Active movement against gravity and some resistance
C. Active movement against full resistance without evident fatigue
The nurse grades the strength of individual muscles or groups of muscles during contraction. The patient should be instructed to apply resistance to the force exerted by the nurse. A score of 5 on the grading scale is active movement against full resistance without evident fatigue (normal muscle strength).
Which finding does the nurse grade as normal on a musculoskeletal system physical assessment?
A. Complete range of motion (ROM) of joints without hypermobility
B. Good range of motion (ROM) with very minor limitations
C. Deviations in leg length of the left to right leg
D. Muscle strength of 3 on the muscle strength scale
A. Complete range of motion (ROM) of joints without hypermobility
A normal physical assessment of the musculoskeletal system includes full range of motion of all joints without pain or laxity (hypermobility); no joint swelling, deformity, or crepitation; normal spine curvatures; no tenderness on palpation of spine; no muscle atrophy or asymmetry; and muscle strength of 5.
