Musculoskeletal

Question 0

Osteomylitis

Answer 0

Possibly a result of latent viral infection

Question 1

Osteomalacia

Answer 1

Older adults, vitamin D deficiency, insufficient exposure to sunlight

Question 2

Osteomalacia

Answer 2

Unsteady gait, bone tenderness over rib cage, long bone bowing

Question 3

Paget’s disease

Answer 3

Hip flexion contractures, long bone Boeing, soft skull

Question 4

Which factors may be associated with osteomalacia?

Answer 4

Vitamin D deficiency, muscle weakness in the pelvic girdle area, muscle weakness in life

Question 5

Which factors may be associated with Pagets disease?

Answer 5

Apathy or lethargic, urinary or renal stones

Question 6

The patient is prescribed calcitonin for treatment of pagets disease. What does the nurse advised patient to do?

Answer 6

Alternate nares to prevent nasal mucosal irritation

Question 7

Patient reports pain in the lower legs and pelvis which is aggravated by activity and worse at night. The nurse observes muscle weakness which appears to be causing a waddling and unsteady gait. What additional information supports the likelihood of osteomalacia in this patient?

Answer 7

Recent immigration from a country where famine is common

Question 8

An x-ray shows the presence of radiolucent bands and a patient. What is this diagnostic finding specific for?

Answer 8

Osteomalacia

Question 9

The nurse is assessing a patient reports moderate bone pain in the hip and has a family history of Pagets disease. And performing a musculoskeletal assessment, the nurse pays particular attention to which element?

Answer 9

Size and shape of the skull

Question 10

A patient with Paget’s disease comes to the clinic for evaluation. Which symptom reported by the patient alerts the nurse to the possibility of osteogenic sarcoma?

Answer 10

Severe bone pain

Question 11

A patient with Paget’s disease has complications related to bony enlargement of the skull. Which complication is potentially the most serious and life-threatening?

Answer 11

Platybasia, or basilar invagination with brainstem manifestation

Question 12

The patient with Paget’s disease has a kidney problem associated with an increase or I’m calcium. What is the nursing priority for this patient?

Answer 12

Encourage the patient to increase fluids, unless contraindicated

Question 13

The patient is having diagnostic testing to determine the probability of Piaget’s disease. If The disease is present which lab result of the nurse expect to see?

Answer 13

Increased serum alkaline phosphate

Question 14

A patient with Paget’s disease has been prescribed drug therapy. The nurse prepares patient teaching information for which medication as a first-line therapy?

Answer 14

Risedronate (actonel)

Question 15

The patient was admitted for acute osteomyelitis of the left lower leg. What does the nurse expect to find documented in the patient’s admitting assessment?

Answer 15

Temperature greater than 101, swelling, tenderness, erythremia, and warmth of area

Question 16

The nurses caring for patient with osteomyelitis. Which lab results are primary concern for this disorder?

Answer 16

White blood cell count and erythrocyte sedimentation rate

Question 17

Which patient is most likely to be a candidate for hyperbaric oxygen therapy?

Answer 17

Patient with chronic, on remitting osteomyelitis

Question 18

The patient comes in the emergency department after accidentally puncturing his hand with an automatic nail gun. Which disorder is this patient primarily at risk for?

Answer 18

Osteomyelitis

Question 19

The nurses caring for a patient with acute osteomyelitis. What assessment findings typically accompany this medical diagnosis?

Answer 19

Fever usually above 101, erythemia on the affected area, swelling around the affected area

Question 20

The nurses teaching a patient about anabiotic therapy for osteomyelitis. What information does the nurse give to the patient?

Answer 20

Infected one maybe irrigated with one or more types of antibiotic solution

Question 21

The patient was a long distance runner reports severe pain in the arch of the foot, especially when getting out of bed and with weight-bearing. What does the nurse suspect in this patient?

Answer 21

Plantar fasciitis

Question 22

The patient is diagnosed with planter fasciitis. What instruction does the nurse gives to the patient about self-care for this condition?

Answer 22

Strap the foot to maintain the arch

Question 23

Which clinical findings does the nurse assessed in the affected area of a patient with them osteomyelitis?

Answer 23

Erythema, tenderness, swelling, constant bone pain

Question 24

The nurses caring for a patient with muscular dystrophy. Although all body systems can be affected, the nurse is alert and carefully assesses for which major problem?

Answer 24

Respiratory failure

Question 25

The nurses caring for several patients on orthopedic trauma unit. Which conditions have a high-risk for development of acute compartment syndrome?

Answer 25

1. Lower legs caught between the bumpers of two cars 2. Massive infiltration of IV fluid into forearm 3. Multiple insect bites to lower legs 4. Severe burns to the upper extremities

Question 26

The patient has a fracture of the right wrist. What is an early sign that indicates this patient may be having a complication?

Answer 26

Patient reports a subjective numbness and tingling

Question 27

The nurse is assessing a patient for severe pain in the right wrist after falling off the stepstool. How does the nurse assesses patients motor function?

Answer 27

Asking the patient to move the fingers

Question 28

The patient and traction reports severe pain from a muscle spasm. What is the nurses priority action?

Answer 28

Assess the patient's body alignment

Question 29

The nurse is reviewing the orders for a patient was admitted for 24 hour observation of a like fracture. A cast is in place. Which order does the nurse question?

Answer 29

Perform neuro, circulation checks every eight hours

Question 30

The patient with a leg cast denies pain, Tozer pink, capillary refill is brisk and toes move freely, the leg is elevated with an ice pack. Six hours later the patient reports worsening pain unrelieved by medication. The patient's toes are cool and capillary refill sluggish. What does the nurse suspect is occurring with this patient

Answer 30

Acute compartmental syndrome

Question 31

An older adults sustained injury to the lower legs after being trapped underneath the following bookcase. Because this patient is at high risk for crush syndrome, which lab values will the nurse specifically monitor?

Answer 31

Serum potassium level and myoglobin in urine

Question 32

And older adults has been admitted with a hip fracture. Approximately 20 hours post injury, the patient developed a symptom recognizes an early sign of fat embolism syndrome. Which symptom is the patient displaying?

Answer 32

Change in mental status

Question 33

Indicate the numeric sequence of bone healing

Answer 33

1. Hematoma formation 2. Hematoma to granulation tissue 3. Osteoblastic proliferation 4. Callous formation 5. Bone remodeling

Question 34

Student nurse is assessing a patient with a probable fractured tibia fibula. What assessment technique used by the nurse causes the supervising nurse to intervene?

Answer 34

Pushes on the leg to elicit pain response

Question 35

The nurses caring for several orthopedic patients were in different types of traction. What should the nurse do in assessing the traction equipment?

Answer 35

1. Inspect ropes and knots for fraying are loosening every 8 to 12 hours 2. Checking amount of weight being used against the prescribed way 3. Observe the traction equipment for proper functioning

Question 36

The patient was put into traction at 0800 hrs. Hourly neurological, and circulation checks were ordered for the first 24 hours and then every four hours thereafter. I what time can the nursing staff start performing the every four checks?

Answer 36

O800 hours next day

Question 37

The nurses educating the patient will have external fixation for treatment of a compound tibial fracture. What information does the nurse including the teaching session?

Answer 37

The device allows for early ambulation

Question 38

The nurses helping to evaluate several patients to determine candidacy for that Illzaroz external fixation device. Which patient has the best candidate?

Answer 38

Child with a congenital bone deformity whose mother is a licensed practical nurse

Question 39

An older adult patient has a fractured humorous. The physician is considering the use of electrical bone stimulation Mathson nurse to take a medical history on the patient. With specific condition, which is contraindication for this therapy, does the nurse asked the patient about?

Answer 39

Cardiac pacemaker

Question 40

The patient is prescribed low intensity post ultrasound treatments for a very slow healing fracture of the right lower leg. What instructions as the nurse give this patient related to the treatment?

Answer 40

Expected dedicate approximately 20 minutes a day for one treatment

Question 41

The nursing student is assisting with the care of a patient with musculoskeletal pain related to soft tissue injury and bone disruption. Student nurse sees the patient has a PRN order for pain medication. What does the student do first in order to decide when to give the pain medication?

Answer 41

Ask the patient about types of activities that increase the pain

Question 42

The patient is receiving scheduled and PRN narcotics for severe pain related to musculoskeletal injury. The nurse finds of the patient's abdomen is distended bowel sounds are hypoactive. Because the nurse suspected that patient is having a medication side effect, which question does the nurse asked the patient?

Answer 42

When was your last bowel movement

Question 43

The patient comes into the ED after falling off his four wheeler. His lower leg is obviously broken, it is bleeding and bone fragments are protruding from the skin. Whatever fracture this is patient likely have?

Answer 43

An open or compound fracture

Question 44

The patient comes to the emergency department after slipping out some chalk and her classroom. She did not fall far and was able to walk with assistance of one of her students. Whatever fracture this is patient likely have?

Answer 44

Incomplete

Question 45

The female patient with osteoporosis come so that you do you after filing suddenly while putting her car door. She said it felt as if her leg gave way. What type of fracture does this patient likely have

Answer 45

Pathologic (spontaneous)

Question 46

What technique is used to treat nonunion or malunion fractures

Answer 46

Illizarov

Question 47

True or false | An externalelectrical bone stimulator system is directed at non-healed fracture site

Answer 47

True

Question 48

True or false | Low intensity Pulse ultrasound is used for slow healing fractures

Answer 48

True

Question 49

The nurses caring for a patient with an open fracture. What intervention does the nurse perform in the order to prevent infection of the fracture?

Answer 49

Use strict aseptic technique for dressing changes in on the irrigation

Question 50

The nurse must adjust Crutches to properly fit a patient. Which description illustrates cracked crutch adjustment?

Answer 50

Elbows flexed no more than 30° on the palm is on the hand

Question 51

An older patients family is trying to find an appropriate cane for the patient to use because of chronic pain in the right ankle. The nurse instruct the family to purchase which type of cane?

Answer 51

One with the top being parallel to the greater trochanter of the femur

Question 52

What members of the healthcare team will be consulted to teach the patient about proper use of the cane?

Answer 52

Physical therapist and registered nurse

Question 53

The nurses caring for a patient with an external fixation of a bone fracture. What are the advantages of this type of treatment?

Answer 53

1. It is less painful than other treatments 2. It allows for earlier ambulation 3. It maintains bone alignment 4. It's stabilizes commuted fractures require bone grafting

Question 54

An older patient with a lower leg fractures having difficulty performing the weight-bearing exercises. Based on the fracture pathophysiology and the patients abilities, which condition could the patient develop?

Answer 54

Pulmonary embolism

Question 55

The nurse case managers making a home visit to assist in elderly patient with a hip fracture. During the home visit, the nurse reviews home environment safety. Which observations indicate the need for additional teaching?

Answer 55

Floors are clean and shiny and covered with throw rugs

Question 56

Which is a potentially fatal complication of acute compartment syndrome?

Answer 56

Myoglobinuric renal failure

Question 57

The patient comes to the ED with crush syndrome from a crush injury to his right upper extremity and a right lower extremity and heavy equipment follow him at the construction site. The patient has signs and symptoms of hypovolemia, hyperkalemia, and compartment syndrome. Masking of care for this patient will focus on preventing which complications?

Answer 57

Cardiac dysrhythmias and acute tubular necrosis

Question 58

Chronic complication of bone healing is called a vascular necrosis. Which statement about this complication is true?

Answer 58

It involves disrupting the blood supply to the bone It results in the death of bone tissue It is most often a complication of hip fractures

Question 59

A 30-year-old patient was hospitalized for a pair of a fractured tibia and fibula reports shortness of breath. Which complication related to the injury might the patient be experiencing?

Answer 59

Fat embolism

Question 60

Avascular necrosis

Answer 60

Disruptive blood supply to the bone, resulting in the death of bone tissue

Question 61

Fat embolism

Answer 61

Fat globules released from the yellow bone marrow into the bloodstream

Question 62

Malunion

Answer 62

Incorrect fracture healing

Question 63

Nonunion

Answer 63

Lack of fracture healing

Question 64

The patient tripped and fell down several stairs reports having heard a popping sound and fears that she's broken her ankle. How does the nurse initially assessed for fracture in this patient?

Answer 64

Observing for deformity or misalignment

Question 65

The nurse is assessing the patient and injury to his shoulder and upper arm after being John from Mars. What is the best position for this patient assessment?

Answer 65

Sitting to observe for shoulder droop

Question 66

The nurses caring for patient with skeletal pins that have been placed for traction. What does the nurse expect to see in the first 48 hours?

Answer 66

Clear fluid drainage weeping from the pin insertion site

Question 67

What potential adverse effects prevents Demerol from being used in all the results?

Answer 67

Seizures

Question 68

The unlicensed assistive personnel is assisting the orthopedic physician to cut a window and a patient's. Once the nurse instruct the UAP to do?

Answer 68

Save the plaster piece that was can be taped in place

Question 69

The nurses caring for patients and bucks traction. Which task is best to delegate to the UAP?

Answer 69

Turning and repositioning

Question 70

The nurses instructing in teenage patient with the tibia fibula fracture was treated with internal fixation along like cats. He's anxious and I want to Castlemere move so that he can resume football practice. Which statement by the patient indicates the need for additional teaching?

Answer 70

I'll use crutches for two weeks and then the castle be removed

Question 71

The patient was an unrestrained driver involved in a motor vehicle accident who is sustained the fifth rib fracture. At the patient is being assessed what is the nurses major concern?

Answer 71

Muffled heart sounds

Question 72

According to the patient's chart there is a family history of osteoporosis. In order to plan interventions related to this finding, what action does the nurse take?

Answer 72

Review the patient's dietary intake of calcium

Question 73

The patient is a middle-aged man with a history of uncontrolled diabetes. His right foot is a dark brownish purple color and there's no palpable dorsal pedis or posterior to tibial pulse. The nurse prepares the patient for which diagnostic test?

Answer 73

Doppler ultrasound

Question 74

Pain patient experiences from a bone fracture results from which processes?

Answer 74

Edema, muscle spasms

Question 75

The patient injured a lower extremity and has been placed in a running traction. What instructions says the nurse gives to the UAP?

Answer 75

Moving the patient out of bed during care can alter the counter traction

Question 76

The nurse supplies bandages do a patient's residual limb in order to help shape and strength for a prosthesis. What is the proper technique for the nurse to use

Answer 76

Use a figure 8 wrapping method prevent restriction of blood flow

Question 77

Skin traction

Answer 77

Involves the use of a fabric fastener boot, belt, or halter which is secured around the body part

Question 78

Plaster traction

Answer 78

Combined skeletal traction and a plaster cast

Question 79

Skeletal traction

Answer 79

Pins, wires, tongs, or through surgically inserted directly into bone

Question 80

An older patient is discharged to home phone and orthopedic injury. Which mobilization device is usually preferred for older patients?

Answer 80

Walker

Question 81

The nurses interviewing in older adult with a history of osteoporosis reports falling and catching her way on her outstretched dominant hand. This patient is most likely to have sustained what type of fracture?

Answer 81

Colles wrist fracture