Musculoskeletal Conditions

Question 1

What are the 3 types of joint surgeries?

Answer 1

Synovectomy
Osteotomy
Debridement

Question 2

What is arthroplasty?

Answer 2

Reconstruction or replacement of a joint to relieve pain, improve or maintain ROM, and correct deformity

Question 3

Describe an open fracture

Answer 3

Skin is broken
Bone is exposed
Causes soft tissue injury

Question 4

Describe a closed fracture

Answer 4

Skin is intact over break site

Question 5

Describe a complete fracture

Answer 5

Break goes completely through the bone

Question 6

Describe an incomplete fracture

Answer 6

Occurs partly through the bone shaft
Bone is still intact

Question 7

Describe the 5 different types of fracture lines

Answer 7

Linear
Oblique
Transverse
Longitudinal
Spiral

Question 8

Describe the different between a displaced fracture and a nondisplaced fracture

Answer 8

Nondisplaced: Bone fragments stay in alignment

Displaced: Two ends of the bone are separated from each other and out of their normal positions

Question 9

What is crepitation?

Answer 9

The audible crunching of bone fragments

Question 10

What are the 6 stages of bone fracture healing?

Answer 10

1) Fracture hematoma; first 72 hours

2) Granulation Tissue; 3-14 days

3) Callus formation; end of 2nd week

4) Ossification 3 weeks - 6 months

5) Consolidation; up to 1 year

6) Remodeling

Question 11

What is angulation in fracture healing?

Answer 11

A complication that occurs when fracture heals in an abnormal position in relation to midline

Question 12

What is malunion in fracture healing?

Answer 12

A complication that occurs when heals on time but in the wrong place (angulation is a type of malunion)

Question 13

What is myositis ossificans?

Answer 13

A complication that occures when calcium is deposited into the muscle tissue

Question 14

For which reason would traction be used in the care of a patient with a bone fracture?

Answer 14

-Reduce a fracture
-Immobilize a joint
-Prevent muscle spasms
-Treat a pathological joint condition

Question 15

What type of cast would be used for a child with a fractured femur?

Answer 15

Hip spica

Question 16

What is the Tinel sign and the Phalen sign?

Answer 16

Tinel Sign: Positive when you tap where the median nerve enters the wrist and tingling feeling is felt through the hand

Phalen Sign: Let the wrist freely fall to allow maximum flexion. Positive when tingling is felt in the hand

Question 17

What are osteophytes?

Answer 17

Extra, lumpy bone growths

Question 18

What is hemiarthroplasty?

Answer 18

Replacement of the femur head with a prothesis

Question 19

What is mesenteric artery syndrome?

Answer 19

Gastrovascular disorder when the duodenum is compressed between the abdominal aorta and the superior mesenteric artery

Question 20

What body part is at risk for superior mesenteric artery syndrome when sustaining a fracture?

Answer 20

Vertebrae

Question 21

What is a greenstick fracture?

Answer 21

An incomplete fracture with one side splintered and the other side bent

Question 22

What is footdrop?

Answer 22

A condition that makes it difficult to raise the from part of the foot

Question 23

What action does the nurse take to prevent footdrop in a patient who has a long leg cast?

Answer 23

Apply a splint to keep the foot in a neutral position

Question 24

What condition can potentially displace a fracture?

Answer 24

Muscle spasms

Question 25

A patient with a knee fracture reports an increase in muscle spasms. What does the nurses suspect that the patient is doing to cause the spasms?

Answer 25

Massaging the muscle

Question 26

What are 3 functions of the Buck traction?

Answer 26

1) It immobilizes the fracture 2) It reduces muscle spasms 3) It prevents or reduces pain

Question 27

What is bursitis?

Answer 27

Painful condition that occurs when the fluid-filled sacs that cushion joints become inflamed

Question 28

What does subluxation mean?

Answer 28

Dislocation

Question 29

What is impingement syndrome?

Answer 29

Entrapment of soft tissue structures under the coracoacromial arch of the shoulder

Question 30

What is the McMurray test?

Answer 30

A test done to diagnose a torn meniscus

Question 31

What condition can occur if a torn meniscus is left untreated for a long period of time?

Answer 31

Quad atrophy

Question 32

What is the Homan sign?

Answer 32

A test where the foot is dorsiflexed while the knee is extended to check for pain in the calf. Used to diagnose Deep Vein Thrombosis

Question 33

When performing a physical examination of a patient, how does the nurse assess the function of the peroneal nerve?

Answer 33

Assess dorsiflexion of the foot Assess sensation in the web space between the first and second toes

Question 34

What is the Lachman test?

Answer 34

Test done to evaluate the integrity of the ACL

Question 35

How does smoking contribute to lower back pain?

Answer 35

Tobacco use impairs circulation to the intervertebral discs

Question 36

What is cada equina?

Answer 36

The cada equina is a bundle of nerve nerves at the end of the spinal cord. When they are compressed or disrupted, it is known as cada equina syndrome and it is a medical emergency

Question 37

What is Sjorgen syndrome?

Answer 37

Chronic autoimmune disease that attacks body's glands that produce saliva and tears. Can also cause dr

Question 38

How is Fibromyalgia diagnosed?

Answer 38

-Widespread Pain Index: Pain in11/18 tender points over past week Criteria: -WPI score of 7+ and Symptom Severity Index (SSI) of 5+ OR -WPI 3-6 & SSI 9+ -Fatigue -Cognitive symptoms

Question 39

What is SEID?

Answer 39

Systemic Exertion Intolerance Disease; disease in which exertion of any sort (physical, emotional, cognitive) is impaired and accompanied by profound fatigue

Question 40

Why do women rarely develop gout?

Answer 40

Estrogen promoted renal excretion of uric acid

Question 41

What is the difference between Primary and Secondary Hyperuricemia?

Answer 41

Primary: Genetic lack of uricase Secondary: Increased uric production, Decreased uric acid excretion, Drugs

Question 42

What is the normal range of uric acid levels?

Answer 42

2.7-8.5mg/dL

Question 43

What are 3 ways that gout can be diagnosed?

Answer 43

1) Uric acid levels 2) Synovial Fluid Aspiration 3) X-rays

Question 44

How is the symmetry in osteoarthritis symptoms?

Answer 44

Is usually asymmetric

Question 45

What is Systemic Lupus Erythematosus?

Answer 45

Autoimmune disease caused by genetic, hormonal, environmental, and immune factors mostly affecting women

Question 46

What is the most common symptom of SLE?

Answer 46

Skin lesions like butterfly rash

Question 47

What is Scleroderma?

Answer 47

Chronic autoimmune disease that causes the skin to thicken and harden

Question 48

What is CREST syndrome?

Answer 48

Symptoms of scleroderma: C: Calcinosis R: Raynaud Phenomenon E: Esophageal Dysfunction S: Sclerodactyly (tightening of skin on fingers and toes leading to semi flexed positions) T: Telangiectasia (red spots on skin from capillary dilation)

Question 49

What clinical manifestation is associated with osteoarthritis?

Answer 49

Crepitation in the weight-bearing joints

Question 50

Which synovial fluid analysis finding is suggestive of rheumatoid arthritis?

Answer 50

-Presence of fibrin flecks -Elevated WBC count -Increased matrix metallopeptidase (MMP-3 enzyme)

Question 51

What is a varus deformity?

Answer 51

Condition where the distal part of a bone or joint angulates inwards

Question 52

What is Reiter syndrome?

Answer 52

Reactive arthritis that usually activates after a bacterial infection

Question 53

Which symptoms are associated with Reiter syndrome?

Answer 53

Urethritis Cervicitis Conjunctivitis Mucocutaneous lesions

Question 54

Which factors can precipitate gout?

Answer 54

Starvation & dehydration Niacin Aspirin

Question 55

Fatigue and fever are present in what kind of arthritis?

Answer 55

Rheumatoid

Question 56

What is Felty Syndrome?

Answer 56

A combination of an enlarged spleen and a low white blood cell count due to rheumatoid arthritis

Question 57

What medication can be prescribed for a patient recently diagnosed with rheumatoid arthritis

Answer 57

Methotrexate

Question 58

Which assessment findings may be associated with rheumatoid arthritis?

Answer 58

Joint stiffness Dry itchy eyes Rheumatoid nodules Atherosclerosis High WBC count

Question 59

What diagnostic tests might be the same for RA and OA?

Answer 59

High erythrocyte sedimentation rate (ESR) Narrowed join space in x-ray

Question 60

What is the Gottron sign?

Answer 60

A characteristic skin rash, appearing as red or purple, scaly patches on the back of the hands, elbows, and knees, typically seen in patients with EARLY dermatomyositis

Question 61

What can a positive Gottron sign indicate?

Answer 61

Dermatomyositis

Question 62

What condition is common is long-standing dermatomyositis?

Answer 62

Calcinosis cutis

Question 63

What type of medication may be prescribed as an alternative to an antimalarial drug for a patient with systemic lupus erythematosus?

Answer 63

Antileprosy

Question 64

What is malar rash also known as?

Answer 64

Butterfly rash

Question 65

What clue would indicate that a patient has ankylosing spondylitis?

Answer 65

AS primarily affects the axial skeleton so increasing lower back pain, stiffness, and limited motion would be indicators

Question 66

Why is Tylenol not used for inflammation?

Answer 66

Decreased pain and fevers but does not provide an antiinflammatory effect

Question 67

What is the antidote for acetaminophen toxicity?

Answer 67

Acetylcysteine

Question 68

How can the common side effects of morphine be minimized?

Answer 68

Increased fluid and fiber in diet