Musculoskeletal Practice Flashcards
A nurse is assessing a pt who has arteriosclerosis and is scheduled for a possible right lower extremity amputation. Which of the following are expected findings in the affected extremity? SATA
a) Skin cool to touch from mild-calf to the toes
b) Increased sensitivity to fine touch
c) Palpable poinding pedal pulse
d) Lack of hair on lower leg
e) Blackened areas on several toes
a,d,e
b-should decrease
c-should lack of pulse
A nurse is caring for a pt following a below-the-elbow amputation. Which of the following actions should the nurse take?SATA
a) Encourage dependent positioning of the residual limb
b) Inspect for the presence and amount of drainage
c) Implement shrinkage intervention of the residual limb
d) Wrap the residual limb in a circular manner using gauze
e) Assess for feelings of body image changes
a,b,c,e
a) for circulation
dependent positioning=hanging down
residual=残りの
b) early detection of infection
A nurse is caring for a pt who had an above-the-knee amputation. The pt reports a sharp, stabbing type of phantom pain. Which of the following actions should the nurse take?
a) Remove the initial pressure dressing
b) Encourage the use of cold therapy
c) Question whether the pain is real
d) Administer an antipileptic medication
d
a- do not remove,the surgeon remove in 36-48hr
b- heat therapy
c- do not question, the pain related to the severed nerve pathway
A nurse is preparing a plan of care to prevent a pt from developing flexion contractions following a below-te knee amputation 24hr ago.
which of the following actions should the nurse include?
a) Limit any type of exercise to the residual limp for the first 48 hr after surgery
b) Position the pt prone several times each day
c) Wrap the residual limb in a figure-eghitpattern
d) Encourage sitting in a chair during the day
b
a- ROM
d- sitting= bend positon=not good
bent (flexed) joint that cannot be straightened
An 82-yr-old patient is frustrated by loose abdominal tissue and rigid hips. How should the nurse respond?
a) “You should go on a diet and exercise more to feel better about yourself.”
b) “Something must be wrong with you because you should not have these problems.”
c) “You have arthritis and need to take nonsteroidal anti-inflammatory drugs (NSAIDs).”
d) “Decreased muscle mass and strength and increased hip rigidity are expected with aging.”
d
The musculoskeletal system’s normal changes of aging include decreased muscle mass and strength; increased rigidity in the hips, neck, shoulders, back, and knees; decreased fine motor dexterity; and slowed reaction times. Going on a diet and exercising will help but not stop these changes. Telling the patient “Something must be wrong with you…” is untrue and will not be helpful to the patient’s frustrations.
The home care nurse visits an 84-yr-old woman with pneumonia after her discharge from the hospital. Which age-related change in the musculoskeletal system should the nurse expect?
a) Positive straight-leg-raising test
b) Muscle strength is scale grade 3/5
c) Lateral S-shaped curvature of the spine
d) Fingers drift to the ulnar side of the forearm
b
Decreased muscle strength is an age-related change of the musculoskeletal system caused by decreased number and size of the muscle cells.
When administered long-term, which medication requires ongoing musculoskeletal assessment?
a) Corticosteroids
b) β-Adrenergic blockers
c) Antiplatelet aggregators
d) Calcium-channel blockers
a
Corticosteroids are associated with avascular necrosis and decreased bone and muscle mass.
A patient is scheduled for dual-energy x-ray absorptiometry (DEXA)Which statement by the patient indicates understanding of the procedure?
a) “The bone density in my heel will be measured.”
b) “This procedure will not cause any pain or discomfort.”
c) “I will not be exposed to any radiation during the procedure.”
d) “I will need to remove my hearing aids before the procedure.”
b
The nurse is performing a musculoskeletal assessment on an 81-yr-old patient whose mobility has been progressively declining. How should the nurse safely assess range of motion (ROM) in the affected leg?
a) Observe the patient’s unassisted ROM in the affected leg.
b) Perform passive ROM, asking the patient to report any pain.
c) Ask the patient to lift progressive weights with the affected leg.
d) Move both the patient’s legs from a supine position to full flexion.
a
Observing the patient’s active ROM is more accurate and safer than lifting weights. Passive ROM should be performed with extreme caution; it may cause harm when performed on older patients.
A patient is about to have a bone scan. In teaching the patient about this procedure, the nurse should include what information?
a) “Mild pain is associated with the procedure.”
b) “Two additional follow-up scans will be required.”
c) “The procedure takes approximately 15 to 30 minutes.”
d) “You will need to drink increased fluids after the procedure.”
d
Patients are asked to drink increased fluids after a bone scan to aid in excretion of the radioisotope, if not contraindicated by another condition. No follow-up scans are required. Only mild pain may be associated with bone scans related to 1 hour of lying supine.
A nurse is admitting an adult tp who has suspected osteoporosis. Which of following findings are risk factors for osteoprorosis? SATA
a) History of consuming one glass of wine daily
b) Lossi n height of 2 in
c) Body mass index of 18
d) Kyphotic curve at upper thracic spine
e) History of lactose intolerance
b,c,d,e
b- d/t fracture of vertebral column
c- d/t low body weight
e- d/t possibe lack of ca
a- alcohol can increase bone loss
A nurse is providing care for a pt who had a vertebroplasty of the thoracic spine. Which of the following actions should the nurse take?
a) Apply heat to the puncture site
b) Place the pt ina supine position
c) Turn the pt every 1 hr
d) Ambulate the pt within the first hour postprocedure
b
for allowing hardening of cement
a- cold therapy for decrease bleeding
c,d- should remain supine position
Vertebroplasty is a treatment that injects cement into a cracked or broken spinal bone to help relieve pain
A nurse is performing health screening at a health fair. Which of the following pt have a risk factor for osteoporosis? SATA
a) a 40 years old pt who has been taking prednisone for 4 month
b) a 30 year old pt who jogs 3 miles daily
c) a 45 year old pt who takes phenytoin for seizures
d) a 65 years old pt who has a sedentary lifestyle
e) a 70 years old pt who has smoked for 50 years
a,c,d,e
phenytoin=anticonvulsant
A nurse is planning discharge teaching on home safety for pt who has osteoporosis. Which of the following info should included?
a) remove throw rugs in the walkway
b) use prescribed assistive devices
c) remove clutter forn the environment
d) wear soft bottom shoes
e) Maintain lighting of doorway areas
a,b,c,e
In assessing the joints of a pt with OA, the nurse understands that Bouchard’s nodes
a) are often red, swollen, and tender
b) indicate osteophyte formation at the PIP joints
c) are the result of pannus formation at the DIP joints
d) occur form deterioration of cartilage by proteolytic enzyme
b
A pt with RA has articular involvement, the nurse recognizes these characteristic changes including SATA
a) bamboo-shaped fingers
b) metatarsal head dislocation in feet
c) noninflammatory pain in large joints
d) asymmetric involvement of small joints
e) morning stiffness lasting 60 mins or more
b,e
