ORTHO: Assessment of Musculoskeletal Function Flashcards
A patient has a fracture of the right femur sustained in a motor vehicle crash. Which process of fracture healing does the nurse determine will occur with this patient?
a. Reactive phase, Reparative phase, Remodeling phase
b. Primary phase, Secondary phase, Third phase
c. First intention, secondary intention, Third intention
d. Active phase, Dormant phase, Restructure phase
**a. **Reactive phase, Reparative phase, Remodeling phase
A patient has a fracture that is being treated with open rigid compression plate fixation devices. How will the progress of bone healing be monitored?
a. Remove the plate and determine if the bone is growing back.
b. Perform serial x-rays
c. Perform an arthroscopy
d. The bone will heal on its own without intervention.
b. Perform serial x-rays
A patient tells the physician about shoulder pain that is present even without any strenuous movement. The physician identifies a sac filled with synovial fluid. What condition should the nurse educate the patient about?
a. A fracture of the clavicle
b. Osteoarthritis of the shoulder
c. Chronic Bursitis
d. Ankylosing spondylitis
c. Chronic Bursitis
A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?
a. Rigidity
b. Flaccidity
c. Atonic
d. Tetanic
b. Flaccidity
A type of paralysis in which a muscle becomes soft and yields to passive stretching, which results from loss of all or practically all peripheral motor nerves that innervated the muscle.
A patient tells the nurse, “I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!” What is the best response by the nurse?
a. “While you are lifting weights, endorphins are released, creating increase in muscle mass, but if the muscles are not used they will atrophy.”
b. “The muscle mass has decreased from the lack of calcium in the cells.”
c. “Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued.”
d. “Once you stop exercising, the contraction of the muscle does not regain its strength.”
c. “Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued.”
After a bone density test, an older adult female patient tells the nurse, “I don’t understand why I have osteoporosis because I eat well and take my calcium.” What does the nurse understand is the reason that the patient may have osteoporosis?
a. Everyone gets osteoporosis and there is nothing you can do to prevent it.
b. Men lose more bone mass than women but women still lose some.
c. In order to prevent bone loss, women have to take hormones.
d. The loss is from withdrawal of estrogen and a decrease in activity levels.
d. The loss is from withdrawal of estrogen and a decrease in activity levels.
(The drop in oestrogen levels that occurs around the time of menopause results in increased bone loss.)
(Estrogen deficiency leads to increased osteoclast formation and enhanced bone resorption.)
A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?
a. Paresthesia
b. Flaccidity
c. Atonia
d. Effusion
a. Paresthesia
(Paresthesia is the feeling of burning or tingling, numbness or “pins and needles.”)
The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as?
a. Lordosis
b. Scoliosis
c. Osteoporosis
d. Kyphosis
d. Kyphosis
(Kyphosis is an excessive curve of your spine and may be called “hunchback” or “round back.”)
The nurse assesses soft subcutaneous nodules
along the line of the tendons in a patient’s hand and wrist. What does this finding indicate to the nurse?
a. The patient has osteoarthritis.
b. The patient has lupus erythematosus.
c. The patient has rheumatoid arthritis.
d. The patient has neurofibromatosis.
**c. **The patient has rheumatoid arthritis.
(Rheumatoid nodules are firm lumps under the skin. They tend to form close to joints in people affected by rheumatoid arthritis.)
The nurse is caring for a pregnant patient with pregnancy-induced hypertension. When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as?
a. Positive Babinski reflex
b. Clonus
c. Hypertrophy
d. Ankle reflex
**b. **Clonus
(Clonus is a sign of neuromuscular irritability that usually reflects severe pre-eclampsia.)
(Clonus- ankle clonus/foot clonus: a series of abnormal reflex movements of the foot, induced by sudden dorsiflexion, causing alternate contraction and relaxation of the triceps surae muscle.)
The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)
a. Pale, cyanotic, or mottled color
b. Cool temperature of the extremity
c. More than 3-second capillary refill
d. Tenting skin turgor
e. Limited range of motion
a. Pale, cyanotic, or mottled color
**b. **Cool temperature of the extremity
**c. **More than 3-second capillary refill
A patient is scheduled for a procedure that
will allow the physician to visualize the knee
joint in order to diagnose the patient’s pain.
What procedure will the nurse prepare the
patient for?
a. Arthrocentesis
b. Bone scan
c. Electromyography
d. Arthroscopy
**d. **Arthroscopy
(Arthroscopy is a surgical procedure that orthopaedic surgeons use to visualize and treat problems inside a joint.)
A patient is having repeated tears of the joint capsule in the shoulder, and the physician orders an arthrogram. What intervention should the nurse provide after the procedure is completed? (Select all that apply.)
a. Apply a compression bandage to the area.
b. Apply heat to the area for 48 hours.
c. Administer a mild analgesic.
d. Inform the patient that a clicking or crackling
noise in the joint may persist for a couple of days.
e. Actively exercise the area immediately after the procedure.
An arthrogram is a series of images of a joint after injection of a contrast medium, usually done by fluoroscopy or MRI. The injection is normally done under a local anesthetic such as Novocain or lidocaine.
a. Apply a compression bandage to the area.
c. Administer a mild analgesic.
d. Inform the patient that a clicking or crackling
noise in the joint may persist for a couple of days.
The major consequence of osteoporosis
Bone Fracture
Two medications used to treat Paget Disease are ____ and ____.
Bisphosphonates and Plicamycin
