Chapter 22: Musculoskeletal System 1. A patient is being assessed for range of joint movement. The nurse asks him to move his arm in toward the center of his body. This movement is called: Adduction. 2. A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth. The nurse knows that for her to move her hand to her mouth, she must perform which movement? Flexion. 3. The functional units of the musculoskeletal system are the: Joints. 4. When reviewing the musculoskeletal system, the nurse recalls that hematopoiesis takes place in the: Bone marrow. 5. Fibrous bands running directly from one bone to another that strengthen the joint and help
12. The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury. The nurse knows that a rotator cuff injury involves the: Glenohumeral joint. 13. During an interview the patient states, “I can feel this bump on the top of both of my shoulders—it doesn’t hurt but I am curious about what it might be.” The nurse should tell the patient, “That is: “Your acromion process.” 14. The nurse is checking the range of motion in a patient’s knee and knows that the knee is capable of which movement(s)? Flexion and extension 15. A patient is visiting the clinic for an evaluation of a swollen, painful knuckle. The nurse notices that the knuckle above his ring on the left hand is swollen and that he is unable to remove his wedding ring. This joint is called the
prevent movement in undesirable directions are called: Ligaments.
joint. Metacarpophalangeal 16. The nurse is assessing a patient’s ischial
6. The nurse notices that a woman in an exercise class is unable to jump rope. The nurse knows that to jump rope, one’s shoulder has to be capable of: Circumduction. 7. The articulation of the mandible and the temporal bone is known as the: Temporomandibular joint. 8. To palpate the temporomandibular joint, the nurse’s fingers should be placed in the depression of the ear. Anterior to the tragus 9. Of the 33 vertebrae in the spinal column, there are: 5 lumbar. 10. An imaginary line connecting the highest point on each iliac crest would cross the vertebra. Fourth lumbar 11. The nurse is explaining to a patient that there are “shock absorbers” in his back to cushion the spine and to help it move. The nurse is referring to his: Intervertebral disks.
tuberosity. To palpate the ischial tuberosity, the nurse knows that it is best to have the patient: Flex the hip. 17. The nurse is examining the hip area of a patient and palpates a flat depression on the upper, lateral side of the thigh when the patient is standing. The nurse interprets this finding as the: Greater trochanter. 18. The ankle joint is the articulation of the tibia, the fibula, and the: Talus. 19. The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler. Where does lengthening of the bones occur? Epiphyses 21. An 85-year-old patient comments during his annual physical that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because: Of the shortening of the vertebral column. 22. A patient has been diagnosed with osteoporosis and asks the nurse, “What is osteoporosis?” The nurse explains to the patient that osteoporosis is defined as: Loss of bone density.
1
Chapter 22: Musculoskeletal System 23. The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal women. Which of these actions is the best way to prevent or delay bone loss in this group? Taking calcium and vitamin D supplements 24. The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal woman. A participant shows that she needs more instruction when she states, “I will: Start swimming to increase my weightbearing exercise.” 25. A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The nurse examines her hand and would expect a fracture if the girl complains: Of sharp pain that increases with movement. 26. A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for awhile, and then gets worse again if he sits for long periods of time. The nurse should assess for other signs of what problem? Rheumatoid arthritis 27. A patient states, “I can hear a crunching or grating sound when I kneel.” She also states that “it is very difficult to get out of bed in the morning because of stiffness and pain in my joints.” The nurse should assess for signs of what problem? Crepitation 28. A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms; the nurse should suspect: Rotator cuff lesions. 29. A professional tennis player comes into the clinic complaining of a sore elbow. The nurse will assess for tenderness at the: Medial and lateral epicondyle. 30. The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen’s test. To perform this test, the nurse should instruct the patient to: Hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.
31. An 80-year-old woman is visiting the clinic for a checkup. She states, “I can’t walk as much as I used to.” The nurse is observing for motor dysfunction in her hip and should have her: Abduct her hip while she is lying on her back. 32. The nurse has completed the musculoskeletal examination of a patient’s knee and has found a positive bulge sign. The nurse interprets this finding to indicate: Swelling from fluid in the suprapatellar pouch. 33. During an examination, the nurse asks a patient to bend forward from the waist and notices that the patient has lateral tilting. When his leg is raised straight up, he complains of a pain going down his buttock into his leg. The nurse suspects: Herniated nucleus pulposus. 37. A 40-year-old man has come into the clinic with complaints of “extreme tenderness in my toes.” The nurse notices that his toes are slightly swollen, reddened, and warm to the touch. His complaints would suggest: Acute gout. 38. A young swimmer comes to the sports clinic complaining of a very sore shoulder. He was running at the pool, slipped on some wet concrete, and tried to catch himself with his outstretched hand. He landed on his outstretched hand and has not been able to move his shoulder since then. The nurse suspects: Dislocated shoulder. 39. A 68-year-old woman has come in for an assessment of her rheumatoid arthritis, and the nurse notices raised, firm, nontender nodules at the olecranon bursa and along the ulna. These nodules are most commonly diagnosed as: Olecranon bursitis. 40. A woman who has had rheumatoid arthritis for years is starting to notice that her fingers are drifting to the side. The nurse knows that this condition is commonly referred to as: Ulnar deviation. 41. A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her fingers. The nurse will assess for signs of what problems? Swan neck deformities
2
Chapter 22: Musculoskeletal System
42. A patient’s annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine; however, this curvature disappears with forward bending. The nurse knows that this abnormality of the spine is called: Functional scoliosis. 43. A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months. Which response by the nurse is appropriate? “Your disease is due to repeated stress on the patellar tendon. It is usually selflimited, and your symptoms should resolve with rest.” 44. When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What Grade should the nurse record using a 0 to 5point scale? 5 48. The nurse should use which test to check for large amounts of fluid around the patella? Ballottement 49. A patient tells the nurse that “all my life I’ve been called ‘knock knees.’” The nurse knows that another term for “knock knees” is: Genu valgum. 50. A patient has been diagnosed with a ganglion cyst over the dorsum of his left wrist. He asks the nurse, “What is this thing?” The nurse’s best answer would be, “It is: A common benign tumor.” 51. A man who has had gout for several years comes to the clinic with a problem with his toe. On examination, the nurse notices the presence of hard, painless nodules over the great toe; one has burst open with a chalky discharge. This finding is known as: Tophi. 52. When performing a musculoskeletal assessment, the nurse knows that the correct approach for the examination should be: Proximal to distal.
1. The nurse is assessing the joints of a woman who has stated, “I have a long family history of arthritis, and my joints hurt.” The nurse suspects that she has osteoarthritis. Which of these are symptoms of osteoarthritis? Select all that apply. Asymmetric joint involvement Pain with motion of affected joints Affected joints are swollen with hard, bony protuberances
3