Deck 19: Musculoskeletal System

Question 1

Musculoskeletal health is especially enhanced by a diet containing recommended amounts of

A) protein, calcium, vitamin D, and phosphorous.
B) carbohydrates, calcium, vitamin D, and potassium.
C) fiber, iron, vitamin D, and sodium.
D) whole grains, calcium, magnesium, and vitamin D.

Answer 1

protein, calcium, vitamin D, and phosphorous.

Question 2

When a patient walks into a clinic,the nurse notes a gait that is uncoordinated,stiff,and jerky.The patient is dragging a foot across the floor in a semicircle.What type of gait does this demonstrate?

A) spastic hemiplegia gait of cerebral palsy
B) festinating gait of Parkinson's disease
C) scissors gait of multiple sclerosis
D) antalgic gait of degenerative joint disease of the hip

Answer 2

scissors gait of multiple sclerosis

Question 3

An elementary school nurse is performing an annual screening on a child.The child is asked to bend forward from the waist and touch her toes.What disorder is characterized by lateral curvature of the spine in this position?

A) list
B) kyphosis
C) lordosis
D) scoliosis

Answer 3

scoliosis

Question 4

The range of joint motion is measured by a(n)

A) joint motion rating scale.
B) examination of range of motion after stretching exercises.
C) x-ray.
D) goniometer.

Question 5

Which illustrates the proper method to conduct a musculoskeletal examination?

A) Examine the painful body part first.
B) Examine the musculoskeletal system in a head-to-toe, proximal-to-distal manner.
C) Manipulate each joint through its full anatomic range of motion even if pain occurs.
D) Always conduct the examination first thing in the morning.

Question 6

While observing a patient walking,you note that she lifts one foot 1-2 inches off the floor and steps forward approximately 12 inches,shifting her weight from the heel onto the ball of that foot,and continues forward.The patient is erect,balanced,and swings her arms freely in the opposite direction to the movement of her legs.You record that her gait and mobility are

A) normal.
B) abnormal; she lifts her foot too high.
C) abnormal; her stride is too long.
D) abnormal; her arm motion is uncoordinated.

Question 7

Visible twitching of a group of muscle fibers that can occur when the muscle is stimulated by tapping is called

A) fibrillation.
B) fasciculation.
C) spasm.
D) myoclonus.

Question 8

A patient is complaining of painful tingling in the digits of her left hand,accompanied by wrist pain.With the patient positioned with the palmar surface of the left hand facing up,the nurse taps the median nerve over the center of the wrist.If the patient has carpal tunnel syndrome,what would she now report to the nurse?

A) inability of the patient to prevent her spread fingers from moving together
B) tingling or pricking sensation of the hand, thumb, index, and middle fingers
C) sudden onset of numbness of the little finger
D) burning wrist pain that radiates to the elbow

Question 9

Unilateral hypertrophy of the arm muscles is most likely seen in an individual who regularly

A) lifts weights.
B) plays tennis.
C) moves furniture.
D) plays soccer.

Question 10

A patient has "complete joint range of motion against gravity with moderate resistance." How would you grade this muscle strength and based on what point scale?

A) strength = 2, on a 5-point scale
B) strength = 3, on a 5-point scale
C) strength = 4, on a 5-point scale
D) strength = 5, on a 5-point scale

Question 11

Palpation,one of the four components of musculoskeletal examination,is used to assess

A) hypertrophy or atrophy of muscles.
B) limb circumference.
C) hypotonicity or spasticity of muscles.
D) muscle strength.

Question 12

Tremors that typically appear only on voluntary movement of an extremity and often intensify when terminating the movement are called

A) action tremors.
B) intention tremors.
C) postural tremors.
D) asterixis.

Question 13

The joint angle decreases in

A) abduction.
B) plantar flexion.
C) flexion.
D) retraction.

Question 14

Which statement is true of a multiaxial joint?

A) It is an example of a hinge joint.
B) It provides angular movement in one axis and one plane.
C) It is the wrist between the distal radius and carpals.
D) It is also called a ball-and-socket joint.

Question 15

Your client can achieve complete range of motion of both elbows only as you support her joints and without applying manual resistance.How would you record her muscle strength?

A) 4/5, good
B) 3/5, fair
C) 2/5, poor
D) 1/5, trace

Question 16

A patient who uses hip and knee flexion to lift the foot off the floor and then place the whole sole of the foot on the floor at once is demonstrating

A) steppage gait.
B) festinating gait.
C) Trendelenburg gait.
D) antalgic gait.

Question 17

A patient has a decreased step height and length with increased step speed.He appears to hesitate both in initiating and in terminating ambulation.Which pathology is he most likely experiencing?

A) multiple sclerosis
B) Parkinson's disease
C) cerebellar disease
D) Alzheimer's disease

Question 18

The term used to describe the weight-bearing status of a patient who rests the injured foot on the floor without bearing weight is

A) non-weight-bearing.
B) touchdown weight bearing.
C) partial weight bearing.
D) minimal weight bearing

Question 19

A freely movable joint that includes the shoulder,elbow,wrist,and thumb is called a(n)

A) amphiarthrosis joint.
B) diarthrosis joint.
C) synarthrosis joint.
D) gliding joint.

Question 20

Bending the joint so that the articulating bones on either side of the joint are moved farther apart is called

A) extension.
B) flexion.
C) adduction.
D) elevation.

Question 21

Pain in the shoulder that occurs as a patient attempts to lower the raised arm slowly to her side indicates

A) rotator cuff damage.
B) scapular winging.
C) bursitis.
D) acromioclavicular joint separation.

Question 22

A patient has hard,nontender enlargements on his distal interphalangeal joints.These are called

A) ganglion cysts.
B) Bouchard's nodes.
C) tophi.
D) Heberden's nodes.

Question 23

A patient with a herniated lumbar disk who reports low back pain with straight leg raising will experience increased pain when you

A) bend the knee.
B) lower the leg.
C) dorsiflex the foot.
D) plantar flex the foot.

Question 24

In addition to pain and decreased perfusion,manifestations of neurovascular deterioration include

A) pallor, paresthesia, and paralysis.
B) paresis, pulselessness, and polyneuralgia.
C) paralysis, polyneuralgia, and pruritus.
D) paresthesia, paresis, and pallor.

Question 25

A foot with a low longitudinal arch is referred to as

A) pes varus.
B) pes valgus.
C) pes planus.
D) pes cavus.

Question 26

A patient experiences a spasm of her facial muscles in response to a light tap over the facial nerve below the temple.This finding most likely indicates

A) temporomandibular joint dysfunction.
B) neuroexcitability associated with hypocalcemia.
C) increased risk for developing epilepsy.
D) compression of the facial nerve.

Question 27

Your patient has a positive bulge sign and a palpable click upon ballottement,which most likely indicate

A) a small effusion of his knee.
B) torn cartilage within the knee joint.
C) a large effusion of his knee.
D) torn ligaments of the knee.

Question 28

You are caring for an 82-years-old patient who fell in his home and is now complaining of pain in his left hip and leg.To determine the length of your patient's legs,you position him supine with his legs extended and measure from the

A) anterior superior iliac spine to the medial malleolus.
B) posterior iliac spine to the medial malleolus.
C) anterior superior iliac spine to the bottom of the foot.
D) posterior iliac spine to the bottom of the foot.

Question 29

Numbness and paresthesia in the palmar aspect of the hand and the first three fingers occurring after maintaining wrist flexion of 90° for 1 minute is a positive

A) Phalen's test.
B) Tinel's sign.
C) Trendelenburg test.
D) tunnel test.

Question 30

A patient's inability to touch his thumb with the little finger of the same hand indicates involvement of the

A) ulnar nerve.
B) radial nerve.
C) metacarpophalangeal joints.
D) median nerve.

Question 31

Your patient was admitted after a fall in her home.After measuring the patient's legs,you determine that her left leg is 4.5 cm shorter than her right leg.This difference most likely indicates

A) a finding within normal limits.
B) a hip fracture with displacement of the proximal femur.
C) dislocation of the hip.
D) flexion contractures of the hip.

Question 32

To assess for a ruptured Achilles tendon,you perform the Thompson test by manually squeezing the calf muscles of the patient's leg.What finding would suggest a ruptured Achilles tendon?

A) absence of dorsiflexion of that foot
B) pain
C) muscle spasms
D) absence of plantar flexion of that foot

Question 33

To assess for Trousseau's sign,place a blood pressure cuff on the patient's upper arm and inflate to

A) 10 mm Hg above the patient's diastolic blood pressure for 1 minute.
B) the patient's systolic blood pressure for 3-5 minutes.
C) 10 mm Hg above the patient's systolic blood pressure for 1-3 minutes.
D) 10 mm Hg below the patient's systolic blood pressure for 3-5 minutes.

Question 34

A patient with a stable,closed fracture of the humerus caused by trauma to the arm has a temporary splint with bulky padding applied with an elastic bandage.The nurse suspects compartment syndrome and notifies the health care provider when the patient experiences

A) pain at the fracture site.
B) increasing warmth and redness of the skin.
C) muscle spasms of the lower arm.
D) pain when the nurse passively extends the fingers.

Question 35

The Lachman test is performed to examine a patient's knee for

A) integrity of the meniscus cartilage.
B) stability of the posterior cruciate ligament.
C) integrity of the infrapatellar tendon.
D) stability of the anterior cruciate ligament.

Question 36

Dorsiflexion of the feet is assessed by instructing the patient to

A) point the toes toward the floor.
B) point the toes toward the chest.
C) turn the soles of the feet outward.
D) turn the soles of the feet inward.

Question 37

A patient is unable to prevent the spread fingers on his left hand from moving together when the nurse applies resistance.This condition may indicate injury to his

A) radial nerve.
B) ulnar nerve.
C) median nerve.
D) thenar eminence.

Question 38

Internal rotation of the shoulder is examined by asking the patient to

A) move the arm backward in an arc as far as possible.
B) move the arm in an arc toward the midline and cross it as far as possible.
C) place both hands behind the back and reach up, trying to touch the scapula.
D) place both hands behind the head with the elbows flexed.

Question 39

Examination of the range of motion of a patient's cervical spine is flexion,45°; hyperextension,55°; lateral bending,40° to left and right; and rotation,70° to left and right.These findings most likely indicate

A) normal range of motion.
B) Klippel-Feil syndrome.
C) degenerative joint disease of the cervical vertebrae.
D) spondylosis.

Question 40

You note that your patient's gluteal cleft is lateral to the imaginary line you drew from her head straight down her spine.This finding indicates

A) structural scoliosis.
B) kyphosis.
C) a list.
D) functional scoliosis.

Question 41

Which of the following describes cartilage? Select all that apply.

A) Dense
B) Resilient
C) Vascular
D) Fibrous
E) Spongy
F) Fragile

Question 42

A patient lying supine with both legs extended and raised 2 inches off the table,is able to maintain this position for only 20 seconds.You would record that the patient has a positive

A) Trendelenburg test.
B) Thomas test.
C) Milgram test.
D) Apley's scratch test.

Question 43

Your patient has a non-weight-bearing cast on her left leg and walks with the aid of crutches.Which observation indicates a problem that requires intervention?

A) The crutches have padded handles.
B) The patient is using a two-point crutch gait for partial weight bearing.
C) The patient is wearing sneakers with a nonskid surface.
D) The patient places weight on the handbar grip as the patient walks.

Question 44

The nurse is doing discharge planning for a patient after open reduction of a fractured femur.Which of the following is important to ask the patient prior to teaching about dietary requirements to facilitate healing?

A) "How much do you typically eat at a meal?"
B) "What foods do you like?"
C) "Are you lactose intolerant?"
D) "Do you cook at home or eat out most of the time?"

Question 45

Which of the following characteristics can be observed in an adolescent female patient with scoliosis and a curvature of 30°?

A) one leg shorter than the other
B) shortness of breath, tachypnea, and tachycardia
C) complaints of excruciating pain when being assessed for scoliosis
D) asymmetry of the clavicles and uneven shoulder and iliac crest levels

Question 46

Which of the following are components of the musculoskeletal system? Select all that apply.

A) Platelets
B) Bones
C) Fascia
D) Joints
E) Skeletal muscles
F) Connective tissue

Question 47

The ____________________ membrane lines a movable joint.

Question 48

Bone marrow is contained in the _________________________.

Question 49

You are assessing a patient for impingement syndrome and rotator cuff tear.Which of the following steps would you include? Select all that apply.

A) Ask the patient to lie in a supine position.
B) Stand next to the patient.
C) Stabilize the shoulder girdle by placing one hand over the scapula and trapezius of the arm to be tested.
D) With the other hand, the examiner grasps the patient's arm posteriorly slightly proximal to the elbow.
E) While holding the elbow, flex the patient's shoulder until the arm is in a flexed and abducted position with the arm at the side of the patient's head.
F) Rotate the shoulder backward.

Question 50

You are caring for a 58-year-old woman,who is complaining of pain in the elbows and fingers.Which of the following changes in a patient's neurovascular examination should be reported as a critical sign of arterial insufficiency?

A) pain unrelieved by analgesics
B) reduced motion in affected extremity
C) hypersensation below the injury
D) pale extremity that is cool to touch

Question 51

A nursing instructor asks the students to name the different biaxial joints of the body.Which response by the students would indicate that further study is needed? Select all that apply.

A) Hinge joint
B) Pivot joint
C) Ball and joint
D) Saddle joint
E) Gliding joint
F) Condyloid joint

Question 52

The function of the tendon is to ______________________________.

Question 53

Osteoporosis is the loss of ____________________.

Question 54

A nursing student is about to perform ROM exercises and the nursing instructor asks the students to explain the process.Which statement by the student would indicate to the instructor that further clarification on the procedure is needed? Select all that apply.

A) Ask the patient to move the joint through each of its various ROM movements.
B) Note angle of each joint movement.
C) Note any pain, tenderness, or crepitus.
D) If the patient is unable to perform active ROM, then contact the physician immediately.
E) Push a joint beyond its anatomic angle.
F) Use a goniometer to determine exact ROM in joints with limited ROM.

Question 55

A patient,lying supine with both legs extended and raised 2 inches off the table,is able to maintain this position for only 20 seconds.This finding most likely indicates that the patient has

A) a herniated intervertebral disk.
B) flexion contractures of the hip joints.
C) degenerative hip joint disease.
D) a loose object within the joint.

Question 56

The function of the tendon is to _______________________________.