Deck 32: the Musculoskeletal System

Question 1

The nurse is aware that positioning and range-of-motion (ROM)exercises most help the immobilized patient to prevent:

A)increased pain.
B)contractures.
C)pressure ulcers.
D)compromised circulation.

Answer 1

contractures.

Question 2

The nurse is instructing the patient on quadriceps and gluteal muscle exercises.The instructions will include:

A)while lying down, straightening the leg and tensing leg muscles while raising heel.
B)flexing the leg and holding it with the hands while pulling the leg back toward the hip.
C)straightening the legs and raising the head.
D)flexing both legs and doing an abdominal crunch up toward the knees.

Answer 2

while lying down, straightening the leg and tensing leg muscles while raising heel.

Question 3

The nurse is changing the position of a person with flaccid paralysis.The priority action will be:

A)to change joint position.
B)not to use a footboard.
C)to move only from side to side, not supine.
D)to refrain from using pillows to keep the patient in place.

Answer 3

to change joint position.

Question 4

The nurse uses a visual aid to show the pathologic muscle tone changes that result in footdrop.Those changes are:

A)calf muscles are stretched.
B)flexor muscles are stretched.
C)toes curl downward.
D)thigh muscles contract.

Question 5

The nurse adds interventions for range-of-motion (ROM)and isometric exercises for the new patient with a stroke because the nurse is aware that contracture formation begins as early as _____ day(s)of immobilization.

A)1
B)2
C)3
D)10

Question 6

The nurse is discussing actions that can be taken to best prevent osteoporosis with a patient.The nurse's teaching should include:

A)taking an extra calcium supplement.
B)eating a balanced diet.
C)exercising throughout life.
D)eating daily amounts of milk products.

Question 7

The nurse informs the patient that the frequency of range-of-motion (ROM)exercises should be:

A)once a day.
B)once in the morning and once in the afternoon.
C)3 to 4 times a day.
D)4 to 6 times a day.

Question 8

When the patient returns to the unit from having had an arthrogram,which intervention will the nurse perform first?

A)Ambulate the patient in the room.
B)Apply ice packs to the knee.
C)Perform passive range-of-motion exercises.
D)Wrap the knee in an elastic bandage.

Question 9

A patient is learning to use crutches on the stairs.When evaluating this patient,which action indicates that the patient needs further instruction?

A)The patient places the good leg on the step to be climbed first.
B)The patient places the affected leg on the step to be climbed first.
C)The patient places the crutches on the floor and uses a swing-through method to get to the next step.
D)The patient places the crutch on the affected side on the next step first.

Question 10

The nurse is caring for a patient who has had an arthrocentesis.The nurse has completed discharge instructions.Which statement by the patient indicates the need for further instruction?

A)"I will need to avoid moving my knee for at least 1 to 2 weeks."
B)"The steroids prescribed by my physician will reduce the inflammation in my knee."
C)"Some pain is anticipated."
D)"My elastic bandage will be worn for 2 to 3 days."

Question 11

The physician has prescribed isometric exercises for a patient.The patient asks the nurse how these exercises work.The nurse uses an example to explain the physiology of isometric exercises,which is:

A)flexing the lower arm while trying to straighten it with the other hand.
B)pulling the knees up to chest with the arms.
C)forcefully flexing the neck to make the chin touch the chest.
D)flexing the toes up toward the head while lying flat.

Question 12

The nurse encourages the patient to use the four-point crutch gait technique.This technique is most likely indicated because it:

A)allows non-weight bearing on one leg.
B)is the most stable gait.
C)mimics normal walking pattern.
D)allows the most rapid pace.

Question 13

The nurse explains that,if muscles are not regularly stretched and contracted,the muscles will become:

A)longer and flexed.
B)fibrosed and spastic.
C)shorter and less elastic.
D)shorter and painful.

Question 14

When a 90-year-old patient says,"My old bones are just about done in," the nurse reminds him that his bones are being constantly renewed through the action of:

A)osteoblasts.
B)stem cells.
C)free circulating calcium ions.
D)combination of phosphorus and vitamin D.

Question 15

When preparing a patient for electromyography (EMG),the nurse will instruct the patient to:

A)cease smoking for 12 hours before the test.
B)refrain from caffeine drinks for 3 hours before the test.
C)take muscle relaxants before the test.
D)prepare for a lengthy testing time (usually about 2 hours).

Question 16

The nurse is assessing the patient's cane for appropriate length.The nurse affirms that the appropriate cane has been selected when the:

A)hand grip is at the level of the hip.
B)elbow is flexed at 45 degrees when weight is placed on the cane.
C)cane tip is placed touching outside the good foot.
D)rubber tip has been removed when measuring cane length.

Question 17

When an 88-year-old patient enters the room for her health assessment,she walks with tiny Step:s,her shoulders are rounded and hunched,and her arms are crossed in front of her with her hands tucked in her armpits.Which response by the nurse is most appropriate?

A)"Are you cold?"
B)"Does your stomach hurt?"
C)"Are your shoes too small?"
D)"Do you always walk like that?"

Question 18

The anatomical structure that joins the bones of a joint together is referred to as:

A)a ligament.
B)a tendon.
C)a muscle.
D)cartilage.

Question 19

The patient's plan of care includes using the continuous passive motion (CPM)machine.Which statement by the patient indicates the need for further teaching?

A)"I marched in the Marines for 20 years, and now I'm marching flat on my back!"
B)"My new knee will be glad to rest at night."
C)"I can make my new knee stronger if I reset this thing to go faster and flex my knee more."
D)"I almost wish this CPM ran at night. The motor noise is soothing."

Question 20

When the patient asks what the purpose of goniometry is,the nurse replies that goniometry measures:

A)bone strength.
B)muscle density.
C)muscle strength.
D)range of motion.

Question 21

When a joint is obliterated by bony overgrowth,the joint is said to be _________.

Question 22

When the nurse plans for the progressive mobilization of a hemiplegic,the nurse will consider the patient's ability to: (Select all that apply.)

A)move limbs.
B)change position in bed independently.
C)transfer self from bed to chair.
D)perform all activities of daily living independently.
E)walk.

Question 23

The nurse points out the age-related changes that occur in the musculoskeletal system,which are: (Select all that apply.)

A)increase of bone density.
B)bones are brittle and break easily.
C)bones heal slowly.
D)decrease in muscle mass.
E)tendon sclerosis.

Question 24

The functions of the musculoskeletal system are: (Select all that apply.)

A)motion.
B)fighting of infections.
C)support.
D)protection of organs.
E)body shape.

Question 25

The canal system that runs through the bone and contains the blood and lymph vessels is called the ____________.

Question 26

The nurse is assessing the patient's crutches.The nurse recognizes that correctly sized crutches are:

A)the same height as the patient's shoulders.
B)approximately 12 inches shorter than the patient's shoulders.
C)approximately 16 inches shorter than the patient's height.
D)tall enough to allow the patient's arms to be fully extended when walking.

Question 27

A patient at risk for the development of osteoporosis has reported plans to increase calcium intake.When making menu choices,which selection demonstrates an understanding of calcium-rich foods?

A)Grilled salmon, green beans, and milk
B)Hamburger patty on a wheat bun, baked chips, and milk
C)Grilled chicken breast, tossed salad, and fruit punch
D)Bacon, lettuce, and tomato sandwich on whole grain bread, orange slices, and milk

Question 28

Matching
Arrange the instructions for a person on crutches to sit down.

Step: 2

A)Transfer both crutches to the side of injury.
B)With weight on good leg, reach back and grasp chair arm.
C)Sit back in chair.
D)Turn slowly and touch backs of legs to seat of chair.
E)Using crutch and chair arm for support, slowly sit on chair.

Question 29

Matching
Arrange the instructions for a person on crutches to sit down.

Step: 4

A)Transfer both crutches to the side of injury.
B)With weight on good leg, reach back and grasp chair arm.
C)Sit back in chair.
D)Turn slowly and touch backs of legs to seat of chair.
E)Using crutch and chair arm for support, slowly sit on chair.

Question 30

Matching
Arrange the instructions for a person on crutches to sit down.

Step: 5

A)Transfer both crutches to the side of injury.
B)With weight on good leg, reach back and grasp chair arm.
C)Sit back in chair.
D)Turn slowly and touch backs of legs to seat of chair.
E)Using crutch and chair arm for support, slowly sit on chair.

Question 31

Matching
Arrange the instructions for a person on crutches to sit down.

Step: 3

A)Transfer both crutches to the side of injury.
B)With weight on good leg, reach back and grasp chair arm.
C)Sit back in chair.
D)Turn slowly and touch backs of legs to seat of chair.
E)Using crutch and chair arm for support, slowly sit on chair.

Question 32

Matching
Arrange the instructions for a person on crutches to sit down.

Step: 1

A)Transfer both crutches to the side of injury.
B)With weight on good leg, reach back and grasp chair arm.
C)Sit back in chair.
D)Turn slowly and touch backs of legs to seat of chair.
E)Using crutch and chair arm for support, slowly sit on chair.