Deck 15: Assessing the Musculoskeletal System

Question 1

Identify the range of motion movement in the accompanying figure that assesses the range of motion of the elbow.

A) Supination
B) Pronation
C) Flexion
D) Extension

Answer 1

Pronation

Question 2

The patient is complaining of acute pain in his shoulder after playing tennis. Assessment of the shoulder includes which of the following four motions?

A) Abduction, adduction, supination, and pronation
B) Lateral bending, extension, dorsiflexion, and plantar flexion
C) Flexion, extension, internal rotation, and external rotation
D) Inversion, eversion, protraction, and retraction

Answer 2

Flexion, extension, internal rotation, and external rotation

Question 3

You are performing an assessment of the vertebrae and assess the posture shown in the accompanying figure. What type of posture do you see in the picture?

A) Lordosis
B) Scoliosis
C) Kyphosis
D) Normal posture

Answer 3

Normal posture

Question 4

What diagnostic test would you expect the health-care provider to order to assess injuries to a tendon, a ligament, or soft tissue?

A) X-ray
B) Ultrasound
C) Magnetic resonance imaging (MRI)
D) Computed tomography (CT) scan

Question 5

The patient reports that he exercises at the local gym 7 days a week for a minimum of 60 minutes each day. He reports that he is able to lift weights up to 100 lb. An elevation of which enzyme may indicate muscle injury secondary to strenuous exercise?

A) Creatinine phosphokinase (CPK)
B) Lactate dehydrogenase (LDH)
C) Serum glutamic oxaloacetic transaminase (SGOT)
D) Serum glutamic-pyruvic transaminase (SGPT)

Question 6

Mr. Brown's knee assessment shows 4/5 muscle strength bilaterally with full flexion and extension. The nurse assesses the skin temperature and notes increased warmth of the left knee joint. Which of the following is most concerning?

A) The muscle strength is 4/5.
B) Knee joint movement should include flexion deviation.
C) The warmth that is present in the left knee joint.
D) Muscle strength is symmetrical.

Question 7

You are performing an assessment of the lower extremities. The accompanying figure indicates which range of motion movement of the hip?

A) Flexion against resistance
B) Extension against resistance
C) Abduction against resistance
D) Adduction against resistance

Question 8

The movement of the sole of the foot away from the floor toward the knee demonstrates:

A) Plantar flexion.
B) Dorsiflexion.
C) Eversion
D) Inversion.

Question 9

The patient had a total hip replacement several years ago. You are going to assess the range of motion of both hips. The range of motion movements for the hip joint include:

A) Supination, dorsiflexion, adduction, and extension.
B) Flexion, internal rotation, supination, and pronation.
C) Adduction, abduction, flexion, and internal rotation.
D) Extension, abduction, inversion, and eversion.

Question 10

External shoulder rotation is demonstrated in which of the following figures?

A)

B)

C)

D)

Question 11

A patient reports that she has had bilateral knee pain for the last 10 years. You review her past medical history and note osteoarthritis as a diagnosis. This type of arthritis is caused by:

A) A progressive, inflammatory, autoimmune disorder.
B) A progressive disease whereby the bone matrix is not being replaced.
C) A progressive disease whereby the protective cartilage wears down.
D) A progressive disease that causes enlargement of the ends of the joints.

Question 12

A 28-year-old client fell off his bicycle while mountain biking. He states that his back hurts but is nonspecific about the location. The patient denies hitting his head. What question or statement should the nurse ask next?

A) "Where does your upper back hurt?"
B) "Point to the location where your back hurts."
C) "Does the pain hurt in the lumbar area?"
D) "Does the pain radiate to your legs?"

Question 13

Who is at greater risk for osteoporosis?

A) An African American man who is thin
B) A Hispanic woman who is obese
C) A Caucasian man who is underweight
D) A Caucasian woman who is of normal weight

Question 14

You are assessing the vertebral column. Which assessment techniques will you perform?

A) Inspection only
B) Inspection and palpation
C) Inspection, palpation, and percussion
D) Inspection, palpation, and muscle strength

Question 15

You are assessing the upper arm muscle strength. What is considered to be a minimal normal muscle strength?

A) 1/5
B) 2/5
C) 3/5
D) 4/5
E) 5/5

Question 16

You are assessing the range of motion of the ankle. Which of the following movements are appropriate to assess? Select all that apply.

A) Inversion
B) Eversion
C) Flexion
D) Extension
E) Dorsiflexion
F) Plantar flexion

Question 17

You are inspecting and palpating the upper extremities. What will you assess for? Select all that apply.

A) Tenderness
B) Position
C) Depressions
D) Bulges
E) Changes in temperature

Question 18

A patient needs an assistive device to ambulate. Which of the following are assistive devices? Select all that apply.

A) Walker
B) Rolling walker
C) Wheelchair
D) Cane
E) Crutches

Question 19

The musculoskeletal system is a complex system that provides structure, support, protection, and movement. Which is a true statement about the musculoskeletal system? Select all that apply.

A) The skeletal system provides attachment points for ligaments and tendons.
B) Movement occurs when muscles contract.
C) Muscle movement is generally involuntary.
D) Muscles relax in response to neurological stimulus.

Question 20

Joints are areas where two or more bones come together. Which of the following statements are true about joints? Select all that apply.

A) Joints that move allow for functional movement of body parts.
B) Ligaments help to stabilize joints.
C) Fused joints are irregularly shaped and flat and are found in the foot.
D) Synovial fluid serves to lubricate and provide nutrients to the joint.
E) Ball and socket joints allow for greater movement.
F) Hinge joints are found in the elbow and the shoulder.

Question 21

When assessing specific musculoskeletal injuries, use of the five "P"s will increase your knowledge about the injury during your focused assessment. Select the correct five "P"s below. Select all that apply.

A) Pain
B) Position
C) Paralysis
D) Paresthesia
E) Pronation
F) Pallor
G) Pulselessness

Question 22

You are a nursing student and need to recognize the normal findings of a musculoskeletal assessment. Identify below all of the normal findings about the musculoskeletal system. Select all that apply.

A) The range of motion of each joint should be symmetric to the opposite limb.
B) Muscle strength should be at least 8/10 in the lower extremities.
C) Limitations against resistance may indicate a problem in the joint.
D) Stretching exercises such as yoga build muscle strength.
E) Bending, lifting, and performing repetitive motions increase the risk of injury.

Question 23

When inspecting the upper extremities with the patient in a relaxed standing position, the nurse expects to observe which of the following? Select all that apply.

A) Straight upper arms
B) Symmetry between left and right upper extremities
C) Forward rounding of the shoulders
D) Wrists in line with the lower arm, palms facing thighs
E) Hyperextension of the elbows

Question 24

When standing, the patient exhibits forward flexion at the hip joint. What may this indicate?
Select all that apply.

A) Normal position for the hip joint
B) Tightness of the muscular structure
C) A problem with the lower back
D) A knee injury

Question 25

Prevention of disease and disability of the musculoskeletal system can be accomplished by working to maintain a level of wellness. This can be accomplished through which of the following? Select all that apply.

A) Eating foods rich in calcium, vitamin D, magnesium, and phosphorus
B) Maintaining an ideal body weight
C) Exercising on a regular basis
D) Performing stretching and flexibility exercises
E) Maintaining good body mechanics

Question 26

Assessment of the geriatric patient's posture and gait can be assessed as he or she enters the room. This will help the nurse to identify a patient's ____________________ risk.

Question 27

____________________ is an unsteady gait, which can be used to compensate for an injury or pain in an extremity. It may also indicate a problem with cerebellar function.

Question 28

Asking a patient to rub the back of his head with his right hand and then the left hand allows functional assessment of ____________________ rotation of the shoulder joint.

Question 29

An exaggerated curvature in the thoracic spine is a common finding in an elderly person due to osteoporosis. This condition of the vertebrae is known as ____________________.

Question 30

Identify the test. Ask the patient to flex both wrists and press them together for 1 minute. Ask the patient if there is any numbness and tingling sensations. This test is known as ____________________ test.

Question 31

The patient reports that he injured his ankle while playing soccer. The health-care provider requested an x-ray of the ankle, which was negative for a fracture. The health-care provider tells the patient his ligament was injured. This injury is called a___________________.

Question 32

Mrs. Green complains of pain in both hands related to osteoarthritis. During the musculoskeletal assessment of her hands, you discover nodes on the distal joints of her fingers. These nodes are commonly identified as ____________________ nodes.

Question 33

The patient reports that she is having pain with erythema on the right side of her left great toe. You assess the patient's left foot and note a lateral deviation and enlarged joint of the left great toe. This deviation and enlargement is called ____________________.

Question 34

The patient has degenerative disc disease with a complication of foot drop. This is where the foot is at _________ degrees to the lower leg.

Question 35

You are performing a musculoskeletal assessment. Put the steps of the assessment in order (1-4). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: 1234.)
1. Assessing strength
2. Palpating
3. Inspecting
4. Assessing range of motion