Deck 24: Musculoskeletal System

Question 1

The functional units of the musculoskeletal system are the:

A)joints.
B)bones.
C)muscles.
D)tendons.

Answer 1

joints.

Question 2

The nurse is checking the range of motion in a patient's knee and knows that the knee is capable of the following movements:

A)Flexion and extension
B)Supination and pronation
C)Circumduction
D)Inversion and eversion

Answer 2

Flexion and extension

Question 3

The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury.The nurse knows that this injury involves:

A)nucleus pulposus.
B)the articular process.
C)the medial epicondyle.
D)the glenohumeral joint.

Answer 3

the glenohumeral joint.

Question 4

Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are called:

A)bursa.
B)tendons.
C)cartilage.
D)ligaments.

Question 5

A patient is being assessed for his range of joint movement.The nurse asks him to move his arm in toward the centre of his body.This movement is called:

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

Question 6

The knee joint is the articulation of the femur,the tibia,and the:

A)fibula.
B)radius.
C)patella.
D)humerus.

Question 7

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 the patient to move her hand to her mouth,she must perform the following movement:

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

Question 8

An imaginary line connecting the highest point on each iliac crest would cross:

A)the first sacral vertebra.
B)the fourth lumbar vertebra.
C)the seventh cervical vertebra.
D)the twelfth thoracic vertebra.

Question 9

The ankle joint is the articulation of the tibia,the fibula,and the:

A)talus.
B)cuboid.
C)calcaneus.
D)talocalcaneonavicular joint.

Question 10

The nurse is assessing a patient's ischial tuberosity.To palpate the ischial tuberosity,the nurse knows that it is best to have the patient:

A)stand.
B)flex his hip.
C)flex his knee.
D)lie in the supine position.

Question 11

The nurse is explaining the growth of long bones to a mother of a toddler.The nurse knows that bones increase in width or diameter by deposition of new bony tissue around the shafts.The nurse also knows that lengthening occurs at the:

A)bursa.
B)calcaneus.
C)epiphyses.
D)tuberosities.

Question 12

During an interview,a 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 her:

A)"That is your subacromial bursa."
B)"That is your acromion process."
C)"That is your glenohumeral joint."
D)"That is the greater tubercle of your humerus."

Question 13

The articulation of the mandible and the temporal bone is known as the:

A)intervertebral foramen.
B)condyle of the mandible.
C)temporomandibular joint.
D)zygomatic arch of the temporal bone.

Question 14

To palpate the temporomandibular joint,the nurse's fingers should be placed in the depression:

A)distal to the helix of the ear.
B)proximal to the helix of the ear.
C)anterior to the tragus of the ear.
D)posterior to the tragus of the ear.

Question 15

A woman who is 8 months pregnant comments that she has noticed a change in her posture and that she is having low back pain.The nurse tells her that during pregnancy,women have a posture shift to compensate for the enlarging fetus.This shift in posture is known as:

A)lordosis.
B)scoliosis.
C)ankylosis.
D)kyphosis.

Question 16

Hematopoiesis takes place in the:

A)liver.
B)spleen.
C)kidneys.
D)bone marrow.

Question 17

A patient is visiting the clinic for an evaluation of a swollen,painful knuckle.The nurse notices that the knuckle above his wedding ring on the left hand is swollen,and he is unable to remove the ring.This joint is called the:

A)interphalangeal joint.
B)tarsometatarsal joint.
C)metacarpophalangeal joint.
D)talocalcaneonavicular joint.

Question 18

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:

A)costal facets.
B)nucleus pulposus.
C)vertebral foramen.
D)intervertebral discs.

Question 19

Of the 33 vertebrae in the spinal column,there are:

A)5 lumbar vertebrae.
B)5 thoracic vertebrae.
C)7 sacral vertebrae.
D)12 cervical vertebrae.

Question 20

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:

A)inversion.
B)supination.
C)protraction.
D)circumduction.

Question 21

The nurse is examining a 3-month-old infant.While holding her thumbs on the infant's inner mid-thighs and her fingers outside on the hips,touching the greater trochanter,the nurse adducts the infant's legs until her thumbs touch and then abducts the legs until the knees touch the table.The nurse does not note any "clunking" sounds,and is confident to record a:

A)positive Allis sign.
B)negative Allis sign.
C)positive Ortolani sign.
D)negative Ortolani sign.

Question 22

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 this hand,and has not been able to move his shoulder since.The nurse suspects:

A)joint effusion.
B)tear of rotator cuff.
C)adhesive capsulitis.
D)dislocated shoulder.

Question 23

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 suspects:

A)crepitation.
B)rotator cuff lesions.
C)dislocated shoulder.
D)rheumatoid arthritis.

Question 24

A 40-year-old man has come into the clinic with complaints of "extreme tenderness in my toes." The nurse notes that his toes are slightly swollen,reddened,and warm to the touch.His complaints would suggest:

A)osteoporosis.
B)acute gout.
C)ankylosing spondylitis.
D)degenerative joint disease.

Question 25

During a neonatal examination,the nurse notes that the newborn infant has six toes.This finding is documented as:

A)unidactyly.
B)syndactyly.
C)polydactyly.
D)multidactyly.

Question 26

A patient is complaining of pain in his joints that is worse in the morning,is better after he has moved around for a while,and then gets worse again if he sits for long periods of time.The nurse suspects that he may have:

A)tendinitis.
B)osteoarthritis.
C)rheumatoid arthritis.
D)intermittent claudication.

Question 27

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:

A)long bones tend to shorten with age.
B)of the shortening of the vertebral column.
C)there is a significant loss of subcutaneous fat.
D)there is a thickening of the intervertebral discs.

Question 28

A patient has been diagnosed with osteoporosis and asks the nurse,"What is osteoporosis?" The nurse knows that osteoporosis can be defined as:

A)the loss of bone matrix.
B)the loss of bone mass.
C)new,weaker bone growth.
D)increased phagocytic activity.

Question 29

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen test.To perform this test,the nurse will instruct the patient to:

A)dorsiflex the foot.
B)plantarflex the foot.
C)hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.
D)hyperextend the wrists with the palmar surface of both hands touching and wait for 60 seconds.

Question 30

A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her hands.The nurse knows that changes associated with rheumatoid arthritis include:

A)Heberden's nodes.
B)Bouchard's nodules.
C)swan-neck deformities.
D)Dupuytren's contractures.

Question 31

The nurse knows that the incidence of osteoporosis is greatest in which group?

A)Males of African descent
B)Females of African descent
C)Females of European descent
D)Aboriginal males

Question 32

An 80-year-old woman is visiting the clinic for a checkup.The nurse is observing for motor dysfunction in the woman's hip and would have her:

A)internally rotate her hip while she is sitting.
B)abduct her hip while she is lying on her back.
C)adduct her hip while she is lying on her back.
D)externally rotate her hip while she is standing.

Question 33

During an examination,the nurse asks a patient to bend forward from the waist and notes that the patient has lateral tilting.When one of his legs is raised straight up,he complains of a pain going down the buttock into the leg.The nurse suspects:

A)scoliosis.
B)a meniscus tear.
C)a herniated nucleus pulposus.
D)a spasm of paravertebral muscles.

Question 34

A professional tennis player comes into the clinic complaining of a sore elbow.The nurse suspects that he has tenderness at the:

A)olecranon bursa.
B)annular ligament.
C)base of the radius.
D)medial and lateral epicondyle.

Question 35

A teenage girl is complaining of pain in her left wrist.She had been playing basketball and fell,landing on her left hand.The nurse examines her hand and would expect a fracture if the girl complains:

A)of a dull ache.
B)that the pain in her wrist is deep.
C)of sharp pain that increases with movement.
D)of dull throbbing pain that increases with rest.

Question 36

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:

A)radial drift.
B)ulnar deviation.
C)swan neck deformity.
D)Dupuytren's contracture.

Question 37

A mother brings her newborn male infant in for a checkup.She tells the nurse that he doesn't seem to be moving his right arm as much as his left and that he seems to have pain when she lifts him up under the arms.The nurse suspects a fractured clavicle and would observe for:

A)a negative Allis sign.
B)a positive Ortolani sign.
C)limited range of motion during the Moro reflex.
D)limited range of motion during LaSegue's reflex.

Question 38

The nurse has completed the musculoskeletal examination of a patient's knee and has found a positive bulge sign.The nurse suspects:

A)irregular bony margins.
B)soft tissue swelling in the joint.
C)swelling from fluid in the epicondyle.
D)swelling from fluid in the suprapatellar pouch.

Question 39

A 68-year-old woman has come in for an assessment of her rheumatoid arthritis,and the nurse notes raised,firm,nontender nodules at the olecranon bursa and along the ulna.These nodules are most commonly diagnosed as:

A)epicondylitis.
B)gouty arthritis.
C)olecranon bursitis.
D)subcutaneous nodules.

Question 40

A patient states,"I can hear a crunching or grating sound when I kneel." She also states,"it is very difficult to get out of bed in the morning because of stiffness and pain in my joints." The nurse suspects that the sound the patient hears is:

A)crepitation.
B)a bone spur.
C)a loose tendon.
D)fluid in the knee joint.

Question 41

The nurse documents hearing a 'click' when performing the McMurray test.The nurse is aware that this signifies:

A)a dislocated hip.
B)a torn meniscus.
C)a torn rotator cuff.
D)atrophy of the shoulder girdle muscles.

Question 42

The nurse is planning to measure a patient's angles of joint flexion.What instrument will be used?

A)Caliper
B)Protractor
C)Goniometer
D)Measuring tape

Question 43

The nurse is assessing a 1-week-old infant and testing his muscle strength.The nurse lifts the infant with her hands under the axillae,and notes that the infant starts to "slip" between her hands.The nurse should:

A)suspect a fractured clavicle.
B)consider that the infant may have a deformity of the spine.
C)suspect that the infant may have weakness of the shoulder muscles.
D)consider this a normal finding because the musculature of an infant at this age is undeveloped.

Question 44

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 is:

A)"It is a common benign tumour."
B)"It is a tumor that will have to be watched because it may turn malignant."
C)"It is caused by chronic repetitive motion injury."
D)"It is a skin infection that will need to be drained."

Question 45

The nurse is examining a 6-month-old baby and places the baby's feet flat on the table and flexes his knees up.The nurse notes that the right knee is significantly lower than the left.Which of the following is true of this finding?

A)This is a positive Allis sign and suggests hip dislocation.
B)The infant probably has a dislocated patella on the right knee.
C)This is a normal finding for the Allis test for an infant of this age.
D)The infant should return to the clinic in 2 weeks to see if this has changed.

Question 46

Which test should the nurse use to check for large amounts of fluid around the patella?

A)Ballottement
B)Tinel's sign
C)Phalen test
D)McMurray's test

Question 47

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:

A)structural scoliosis.
B)functional scoliosis.
C)herniated nucleus pulposus.
D)dislocated nucleus pulposus.

Question 48

A man who has had gout for several years comes to the clinic with a "problem with my toe." On examination,the nurse notes the presence of hard,painless nodules over the great toe;one has burst open and released a chalky discharge.This finding is known as:

A)a callus.
B)a plantar wart.
C)tenosynovitis.
D)tophi.

Question 49

The nurse knows that another term for "knock knees" is:

A)genu varum.
B)genu valgum.
C)pes planus.
D)metatarsus adductus.

Question 50

When performing a musculoskeletal assessment,the nurse knows that the correct approach for the examination should be head to toe and:

A)proximal to distal.
B)distal to proximal.
C)posterior to anterior.
D)anterior to posterior.

Question 51

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 the following are symptoms of osteoarthritis? (Select all that apply. )

A)Symmetrical joint involvement
B)Asymmetrical joint involvement
C)Pain with motion of affected joints
D)Affected joints swollen with hard,bony protuberances
E)Affected joints hot,red,and swollen

Question 52

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?

A)"If these symptoms persist,you may need arthroscopic surgery."
B)"You are experiencing degeneration of your knee,which may not resolve."
C)"Your disease is due to repeated stress on the patellar tendon.It is usually self-limited,and your symptoms should resolve with rest."
D)"Increasing your activity and performing knee-strengthening exercises will help to decrease the inflammation and maintain mobility in the knee."