Deck 24: Musculoskeletal System

Question 1

The nurse is assessing a patient who sprained his ankle playing soccer.The nurse explains that the fibrous bands which usually connect the medial and lateral malleolus and strengthen that joint have been stretched beyond their limits.The nurse identifies these bands as:

A)Bursa
B)Tendons
C)Cartilage
D)Ligaments

Answer 1

Ligaments

Question 2

After an impact injury to the jaw, the nurse palpates the area in front of both ears to assess the function of the patient's:

A)Intervertebral foramen
B)Condyle of the mandible
C)Temporomandibular joint
D)Zygomatic arch of the temporal bone

Answer 2

Temporomandibular joint

Question 3

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)Vertebral column
B)Nucleus pulposus
C)Vertebral foramen
D)Intervertebral discs

Answer 3

Intervertebral discs

Question 4

An imaginary line connecting the highest point on each iliac crest would cross the __________ vertebra.

A)First sacral
B)Fourth lumbar
C)Seventh cervical
D)Twelfth thoracic

Question 5

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:

A)Ischial tuberosity
B)Greater trochanter
C)Iliac crest
D)Gluteus maximus muscle

Question 6

The nurse is checking the ROM in a patient's knee and knows that the knee is capable of which movement(s)?

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

Question 7

A patient is being assessed for 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 8

During an interview with a patient with aplastic anemia, the nurse explains that this condition can cause fatigue because of decreased production of new red blood cells by the musculoskeletal system in the:

A)Liver
B)Spleen
C)Kidneys
D)Bone marrow

Question 9

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?

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

Question 10

During assessment of the ankle joint, the nurse asks the patient to flex and extend the articulation of the tibia, fibula, and:

A)Talus
B)Cuboid bones
C)Calcaneus
D)Cuneiform bones

Question 11

The nurse is assessing a patient who reports having functional difficulty and pain bending her knees when climbing stairs.The nurse will assess the functional unit of the musculoskeletal system involved, which is the:

A)Joint
B)Bone
C)Muscle
D)Tendon

Question 12

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?

A)Bursa
B)Calcaneus
C)Epiphyses
D)Tuberosities

Question 13

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 _________ joint.

A)Interphalangeal
B)Tarsometatarsal
C)Metacarpophalangeal
D)Tibiotalar

Question 14

To palpate the TMJ, the nurse's fingers should be placed in the depression __________ of the ear.

A)Distal to the helix
B)Proximal to the helix
C)Anterior to the tragus
D)Posterior to the tragus

Question 15

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

A)Lordosis
B)Scoliosis
C)Ankylosis
D)Kyphosis

Question 16

When assessing the patient's spine, the nurse differentiates between the cervical and thoracic vertebrae at the base of the neck by using the:

A)Spinous processes
B)Thoracic vertebrae T7 and T8
C)Iliac crests
D)12 cervical vertebrae

Question 17

The nurse notices that a woman in an exercise class is unable to jump rope.The nurse is aware that to jump rope, one's shoulder has to be capable of:

A)Inversion
B)Supination
C)Protraction
D)Circumduction

Question 18

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 it is his:

A)Subacromial bursa
B)Acromion process
C)Glenohumeral joint
D)Greater tubercle of the humerus

Question 19

The nurse is assessing a patient's ischial tuberosity.To palpate the ischial tuberosity, the nurse asks the patient to bend his knee toward his chest to:

A)Flex the ankle
B)Flex the hip
C)Extend the knee
D)Extend the spine

Question 20

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

A)Nucleus pulposus
B)Articular processes
C)Medial epicondyle
D)Glenohumeral joint

Question 21

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

A)Unidactyly
B)Syndactyly
C)Polydactyly
D)Multidactyly

Question 22

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:

A)Epicondylitis
B)Gouty arthritis
C)Olecranon bursitis
D)Subcutaneous nodules

Question 23

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?

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

Question 24

During assessment of a 75-year-old female admitted with a hip fracture after falling, the patient states a history of osteoporosis.The nurse recognizes that the patient is more susceptible to bone fractures because of:

A)Increased bone matrix
B)Loss of bone density
C)New, weaker bone growth
D)Increased phagocytic activity

Question 25

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:

A)Crepitation
B)Rotator cuff lesions
C)Dislocated shoulder
D)Rheumatoid arthritis

Question 26

A 40-year-old man has come into the clinic with extreme pain in his toes.The nurse notices that his toes are slightly swollen, reddened, and warm to the touch and recognizes that he has findings of:

A)Osteoporosis
B)Acute gout
C)Ankylosing spondylitis
D)Degenerative joint disease

Question 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?

A)Crepitation
B)Bone spur
C)Loose tendon
D)Fluid in the knee joint

Question 28

The nurse is assessing a 22-year-old patient, a dedicated violin player, who complains of elbow pain and aching forearm muscles.During examination, the nurse elicits pain by touching the outside area of the elbow and when having the patient resist extension of the hand.The nurse recognizes this as:

A)Rotator cuff tear
B)Adhesive capsulitis
C)Epicondylitis
D)Gouty arthritis

Question 29

The nurse is examining a 3-month-old infant and performs the Ortolani manoeuvre.The nurse notes that the movements feel smooth and no sounds are produced.The nurse will document the findings as a:

A)Normal finding of a positive Ortolani sign
B)Normal finding of a negative Ortolani sign
C)Positive Ortolani sign and warrants a referral
D)Negative Ortolani sign and seek immediate referral

Question 30

The nurse is teaching a class on preventing osteoporosis with a group of perimenopausal women.The nurse recommends:

A)Increasing intake of coffee
B)Eating less dairy products
C)Brisk walking outside in good weather
D)Reducing activity to rest the body

Question 31

A woman who has had rheumatoid arthritis for years is noticing that her fingers are starting to drift 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 32

A patient is complaining of pain in his joints that is worse in the morning, better after he moves around for a while, and then gets worse again if he sits for long periods.The nurse should assess for other signs of what problem?

A)Tendinitis
B)Osteoarthritis
C)Rheumatoid arthritis
D)Intermittent claudication

Question 33

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 ask her to:

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 34

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:

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 35

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen test.To perform this test, the nurse should 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 36

During an examination, the nurse asks a patient to bend forward from the waist and notices that the patient has lateral tilting.When asked to perform the LaSègue test, the patient complains of a pain going down his buttock into his leg.The nurse suspects:

A)Scoliosis
B)Meniscus tear
C)Herniated nucleus pulposus
D)Spasm of paravertebral muscles

Question 37

An 85-year-old patient comments during his annual physical examination 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)The vertebral column shortens.
C)A significant loss of subcutaneous fat occurs.
D)A thickening of the intervertebral discs develops.

Question 38

A mother brings her newborn baby boy in for a checkup; she tells the nurse that he does not seem to be moving his right arm as much as his left arm and that he seems to have pain when she lifts him up by holding him under the arms.The nurse suspects a fractured clavicle and would observe for:

A)Negative Allis test
B)Positive Ortolani sign
C)Limited ROM during the Moro reflex
D)Limited ROM during the LaSègue test

Question 39

A professional tennis player comes into the clinic complaining of a sore elbow.The nurse will assess for tenderness at the:

A)Olecranon bursa
B)Annular ligament
C)Base of the radius
D)Medial and lateral epicondyle

Question 40

A young swimmer comes to the sports clinic complaining of a very sore shoulder.He was running at the pool, slipped on 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.The nurse suspects:

A)Joint effusion
B)Tear of rotator cuff
C)Adhesive capsulitis
D)Dislocated shoulder

Question 41

The nurse is examining a 6-month-old infant and places the infant'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 these statements is true of this finding?

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

Question 42

The nurse is examining a 2-month-old infant and notices asymmetry of the infant's gluteal folds.The nurse should assess for other signs of what disorder?

A)Fractured clavicle
B)Down's syndrome
C)Spina bifida
D)Hip dislocation

Question 43

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.)

A)Symmetrical joint involvement
B)Asymmetrical joint involvement
C)Pain with motion of affected joints
D)Affected joints are swollen with hard, bony protuberances
E)Affected joints may have heat, redness, and swelling

Question 44

The nurse is assessing a 1-week-old infant and is testing his muscle strength.The nurse lifts the infant with hands under the axillae and notices that the infant starts to slide down between the hands.The nurse should:

A)Suspect a fractured clavicle
B)Suspect that the infant may have a deformity of the spine
C)Suspect that the infant may have weakness of the shoulder muscles
D)Conclude that this is a normal finding because the musculature of an infant at this age is not fully developed

Question 45

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 recognizes these findings to likely be:

A)Structural scoliosis
B)Functional scoliosis
C)Herniated nucleus pulposus
D)Dislocated hip

Question 46

During assessment of a 15-year-old patient who developed knee pain and swelling after a soccer game, the nurse will check for large amounts of fluid around the patella using:

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

Question 47

A patient tells the nurse, "All my life I've been called 'knock knees'." The nurse knows that another term for "knock knees" is:

A)Genu varum
B)Genu valgum
C)Pes planus
D)Metatarsus adductus

Question 48

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:

A)Callus
B)Plantar wart
C)Bunion
D)Tophi

Question 49

When assessing muscle strength, the nurse observes that a patient has complete ROM against gravity with full resistance.What grade of muscle strength should the nurse record using a 0-to-5-point scale?

A)2
B)3
C)4
D)5

Question 50

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 condition is caused by repeated stress on the patellar tendon.It is the result of your present growth and activity, and your symptoms should resolve with rest."
D)"Increasing your activity and performing knee-strengthening exercises will help decrease the inflammation and maintain mobility in the knee."

Question 51

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

A)Proximal to distal
B)Distal to proximal
C)Posterior to anterior
D)Anterior to posterior