NR511 / NR 511 Week 5 Musculoskeletal

Mickey, age 18, is on a chemotherapeutic antibiotic for a musculoskeletal neoplasm. Which drug do you think he is taking? 1.Cyclophosphamide (Cytoxan). 2.Doxorubicin (Adriamycin). 3.Methotrexate (Rheumatrex). 4.Cisplatin (Platinol). - Doxorubicin (Adriamycin). rationale: The only antineoplastic antibiotic listed is doxorubicin (Adriamycin). All of the other medications are chemotherapeutic agents of other classifications that may be used for musculoskeletal neoplasms. A 13-year-old obese (body mass index [BMI] above the 95th percentile) boy reports low-grade left knee pain for the past 2 months. He denies antecedent trauma but admits to frequent "horseplay" with his friends. The pain has progressively worsened, and he is now unable to bear weight at all on his left leg. His current complaints include left groin, thigh, and medial knee pain and tenderness. His examination demonstrates negative drawer, Lachman, and McMurray tests; left hip with decreased internal rotation and abduction; and external hip rotation with knee flexion. Based on the above scenario, the nurse practitioner should suspect: 1.A left meniscal tear. 2.A left anterior cruciate ligament (ACL) tear. 3.A slipped capital femoral epiphysis (SCFE). 4.Osgood-Schlatter disease. - A slipped capital femoral epiphysis (SCFE). rationale: SCFE is a displacement of the femoral head relative to the femoral neck that occurs through the physis (growth plate) of the femur. The vast majority of clients with this condition are obese, as the added weight increases shear stress across the physis. The mean age at diagnosis is 12 years for females and 13.5 years for males. Surgery is often required via in situ pin fixation (single screw) to stabilize the growth plate to prevent further slippage and avoid complications. The valgus stress test, varus stress test, Lachman test, and thumb sign are all considered standard tests to check the integrity of the ligaments of the knee. Which test would the nurse practitioner choose to assess the anterior cruciate ligament (ACL), which is the most commonly involved structure in severe knee injury? 1.Valgus stress test. 2.Varus stress test. 3.Lachman test. 4.Thumb sign. - Lachman test rationale: The Lachman test assesses the ACL. In assessing the skeletal muscles, the nurse practitioner turns the patient's forearm so that the palm is up. This is called: 1.Supination. 2.Pronation. 3.Abduction. 4.Eversion. - Supination. rationale: Turning the forearm so that the palm is up is called supination. Lillian