This is a comprehensive and detailed testbank on Chapter 14; musculoskeletal system from Wilson health assessment for Nursing practice,6th edition.
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Health Assessment for Nursing Practice 6th Edition Wilson Test Bank
Chapter 14: Musculoskeletal System
Wilson: Health Assessment for Nursing Practice, 6th Edition
MULTIPLE CHOICE
1. Which description of pain from the patient makes a nurse suspect the patient’s pain is
originating from a muscle?
a. “Crampy”
b. “Dull and deep”
c. “Boring and intense”
d. “Sharp upon movement”
ANS: A
Muscle pain is often described as “crampy.” Bone pain typically is described as “deep” and
“dull.” Bone pain typically is described as “boring” and “intense.” Muscle pain usually
remains crampy on movement.
DIF: Cognitive Level: Understand REF: p. 279
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
2.
a. Rheumatoid arthritis
b. Osteoarthritis
c. Gout
d. Tendonitis
ANS: C
Sudden onset of pain and erythema in the great toe, ankle, and lower leg suggests gout (also
called gouty arthritis). Patients with rheumatoid arthritis often have morning stiffness lasting 1
to 2 hours. Patients with osteoarthritis experience pain when bearing weight that is relieved by
rest. Tendonitis may awaken the patient, especially when the patient is lying on the affected
limb.
DIF: Cognitive Level: Apply REF: p. 279
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
3. During a history, the patient reports having gout. Based on this information, what findings
does the nurse anticipate during a focused assessment?
a. Warm, tender, and deformed wrists and peripheral interphalangeal (PIP) joints
bilaterally
b. Edema, warmth, and redness of one great toe and pealike nodules in the ear lobes
c. Enlarged and tender PIP or distal interphalangeal (DIP) joints on one or several
fingers
NURSINGTB.COM
, Health Assessment for Nursing Practice 6th Edition Wilson Test Bank
d. Tenderness with pronation and supination of the elbow and point tenderness on the
lateral epicondyle
ANS: B
Option B is a description of gout. The pealike nodules are tophi, collections of uric acid in
subcutaneous tissue. Option A is a description of findings of a patient who has rheumatoid
arthritis. Bilateral joint involvement is common. Option C is a description of findings of a
patient who has osteoarthritis. Enlarged and tender PIP joints refer to Heberden nodes and
DIP joints refer to Bouchard nodes. Option D is a description of epicondylitis (tennis elbow).
DIF: Cognitive Level: Apply REF: p. 279 | p. 304
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
4.
a. Abrupt onset of local tenderness, edema, and decreased range of motion of the
shoulder and hip bilaterally
b. Decreased range of motion of one hip and knee with pain on flexion and crepitus
during movement of these joints
c. Erythema in one great toe, ankle, and lower leg that is painful to the touch
d. Hot, painful, deformed, and edematous wrists and peripheral interphalangeal joints
bilaterally
ANS: D
The history and these examination findings are consistent with rheumatoid arthritis. Joints are
involved bilaterally in rheumatoid arthritis because it is a systemic autoimmune disorder. The
examination finding in option A is more consistent with bursitis. The examination finding in
option B is more consistent with osteoarthritis. The examination finding in option C is more
consistent with gout.
DIF: Cognitive Level: Analyze REF: p. 293 | p. 295
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
5. In assessing a patient with a history of poliomyelitis, the nurse suspects the right leg muscles
are smaller than the left leg. What is the best approach for the nurse to confirm or reject this
suspicion?
a. Palpating both legs using the pads of the thumb and index fingers and comparing
one side with another
b. Using a tape to measure each leg’s circumference at the same location, above or
below the nearest joint
c. Using a goniometer to measure the upper and lower legs with the patient in supine
and standing positions
d. Palpating the legs using the tips of the thumb and index fingers, and comparing the
findings with the Lovett scale
ANS: B
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