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Chapter 64: Nursing Assessment: Musculo-skeletal SystemLewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE CHOICE
1. The nurse is caring for a client who has pain during circumduction of the shoulder when
the nurse moves the arm behind the client. Which of the following questions should the
nurse ask?
a. “Do you have difficulty in putting on a jacket?”
b. “Are you able to feed yourself without difficulty?”
c. “Are you able to sleep through the night without waking?”
d. “Do you ever have trouble lowering yourself to the toilet?”
ANS: A
The client’s pain will make it more difficult to accomplish tasks like putting on a shirt or
jacket. This pain should not affect the client’s ability to feed himself or herself or use the
toilet because these tasks do not involve moving the arm behind the client. The arm will
not usually be positioned behind the client during sleeping.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
2. The nurse is caring for a client with knee pain who is diagnosed with bursitis and asks the
nurse to explain just what bursitis is. The nurse will respond that bursitis is an
inflammation of which of the following structures?
a. A small, fluid-filled sac found at many joints
b. The synovial membrane that lines the joint area
c. The fibrocartilage that acts as a shock absorber in the knee joint
d. Any connective tissue that is found supporting the joints of the body
ANS: A
Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a
solid tissue that cushions some joints. Bursae are a specific type of connective tissue. The
synovial membrane lines many joints but is not a bursa.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. The nurse is assessing an older female client and notes that the client has lost 2.5 cm in
height since the previous visit 2 years ago. Which of the following diagnostic tests should
the nurse include in the teaching plan?
a. Discography studies
b. Myelographic testing
c. Magnetic resonance imaging (MRI)
d. Dual-energy x-ray absorptiometry (DEXA)
ANS: D
, The decreased height and the client’s age suggest that the client may have osteoporosis
and that bone density testing is needed. Discography, MRI, and myelography are typically
done for clients with current symptoms caused by musculo-skeletal dysfunction and are
not the initial diagnostic tests for osteoporosis.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
4. Which of the following information in a female, older-adult client’s health history will
alert the nurse to the need for a more focused assessment of the musculo-skeletal system?
a. The client experienced a sprained ankle at age 13.
b. The client’s mother became much shorter with aging.
c. The client’s father died of complications of miliary tuberculosis.
d. The client reports taking ibuprofen for occasional headaches.
ANS: B
A family history of height loss with aging may indicate osteoporosis, and the nurse should
perform a more thorough assessment of the client’s current height and other risk factors
for osteoporosis. A sprained ankle during adolescence does not place the client at
increased current risk for musculo-skeletal problems. A family history of tuberculosis is
not a risk factor. Occasional nonsteroidal anti-inflammatory drug (NSAID) use does not
indicate any increased musculo-skeletal risk.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
5. Which of the following information obtained during the nurse’s assessment of the client’s
nutritional-metabolic pattern may indicate the risk for musculo-skeletal problems?
a. The client takes a multivitamin daily.
b. The client dislikes fruits and vegetables.
c. The client is 158 cm and weighs 81.6 kg.
d. The client prefers whole milk to nonfat milk.
ANS: C
The client’s height and weight indicate obesity, which places stress on weight-bearing
joints. The use of whole milk, avoiding fruits and vegetables, and use of a daily
multivitamin are not risk factors for musculo-skeletal problems.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
6. The nurse is assessing a new client in the clinic. Which of the following information about
the client’s medications should be of most concern?
a. The client takes a daily multivitamin and calcium supplement.
b. The client has migraine headaches that are treated with nonsteroidal
anti-inflammatory drugs (NSAIDs).
c. The client has severe asthma and requires frequent therapy with oral steroids.
d. The client takes hormone replacement therapy (HRT) to prevent “hot flashes.”
ANS: C
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