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Chapter 62 Musculoskeletal System Question and answer verified to pass The nurse is performing a musculoskeletal assessment of an 81-year-old female patient whose mobility has been progressively decreasing in recent months. How should the nurse best assess the patient's range of motion (ROM) in ...

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  • August 18, 2024
  • 19
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • chapter 62 musculoskeletal system
  • chapter 62 musculoskeletal system question and ans

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Chapter 62 Musculoskeletal System
The nurse is performing a musculoskeletal assessment of an 81-year-old
female patient whose mobility has been progressively decreasing in recent
months. How should the nurse best assess the patient's range of motion
(ROM) in the affected leg?


A Observe the patient's unassisted ROM in the affected leg.
B Perform passive ROM, asking the patient to report any pain.
C Ask the patient to lift progressive weights with the affected leg.
D Move both of the patient's legs from a supine position to full flexion. - correct
answer ✔A Observe the patient's unassisted ROM in the affected leg.


Passive ROM should be performed with extreme caution and may be best
avoided when assessing older patients. Observing the patient's active ROM is
more accurate and safe than asking the patient to lift weights with her legs.


When working with patients, the nurse knows that patients have the most
difficulties with diarthrodial joints. Which joints are included in this group of
joints (select all that apply)?


A Hinge joint of the knee
B Ligaments joining the vertebrae
C Fibrous connective tissue of the skull
D Ball and socket joint of the shoulder or hip
E Cartilaginous connective tissue of the pubis joint - correct answer ✔A
Hinge joint of the knee
D Ball and socket joint of the shoulder or hip

,The diarthrodial joints include the hinge joint of the knee and elbow, the ball
and socket joint of the shoulder and hip, the pivot joint of the radioulnar joint,
and the condyloid, saddle, and gliding joints of the wrist and hand. The
ligaments and cartilaginous connective tissue joining the vertebrae and pubis
joint and the fibrous connective tissue of the skull are synarthrotic joints.


An 82-year-old patient is frustrated by her flabby belly and rigid hips. What
should the nurse tell the patient about these frustrations?


A "You should go on a diet and exercise more to feel better about yourself."
B "Something must be wrong with you because you should not have these
problems."
C "You have arthritis and need to go on nonsteroidal antiinflammatory drugs
(NSAIDs)."
D "Decreased muscle mass and strength and increased hip rigidity are normal
changes of aging." - correct answer ✔D "Decreased muscle mass and
strength and increased hip rigidity are normal changes of aging."


The musculoskeletal system's normal changes of aging include decreased
muscle mass and strength; increased rigidity in the hips, neck, shoulders,
back, and knees; decreased fine motor dexterity; and slowed reaction times.
Going on a diet and exercising will help but not stop these changes. Telling
the patient "Something must be wrong with you..." will not be helpful to the
patient's frustrations.


A 50-year-old patient is reporting a sore shoulder after raking the yard. The
nurse should suspect which problem?


A Bursitis
B Fasciitis
C Sprained ligament

, D Achilles tendonitis - correct answer ✔A Bursitis
Bursitis is common in adults over age 40 and with repetitive motion, such as
raking. Plantar fasciitis frequently occurs as a stabbing pain at the heel
caused by straining the ligament that supports the arch. Achilles tendonitis is
an inflammation of the tendon that attaches the calf muscle to the heel bone,
not the shoulder, and causes pain with walking or running. A sprained
ligament occurs when a ligament is stretched or torn from a direct injury or
sudden twisting of the joint, not repetitive motion.


A 63-year-old woman has been taking prednisone (Deltasone) daily for
several years after a kidney transplant to prevent organ rejection. What is
most important for the nurse to assess?


A Staggering gait Incorrect
B Ruptured tendon
C Back or neck pain
D Tardive dyskinesia - correct answer ✔C Back or neck pain


Osteoporosis with resultant fractures is a frequent and serious complication of
systemic corticosteroid therapy. The ribs and vertebrae are affected the most,
and patients should be observed for signs of compression fractures (back and
neck pain). Phenytoin (Dilantin) is an antiseizure medication. An adverse
effect of phenytoin is an ataxic (or staggering) gait. A rare adverse effect of
ciprofloxacin (Cipro) and other fluoroquinolones is tendon rupture, usually of
the Achilles tendon. The highest risk is in people age 60 and older and in
people taking corticosteroids. Antipsychotics and antidepressants may cause
tardive dyskinesia, which is characterized by involuntary movements of the
tongue and face.


The home care nurse visits an 84-year-old woman with pneumonia after her
discharge from the hospital. Which assessment finding would the nurse
expect because of age-related changes in the musculoskeletal system?

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