A 42-year-old male patient complains of shoulder pain when the nurse moves his arm behind the back. Which question should the nurse ask? a. Are you able to feed yourself without difficulty? b. Do you have difficulty when you are putting on a shirt? c. Are you able to sleep through the night without...
Musculoskeletal Test Bank 2024
A 42-year-old male patient complains of shoulder pain when the nurse moves his arm
behind the back. Which question should the nurse ask?
a. Are you able to feed yourself without difficulty?
b. Do you have difficulty when you are putting on a shirt?
c. Are you able to sleep through the night without waking?
d. Do you ever have trouble lowering yourself to the toilet? - b. Do you have difficulty
when you are putting on a shirt?
The patients pain will make it more difficult to accomplish tasks like putting on a shirt or
jacket. This pain should not affect the patients ability to feed himself or use the toilet
because these tasks do not involve moving the arm behind the patient. The arm will not
usually be positioned behind the patient during sleeping.
A patient with left knee pain is diagnosed with bursitis. The nurse will explain that
bursitis is an inflammation of
a. the synovial membrane that lines the joint.
b. a small, fluid-filled sac found at some joints.
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. - b. a small,
fluid-filled sac found at some joints.
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.
The nurse who notes that a 59-year-old female patient has lost 1 inch in height over the
past 2 years will plan to teach the patient about
a. discography studies.
b. myelographic testing.
c. magnetic resonance imaging (MRI).
d. dual-energy x-ray absorptiometry (DXA). - d. dual-energy x-ray absorptiometry
(DXA).
The decreased height and the patients age suggest that the patient may have
osteoporosis and that bone density testing is needed. Discography, MRI, and
myelography are typically done for patients with current symptoms caused by
musculoskeletal dysfunction and are not the initial diagnostic tests for osteoporosis.
Which information in a 67-year-old womans health history will alert the nurse to the
need for a more focused assessment of the musculoskeletal system?
a. The patient sprained her ankle at age 13.
b. The patients mother became shorter with aging.
c. The patient takes ibuprofen (Advil) for occasional headaches.
,d. The patients father died of complications of miliary tuberculosis. - b. The patients
mother became shorter with aging.
A family history of height loss with aging may indicate osteoporosis, and the nurse
should perform a more thorough assessment of the patients current height and other
risk factors for osteoporosis. A sprained ankle during adolescence does not place the
patient at increased current risk for musculoskeletal problems. A family history of
tuberculosis is not a risk factor. Occasional nonsteroidal antiinflammatory drug (NSAID)
use does not indicate any increased musculoskeletal risk.
Which information obtained during the nurses assessment of a 30-year-old patients
nutritional-metabolic pattern may indicate the risk for musculoskeletal problems?
a. The patient takes a multivitamin daily.
b. The patient dislikes fruits and vegetables.
c. The patient is 5 ft 2 in and weighs 180 lb.
d. The patient prefers whole milk to nonfat milk. - c. The patient is 5 ft 2 in and weighs
180 lb.
The patients 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 musculoskeletal problems.
Which medication information will the nurse identify as a concern for a patients
musculoskeletal status?
a. The patient takes a daily multivitamin and calcium supplement.
b. The patient takes hormone therapy (HT) to prevent hot flashes.
c. The patient has severe asthma and requires frequent therapy with oral
corticosteroids.
d. The patient has migraine headaches treated with nonsteroidal antiinflammatory drugs
(NSAIDs). - c. The patient has severe asthma and requires frequent therapy with oral
corticosteroids.
Frequent or chronic corticosteroid use may lead to skeletal problems such as avascular
necrosis and osteoporosis. The use of HT and calcium supplements will help prevent
osteoporosis. NSAID use does not increase the risk for musculoskeletal problems.
The nurse finds that a patient can flex the arms when no resistance is applied but is
unable to flex when the nurse applies light resistance. The nurse should document the
patients muscle strength as level
a. 0.
b. 1.
c. 2.
d. 3. - d. 3.
A level 3 indicates that the patient is unable to move against resistance but can move
against gravity. Level 1 indicates minimal muscle contraction, level 2 indicates that the
,arm can move when gravity is eliminated, and level 4 indicates active movement with
some resistance.
After completing the health history, the nurse assessing the musculoskeletal system will
begin by
a. having the patient move the extremities against resistance.
b. feeling for the presence of crepitus during joint movement.
c. observing the patients body build and muscle configuration.
d. checking active and passive range of motion for the extremities. - c. observing the
patients body build and muscle configuration.
The usual technique in the physical assessment is to begin with inspection.
Abnormalities in muscle mass or configuration will allow the nurse to perform a more
focused assessment of abnormal areas. The other assessments are also included in the
assessment but are usually done after inspection.
Which nursing action is correct when performing the straight-leg raising test for an
ambulatory patient with back pain?
a. Raise the patients legs to a 60-degree angle from the bed.
b. Place the patient initially in the prone position on the exam table.
c. Have the patient dangle both legs over the edge of the exam table.
d. Instruct the patient to elevate the legs and tense the abdominal muscles. - a. Raise
the patients legs to a 60-degree angle from the bed.
When performing the straight leg-raising test, the patient is in the supine position and
the nurse passively lifts the patients legs to a 60-degree angle. The other actions would
not be correct for this test.
A 72-year-old patient with kyphosis is scheduled for dual-energy x-ray absorptiometry
(DXA) testing. The nurse will plan to
a. explain the procedure.
b. start an IV line for contrast medium injection.
c. give an oral sedative 60 to 90 minutes before the procedure.
d. screen the patient for allergies to shellfish or iodine products. - a. explain the
procedure.
DXA testing is painless and noninvasive. No IV access is necessary. Contrast medium
is not used. Because the procedure is painless, no antianxiety medications are required.
A patient has a new order for magnetic resonance imaging (MRI) to evaluate for left
femur osteomyelitis after a hip replacement surgery. Which information indicates that
the nurse should consult with the health care provider before scheduling the MRI?
a. The patient has a pacemaker.
b. The patient is claustrophobic.
c. The patient wears a hearing aid.
d. The patient is allergic to shellfish. - a. The patient has a pacemaker.
, Patients with permanent pacemakers cannot have MRI because of the force exerted by
the magnetic field on metal objects. An open MRI will not cause claustrophobia. The
patient will need to be instructed to remove the hearing aid before the MRI, but this
does not require consultation with the health care provider. Because contrast medium
will not be used, shellfish allergy is not a contraindication to MRI.
The nurse notes crackling sounds and a grating sensation with palpation of an older
patients elbow. How will this finding be documented?
a. Torticollis
b. Crepitation
c. Subluxation
d. Epicondylitis - b. Crepitation
Crackling sounds and a grating sensation that accompany movement are described as
crepitus or crepitation. Torticollis is a twisting of the neck to one side, subluxation is a
partial dislocation of the joint, and epicondylitis is an inflammation of the elbow that
causes a dull ache that increases with movement.
Which finding is of highest priority when the nurse is planning care for a 77-year-old
patient seen in the outpatient clinic?
a. Symmetric joint swelling of fingers
b. Decreased right knee range of motion
c. Report of left hip aching when jogging
d. History of recent loss of balance and fall - d. History of recent loss of balance and fall
A history of falls requires further assessment and development of fall prevention
strategies. The other changes are more typical of bone and joint changes associated
with normal aging.
Which finding from a patients right knee arthrocentesis will be of concern to the nurse?
a. Cloudy fluid
b. Scant thin fluid
c. Pale yellow fluid
d. Straw-colored fluid - a. Cloudy fluid
The presence of purulent fluid suggests a possible joint infection. Normal synovial fluid
is scant in amount and pale yellow/straw-colored.
Which action can the nurse delegate to unlicensed assistive personnel (UAP) who are
working in the orthopedic clinic?
a. Grade leg muscle strength for a patient with back pain.
b. Obtain blood sample for uric acid from a patient with gout.
c. Perform straight-leg-raise testing for a patient with sciatica.
d. Check for knee joint crepitation before arthroscopic surgery. - b. Obtain blood sample
for uric acid from a patient with gout.
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