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Study Questions
Chapter 18: Musculoskeletal System
1.
Examples of hinge joints include:
(a) elbows, fingers, and knees.
(b) atlantoodontal joint of the first and second cervical vertebrae.
(c) wrist and metacarpals.
(d) shoulders and hips.
Answer: a
Rationale: Answers (b), (c), and (d) represent other types of joints.
2.
The following musculoskeletal diseases are more likely in men than in women:
(a) osteoporosis and scoliosis
(b) systemic lupus erythematosus and multiple sclerosis
(c) Dupuytren’s contracture and muscular dystrophy
(d) rheumatoid arthritis and scleroderma
Answer: c
Rationale: Answers (a), (b), and (d) are more common in women.
3.
Your patient is a 36-year-old woman recently diagnosed with multiple sclerosis. She is
concerned about the effect of this on her husband and two daughters, aged 8 and 11, who
depend on her for all household chores, and about being able to continue her job as a
church secretary. You might advise her to (choose two):
(a) take an aerobic exercise class to increase her endurance.
(b) quit her job in order to devote time and energy to her family.
(c) allow for adequate rest, while maintaining her activities as much as possible.
(d) get her family more involved in household maintenance.
Answer: c, d
Rationale: An aerobic class might be too strenuous. Working outside the home may help her
maintain her self-esteem and independence, and quitting may contribute to depression and
feelings of isolation. Adequate rest is very important for MS, and the family should share in tasks,
because this benefits everyone, and roles change over time in any family situation.
Questions 4 and 5 refer to the following: Your patient is a 65-year-old woman who has been
diagnosed with osteoporosis. Her doctor has prescribed risedronate sodium (Actonel) 35 mg
weekly and told her to take calcium, 1200–1500 mg daily.
4.
She asks you about measures that she could take to safeguard her home. You might
suggest all but which one of the following:
(a) removing rugs which are not secured to the floor
(b) installing a grab bar on the wall of her shower or tub
(c) ensuring adequate lighting, especially near stairways
(d) wearing socks without shoes in the house so that she does not trip over shoelaces
Answer: d
Rationale: Socks are generally more slippery than shoes. She should wear shoes with nonskid
soles.
5.
As she is leaving your office, she falls, hitting her head. She is conscious but complains
of head and neck pain. Appropriate interventions would include (choose two):
(a) placing a pillow under her head.
(b) calling for help.
(c) not moving her.
(d) repositioning her to make her more comfortable.
Answer: c, d
Rationale: Never move someone with a possible neck injury. Also, with any type of incident, a
report should be made in accordance with your facility’s policies.
6.
A normal gait includes the following:
(a) There is no knee flexion, and the heel hits the ground before the ball of the foot.
(b) There is limited weight bearing on one leg.
(c) The foot is lifted 1 to 2 inches off the ground and moved forward 12 to 18 inches.
(d) One leg is moved by swinging it in a semicircle.
Answer: c
Rationale: Answer (a) describes a “goose step.” Limited weight bearing may be due to pain. Legs
should be moved by hip and knee flexion rather than swinging in a semicircle.
7.
Your patient is a 62-year-old woman with cancer that has metastasized to her spine. She
cannot tolerate lying on her back and requests frequent turning from side to side. You
emphasize to your coworkers:
(a) use as many people to help as possible to allow for smooth movement.
(b) be especially gentle, because even minor stress can cause pathological fractures.
(c) she will be given enough medication to prevent feeling any pain from movement.
(d) the cancer in her spine will prevent fractures.
Answer: a, b
Rationale: Bone metastasis can cause pathological fractures, and smooth, gentle movement can
minimize the danger. Pain medication is not always ordered or given in adequate amounts when
pain is truly severe.
8.
To measure range of motion, use:
(a) a measuring tape.
(b) manual resistance.
(c) a goniometer.
(d) calipers.
Answer: c
Rationale: A goniometer measures angles achieved by a joint in flexion or hyperextension.
9.
Your patient is a 17-year-old male who injured his right knee when he was tackled during
a football game. You would test for meniscal tears using this test:
(a) drawer test
(b) Lachman’s test
(c) varus stress test
(d) McMurray’s sign
Answer: d
Rationale: The drawer and Lachman’s tests check for damage to cruciate ligaments. The varus
stress test is for the lateral collateral ligament.
10.
Hallux valgus is commonly known as a:
(a) bunion.
(b) hammertoe.
(c) corn.
(d) callus.
Answer: a
Rationale: Answer (a) is correct.
11.
This assistive device is most likely to be used by a 20-year-old patient with a fractured
tibia:
(a) rolling walker
(b) pickup walker
(c) crutches
(d) cane
Answer: c
Rationale: Crutches allow for non-weight bearing on the affected leg.
Which of the following does not contribute to an elderly person’s decreased mobility?
(a) deterioration of cartilage
(b) vertebral inflexibility
(c) muscle atrophy
(d) maintenance of an active lifestyle
Answer: d
Rationale: Body tissues deteriorate with age, but maintaining activity helps guard against bone
density loss and muscle atrophy.
12.
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