Download Module 5 Musculoskeletal EXAM 1. A 44-year

Module 5
Musculoskeletal EXAM
1. A 44-year-old patient who has been seen in the clinic for arthritis is about to undergo a
procedure to retrieve synovial fluid from her knee to decrease the pain. The nurse knows
that which of the following procedures will be involved?
A) Angiography
B) Myelography
C) Paracentesis
D) Arthrocentesis
2. A patient complaining of pain in her joints has just returned from having an x-ray. The
x-rays indicate a narrowing of the joint spaces. This is indicative of which of the
following disease processes?
A) Fibromyalgia
B) Scleroderma
C) Gout
D) Osteoarthritis
3. Which of the following is a well-recognized risk factor for osteoarthritis?
A) Smoking
B) Obesity
C) Weight loss
D) Less than 20 years of age
4. Of the following medications used in rheumatic disease, which not only has antiinflammatory effects, but also is used as an injection for joints unresponsive to
nonsteroidal anti-inflammatory drugs (NSAIDs)?
A) Salicylates
B) NSAIDs
C) Disease-modifying antirheumatic drugs (DMARDs)
D) Corticosteroids
5. Of the following medications used in rheumatic disease, which not only has antiinflammatory effects but also acts as a platelet aggregation inhibitor and antipyretic?
A) Penicillamine
B) Indomethacin
C) Antimalarials
D) Prednisone
6. The nurse teaches a patient with rheumatic disease who is being prescribed salicylate
therapy to monitor herself for:
A) Tinnitus
B) Visual changes
C) Stomatitis
D) Hirsutism
7. The nurse teaches the patient with rheumatic disease that it is acceptable to perform
passive range-of-motion exercises during which phase of the inflammatory process?
A) Acute exacerbation, severe pain
B) Subacute exacerbation, moderate pain
C) Subacute exacerbation, minimal pain
D) Remission
8. The nurse is assessing a patient with possible osteoarthritis. The most significant risk
factor for osteoarthritis is:
A) Congenital deformity
B) Age
C) Trauma
D) Obesity
9. A patient with possible osteoarthritis is having x-rays performed on both knees. X-rays
of an osteoarthritic joint reveal:
A) Enlargement of the joint space or margin
B) Fluid deposition in joint spaces
C) Osteophyte formation
D) Cartilage growths at weight-bearing joints
10. The nurse is managing the care of a patient with osteoarthritis. Appropriate treatment
strategies for osteoarthritis include:
A) Administration of narcotics for pain control
B) Bed rest for painful exacerbations
C) Administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Vigorous physical therapy for the joints
11. A 78-year-old patient has a history of osteoarthritis. Which signs and symptoms would
the nurse expect to find on physical assessment?
A) Joint pain, crepitus, and Heberden's nodes
B) Hot, inflamed joints, crepitus, joint pain
C) Tophi, enlarged joints, Bouchard's nodes
D) Swelling, joint pain, tenderness on palpation
12.
A 69-year-old patient asks the nurse what the difference is between osteoarthritis (OA)
and rheumatoid arthritis (RA). Which of the following is the best response by the nurse?
A) “OA is a non-inflammatory joint disease. RA is characterized by inflamed, swollen
joints.
B) “OA and RA are very similar. OA affects the smaller joints, and RA affects the
larger, weight-bearing joints.”
C) “OA affects joints on both sides of the body. RA is usually unilateral.”
D) “OA is more common in women. RA is more common in men.”
13 The nurse is preparing a care plan for a patient who has sustained a long bone fracture.
Which intervention will the nurse include in the care plan to enhance fracture healing?
A) Limit weight bearing and exercising
B) Monitor color, temperature, and pulses of the affected extremity
C) Avoid immobilization of the fracture fragments
D) Administer high doses of corticosteroids
14. The nurse caring for a patient with an open fracture of the radius is developing a care
plan for the patient. The nurse will assign priority to which of the following nursing
diagnoses?
A) Risk for infection
B) Risk for activity intolerance
C) Risk for imbalanced nutrition, less than body requirements
D) Risk for powerlessness
15. The priority nursing diagnosis for a patient experiencing acute compartment syndrome
is:
A) Activity intolerance
B) Risk for peripheral neurovascular dysfunction
C) Risk for imbalanced body temperature
D) Disturbed body image
16. While providing teaching, the nurse instructs the patient with a simple fracture to:
A) Elevate the affected extremity to shoulder level
B) Engage in exercises that strengthen the unaffected muscles
C) Take corticosteroids as prescribed
D) Expect to regain full strength and mobility in 2 to 4 weeks
17. A patient returning to the outpatient office 6 weeks after an above the knee amputation
(AKA) reports symptoms of phantom pain. To reduce the discomfort, the nurse
correctly instructs the patient to:
A) Apply hot compresses to the area of the amputation
B) Avoid rehabilitation exercises until the pain subsides
C) Comfortably increase his level of activity
D) Assess for a pulse in the extremity of the amputation every 4 to 6 hours
18. The nurse caring for a patient who had a right extremity below the knee amputation
(BKA) recognizes the importance of implementing measures that focus on preventing
flexion contracture of the hip and maintaining proper positioning. Which of the
following measures will achieve these goals?
A) Encouraging the patient to turn from side to side and to assume a prone position
B) Initiating ROM exercises of the hip and knee 3 months after the amputation
C) Minimizing movement of the flexor muscles of the hip
D) Encouraging the patient to sit in the chair for at least 8 hours a day
19. The nurse working in the ER is aware that emergency management of an open fracture
of the left tibia includes which of the following?
A) Reducing the fracture
B) Using unpadded splints
C) Covering the wound with the patient's clothes
D) Assessing the neurovascular status distal to the injury
20. Upon assessment of a 28-year-old man who fractured his humerus yesterday, the nurse
finds the patient tachycardic, pale, and confused. The nurse suspects the patient may be
experiencing which of the following complications?
A) Disseminated intravascular coagulopathy
B) Compartment syndrome
C) Fat emboli
D) Deep vein thrombosis
21. A patient states that she has a throbbing deep pain of the forearm after sustaining a
fracture to it. The nurse suspects that she may be experiencing compartment syndrome.
Which of the following possible manifestations can the nurse expect to find?
A) Acute pain with passive stretching of the muscle of the affected limb
B) Control of pain with opioids
C) The affected muscle soft and shrunken
D) An absence of an arterial pulse in the affected limb
22. Which of the following is the most appropriate nursing intervention for the nursing
diagnosis of impaired physical mobility relate to fractured hip?
A) Administer analgesics as required.
B) Place a pillow between the legs when turning.
C) Monitor vital signs.
D) Assess wound appearance.
23. In which of the following positions should a patient's residual limb be placed after a
below-the-knee amputation?
A) Elevated on a pillow
B) Abduction
C) External rotation
D) Extended position
24. The homecare nurse is visiting a patient with a lower extremity amputation who was
discharged from the hospital 6 days prior. Which of the following indicates that the
patient is taking appropriate steps to care for the residual limb?
A) Washing the limb once a week
B) Inspecting the skin every other day
C) Removing bandages when the limb is in a dependent position
D) Repositioning himself frequently
25. The patient who has had an above-the-knee amputation refuses to look at the stump.
When the nurse attempts to speak with the patient about his surgery, he says that he
doesn't wish to discuss it. He also refuses to let his family visit. The nursing diagnosis
that best describes the patient's problem is:
A) Hopelessness
B) Powerlessness
C) Disturbed body image
D) Fear
26. The nurse is caring for a patient placed in traction to treat a fractured femur. Which
nursing intervention has the highest priority?
A) Assessing the extremity for neurovascular integrity
B) Keeping the patient from sliding to the foot of the bed
C) Keeping the ropes over the center of the pulley
D) Ensuring that the weights hang freely at all times
27. The nurse is caring for a patient with a fractured humerus in a long arm cast. Twelve
hours after the cast was applied, the patient begins to complain of arm pain, which is
unrelieved by analgesics. Which nursing action is most appropriate?
A) Preparing the patient for cast removal or bivalving of the cast
B) Obtaining an order for a different pain medication
C) Encouraging the patient to wiggle and move his fingers
D) Petaling the edges of his cast