Chapter 25: Musculoskeletal Function

Gerontologic Nursing 5th Edition by Sue E. Meiner

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Chapter 25: Musculoskeletal Function

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. To best identify a risk for injury in an older adult patient, the nurse assesses for:
a. decreased muscle mass in the legs.
b. history of falls.
c. hyperextension of the spine.
d. decreased bone density.

 

 

ANS:  B

Musculoskeletal aging changes increase the risk for falls in older adults. Approximately one third of those age 65 or older have falls each year. About 2% of this group is hospitalized as a result of injuries incurred during the fall. The other assessments are appropriate, but a history of falls is most predictive.

 

DIF:    Remembering (Knowledge)             REF:   Page 512        OBJ:   25-2

TOP:   Nursing Process: Assessment           MSC:  Safe Effective Care Environment

 

  1. A nurse is caring for the older patient who had knee replacement surgery 8 days ago. What assessment by the nurse is most important?
a. Determining whether the patient has sensation to the foot
b. Asking the patient to rate his or her current pain.
c. Observing the incision site for redness or drainage.
d. Monitoring the calf circumference on the affected side

 

 

ANS:  D

Major complications after joint replacement surgery include thromboembolism (deep venous thrombosis [DVT]), joint or wound infection, blood loss, nerve injury, joint dislocation, and surgical pain. The risk of DVT is highest between the first and second week after surgery. An increase in calf circumference can indicate the presence of a DVT. The other assessments are appropriate but not as critical.

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   25-5

TOP:   Nursing Process: Assessment           MSC:  Physiologic Integrity

 

  1. A patient had hip replacement surgery. What intervention is most appropriate to prevent dislocation?
a. Instruct staff to use a fracture pan when the patient needs to toilet.
b. Administer ordered pain medication prior to turning.
c. Elevate the patient’s knee on the affected side with a pillow.
d. Apply an abduction splint while the patient is in bed.

 

 

ANS:  D

Patients who have total hip replacement surgery are at risk for hip dislocation. The hip should be maintained in a position of abduction and neutral alignment. Some physicians may require the use of pillows or abduction splints while the patient is in bed. The other actions will not prevent dislocation.

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   25-5

TOP:   Communication and Documentation                                 MSC:  Physiologic Integrity

 

  1. An older adult patient who has experienced a left knee replacement asks the nurse, “When will I be back to normal?” The nurse responds that:
a. “What did the surgeon tell you about function after the surgery?”
b. Normal means different things to different people.”
c. “You should be back to normal after 6 to 8 weeks.”
d. “Surgery will improve your mobility but I’m not sure about being normal.”

 

 

ANS:  A

The goal of total knee replacement surgery is to restore at least 90 degrees of knee flexion. However, the patient may have unrealistic expectations, so the nurse should first assess what the patient was told the outcome would be. The other statements do not give accurate information.

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   25-5

TOP:   Nursing Process: Assessment           MSC:  Physiologic Integrity

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