Chapter 61: Assessment of Musculoskeletal System

Chapter 61: Assessment of Musculoskeletal System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient complains of shoulder pain when the nurse moves the patient’s 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?”

 

 

ANS:  B

The patient’s pain will make it more difficult to accomplish tasks such as putting on a shirt or jacket. This pain should not affect the patient’s 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.

 

DIF:    Cognitive Level: Apply (application)           REF:               1452

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Health Promotion and Maintenance

 

2. A patient with left knee pain is diagnosed with bursitis. The nurse will explain that bursitis is an inflammation of

a.	a fluid-filled sac found at some joints.
b.	a synovial membrane that lines the joint.
c.	the connective tissue joining bones within a joint.
d.	the fibrocartilage that acts as a shock absorber in the knee.

 

 

ANS:  A

Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a solid tissue that cushions some joints. Ligaments are connective tissue joining bones within a joint The synovial membrane lines many joints but is not a bursa.

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   1450

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

3. The nurse who notes that a 59-yr-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).

 

 

ANS:  D

The decreased height and the patient’s age suggest that the patient may have osteoporosis, and 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.

 

DIF:    Cognitive Level: Apply (application)           REF:               1458

TOP:   Nursing Process: Planning               MSC:  NCLEX: Health Promotion and Maintenance

 

4. Which information in a 67-yr-old woman’s 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 patient’s mother became shorter with aging.
c.	The patient takes ibuprofen for occasional headaches.
d.	The patient’s father died of complications of miliary tuberculosis.

 

 

ANS:  B

A family history of height loss with aging may indicate osteoporosis, and the nurse should perform a more thorough assessment of the patient’s 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.

 

DIF:    Cognitive Level: Apply (application)           REF:               1452

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Health Promotion and Maintenance

 

5. Which information obtained during the nurse’s assessment of a patient’s nutritional-metabolic pattern may indicates increased 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 tall and weighs 180 lb.
d.	The patient prefers whole milk to nonfat milk.

 

 

ANS:  C

The patient’s height and weight indicate obesity, which places stress on weight-bearing joints and predisposes the patient to osteoarthritis. The use of whole milk, avoidance of fruits and vegetables, and use of a daily multivitamin are not risk factors for musculoskeletal problems.

 

DIF:    Cognitive Level: Apply (application)           REF:               1452

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Health Promotion and Maintenance