Chapter 63: Musculoskeletal Problems

Chapter 63: Musculoskeletal Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient with acute osteomyelitis of the left femur is hospitalized for regional antibiotic irrigation. Which intervention will the nurse include in the initial plan of care?

a.	Quadriceps-setting exercises
b.	Immobilization of the left leg
c.	Positioning the left leg in flexion
d.	Assisted weight-bearing ambulation

 

 

ANS:  B

Immobilization of the affected leg helps to decrease pain and reduce the risk for pathologic fracture. Weight-bearing exercise increases the risk for pathologic fractures. Flexion of the affected limb is avoided to prevent contractures.

 

DIF:    Cognitive Level: Apply (application)           REF:               1499

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

 

2. A patient is being discharged after 1 week of IV antibiotic therapy for acute osteomyelitis in the right leg. Which information will be included in the discharge teaching?

a.	How to apply warm packs to the leg to reduce pain
b.	How to monitor and care for a long-term IV catheter
c.	The need for daily aerobic exercise to help maintain muscle strength
d.	The reason for taking oral antibiotics for 7 to 10 days after discharge

 

 

ANS:  B

The patient will be taking IV antibiotics for several months. The patient will need to recognize signs of infection at the IV site and know how to care for the catheter during daily activities such as bathing. IV antibiotics rather than oral antibiotics are used for acute osteomyelitis. Patients are instructed to avoid exercise and heat application because these will increase swelling and the risk for spreading infection.

 

DIF:    Cognitive Level: Apply (application)           REF:               1499

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

 

3. A patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the left femur. The nurse identifies a need for additional teaching related to health maintenance when the nurse finds that the patient

a.	is frustrated with the length of treatment required.
b.	takes and records the oral temperature twice a day.
c.	is unable to plantar flex the foot on the affected side.
d.	uses crutches to avoid weight bearing on the affected leg.

 

 

ANS:  C

Foot drop is an indication that the foot is not being supported in a neutral position by a splint. Using crutches and monitoring the oral temperature are appropriate self-care activities. Frustration with the length of treatment is not an indicator of ineffective health maintenance of the osteomyelitis.

 

DIF:    Cognitive Level: Apply (application)           REF:               1499

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

 

4. The nurse instructs a patient who has osteosarcoma of the tibia about a scheduled above-the-knee amputation. Which statement by a patient indicates additional patient teaching is needed?

a.	“I will need to participate in physical therapy after surgery.”
b.	“I wish I did not need to have chemotherapy after this surgery.”
c.	“I did not have this bone cancer until my leg broke a week ago.”
d.	“I can use the patient-controlled analgesia (PCA) to manage postoperative pain.”

 

 

ANS:  C

Osteogenic sarcoma may be diagnosed following a fracture, but it is not caused by the injury. The other statements indicate patient teaching has been effective.

 

DIF:    Cognitive Level: Apply (application)           REF:               1501

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

 

5. A patient with muscular dystrophy is hospitalized with pneumonia. Which nursing action will be included in the plan of care?

a.	Logroll the patient every 2 hours.
b.	Assist the patient with ambulation.
c.	Discuss the need for genetic testing with the patient.
d.	Teach the patient about the muscle biopsy procedure.

 

 

ANS:  B

Because the goal for the patient with muscular dystrophy is to keep the patient active for as long as possible, assisting the patient to ambulate will be part of the care plan. The patient will not require logrolling. Muscle biopsies are necessary to confirm the diagnosis but are not necessary for a patient who already has a diagnosis. There is no need for genetic testing because the patient already knows the diagnosis.

 

DIF:    Cognitive Level: Apply (application)           REF:               1502

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