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Test Bank
MULTIPLE CHOICE
1. A 42-year-old male patient complains of shoulder pain when the nurse moves his 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 patients pain will make it more difficult to accomplish tasks like putting on a shirt or
jacket. This pain should not affect the patients 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.
2. A patient with left knee pain is diagnosed with bursitis. The nurse will explain that bursitis is
an inflammation of
a. the synovial membrane that lines the joint.
b. a small, fluid-filled sac found at some joints.
c. the fibrocartilage that acts as a shock absorber in the knee joint.
d. any connective tissue that is found supporting the joints of the body.
ANS: B
Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a solid
tissue that cushions some joints. Bursae are a specific type of connective tissue. The synovial
membrane lines many joints but is not a bursa.
3. The nurse who notes that a 59-year-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 patients age suggest that the patient may have osteoporosis and
that 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.
6. Which medication information will the nurse identify as a concern for a patients
musculoskeletal status?
a. The patient takes a daily multivitamin and calcium supplement.
b. The patient takes hormone therapy (HT) to prevent hot flashes.
c. The patient has severe asthma and requires frequent therapy with oral
corticosteroids.
d. The patient has migraine headaches treated with nonsteroidal antiinflammatory
drugs (NSAIDs).
ANS: C
Frequent or chronic corticosteroid use may lead to skeletal problems such as avascular
necrosis and osteoporosis. The use of HT and calcium supplements will help prevent
osteoporosis. NSAID use does not increase the risk for musculoskeletal problems.
8. After completing the health history, the nurse assessing the musculoskeletal system will begin
by
a. having the patient move the extremities against resistance.
b. feeling for the presence of crepitus during joint movement.
c. observing the patients body build and muscle configuration.
d. checking active and passive range of motion for the extremities.
ANS: C
The usual technique in the physical assessment is to begin with inspection. Abnormalities in
muscle mass or configuration will allow the nurse to perform a more focused assessment of
abnormal areas. The other assessments are also included in the assessment but are usually
done after inspection.
9. Which nursing action is correct when performing the straight-leg raising test for an
ambulatory patient with back pain?
a. Raise the patients legs to a 60-degree angle from the bed.
b. Place the patient initially in the prone position on the exam table.
c. Have the patient dangle both legs over the edge of the exam table.
d. Instruct the patient to elevate the legs and tense the abdominal muscles.
ANS: A
When performing the straight leg-raising test, the patient is in the supine position and the
nurse passively lifts the patients legs to a 60-degree angle. The other actions would not be
correct for this test.
10. A 72-year-old patient with kyphosis is scheduled for dual-energy x-ray absorptiometry (DXA)
testing. The nurse will plan to
a. explain the procedure.
b. start an IV line for contrast medium injection.
c. give an oral sedative 60 to 90 minutes before the procedure.
d. screen the patient for allergies to shellfish or iodine products.
ANS: A
DXA testing is painless and noninvasive. No IV access is necessary. Contrast medium is not
used. Because the procedure is painless, no antianxiety medications are required.
11. A patient has a new order for magnetic resonance imaging (MRI) to evaluate for left femur
osteomyelitis after a hip replacement surgery. Which information indicates that the nurse
should consult with the health care provider before scheduling the MRI?
a. The patient has a pacemaker.
b. The patient is claustrophobic.
c. The patient wears a hearing aid.
d. The patient is allergic to shellfish.
ANS: A
Patients with permanent pacemakers cannot have MRI because of the force exerted by the
magnetic field on metal objects. An open MRI will not cause claustrophobia. The patient will
need to be instructed to remove the hearing aid before the MRI, but this does not require
consultation with the health care provider. Because contrast medium will not be used, shellfish
allergy is not a contraindication to MRI.
12. The nurse notes crackling sounds and a grating sensation with palpation of an older patients
elbow. How will this finding be documented?
a. Torticollis
b. Crepitation
c. Subluxation
d. Epicondylitis
ANS: B
Crackling sounds and a grating sensation that accompany movement are described as crepitus
or crepitation. Torticollis is a twisting of the neck to one side, subluxation is a partial
dislocation of the joint, and epicondylitis is an inflammation of the elbow that causes a dull
ache that increases with movement.
13. Which finding is of highest priority when the nurse is planning care for a 77-year-old patient
seen in the outpatient clinic?
a. Symmetric joint swelling of fingers
b. Decreased right knee range of motion
c. Report of left hip aching when jogging
d. History of recent loss of balance and fall
ANS: D
A history of falls requires further assessment and development of fall prevention strategies.
The other changes are more typical of bone and joint changes associated with normal aging.
14. Which finding from a patients right knee arthrocentesis will be of concern to the nurse?
a. Cloudy fluid
b. Scant thin fluid
c. Pale yellow fluid
d. Straw-colored fluid
ANS: A
The presence of purulent fluid suggests a possible joint infection. Normal synovial fluid is
scant in amount and pale yellow/straw-colored.
15. Which action can the nurse delegate to unlicensed assistive personnel (UAP) who are working
in the orthopedic clinic?
a. Grade leg muscle strength for a patient with back pain.
b. Obtain blood sample for uric acid from a patient with gout.
c. Perform straight-leg-raise testing for a patient with sciatica.
d. Check for knee joint crepitation before arthroscopic surgery.
ANS: B
Drawing blood specimens is a common skill performed by UAP in clinic settings. The other
actions are assessments and require registered nurse (RN)level judgment and critical
thinking.
OTHER
1. Which part of the musculoskeletal assessment is the nurse doing in the video?
ANS:
D
Hip abduction and adduction is assessed by having the patient move the hip joint laterally and
medially.
DIF: Cognitive Level: Understand (comprehension) REF: 1492 | 1498
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance