1.
1. A nurse on the orthopedic floor is assessing her patient's peroneal nerve. The nurse will perform this assessment by pricking what?
Correct Answer
A. A) The skin centered between the great and second toe
Explanation
The peroneal nerve supplies sensation to the skin on the outer side of the lower leg and the top of the foot. It specifically innervates the area between the great toe and the second toe. By pricking the skin in this area, the nurse can assess the function of the peroneal nerve and determine if there are any abnormalities or deficits in sensation.
2.
2. The nursing instructor is discussing disability in the United States. What would the instructor tell the students is the leading cause of disability in the United States?
Correct Answer
B. B) Arthritis
Explanation
Arthritis is the leading cause of disability in the United States. Arthritis is a condition that causes inflammation and stiffness in the joints, leading to pain and limited mobility. It affects millions of people, making it a significant cause of disability. Osteoporosis, hip fractures, and long bone fractures can also cause disability, but they are not as prevalent or as common as arthritis. Therefore, arthritis is the correct answer for the leading cause of disability in the United States.
3.
3. You are caring for a patient whose laboratory studies show that the patient is hypocalcemic. When the nurse analyzes the other laboratory studies, the nurse will expect the results to reveal what?
Correct Answer
A. A) An elevated parathyroid hormone level
Explanation
Hypocalcemia is a condition characterized by low levels of calcium in the blood. The parathyroid hormone (PTH) plays a crucial role in regulating calcium levels in the body. When calcium levels are low, the parathyroid glands release more PTH to stimulate the release of calcium from bones and increase calcium absorption from the intestines and kidneys. Therefore, in a patient with hypocalcemia, it is expected to see an elevated parathyroid hormone level in order to compensate for the low calcium levels.
4.
4. While doing an initial assessment on a patient, she tells the nurse that she has bone pain. The nurse asks the patient to describe the characteristics of the pain. Which of the following are typical characteristics of bone pain?
Correct Answer
A. A) Dull, deep ache that is “boring” in nature
Explanation
Bone pain is typically described as a dull, deep ache that is "boring" in nature. This type of pain is often constant and may worsen with movement or weight-bearing activities. It is not typically relieved by immobilization or rest. Soreness or aching that may include cramping is more commonly associated with muscle pain, while sharp and piercing pain is more characteristic of nerve pain. Spastic or sharp pain that radiates is also not typical of bone pain.
5.
5. A nurse is doing an assessment on his patient for peripheral neurovascular dysfunction. What assessment findings may indicate to the nurse peripheral neurovascular dysfunction?
Correct Answer
B. B) Absence of feeling, capillary refill of 4 to 5 seconds and cool skin
Explanation
The assessment findings of absence of feeling, capillary refill of 4 to 5 seconds, and cool skin indicate peripheral neurovascular dysfunction. Absence of feeling suggests nerve damage, while a delayed capillary refill time indicates impaired blood flow. Cool skin is a sign of poor circulation. These findings collectively suggest that there may be a problem with the nerves and blood vessels in the peripheral areas of the body.
6.
6. An elderly patient has symptoms of osteoporosis and is being assessed during her annual physical examination. The assessment shows the patient will require further testing related to the symptoms of osteoporosis. The nurse informs the patient that the most accurate test for osteoporosis is what?
Correct Answer
A. A) Hip bone densitometry (BMD)
Explanation
The most accurate test for osteoporosis is hip bone densitometry (BMD). This test measures the density of the bones in the hip, which is a common site for osteoporotic fractures. It provides a precise assessment of bone mineral density and can accurately diagnose osteoporosis. A bone scan, computed tomography (CT), and magnetic resonance imaging (MRI) can provide valuable information, but they are not as accurate as hip bone densitometry in diagnosing osteoporosis.
7.
7. A patient injured in a motor vehicle accident has sustained damage to the diaphysis of the right femur. What is the diaphysis of the femur mainly constructed of?
Correct Answer
C. C) Cortical bone
Explanation
The diaphysis of the femur is mainly constructed of cortical bone. Cortical bone, also known as compact bone, is a dense and hard type of bone tissue that forms the outer layer of most bones in the body. It provides strength and support to the bone, allowing it to withstand mechanical stress and bear weight. In contrast, epiphyses are the rounded ends of long bones, cartilage is a flexible connective tissue found in joints, and cancellous bone is a spongy type of bone tissue found at the ends of long bones.
8.
8. An elderly patient has come to the clinic for a regular check-up. While reviewing a patient's history, the nurse notes that the patient has an increased thoracic curvature of the spine. What is this referred to as?
Correct Answer
D. D) KypHosis
Explanation
Kyphosis refers to an increased thoracic curvature of the spine, causing a hunchback appearance. It is commonly seen in elderly individuals due to age-related degenerative changes in the spine, such as osteoporosis and vertebral compression fractures. Kyphosis can lead to back pain, difficulty in maintaining an upright posture, and reduced mobility. Treatment options include physical therapy, pain management, and in severe cases, surgery.
9.
9. When assessing the patient's peripheral nerve function the nurse uses an instrument to prick the fat pad at the top of the small finger. This action will assess which of the following nerves?
Correct Answer
B. B) Ulnar
Explanation
When assessing the patient's peripheral nerve function, the nurse pricks the fat pad at the top of the small finger to assess the ulnar nerve. The ulnar nerve is responsible for sensory and motor functions in the hand, including the small finger. By pricking the fat pad, the nurse can evaluate the sensitivity and motor control associated with the ulnar nerve. This test helps determine if there are any abnormalities or impairments in the ulnar nerve function.
10.
10. A patient comes to the free clinic to see the Nurse Practitioner. The Nurse Practitioner notices a spinal abnormality as she observes the patient standing. The Nurse Practitioner observes an increase in the lumbar curvature of the spine. She will document this finding on the assessment record as what?
Correct Answer
C. C) Lordosis
Explanation
The Nurse Practitioner will document the finding of an increase in the lumbar curvature of the spine as "Lordosis". Lordosis refers to an excessive inward curve of the spine, specifically in the lower back region. This abnormality can cause the lower back to appear more pronounced or swaybacked. It is important for the Nurse Practitioner to document this finding accurately in the assessment record to ensure proper diagnosis and treatment for the patient.
11.
11. The human body is designed to protect its vital parts. The nurse is aware that a fracture of what type of bone may interfere with the protection of vital organs?
Correct Answer
C. C) Flat bones
Explanation
Flat bones, such as those in the skull, ribs, and pelvis, provide protection to vital organs. A fracture in these bones can compromise the integrity of the protective barrier, potentially endangering the organs they shield.
12.
12. A patient has just had an arthroscopy. What is a nursing intervention that is necessary for the nurse to implement following an arthroscopy?
Correct Answer
A. A) Wrap the joint in compression dressing.
Explanation
After an arthroscopy, it is necessary for the nurse to implement the nursing intervention of wrapping the joint in a compression dressing. This intervention helps to reduce swelling and provide support to the joint, promoting healing and preventing further injury. Wrapping the joint in a compression dressing also helps to control bleeding and minimize the risk of infection. Flexing or extending the joint, as well as applying heat, may not be appropriate immediately following an arthroscopy and could potentially cause further damage or delay healing.
13.
13. While assessing a patient, the patient tells the nurse that she is experiencing rhythmic contractions in the ankle after kneeling down in such a way that the foot is dorsiflexed. What is this muscle contraction referred to as?
Correct Answer
D. D) Clonus
Explanation
Clonus refers to a rhythmic contraction and relaxation of a muscle. In this case, the patient is experiencing rhythmic contractions in the ankle after assuming a specific position. This is characteristic of clonus, which is commonly seen in conditions such as spinal cord injury or neurological disorders. Fasciculations refer to brief, involuntary muscle twitches, contracture refers to a permanent shortening of a muscle or joint, and effusion refers to the accumulation of fluid in a joint or body cavity. Therefore, the correct answer is D) Clonus.
14.
14. The nurse considers when developing the patient's care plan that without proper intervention, the muscles of the patient are at risk of developing what?
Correct Answer
B. B) AtropHy
Explanation
Without proper intervention, the muscles of the patient are at risk of developing atrophy. Atrophy refers to the wasting away or loss of muscle mass and strength. It can occur due to various reasons such as disuse, immobility, aging, or certain medical conditions. Proper intervention, such as physical therapy, exercise, and mobility aids, can help prevent or manage muscle atrophy.
15.
15. You are caring for a patient who has a bone scan scheduled. What would the nurse teach the patient about the test?
Correct Answer
C. C) Fluids will be encouraged after the administration of the radioisotope injection
Explanation
The nurse would teach the patient that after the administration of the radioisotope injection, fluids will be encouraged. This is because the radioisotope injection can cause dehydration, so it is important for the patient to drink plenty of fluids to stay hydrated.
16.
16. You are assessing the muscle tone of a 10-year-old admitted with muscular dystrophy. You assess with movement that the patient's muscle has a greater-than-normal tone. How will the nurse document this finding?
Correct Answer
D. D) Spastic
Explanation
The nurse will document the finding as "spastic." Spasticity refers to increased muscle tone or stiffness, which can be seen in conditions such as muscular dystrophy. It is characterized by increased resistance to passive movement and can result in muscle spasms and difficulty with movement.
17.
17. Which of the following techniques will the nurse implement to assess a patient's gait?
Correct Answer
C. C) Instruct the patient to walk away from the nurse for a short distance.
Explanation
The nurse will implement the technique of instructing the patient to walk away from the nurse for a short distance to assess the patient's gait. This technique allows the nurse to observe the patient's walking pattern, balance, and coordination while they walk independently. It provides a more accurate assessment of the patient's gait compared to the other options, as it allows the nurse to observe the patient's gait in a natural and unrestricted manner.
18.
18. The clinic nurse is caring for a 70-year-old female with a history of osteoporosis. The patient has come to the clinic for her annual physical. Which of the following diagnostic tests will the nurse expect the physician to order to assess the risk of fracture for people with osteoporosis?
Correct Answer
C. C) Bone densitometry
Explanation
The nurse can expect the physician to order a bone densitometry test to assess the risk of fracture for people with osteoporosis. This test is commonly used to measure bone mineral density and can help determine the severity of osteoporosis and the risk of fractures. Arthrography, bone scan, and arthroscopy are not typically used to assess the risk of fracture in osteoporosis.
19.
19. You are performing a musculoskeletal assessment on a patient with arthritis. During passive range-of-motion exercises the nurse hears a grating and cracking sound. This assessment finding is correctly referred to as what?
Correct Answer
D. D) Crepitus
Explanation
During a musculoskeletal assessment, the nurse hears a grating and cracking sound during passive range-of-motion exercises in a patient with arthritis. This assessment finding is correctly referred to as crepitus. Crepitus is a term used to describe the grating, cracking, or popping sound that occurs when the rough surfaces of bones or cartilage rub against each other. In the case of arthritis, the joint inflammation and damage can lead to the roughening of the joint surfaces, causing crepitus. This finding is important to note as it can indicate joint degeneration and may require further evaluation or management.
20.
20. What is the term for the process of cartilage formation at a fracture site?
Correct Answer
A. A) Callus formation
Explanation
Callus formation is the term used to describe the process of cartilage formation at a fracture site. When a bone is fractured, the body initiates a healing response by forming a callus, which is a mass of tissue that bridges the gap between the broken ends of the bone. This callus is initially made up of cartilage, which later undergoes ossification, or the process of turning into bone. Callus formation is an important step in the healing process as it provides stability to the fractured bone and eventually allows for the regeneration of new bone tissue.
21.
21. The nursing instructor is talking about the musculoskeletal system with her students. The instructor tells her students that there are four types of bones in the human body. What would the instructor tell the students about the determination of the shape and construction of a specific bone?
Correct Answer
B. B) It is determined by its function and the forces exerted on it.
Explanation
The shape and construction of a specific bone are determined by its function and the forces exerted on it. This means that the bone's structure and shape are influenced by the demands placed on it, such as the type of movement it needs to support and the amount of force it needs to withstand. The bone will adapt and remodel itself over time to better meet these demands, resulting in a shape and construction that is specific to its function.
22.
22. The nurse is caring for a patient who has an MRI scheduled. What does the nurse assess the patient for prior to the study?
Correct Answer
D. D) Inability to tolerate required positions
Explanation
Prior to an MRI study, the nurse assesses the patient for their ability to tolerate the required positions. This is important because MRI scans often require the patient to lie still in a specific position for an extended period of time. If the patient is unable to tolerate these positions, it may affect the quality of the scan or cause discomfort to the patient. Therefore, assessing the patient's ability to tolerate the required positions is essential for a successful MRI study.
23.
23. When taking a health history on a patient with musculoskeletal dysfunction what would the nurse include?
Correct Answer
A. A) Evaluation of the effects of the musculoskeletal disorder on the patient
Explanation
When taking a health history on a patient with musculoskeletal dysfunction, the nurse would include an evaluation of the effects of the musculoskeletal disorder on the patient. This would involve assessing the impact of the disorder on the patient's daily activities, mobility, pain levels, and overall quality of life. Understanding the effects of the disorder is crucial in developing an appropriate care plan and providing targeted interventions to address the patient's specific needs.
24.
24. A patient on the unit is scheduled for a bone scan to rule out osteosarcoma of the pelvic bones. What would be important for the nurse to assess before the patient's scan?
Correct Answer
B. B) That the patient emptied their bladder
Explanation
Before a bone scan, it is important for the patient to empty their bladder. This is because a full bladder can interfere with the accuracy of the scan by obstructing the view of the pelvic bones. By ensuring that the patient has emptied their bladder, the nurse can help to ensure that the scan results are as accurate as possible.
25.
25. The anatomy and physiology pre-nursing class is learning about bone growth. The students learn that in an adult several factors influence the balance between bone resorption and formation. What dietary nutrients and hormones play a role in the resorption and formation of adult bones? (Mark all that apply.)
Correct Answer(s)
A. A) Thyroid hormone
B. B) Growth hormone
C. C) Estrogen
Explanation
Thyroid hormone, growth hormone, and estrogen all play a role in the resorption and formation of adult bones. Thyroid hormone helps regulate bone remodeling by stimulating bone resorption. Growth hormone promotes bone growth and stimulates the production of insulin-like growth factor, which also promotes bone formation. Estrogen helps maintain bone density by inhibiting bone resorption. Inactivated vitamin D and leutinizing hormone do not directly influence bone resorption or formation.
26.
26. Diagnostic tests show that bone density and osteogenesis have decreased in a 55-year-old male patient. The patient asks the nurse what causes bone density to decrease. What would be the nurse's best response?
Correct Answer
A. A) When the blood supply becomes diminished, bone density decreases.
Explanation
The nurse's best response would be that when the blood supply becomes diminished, bone density decreases. This is because blood supply plays a crucial role in delivering essential nutrients and oxygen to the bones, which are necessary for maintaining bone density. When the blood supply is reduced, the bones receive fewer nutrients and oxygen, leading to a decrease in bone density.
27.
27. Your patient has just returned to the unit after having a bone biopsy done. What would the nurse monitor the patient for after the biopsy?
Correct Answer
B. B) Edema
Explanation
After a bone biopsy, the nurse would monitor the patient for edema. Edema refers to swelling caused by excess fluid in the tissues. It is a common post-procedure complication and can be a result of inflammation or trauma to the surrounding tissues during the biopsy. Monitoring for edema is important as it can indicate infection, bleeding, or other complications.
28.
28. The nurse is taking a health history on a new patient hospitalized with parasthesias. What is an appropriate question for the nurse to ask the patient to elicit information on altered sensations?
Correct Answer
C. C) How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?
Explanation
An appropriate question for the nurse to ask the patient to elicit information on altered sensations would be "How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?" This question specifically addresses the issue of altered sensations and allows the patient to provide information about any differences they may be experiencing in terms of sensation between the affected and unaffected extremity.
29.
29. A patient tells his nurse that he is having pain. The nurse asks the patient to describe his pain and the patient says that the pain is steadily increasing . The nurse knows that steadily increasing pain is an indication of what?
Correct Answer
D. D) Malignant tumor
Explanation
Steadily increasing pain is often associated with a malignant tumor. Malignant tumors can grow and spread rapidly, causing increasing pain as they invade and damage surrounding tissues. This type of pain is typically progressive and may worsen over time. It is important for healthcare providers to consider the possibility of a malignant tumor when a patient reports steadily increasing pain, as early detection and treatment are crucial for improving outcomes.
30.
30. The nursing instructor is talking about the importance of the health history to her beginning nursing class. When assessing the musculoskeletal system, what pertinent data should the nurse gather?
Correct Answer
A. A) Occupation
Explanation
When assessing the musculoskeletal system, it is important for the nurse to gather data about the patient's occupation. This is because the type of work a person does can have a significant impact on their musculoskeletal health. Certain occupations may require repetitive movements or heavy lifting, which can increase the risk of musculoskeletal injuries or conditions. Understanding the patient's occupation can help the nurse assess any potential risks or issues related to the musculoskeletal system and provide appropriate care and education.
31.
31. A patient is suspected of having a musculoskeletal disorder. The nurse is performing a nursing assessment on this patient. What does the nursing assessment focus on with a patient who has a musculoskeletal disorder?
Correct Answer
B. B) ADLs
Explanation
The nursing assessment for a patient with a musculoskeletal disorder focuses on ADLs (Activities of Daily Living). This includes assessing the patient's ability to perform basic self-care tasks such as bathing, dressing, eating, and toileting. By assessing the patient's ADLs, the nurse can determine the impact of the musculoskeletal disorder on the patient's functional abilities and independence. This information is important for developing a care plan and determining the appropriate interventions and support needed for the patient.
32.
32. You are assessing attendees at a hospital health fair. A 15-year-old girl comes in for an assessment. You note that this girl's shoulders are not level, she does not have an asymmetric waistline, and she has a prominent scapula that is accentuated by bending forward. You would refer this patient to her primary care physician for what?
Correct Answer
C. C) Suspected scoliosis
Explanation
The girl's symptoms of uneven shoulders, no asymmetric waistline, and a prominent scapula accentuated by bending forward are indicative of scoliosis. Scoliosis is a condition characterized by an abnormal sideways curvature of the spine. Referring the patient to her primary care physician is necessary for further evaluation and appropriate management of scoliosis.
33.
33. A patient, diagnosed with multiple sclerosis, has an abnormal gait that is associated with lower motor neuron disease. What is the term used to describe this gait?
Correct Answer
D. D) Steppage gait
Explanation
Steppage gait is the term used to describe an abnormal gait associated with lower motor neuron disease, such as multiple sclerosis. This gait is characterized by excessive lifting of the foot and a high stepping pattern, as the patient has difficulty in dorsiflexing the foot. This compensatory movement helps the patient to clear the foot from the ground during walking.
34.
34. You are a nurse working in an outpatient surgery center. Your patient has just had an arthroscopy and is getting ready to go home. What symptoms would be important for you to teach this patient and their family to report to the physician?
Correct Answer
A. A) Cool skin
Explanation
Cool skin can be a sign of poor circulation or decreased blood flow to the surgical site, which may indicate a complication such as infection or blood clot. It is important for the patient and their family to report this symptom to the physician so that appropriate medical intervention can be provided.
35.
35. A patient has been admitted to the orthopedic unit with suspected Paget's disease of the bone. What would you expect the laboratory results to show if the patient has Paget's disease?
Correct Answer
B. B) Altered serum calcium levels
Explanation
Paget's disease of the bone is a condition characterized by abnormal bone remodeling, resulting in enlarged and weakened bones. This can lead to an imbalance in calcium levels in the blood. Therefore, it is expected that the laboratory results would show altered serum calcium levels in a patient with Paget's disease.
36.
36. A nurse is caring for a patient with metastatic bone tumors. What laboratory value would the nurse expect to be elevated in this patient?
Correct Answer
C. C) Alkaline pHospHatase
Explanation
In patients with metastatic bone tumors, the nurse would expect the laboratory value for alkaline phosphatase to be elevated. Alkaline phosphatase is an enzyme that is found in high concentrations in bone tissue. When there is bone destruction or increased bone turnover, such as in metastatic bone tumors, the levels of alkaline phosphatase in the blood will rise. This can be a useful marker for monitoring the progression of the disease and the effectiveness of treatment. Sodium, potassium, and creatinine levels are not directly related to bone tumors and would not be expected to be elevated in this patient.
37.
37. When doing an initial assessment for his shift the nurse finds that one of his patients is exhibiting signs of compartment syndrome. The nurse knows that the patient can permanently lose function in the extremity if the anoxic situation continues for longer than what?
Correct Answer
D. D) 6 hours
Explanation
If a patient is exhibiting signs of compartment syndrome, it means there is increased pressure within a muscle compartment, leading to reduced blood flow and oxygen to the affected area. If this anoxic situation continues for longer than 6 hours, the patient can permanently lose function in the extremity.
38.
38. The nurse is assessing a patient on the orthopedic unit. What can the assessment of the patient's skin influence?
Correct Answer
A. A) The nursing management of musculoskeletal conditions
Explanation
The assessment of the patient's skin can influence the nursing management of musculoskeletal conditions. Skin assessment can provide valuable information about the patient's overall health, including any potential skin breakdown or pressure ulcers that may affect their mobility and ability to manage musculoskeletal conditions. By assessing the patient's skin, the nurse can identify any issues that may require intervention or adjustments in the nursing care plan, such as the use of specialized support surfaces or additional interventions to prevent skin breakdown. This assessment helps in providing appropriate and individualized nursing care for patients with musculoskeletal conditions.
39.
39. The nurse is assessing a patient newly admitted to the floor. The nurse notes involuntary twitching of muscle groups. How would the nurse document this observation in the patient's chart?
Correct Answer
D. D) Fasiculation
Explanation
The nurse would document the observation of involuntary twitching of muscle groups as "fasciculation" in the patient's chart.