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A clinic nurse is caring for a patient with a history of osteoporosis. Which of the following diagnostic tests best allows the care team to assess the patient's risk of fracture?
- A. Arthrography
- B. Bone scan
- C. Bone densitometry
- D. Arthroscopy
Correct Answer: C
Rationale: Bone densitometry is used to detect bone density and can be used to assess the risk of fracture in osteoporosis. Arthrography is used to detect acute or chronic tears of joint capsule or supporting ligaments. Bone scans can be used to detect metastatic and primary bone tumors, osteomyelitis, certain fractures, and aseptic necrosis. Arthroscopy is used to visualize a joint.
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A nurse is performing a musculoskeletal assessment of a patient with arthritis. During passive range-of-motion exercises, the nurse hears an audible grating sound. The nurse should document the presence of which of the following?
- A. Fasciculations
- B. Clonus
- C. Effusion
- D. Crepitus
Correct Answer: D
Rationale: Crepitus is a grating, crackling sound or sensation that occurs as the irregular joint surfaces move across one another, as in arthritic conditions. Fasciculations are involuntary twitching of muscle fiber groups. Clonus is the rhythmic contractions of a muscle. Effusion is the collection of excessive fluid within the capsule of a joint.
A nurse is taking a health history on a new patient who has been experiencing unexplained paresthesia. What question should guide the nurse's assessment of the patient's altered sensations?
- A. How does the strength in the affected extremity compare to the strength in the unaffected extremity?
- B. Does the color in the affected extremity match the color in the unaffected extremity?
- C. How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?
- D. Does the patient have a family history of paresthesia or other forms of altered sensation?
Correct Answer: C
Rationale: Questions that the nurse should ask regarding altered sensations include How does this feeling compare to sensation in the unaffected extremity? Asking questions about strength and color are not relevant and a family history is unlikely.
A nurse is caring for an older adult who has been diagnosed with geriatric failure to thrive. This patient's prolonged immobility creates a risk for what complication?
- A. Muscle clonus
- B. Muscle atrophy
- C. Rheumatoid arthritis
- D. Muscle fasciculations
Correct Answer: B
Rationale: If a muscle is in disuse for an extended period of time, it is at risk of developing atrophy, which is the decrease in size. Clonus is a pattern of rhythmic muscle contractions and fasciculation is the involuntary twitch of muscle fibers; neither results from immobility. Lack of exercise is a risk factor for rheumatoid arthritis.
A nurse on a patient has been experiencing significant pain in her knee and diagnostic imaging reveals an effusion in the synovial capsule. What intervention should the nurse anticipate?
- A. Arthrography
- B. Knee replacement
- C. Arthrocentesis
- D. Arthroscopy
Correct Answer: C
Rationale: Arthrocentesis (joint aspiration) is carried out to obtain synovial fluid for examination or to relieve pain due to effusion. Arthrography is used to visualize joint structures, not to remove fluid. Arthroscopy is a diagnostic visualization, and knee replacement is not indicated for effusion.
An older adult patient has symptoms of osteoporosis and is being assessed during her annual physical examination. The assessment shows that the patient will require further testing related to a possible exacerbation of her osteoporosis. The nurse should anticipate what diagnostic test?
- A. Bone densitometry
- B. Hip bone radiography
- C. Computed tomography (CT)
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Bone densitometry is considered the most accurate test for osteoporosis and for predicting a fracture. As such, it is more likely to be used than CT, MRI, or x-rays.