Nokea
A patient has been experiencing an unexplained decline in knee function and has consequently been scheduled for arthrography. The nurse should teach the patient about what process?
- A. Injection of a contrast agent into the knee joint prior to ROM exercises
- B. Aspiration of synovial fluid for serologic testing
- C. Injection of corticosteroids into the patient's knee joint to facilitate ROM
- D. Replacement of the patient's synovial fluid with a synthetic substitute
Correct Answer: A
Rationale: During arthrography, a radiopaque contrast agent or air is injected into the joint cavity to visualize the joint structures such as the ligaments, cartilage, tendons, and joint capsule. The joint is put through its range of motion to distribute the contrast agent while a series of x-rays are obtained. Synovial fluid is not aspirated or replaced and corticosteroids are not administered.
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A child is growing at a rate appropriate for his age. What cells are responsible for the secretion of bone matrix that eventually results in bone growth?
- A. Osteoblasts
- B. Osteocytes
- C. Osteoclasts
- D. Lamellae
Correct Answer: A
Rationale: Osteoblasts function in bone formation by secreting bone matrix. Osteocytes are mature bone cells and osteoclasts are multinuclear cells involved in dissolving and resorbing bone. Lamellae are circles of mineralized bone matrix.
A patient has been experiencing progressive increases in knee pain and diagnostic imaging reveals a worsening effusion in the synovial capsule. The nurse should anticipate which of the following?
- A. Arthrography
- B. Knee biopsy
- C. Arthrocentesis
- D. Electromyography
Correct Answer: C
Rationale: Arthrocentesis (joint aspiration) is carried out to obtain synovial fluid for purposes of examination or to relieve pain due to effusion. Arthrography, biopsy, and electromyography would not remove fluid and relieve pressure.
A nurse on the orthopedic unit is assessing a patient's peroneal nerve. The nurse will perform this assessment by doing which of the following actions?
- A. Pricking the skin between the great and second toe
- B. Stroking the skin on the sole of the patient's foot
- C. Pinching the skin between the thumb and index finger
- D. Stroking the distal fat pad of the small finger
Correct Answer: A
Rationale: The nurse will evaluate the sensation of the peroneal nerve by pricking the skin centered between the great and second toe. None of the other listed actions elicits the function of one of the peripheral nerves.
The results of a nurse's musculoskeletal examination show an increase in the lumbar curvature of the spine. The nurse should recognize the presence of what health problem?
- A. Osteoporosis
- B. Kyphosis
- C. Lordosis
- D. Scoliosis
Correct Answer: C
Rationale: The nurse documents the spinal abnormality as lordosis. Lordosis is an increase in lumbar curvature of the spine. Kyphosis is an increase in the convex curvature of the spine. Scoliosis is a lateral curvature of the spine. Osteoporosis is the significant loss of bone mass and strength with an increased risk for fracture.
A nurse's assessment of a teenage girl reveals that her shoulders are not level and that she has one prominent scapula that is accentuated by bending forward. The nurse should expect to read about what health problem in the patient's electronic health record?
- A. Lordosis
- B. Kyphosis
- C. Scoliosis
- D. Muscular dystrophy
Correct Answer: C
Rationale: Scoliosis is evidenced by an abnormal lateral curve in the spine, shoulders that are not level, an asymmetric waistline, and a prominent scapula, accentuated by bending forward. Lordosis is the curvature in the lower back; kyphosis is an exaggerated curvature of the upper back. This finding is not suggestive of muscular dystrophy.