Nokea
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.
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A nurse is performing a nursing assessment of a patient suspected of having a musculoskeletal disorder. What is the primary focus of the nursing assessment with a patient who has a musculoskeletal disorder?
- A. Range of motion
- B. Activities of daily living
- C. Gait
- D. Strength
Correct Answer: B
Rationale: The nursing assessment is primarily a functional evaluation, focusing on the patient's ability to perform activities of daily living. The nurse also assesses strength, gait, and ROM, but these are assessed to identify their effect on functional status rather than to identify a medical diagnosis.
The nurse's musculoskeletal assessment of a patient reveals involuntary twitching of muscle groups. How would the nurse document this observation in the patient's chart?
- A. Tetany
- B. Atony
- C. Clonus
- D. Fasciculations
Correct Answer: D
Rationale: Fasciculation is involuntary twitching of muscle fiber groups. Clonus is a series of involuntary, rhythmic, muscular contractions and tetany is involuntary muscle contraction, but neither is characterized as twitching. Atony is a loss of muscle strength.
A nurse is caring for a patient who has been scheduled for a bone scan. What should the nurse teach the patient about this diagnostic test?
- A. The test is brief and requires that you drink a calcium solution 2 hours before the test.
- B. You will not be allowed fluid for 2 hours before and 3 hours after the test.
- C. You'll be encouraged to drink water after the administration of the radioisotope injection.
- D. This is a common test that can be safely performed on anyone.
Correct Answer: C
Rationale: It is important to encourage the patient to drink plenty of fluids to help distribute and eliminate the isotopic after it is injected. There are important contraindications to the procedure, include pregnancy or an allergy to the radioisotope. The test requires the injection of an intravenous radioisotope and the scan is preformed 2 to 3 hours after the isotope is injected. A calcium solution is not utilized.
Diagnostic tests show that a patient's bone density has decreased over the past several years. The patient asks the nurse what factors contribute to bone density decreasing. What would be the nurse's best response?
- A. For many people, lack of nutrition can cause a loss of bone density.
- B. Progressive loss of bone density is mostly related to your genes.
- C. Stress is known to have many unhealthy effects, including reduced bone density.
- D. Bone density decreases with age, but scientists are not exactly sure why this is the case.
Correct Answer: A
Rationale: Nutrition has a profound effect on bone density, especially later life. Genetics are also an important factor, but nutrition has a more pronounced effect. The pathophysiology of bone density is well understood and psychosocial stress has a minimal effect.
The nurse is performing an assessment of a patient's musculoskeletal system and is appraising the patient's bone integrity. What action should the nurse perform during this phase of assessment?
- A. Compare parts of the body symmetrically.
- B. Assess extremities when in motion rather than at rest.
- C. Percuss as many joints as accessible.
- D. Administer analgesia 30 to 60 minutes before assessment.
Correct Answer: A
Rationale: When assessing bone integrity, symmetric parts of the body, such as extremities, are compared. Analgesia should not be necessary and percussion is not a clinically useful assessment technique. Bone integrity is best assessed when the patient is not moving.