Nokea
A patient injured in a motor vehicle accident has sustained a fracture to the diaphysis of the right femur. Of what is the diaphysis of the femur mainly constructed?
- A. Epiphyses
- B. Cartilage
- C. Cortical bone
- D. Cancellous bone
Correct Answer: C
Rationale: The long bone shaft, which is referred to as the diaphysis, is constructed primarily of cortical bone.
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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 explaining a patient's decreasing bone density in terms of the balance between bone resorption and formation. What dietary nutrients and hormones play a role in the resorption and formation of adult bones?
- A. Thyroid hormone
- B. Growth hormone
- C. Estrogen
- D. Vitamin B12
- E. Luteinizing hormone
Correct Answer: A,B,C
Rationale: The balance between bone resorption and formation is influenced by the following factors: physical activity; dietary intake of certain nutrients, especially calcium; and several hormones, including calcitriol (i.e., activated vitamin D), parathyroid hormone (PTH), calcitonin, thyroid hormone, cortisol, growth hormone, and the sex hormones estrogen and testosterone. Luteinizing hormone and vitamin B12 do not play a role in bone formation or resorption.
A patient is undergoing diagnostic testing for suspected Paget's disease. What assessment finding is most consistent with this diagnosis?
- A. Altered serum magnesium levels
- B. Altered serum calcium levels
- C. Altered serum potassium levels
- D. Altered serum sodium levels
Correct Answer: B
Rationale: Serum calcium levels are altered in patients with osteomalacia, parathyroid dysfunction, Paget's disease, metastatic bone tumors, or prolonged immobilization. Paget's disease is not directly associated with altered magnesium, potassium, or sodium levels.
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.
A nurse is caring for a patient who has an MRI scheduled. What is the priority safety action prior to this diagnostic procedure?
- A. Assessing the patient for signs and symptoms of active infection
- B. Ensuring that the patient can remain immobile for up to 3 hours
- C. Assessing the patient for a history of nut allergies
- D. Ensuring that there are no metal objects on or in the patient
Correct Answer: D
Rationale: Absolutely no metal objects can be present during MRI their presence constitutes a serious safety risk. The procedure takes up to 90 minutes. Nut allergies and infection are not contraindications to MRI.