Nokea
The nurse is assessing a patient in the clinic who has knee pain following an arthroscopic procedure 7 days previously and has just had an arthrocentesis. Which of the following findings should be of most concern to the nurse?
- A. Scant thin fluid
- B. Sanguinous fluid
- C. Straw-coloured fluid
- D. Purulent appearing fluid
Correct Answer: D
Rationale: The presence of purulent fluid suggests a possible joint infection. Bloody fluid might be expected after an arthroscopic procedure. Normal synovial fluid is scant in amount and straw-coloured.
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Which of the following assessments of synovial fluid indicates that the findings are normal?
- A. Transparent and colourless
- B. Reddish pink fluid
- C. Grey, thin fluid
- D. Whitish yellow fluid
Correct Answer: A
Rationale: Normal synovial fluid is transparent and colourless or straw-coloured. It should be scant in amount and of low viscosity. Fluid from an infected joint may be purulent and thick or grey and thin. In gout, the fluid may be whitish yellow. Blood may be aspirated.
The nurse is caring for a patient with kyphosis. Which of the following findings should the nurse expect to assess?
- A. Shortened stride
- B. Exaggerated thoracic curvature
- C. Grating sound when performing passive ROM
- D. Uncoordinated, swaying gait
Correct Answer: B
Rationale: Patients with kyphosis (dowager's hump) have a forward bending of thoracic spine, an exaggerated thoracic curvature. A shortened stride is antalgic gait. Crepitation is crackling sound or grating sensation as a result of friction between bones, broken bone, or cartilage bits in joint. An uncoordinated swaying gait is an ataxic gait.
The nurse is assessing the movement of a patient's elbow and notes crackling sounds and a grating sensation with palpation. Which of the following terms should the nurse use to document these findings?
- A. Torticollis
- B. Crepitation
- C. Subluxation
- D. Epicondylitis
Correct Answer: B
Rationale: Crackling sounds and a grating sensation that accompany movement are described as crepitus or crepitation. Torticollis is a twisting of the neck to one side, subluxation is a partial dislocation of the joint, and epicondylitis is an inflammation of the elbow that causes a dull ache that increases with movement.
The nurse is assessing a new patient in the clinic. Which of the following information about the patient's medications should be of most concern?
- A. The patient takes a daily multivitamin and calcium supplement.
- B. The patient has migraine headaches that are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. The patient has severe asthma and requires frequent therapy with oral steroids.
- D. The patient takes hormone replacement therapy (HRT) to prevent 'hot flashes.'
Correct Answer: C
Rationale: Corticosteroid use may lead to skeletal problems such as avascular necrosis and osteoporosis. The use of HRT and calcium supplements will help prevent osteoporosis. NSAID use does not increase the risk for musculoskeletal problems.
The nurse is conducting a musculoskeletal assessment on an older-adult patient. Which of the following are age-related changes in this body system? (Select all that apply.)
- A. Decreased bone density
- B. Decreased risk for cartilage disruption
- C. Increased glycogen stores
- D. Decreased elasticity in cartilage
- E. Increased muscle cell diameter
Correct Answer: A,D
Rationale: A decrease in both bone density and elasticity in the cartilage are age-related changes in the musculoskeletal system. Other changes include an increased risk for cartilage disruption, decreased glycogen stores, and a decrease in the diameter of muscle cells.