Nokea
The nurse is caring for a patient with knee pain who is diagnosed with bursitis and asks the nurse to explain just what bursitis is. The nurse will respond that bursitis is an inflammation of which of the following structures?
- A. A small, fluid-filled sac found at many joints
- B. The synovial membrane that lines the joint area
- C. The fibrocartilage that acts as a shock absorber in the knee joint
- D. Any connective tissue that is found supporting the joints of the body
Correct Answer: A
Rationale: Bursae are fluid-filled sacs that cushion joints and bony prominences. Fibrocartilage is a solid tissue that cushions some joints. Bursae are a specific type of connective tissue. The synovial membrane lines many joints but is not a bursa.
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The nurse is preparing to assess a patient's musculoskeletal system. Which of the following actions should the nurse do first?
- A. Feel for the presence of crepitus during joint movement.
- B. Have the patient move the extremities against resistance.
- C. Observe the patient's body build and muscle configuration.
- D. Check active and passive range of motion for the extremities.
Correct Answer: C
Rationale: The usual technique in the physical assessment is to begin with inspection. Abnormalities in muscle mass or configuration will allow the nurse to perform a more focused assessment of abnormal areas. The other assessments also are included in the assessment but are usually done after inspection.
The nurse is caring for a patient who has a new prescription for magnetic resonance imaging (MRI) to evaluate for right femur osteomyelitis. Which of the following patient information indicates that the nurse should consult with the health care provider before scheduling the MRI?
- A. The patient has a pacemaker.
- B. The patient is claustrophobic.
- C. The patient wears a hearing aid.
- D. The patient is allergic to shellfish.
Correct Answer: A
Rationale: Patients with permanent pacemakers cannot have MRI because of the force exerted by the magnetic field on metal objects. An open MRI will not cause claustrophobia. The patient will need to be instructed to remove the hearing aid before the MRI, but this does not require consultation with the health care provider. Since contrast medium will not be used, shellfish allergy is not a contraindication to MRI.
The nurse is caring for a patient who has pain during circumduction of the shoulder when the nurse moves the arm behind the patient. Which of the following questions should the nurse ask?
- A. Do you have difficulty in putting on a jacket?
- B. Are you able to feed yourself without difficulty?
- C. Are you able to sleep through the night without waking?
- D. Do you ever have trouble lowering yourself to the toilet?
Correct Answer: A
Rationale: The patient's pain will make it more difficult to accomplish tasks like putting on a shirt or jacket. This pain should not affect the patient's ability to feed himself or herself or use the toilet because these tasks do not involve moving the arm behind the patient. The arm will not usually be positioned behind the patient during sleeping.
Which of the following information in a female, older-adult patient's health history will alert the nurse to the need for a more focused assessment of the musculoskeletal system?
- A. The patient experienced a sprained ankle at age 13.
- B. The patient's mother became much shorter with aging.
- C. The patient's father died of complications of military tuberculosis.
- D. The patient reports taking ibuprofen for occasional headaches.
Correct Answer: B
Rationale: A family history of height loss with aging may indicate osteoporosis, and the nurse should perform a more thorough assessment of the patient's current height and other risk factors for osteoporosis. A sprained ankle during adolescence does not place the patient at increased current risk for musculoskeletal problems. A family history of tuberculosis is not a risk factor. Occasional nonsteroidal anti-inflammatory drug (NSAID) use does not indicate any increased musculoskeletal risk.
Which of the following information obtained during the nurse's assessment of the patient's nutritional-metabolic pattern may indicate the risk for musculoskeletal condition?
- A. The patient takes a multivitamin daily.
- B. The patient dislikes fruits and vegetables.
- C. The patient is 158 cm and weighs 81 kg.
- D. The patient prefers whole milk to nonfat milk.
Correct Answer: C
Rationale: The patient's height and weight indicate obesity, which places stress on weight-bearing joints. The use of whole milk, avoiding fruits and vegetables, and use of a daily multivitamin are not risk factors for musculoskeletal condition.