Nokea
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.
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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 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 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 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.
The nurse obtains this information when assessing an older-adult patient in the outpatient clinic. Which of the following findings is of highest priority when the nurse is planning care for the patient?
- A. Symmetrical joint swelling of fingers
- B. Decreased right knee range of motion
- C. History of recent loss of balance and fall
- D. Complaint of left hip aching when jogging
Correct Answer: C
Rationale: A history of falls requires further assessment and development of fall prevention strategies. The other changes are more typical of bone and joint changes associated with normal aging.