Nokea
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.
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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 is assessing an older female patient and notes that the patient has lost 2 cm in height since the previous visit 2 years ago. Which of the following diagnostic tests should the nurse include in the teaching plan?
- A. Discography studies
- B. Myelographic testing
- C. Magnetic resonance imaging (MRI)
- D. Dual-energy x-ray absorptiometry (DEXA)
Correct Answer: D
Rationale: The decreased height and the patient's age suggest that the patient may have osteoporosis and that bone density testing is needed. Discography, MRI, and myelography are typically done for patients with current symptoms caused by musculoskeletal dysfunction and are not the initial diagnostic tests for osteoporosis.
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.
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.
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.