Lewis: Chapter 64:
Musculoskeletal Problems (low
back pain) Exams Questions
with Complete Solutions
User [Date] [Course title]
, The nurse cares for a 58-year-old woman with breast cancer who is admitted for severe back pain
related to a compression fracture. The patient's laboratory values include serum potassium of 4.5
mEq/L, serum sodium of 144 mEq/L, and serum calcium of 14.3 mg/dL. Which signs and symptoms will
the nurse expect the patient to exhibit?
A. Anxiety, irregular pulse, and weakness
B. Muscle stiffness, dysphagia, and dyspnea
C. Hyperactive reflexes, tremors, and seizures
D. Nausea, vomiting, and altered mental status - Correct Answer: D. Nausea, vomiting, and altered
mental status
Breast cancer can metastasize to the bone. Vertebrae are a common site. Pathologic fractures at the site
of metastasis are common because of a weakening of the involved bone. High serum calcium levels
result as calcium is released from damaged bones. Normal serum calcium is between 8.6 to 10.2 mg/dL.
Clinical manifestations of hypercalcemia include nausea, vomiting, and altered mental status (e.g.,
lethargy, decreased memory, confusion, personality changes, psychosis, stupor, coma). Other
manifestations include weakness, depressed reflexes, anorexia, bone pain, fractures, polyuria,
dehydration, and nephrolithiasis. Manifestations of hypomagnesemia include hyperactive reflexes,
tremors, and seizures. Symptoms of hyperkalemia include anxiety, irregular pulse, and weakness.
Symptoms of hypocalcemia include muscle stiffness, dysphagia, and dyspnea.
The nurse provides instructions to a 30-year-old female office worker who has low back pain. Which
statement by the patient requires an intervention by the nurse?
A. "Acupuncture to the lower back would cause irreparable nerve damage."
B. "Smoking may aggravate back pain by decreasing blood flow to the spine."
C. "Sleeping on my side with knees and hips bent reduces stress on my back."
D. "Switching between hot and cold packs provides relief of pain and stiffness." - Correct Answer: A.
"Acupuncture to the lower back would cause irreparable nerve damage."
Acupuncture is a safe therapy when the practitioner has been appropriately trained. Very fine needles
are inserted into the skin to stimulate specific anatomic points in the body for therapeutic purposes.
Musculoskeletal Problems (low
back pain) Exams Questions
with Complete Solutions
User [Date] [Course title]
, The nurse cares for a 58-year-old woman with breast cancer who is admitted for severe back pain
related to a compression fracture. The patient's laboratory values include serum potassium of 4.5
mEq/L, serum sodium of 144 mEq/L, and serum calcium of 14.3 mg/dL. Which signs and symptoms will
the nurse expect the patient to exhibit?
A. Anxiety, irregular pulse, and weakness
B. Muscle stiffness, dysphagia, and dyspnea
C. Hyperactive reflexes, tremors, and seizures
D. Nausea, vomiting, and altered mental status - Correct Answer: D. Nausea, vomiting, and altered
mental status
Breast cancer can metastasize to the bone. Vertebrae are a common site. Pathologic fractures at the site
of metastasis are common because of a weakening of the involved bone. High serum calcium levels
result as calcium is released from damaged bones. Normal serum calcium is between 8.6 to 10.2 mg/dL.
Clinical manifestations of hypercalcemia include nausea, vomiting, and altered mental status (e.g.,
lethargy, decreased memory, confusion, personality changes, psychosis, stupor, coma). Other
manifestations include weakness, depressed reflexes, anorexia, bone pain, fractures, polyuria,
dehydration, and nephrolithiasis. Manifestations of hypomagnesemia include hyperactive reflexes,
tremors, and seizures. Symptoms of hyperkalemia include anxiety, irregular pulse, and weakness.
Symptoms of hypocalcemia include muscle stiffness, dysphagia, and dyspnea.
The nurse provides instructions to a 30-year-old female office worker who has low back pain. Which
statement by the patient requires an intervention by the nurse?
A. "Acupuncture to the lower back would cause irreparable nerve damage."
B. "Smoking may aggravate back pain by decreasing blood flow to the spine."
C. "Sleeping on my side with knees and hips bent reduces stress on my back."
D. "Switching between hot and cold packs provides relief of pain and stiffness." - Correct Answer: A.
"Acupuncture to the lower back would cause irreparable nerve damage."
Acupuncture is a safe therapy when the practitioner has been appropriately trained. Very fine needles
are inserted into the skin to stimulate specific anatomic points in the body for therapeutic purposes.
