ATI Musculoskeletal Practice Quiz (Q&A) Revised 2023.

ATI Musculoskeletal Practice Quiz (Q&A) Revised 2023. A nurse is teaching a client who has rheumatoid arthritis about increasing physical rest as part of her treatment. Which of the following outcomes of this intervention should the nurse document as a goal for this client? -Reduced joint stress Rheumatoid arthritis in an autoimmune disease in which the cartilage and bone of the joints are destroyed resulting in increased pain and limited range of motion. The nurse should instruct the client that rest reduces stress on the joints and can be an effective intervention for relieving pain associated with rheumatoid arthritis. A nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin 650mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication? -Erythrocyte sedimentation rate (ESR) Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue inflammation in clients with RA. As the disease improves the ESR decreases. A nurse is teaching a client how to follow a low purine diet as prescribed by the provider for the management of gout. Which of the following statements indicates the client understands the teaching? -“I should avoid eating liver and other organ meats.” The nurse should encourage the client who has gout to avoid organ meats, such as liver, due to high levels of purine. A nurse is teaching a client who has a new diagnosis of gout about managing the disorder. Which of the following instructions should the nurse include in the teaching? -Eat less liver, sardines, and shrimp Gout results from urate crystals in joint spaces. Potential causes include hyperuricemia due to an overproduction of uric acid and a decreased ability of the kidney to excrete excess uric acid. Uric acid is a product of purine metabolism. The client should reduce the amount of liver, sardines, and shrimp in his diet, as these substances are high in purines. A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching? SATA -Aging Aging is a risk factor for osteoarthritis, as the joints bear the load of the body’s weight over time. -Obesity Obesity is a risk factor for osteoarthritis, as it increases the load of the body’s weight over time. -Smoking Smoking is a risk factor for osteoarthritis, as smoking predisposes people to the loss of cartilage in the knees. A nurse in a clinic is assessing a client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? -Smokes 1 pack of cigarettes per day The nurse should identify active or passive smoking as a risk factor for osteoporosis. The nurse should identify that high alcohol intake of 3 or more drinks a day is a risk factor for osteoporosis. A nurse is caring for a client who is postoperative following a total hip arthroplasty. The nurse assists the client into a supine position. Which of the following is appropriate to prevent dislocation of the hip? -Place a wedge pillow between the legs The nurse places a wedge pillow or other abduction device between the legs to prevent adduction which can lead to possible dislocation. A nurse is teaching a client who has rheumatoid arthritis about self-care strategies for managing the disease. Which of the following activities should the nurse include in the teaching? -Press water from a sponge rather than wringing it. The nurse should instruct the client to modify fine motor activities, such as wringing out a sponge, by using larger joints or body surfaces, such as the palm of the hand, to substitute for smaller ones. A nurse is caring for a client who is 3 days postoperative following an above the knee amputation. Which of the following actions should the nurse take? -Have the client lie prone several times per day. The nurse should encourage the client to lie prone for 20 to 30 min every 3 to 4 hr to help prevent hip flexion contractures. A nurse is caring for a client who has a severe gangrenous infection of the right lower extremity. The nurse should plan preoperative teaching based on the possibility of which of the following amputation procedures? -“Your pain will gradually become less severe” Phantom leg pain usually diminishes over time, and often is intermittent in response to a trigger. A nurse is assessing a client at a follow-up clinic visit for acute low back pain. A goal for this client is to use proper body mechanics at all times. Which of the following findings indicates that the client is meeting this goal? -The client faces the direction of movement when sliding an object across the floor. Sliding an object across the floor rather than lifting it prevents strain on the lower back muscles. Facing the direction of movement prevents twisting his back. To enlarge his base of support when pushing an object, the client should move his front foot forward. A nurse is providing teaching for a client who is preparing for a below the knee amputation. Which of the following statements is true regarding the postoperative replacement of a prosthesis? -“You will do special exercises in advance of getting your prosthesis” The physical therapist will teach muscle strengthening exercises to prepare the client for prosthesis use. Most clients are fitted for their prosthesis after the residual limb has healed. A nurse is teaching with a client about taking high doses of oral glucocorticoids for an extended period of time to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching? -“Monitor for compression fractures of the back and neck” High-dose, long-term use of glucocorticoids can result in bone loss in the back and neck within weeks of starting the medication. Clients experience an increase in parathyroid hormone, which causes calcium to move out of the bones can result in fractures. A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? -“Monitor for muscle pain” This medication can cause rhabdomyolysis. The client should monitor and report muscle pain. The client should report manifestations of gastric toxicity such as nausea, vomiting, and diarrhea. Grapefruit juice can interfere with the metabolism of this medication and increase the risk for toxicity. The client should report manifestations of thrombocytopenia such as bruising and bleeding, which are adverse effects of this medication. A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide? -Drink 2 to 3 L of water per day while on the medication. Methotrexate can cause renal toxicity. Adequate hydration promotes its excretion and helps prevent this adverse effect. A nurse is assessing a client who has a hip fracture. Which of the following findings should the nurse expect? -Muscle spasms The nurse should expect muscle spasms with a hip fracture. The nurse should expect leg adduction, leg shortening, and ecchymosis at the site. A nurse is teaching a client who has a new prescription for cyclosporine oral solution to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching? -Mix with chocolate milk The client may combine cyclosporine with milk, chocolate milk, or orange juice to make the medication more palatable. Take with meals, mix in glass container, and do not take with orange juice. A nurse is completing a physical assessment of a client who has early osteoarthritis. Which of the following manifestations should the nurse expect? -Pain worsens with activity The typical cycle of pain and relief in a client who has early osteoarthritis consists of pain with activity and pain relief with rest. As the disorder progresses, clients typically experience pain even while the joint is at rest. A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client? -Kyphosis Kyphosis, a forward "stooping" posture with a loss of height, is an angulation of the posterior curve of the thoracic spine, usually a result of osteoporosis. It is most common in older adults and increases with aging and vertebral fractures. A nurse is teaching a client who has a prosthetic limb due to a right below the knee amputation about prosthesis and stump care. Which of the following instructions should the nurse include in the teaching? -Dry the prosthesis socket completely before applying it to the limb The client should dry the prosthesis socket thoroughly with a clean cloth. Moisture between the socket and the stump can put the client at risk for fungal or bacterial infection and skin breakdown. A nurse is teaching a client who is starting to take methotrexate to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching? -“Drink at least 2 liters of water daily” The client should drink 2 to 3 L of water per day because methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent renal damage. Take med weekly. Do not use alcohol based mouthwash. A nurse is teaching a client who is to begin long term therapy with prednisone to treat rheumatoid arthritis. The nurse should instruct the client to take which of the following supplements while taking this medication? -Calcium and vitamin D