NUR 326 Exam 1- jennifer fox/Lewis 10th
Chapter 63 Musculoskeletal Problems Evolve
NCLEX practice
"Assured Academic Growth with Verified
Answers"
The nurse provides instructions to a 30-yr-old female office worker who has low back pain. Which
statement indicates additional patient teaching is required?
a. "Switching between hot and cold packs may relieve pain and stiffness."
b. "Acupuncture to the lower back would cause irreparable nerve damage."
c. "Smoking may aggravate back pain by decreasing blood flow to the spine."
d. "Sleeping on my side with knees and hips bent reduces stress on my back." - -correct ans- -b.
"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.
The nurse is caring for patients in a primary care clinic. Which individual is most at risk to develop
osteomyelitis caused by Staphylococcus aureus?
a. 22-yr-old female patient with gonorrhea who is an IV drug user
b. 48-yr-old male patient with muscular dystrophy and acute bronchitis
c. 32-yr-old male patient with type 1 diabetes mellitus and stage IV pressure ulcer
d. 68-yr-old female patient with hypertension who had a knee arthroplasty 3 years ago - -correct ans- -c.
32-yr-old male patient with type 1 diabetes mellitus and stage IV pressure ulcer
,Osteomyelitis caused by Staphylococcus aureus is usually associated with a pressure ulcer or vascular
insufficiency related to diabetes mellitus. Osteomyelitis caused by Staphylococcus epidermidis is usually
associated with indwelling prosthetic devices from joint arthroplasty. Osteomyelitis caused by Neisseria
gonorrhoeae is usually associated with gonorrhea. Osteomyelitis caused by Pseudomonas is usually
associated with IV drug use. Muscular dystrophy is not associated with osteomyelitis.
The nurse is caring for a patient hospitalized with a herniated lumbar disc and an exacerbation of
chronic bronchitis. Which breakfast choice would be most appropriate for the patient to select from the
breakfast menu?
a. Bran muffin
b. Scrambled eggs
c. Puffed rice cereal
d. Buttered white toast - -correct ans- -a. Bran muffin
Each meal should contain one or more sources of fiber to reduce the risk of constipation and straining
with defecation, which increases back pain. A patient with chronic breathing difficulties also will benefit
from regularity and ease of bowel evacuation. In addition, if lumbar nerve compression is present,
bowel and bladder function may be impaired. Bran is a typical high-fiber food choice and is an
appropriate selection from the menu. Scrambled eggs, puffed rice cereal, and buttered white toast do
not have as much fiber.
The nurse is planning health promotion teaching for a 45-yr-old patient with asthma who is experiencing
low back pain from herniated lumbar disc. What activity will the nurse include in an individualized
exercise plan for the patient?
a. Yoga
b. Walking
c. Calisthenics
d. Weight lifting - -correct ans- -b. Walking
The patient would benefit from an aerobic exercise that considers the patient's health status and fits the
patient's lifestyle. The best exercise is walking, which builds strength in the back and leg muscles
, without putting undue pressure or strain on the spine. If the patient has exercise-induced asthma, the
nurse would recommend use of a rescue inhaler prior to exercise. Yoga, calisthenics, and weight lifting
would all put pressure on or strain the spine.
When the patient is diagnosed with muscular dystrophy, what information should the nurse include in
the teaching plan?
a. Use prolonged bed rest to decrease fatigue.
b. Continuous positive airway pressure will facilitate sleeping.
c. An orthotic jacket will limit mobility and may contribute to deformity.
d. Remain active to prevent skin breakdown and respiratory complications. - -correct ans- -d. Remain
active to prevent skin breakdown and respiratory complications.
With muscular dystrophy, the patient must remain active for as long as possible. Prolonged bed rest
should be avoided because immobility leads to further muscle wasting. An orthotic jacket may be used
to provide stability and prevent further deformity. Continuous positive airway pressure (CPAP) may be
used as respiratory function decreases before mechanical ventilation is needed to sustain respiratory
function.
The nurse is admitting a patient who complains of new onset of lower back pain. To differentiate
between the pain of a lumbar herniated disc from other causes, what is the best question for the nurse
to ask the patient?
a. "Is the pain worse in the morning or in the evening?"
b. "Is the pain sharp and stabbing or burning and aching?"
c. "Does the pain radiate down the buttock or into the leg?"
d. "Is the pain totally relieved by acetaminophen (Tylenol)?" - -correct ans- -c. "Does the pain radiate
down the buttock or into the leg?"
Lower back pain associated with a herniated lumbar disc is accompanied by radiation along the sciatic
nerve and can be commonly described as traveling through the buttock to the posterior thigh or down
the leg. This is because the herniated disc causes compression on spinal nerves as they exit the spinal
column. Time of occurrence, type of pain, and pain relief questions do not elicit differentiating data.
Chapter 63 Musculoskeletal Problems Evolve
NCLEX practice
"Assured Academic Growth with Verified
Answers"
The nurse provides instructions to a 30-yr-old female office worker who has low back pain. Which
statement indicates additional patient teaching is required?
a. "Switching between hot and cold packs may relieve pain and stiffness."
b. "Acupuncture to the lower back would cause irreparable nerve damage."
c. "Smoking may aggravate back pain by decreasing blood flow to the spine."
d. "Sleeping on my side with knees and hips bent reduces stress on my back." - -correct ans- -b.
"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.
The nurse is caring for patients in a primary care clinic. Which individual is most at risk to develop
osteomyelitis caused by Staphylococcus aureus?
a. 22-yr-old female patient with gonorrhea who is an IV drug user
b. 48-yr-old male patient with muscular dystrophy and acute bronchitis
c. 32-yr-old male patient with type 1 diabetes mellitus and stage IV pressure ulcer
d. 68-yr-old female patient with hypertension who had a knee arthroplasty 3 years ago - -correct ans- -c.
32-yr-old male patient with type 1 diabetes mellitus and stage IV pressure ulcer
,Osteomyelitis caused by Staphylococcus aureus is usually associated with a pressure ulcer or vascular
insufficiency related to diabetes mellitus. Osteomyelitis caused by Staphylococcus epidermidis is usually
associated with indwelling prosthetic devices from joint arthroplasty. Osteomyelitis caused by Neisseria
gonorrhoeae is usually associated with gonorrhea. Osteomyelitis caused by Pseudomonas is usually
associated with IV drug use. Muscular dystrophy is not associated with osteomyelitis.
The nurse is caring for a patient hospitalized with a herniated lumbar disc and an exacerbation of
chronic bronchitis. Which breakfast choice would be most appropriate for the patient to select from the
breakfast menu?
a. Bran muffin
b. Scrambled eggs
c. Puffed rice cereal
d. Buttered white toast - -correct ans- -a. Bran muffin
Each meal should contain one or more sources of fiber to reduce the risk of constipation and straining
with defecation, which increases back pain. A patient with chronic breathing difficulties also will benefit
from regularity and ease of bowel evacuation. In addition, if lumbar nerve compression is present,
bowel and bladder function may be impaired. Bran is a typical high-fiber food choice and is an
appropriate selection from the menu. Scrambled eggs, puffed rice cereal, and buttered white toast do
not have as much fiber.
The nurse is planning health promotion teaching for a 45-yr-old patient with asthma who is experiencing
low back pain from herniated lumbar disc. What activity will the nurse include in an individualized
exercise plan for the patient?
a. Yoga
b. Walking
c. Calisthenics
d. Weight lifting - -correct ans- -b. Walking
The patient would benefit from an aerobic exercise that considers the patient's health status and fits the
patient's lifestyle. The best exercise is walking, which builds strength in the back and leg muscles
, without putting undue pressure or strain on the spine. If the patient has exercise-induced asthma, the
nurse would recommend use of a rescue inhaler prior to exercise. Yoga, calisthenics, and weight lifting
would all put pressure on or strain the spine.
When the patient is diagnosed with muscular dystrophy, what information should the nurse include in
the teaching plan?
a. Use prolonged bed rest to decrease fatigue.
b. Continuous positive airway pressure will facilitate sleeping.
c. An orthotic jacket will limit mobility and may contribute to deformity.
d. Remain active to prevent skin breakdown and respiratory complications. - -correct ans- -d. Remain
active to prevent skin breakdown and respiratory complications.
With muscular dystrophy, the patient must remain active for as long as possible. Prolonged bed rest
should be avoided because immobility leads to further muscle wasting. An orthotic jacket may be used
to provide stability and prevent further deformity. Continuous positive airway pressure (CPAP) may be
used as respiratory function decreases before mechanical ventilation is needed to sustain respiratory
function.
The nurse is admitting a patient who complains of new onset of lower back pain. To differentiate
between the pain of a lumbar herniated disc from other causes, what is the best question for the nurse
to ask the patient?
a. "Is the pain worse in the morning or in the evening?"
b. "Is the pain sharp and stabbing or burning and aching?"
c. "Does the pain radiate down the buttock or into the leg?"
d. "Is the pain totally relieved by acetaminophen (Tylenol)?" - -correct ans- -c. "Does the pain radiate
down the buttock or into the leg?"
Lower back pain associated with a herniated lumbar disc is accompanied by radiation along the sciatic
nerve and can be commonly described as traveling through the buttock to the posterior thigh or down
the leg. This is because the herniated disc causes compression on spinal nerves as they exit the spinal
column. Time of occurrence, type of pain, and pain relief questions do not elicit differentiating data.
