CARE OF PATIENTS WITH MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS EXAM
1. A patient has come to the ambulatory care clinic with a sprain. The nurse correctly differentiates a
grade 2 sprain from a grade 3 sprain with the assessment of which finding?
a. Pain
b. Swelling
c. Bleeding into the joint
d. Minor loss of function - (answer) ANS: D
The minor loss of function is the differentiating factor. Pain, swelling, and bleeding into the joint are true
of both grade 2 and grade 3 sprains. A grade 3 sprain has loss of function of the joint.
An older adult has fallen and sprained his ankle in a local park. Which action should the responder
perform first?
a. Elevate the foot.
b. Apply ice.
c. Administer aspirin.
d. Assist the patient with ambulation. - (answer) ANS: A
Elevation to reduce swelling is the most important initial intervention. Elevation may be done
immediately. The responder will have to acquire the ice and pain medication, but should do so as quickly
as possible. The responder should not attempt to ambulate the patient at this time.
When the clinic nurse starts to take the "air cast" off the grade 2 sprain, the patient asks why it is being
removed since he still has pain. Which explanation is best?
a. "Long-term immobilization can interfere with adequate circulation."
b. "Long-term immobilization may increase long-term edema."
c. "Long-term immobilization can cause permanent disability."
d. "This cast will be replaced with a heavier cast." - (answer) ANS: C
Air casts, braces, or supports are used only until a joint has been strengthened. If a joint is immobilized
too long and muscles are not exercised, muscle atrophy—which begins in a matter of days—can cause
permanent disability
Which statement indicates that the patient needs further instruction about application of ice to a sprain?
a. "I know this ice will reduce the swelling."
, CARE OF PATIENTS WITH MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS EXAM
b. "I will keep the ice on this knee for the rest of the day."
c. "I will use the ice as you have directed for 24 hours."
d. "I can elevate my leg and use ice to reduce swelling." - (answer) ANS: B
Ice should be applied for 20 minutes of each hour for the first 24 hours.
The industrial nurse examines an employee who complains of right shoulder pain on abduction. He
points with one finger to the exact location of the pain and mentions that he won a racquetball
tournament yesterday. The nurse suspects the employee is suffering from which problem?
a. Rotator cuff tear
b. Bursitis
c. Dislocation
d. Subluxation - (answer) ANS: B
Bursitis occurs after overuse, with pain in the joint on activity with no erythema and little, if any,
swelling. Dislocations are very painful and the pain is spread all over the shoulder. The shoulder also
looks misshapen in a dislocation. Rotator cuff tear would prevent the patient from abducting his
shoulder
The nurse is caring for a patient who works as a legal secretary. The patient asks the nurse about ways to
avoid developing carpal tunnel syndrome (CTS). Which action should the nurse suggest?
a. "Exercise your wrists with repetitive flexion movements nightly."
b. "Wrap your wrists with elastic bandages."
c. "Acquire a pad to support your wrists while typing."
d. "Apply warm compresses to wrists every evening." - (answer) ANS: C
Elevating the wrist with a firm support eliminates the need to keep the wrists flexed for long periods of
time. This wrist support will help prevent CTS. Repetitive motion increases risk for carpal tunnel.
Wrapping the wrists or applying warm compresses do not lessen risk of developing carpal tunnel.
Carpal tunnel syndrome (CTS) is caused when the carpal tunnel compresses which location?
a. Radial artery
b. Brachial artery
c. Median nerve
1. A patient has come to the ambulatory care clinic with a sprain. The nurse correctly differentiates a
grade 2 sprain from a grade 3 sprain with the assessment of which finding?
a. Pain
b. Swelling
c. Bleeding into the joint
d. Minor loss of function - (answer) ANS: D
The minor loss of function is the differentiating factor. Pain, swelling, and bleeding into the joint are true
of both grade 2 and grade 3 sprains. A grade 3 sprain has loss of function of the joint.
An older adult has fallen and sprained his ankle in a local park. Which action should the responder
perform first?
a. Elevate the foot.
b. Apply ice.
c. Administer aspirin.
d. Assist the patient with ambulation. - (answer) ANS: A
Elevation to reduce swelling is the most important initial intervention. Elevation may be done
immediately. The responder will have to acquire the ice and pain medication, but should do so as quickly
as possible. The responder should not attempt to ambulate the patient at this time.
When the clinic nurse starts to take the "air cast" off the grade 2 sprain, the patient asks why it is being
removed since he still has pain. Which explanation is best?
a. "Long-term immobilization can interfere with adequate circulation."
b. "Long-term immobilization may increase long-term edema."
c. "Long-term immobilization can cause permanent disability."
d. "This cast will be replaced with a heavier cast." - (answer) ANS: C
Air casts, braces, or supports are used only until a joint has been strengthened. If a joint is immobilized
too long and muscles are not exercised, muscle atrophy—which begins in a matter of days—can cause
permanent disability
Which statement indicates that the patient needs further instruction about application of ice to a sprain?
a. "I know this ice will reduce the swelling."
, CARE OF PATIENTS WITH MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS EXAM
b. "I will keep the ice on this knee for the rest of the day."
c. "I will use the ice as you have directed for 24 hours."
d. "I can elevate my leg and use ice to reduce swelling." - (answer) ANS: B
Ice should be applied for 20 minutes of each hour for the first 24 hours.
The industrial nurse examines an employee who complains of right shoulder pain on abduction. He
points with one finger to the exact location of the pain and mentions that he won a racquetball
tournament yesterday. The nurse suspects the employee is suffering from which problem?
a. Rotator cuff tear
b. Bursitis
c. Dislocation
d. Subluxation - (answer) ANS: B
Bursitis occurs after overuse, with pain in the joint on activity with no erythema and little, if any,
swelling. Dislocations are very painful and the pain is spread all over the shoulder. The shoulder also
looks misshapen in a dislocation. Rotator cuff tear would prevent the patient from abducting his
shoulder
The nurse is caring for a patient who works as a legal secretary. The patient asks the nurse about ways to
avoid developing carpal tunnel syndrome (CTS). Which action should the nurse suggest?
a. "Exercise your wrists with repetitive flexion movements nightly."
b. "Wrap your wrists with elastic bandages."
c. "Acquire a pad to support your wrists while typing."
d. "Apply warm compresses to wrists every evening." - (answer) ANS: C
Elevating the wrist with a firm support eliminates the need to keep the wrists flexed for long periods of
time. This wrist support will help prevent CTS. Repetitive motion increases risk for carpal tunnel.
Wrapping the wrists or applying warm compresses do not lessen risk of developing carpal tunnel.
Carpal tunnel syndrome (CTS) is caused when the carpal tunnel compresses which location?
a. Radial artery
b. Brachial artery
c. Median nerve
