West Georgia Technical College RNSG 1720/ RNSG1720: Musculoskeletal Exam Chapters: 52,53.54 | Answered and explained Correctly Latest Fall 2025/26.

West Georgia Technical College RNSG 1720/ RNSG1720: Musculoskeletal Exam Chapters: 52,53.54 | Answered and explained Correctly Latest Fall 2025/26. EXAM 1 Chapters: 52,53.54 Musculoskeletal Questions 1. The DEXA (Dual X-ray Absorptiometry) scan is a diagnostic test for which musculoskeletal disorder? A DEXA scan gives precise measurements at clinically relevant skeletal points within the body, which highlight areas for future fracture risks. The DEXA scan reports T scores of the standard deviation above or below the mean for healthy young individuals. A low BMD (bone mass density), one that is 2.5 standard deviations or more below the mean for a young adult person, is highly correlated with an increased risk for fractures. A BMD that is low but not at the level of osteoporosis is indicative of osteopenia, a precursor to osteoporosis 2. Femur fractures can cause hemorrhage and hypovolemic shock. A. True B. False Could lose up to 3L of blood with femur fracture 3. Long bone fractures, such as femur fractures can cause a fat embolus in the bloodstream. A. True B. False 4. As we age, height may be lost due to shrinking of the intervertebral discs. A. True B. False 5. Define paresthesia. Abnormal feeling of pins and needles; itching, numbness, and tingling 6. What is the difference between active and passive ROM? Active ROM: Active range of motion (ROM) refers to the movement of a joint solely by the muscles surrounding it, meaning you move the joint using your own strength Passive ROM: passive ROM is when an external force, like a therapist, moves a joint for you, with the muscles completely relaxed; essentially, the key difference is whether you are actively contracting muscles to move the joint or not. 7. Define the following conditions: A. Lordosis: (swayback) Exaggerated curvature of lumbar spine. B. Kyphosis: (hunchback) increased forward curvature of thoracic spine. C. Scoliosis – explain how to screen for scoliosis: (congenital or idiopathic) – lateral curving deviation of the spine. – note height of shoulders or iliac crests while standing and bending forward, look for prominent scapula, unequal shoulders, asymmetrical hips. D. Contracture: a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints. 8. List the 3 components/parts of a neurovascular check and tell what should be checked/evaluated in each: 1. Circulation (color, temperature, capillary refill) 2. Motion (weakness, paralysis) 3. Sensation (paresthesia, pain, absence of feeling) 9. Define the following diagnostic tests: A. arthroscopy: visualization of joint through scope. Watch for bleeding, infection, neurovascular compromise (numbness/cool skin, swelling). Ice and elevation for comfort and to reduce edema. B. arthrocentesis: joint aspiration. Watch for bleeding, infection, swelling, cool skin, and fever. C. electromyography (EMG): needles into muscle. Evaluates muscle weakness/pain. Contraindicated if taking anticoagulants (warfarin). Avoid using lotions/creams the day of procedure. 10. What drug is contraindicated for a patient having an EMG? Anticoagulants (Warfarin) 11. What is the highest nursing priority for a client with osteoporosis (as well as many musculoskeletal diseases)? Ensuring their safety and minimizing the risk of fractures 12. Why are women more at risk of developing osteoporosis after menopause? Low estrogen levels allow calcium to leave the bone easier. 13. What instruction should the nurse give the client regarding the diet of a patient with osteoporosis? Diet high in dairy products, canned salmon with bones, & broccoli. Take vitamin D and Calcium supplements. 14. What instruction should the nurse give the client taking alendronate for osteoporosis? Take on an empty stomach with a cup of water, no mineral water, coffee, tea (caffeine), or milk (calcium); avoid taking other medications, vitamins/minerals and antacids for 30 minutes. 15. Calcitonin nasal spray is used to treat osteoporosis. A. True B. False 16. What is the pathophysiology of Paget’s disease? Paget’s disease of the bone (PDB), also referred to as osteitis deformans, is a bone metabolism disorder associated with accelerated bone remodeling, resulting in bone that is structurally abnormal. The skeletal areas most commonly affected are the skull, femur, tibia, pelvic bones, and vertebral column. Osteoblasts add to new bone at an increased rate, which leads to enlarged bony structures that are disorganized in structure and reduced in mechanical strength, leading to patients at risk for the development of deformities and fractures. 17. Signs/Symptoms of Paget’s disease include bone deformities and pain. A. True B. False 18. What lab helps diagnose Paget’s disease? What electrolyte is normal, although it is a bone disease? Blood alkaline phosphate levels will be elevated due to Paget’s disease. Calcium levels remain normal. 19. What is the cause and treatment of osteomyelitis? Bone infection; Caused by bacteria (Staph-MRSA) from wounds/surgery. Antibiotics for 6 -12 weeks (IV to oral). 20. What are the 3 classic signs/symptoms of a hip fracture? 1. shortening of the extremity 2. pain 3. external rotation of hips 21. List some special equipment that is used in the treatment following a THA (Total Hip Arthroplasty): Long-handled shoehorns, dressing sticks for putting on shoes and socks, crutches/walker within a day of surgery 22. What is the purpose of an abduction pillow and orthopedic chairs, raised toilet seats following a THA? To prevent hip dislocation by maintaining proper hip alignment and limiting the range of motion 22. Following a THA, what is the purpose of the abduction pillow, assistive devices, as well as avoiding hip flexion for 4 months after the surgery? The primary concern is to not bend your hip beyond a 90-degree angle to protect the healing joint. 23. How should the THA patient be turned following surgery. Turn patients only to the unaffected side with abduction pillow in place. When allowed OOB, patient gets up with an abduction pillow. 24. Neurovascular checks should be performed following surgical procedures for musculoskeletal disorders, as well as injuries. A. True B. False 25. Define: A. Strain: involves tendon and muscles; when either stretches too far or partially tears B. Sprain: ligaments; tears or stretching 26. What does the acronym RICE stand for? Rest, Ice, Compression, Elevation 27. What is a common complication of fractures? Osteomyelitis 28. What are the signs/symptoms (6 Ps) of compartment syndrome? Pain, pressure, paresthesia, pallor, paralysis, pulselessness 29. What is Volkmann’s contracture? Volkmann’s contracture (Volkmann’s ischemic fracture) – reduced blood flow to forearm (causes clawlike hand). Fracture of supracondylar of humerus or any arm/forearm fractures. 30. What could a spiral fracture indicate? A twisting or rotational force applied to the bone while one end is fixed; it’s considered a red flag for potential abuse situations. 31. What bone is most likely involved in a greenstick fracture in children? Greenstick fractures usually affect kids' long bones; fibula, tibia, ulna, radius, humerus, and clavicle. 32. What type of bone fracture causes the bone to protrude from the skin? Open (compound) 33. Define: A. closed reduction: Closed reduction – general anesthesia – manipulated back into place, then placed in cast/splint. B. open reduction and internal/external fixation: Open reduction with internal/external fixation (pins, screws, plates). External fixation – have external frame (pin care). C. skin traction: (harness, boot, belt) – Buck’s traction with 5-10 lb. weight. Relieves muscle spasms (pain) and maintains bone length. D. skeletal traction: pin care, as prescribed (hydrogen peroxide). (Skeletal is continuous; skin is intermittent) 34. What is the purpose of skeletal traction? Uses pins, wires, or screws to stabilize a broken bone and help it heal. 35. What is the appearance of the urine in a client with rhabdomyolysis? Tea-colored urine 36. What is the priority nursing concern following an amputation? Control bleeding; hypotension and tachycardia 37. What should be kept readily available at the bedside for a patient who had an amputation? Pressure bandage or tourniquet 38. What is phantom limb pain? What is a medication used to treat phantom limb pain? Phantom limb pain is a common complication of amputations that produces numbness, tingling, and a sharp burning pain perceived as manifesting in the removed limb or in the distal aspect of the remaining limb. Gabapentin is used for phantom limb pain. 39. What is the rational for not flexing the residual stump following an amputation, especially after 24 hours? To prevent flexion contractures. 40. When should NSAIDS be taken? With food 41. The McMurray’s and Steinman’s test helps diagnose which musculoskeletal disorder? Meniscus injury 42. What is carpal tunnel syndrome? A condition where the median nerve in your wrist becomes compressed as it passes through a narrow passage called the carpal tunnel 43. What types of jobs increase the risk for carpal tunnel syndrome? Typist, assembly line workers, hairdressers 44. What are the signs/symptoms of carpal tunnel syndrome? Pain, numbness, paresthesia, fist clenching in the AM 45. What is the Phalan’s and Tinel’s sign? How do you test for each? Tinel sign – percussion over median nerve in the wrist; patient exhibits symptoms Phalen sign – flex wrists together for 30 seconds to 1 minute; patient exhibits symptoms. 46. What are 2 treatments for carpal tunnel syndrome? Corticosteroids and surgery 47. What class and action of drug is methylprednisolone? Methylprednisolone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions. 48. What is the drug, cyclobenzaprine, used for? Cyclobenzaprine relieves skeletal muscle spasms of local origin without interfering with muscle function.