Chapter 66- Assessment of Musculoskeletal Function

Chapter 66- Assessment of Musculoskeletal Function Brunner: Medical-Surgical Nursing, 11th Edition Test Bank Chapter 66: Assessment of Musculoskeletal Function Multiple Choice 1. The nurse's assessment of the sensation of the peroneal nerve will be performed by pricking the: A) Skin centered between the great and second toe B) Medial and lateral surface of the sole C) Skin centered between the thumb and second finger D) Top or distal surface of the index finger Ans: A Chapter: 66 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 3 Patient Needs: D-4 Feedback: The nurse will evaluate the sensation of the peroneal nerve by pricking the skin centered between the great and second toe. Evaluating sensation of the tibial nerve involves pricking the medial and lateral surface of the sole. Evaluating sensation of the radial nerve involves pricking the skin centered between the thumb and second finger. Evaluating sensation of the medial nerve involves pricking the top or distal surface of the index finger. 2. The nurse notices an increase in the lumbar curvature of the spine as she observes the patient standing. She will document this spinal abnormality on the assessment record as: A) Osteoporosis B) Kyphosis C) Lordosis D) Scoliosis Ans: C Chapter: 66 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication/Documentation Objective: 3 Patient Needs: D-4 Feedback: The nurse documents the spinal abnormality as lordosis, which is an increase in the lumbar curvature of the spine. Osteoporosis is the significant loss of bone mass and strength with an increased risk for fracture. Kyphosis is an increase in the convex curvature of the spine. Scoliosis is a lateral curvature of the spine. 3. The community health nurse discussing care of the musculoskeletal system with a small church group informs them that the leading cause of disability in the United States is: A) Osteoporosis B) Arthritis C) Hip fractures D) Long bone fractures Ans: B Chapter: 66 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: The leading cause of disability in the United States is arthritis. 4. A patient with cancer has impaired hematopoiesis. Upon evaluation of the patient's laboratory studies, the nurse would expect to see which of the following abnormalities? A) Decreased red blood cell, white blood cell, and platelet levels B) Increased hemoglobin and hematocrit levels C) Decreased sodium, potassium, and calcium levels D) Increased ammonia, creatinine, and albumin levels Ans: A Chapter: 66 Cognitive Level: Analysis Difficulty: Easy Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: The red bone marrow located within bone cavities produces red blood cells, white blood cells, and platelets through a process referred to as hematopoiesis. Impaired hematopoiesis leads to decreased levels of red and white blood cells and platelets. 5. The nurse is aware that a fracture of which type of bone may interfere with the protection of vital organs? A) Long bones B) Short bones C) Flat bones D) Irregular bones Ans: C Chapter: 66 Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing Process Objective: 1 Patient Needs: D-4 Feedback: Flat bones, such as the sternum, provide vital organ protection. Fractures of the flat bones may lead to puncturing of the vital organs or may interfere with the protection of the vital organs. 6. Upon evaluation of the patient's laboratory studies, the nurse recognizes that the patient is hypocalcemic. When analyzing other laboratory results, the nurse will expect them to reveal a(n): A) Elevated parathyroid hormone level B) Decreased parathyroid hormone level C) Elevated potassium level D) Decreased potassium level Ans: A Chapter: 66 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 4 Patient Needs: D-4 Feedback: In response to low calcium levels in the blood, increased levels of parathyroid hormone prompt the mobilization of calcium, the demineralization of bone, and the formation of bone cysts. 7. The nurse using movement assesses that the patient's muscle has a greater-than-normal tone and will document this finding as what type of muscle tone? A) Tonus B) Flaccid C) Atonic D) Spastic Ans: D Chapter: 66 Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication/Documentation Objective: 1 Patient Needs: D-4 Feedback: A muscle with greater-than-normal tone is described as spastic. The state of readiness, known as muscle tone (tonus), is produced by the maintenance of some of the muscle fibers in a contracted state. A muscle that is limp and without tone is described as flaccid. Soft and flabby muscle tone is defined as atonic. 8. The nurse asks a patient experiencing bone pain to describe his pain. Which of the following is a typical characteristic of bone pain? A) Dull, deep ache that is “boring” in nature B) Soreness or aching that may include cramping C) Sharp and piercing; relieved by immobilization D) Spastic or sharp pain that radiates Ans: A Chapter: 66 Cognitive Level: Application Difficulty: Difficult Integrated Process: Nursing Process Objective: 2 Patient Needs: D-4 Feedback: Bone pain is characteristically described as a dull, deep ache that is “boring” in nature, whereas muscular pain is described as soreness or aching and is referred to as “muscle cramps.” Fracture pain is sharp and piercing and is relieved by immobilization. Sharp pain may also result from bone infection with muscle spasm or pressure on a sensory nerve.