Chapter 31: The Musculoskeletal System |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse is discussing actions that can be taken to best prevent osteoporosis with a patient. Which information should the nurse include? a. Take an extra calcium supplement. b. Eat a balanced diet. c. Exercise throughout life. d. Increase daily intake of milk products. ANS: C A lifetime of even mild daily exercise will delay or prevent osteoporosis. PTS:1 DIF: Cognitive Level: Comprehension REF: 720 OBJ:4 (theory) TOP: Osteoporosis: Supplement KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. What does goniometry measure? a. Bone strength b. Muscle strength c. density d. Range-of-motion (ROM) ANS: D Goniometry measures joint mobility, described as the number of degrees that the joint can move from the 0-degree mark. PTS:1 DIF: Cognitive Level: Comprehension REF: 721 OBJ:2 (clinical) TOP: Goniometry: Joint Mobility KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 3. Positioning and range-of-motion (ROM) exercises most help the immobilized patient to prevent which complication? a. Increased pain b. Contractures c. Pressure ulcers d. Compromised circulation ANS: B Although positioning may help decrease pain and increase circulation, anatomical alignment and ROM exercises are most helpful in preventing contractures in the immobilized patient. Pressure ulcers are prevented by frequent position changes. PTS:1 DIF: Cognitive Level: Analysis REF: 728 OBJ:2 (clinical) TOP: Contractures: Prevention KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance 4. The nurse adds interventions for range-of-motion (ROM) and isometric exercises for the new patient with a stroke. Thenurse’s reasoning stems from her awareness that contracture formation may begin with how many days of immobilization? a. 1 day b. 2 days c. 3 days d. 10 days ANS: C Contracture-related muscle changes occur as early as 3 days of immobilization. PTS: 1 DIF: Cognitive Level: Comprehension REF: 731 OBJ: 2 (clinical) TOP: Process of Contracture Formation: Time Frame KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance 5. If muscles are not regularly stretched and contracted, how will the muscles be effected? a. Muscles will become longer and flexed. b. Muscles will become fibrosed and spastic. c. Muscles will become shorter and less elastic. d. Muscles will become shorter and painful.