Chapter 12: Peripheral Vascular Disorders
1. The nurse practitioner is serving in a clinic dedicated to patients over age 65 years. The nurse
practitioner observes several common characteristics in the posture of elderly patients. Which of the
following is common?
1. Increase in the length of the trunk in relationship to the upper extremities.
2. Head tips backward.
3. Disappearance of bony prominences.
4. Increase in the range of motion (ROM). - 1. Answer:
2 Page: 305
Feedback
1.
Aging often brings about a decrease in height, resulting from a decrease in the length of the trunk with
respect to the length of the extremities.
2.
An older person may tilt the head backward to compensate for the bend in the thoracic spine,
producing the typical posture of those in this age group.
3.
Because of the loss of subcutaneous fat caused by aging, bony prominences became more noticeable.
4.
Without continued use, muscles stiffen and ROM becomes impaired as an older person continues to
age.
2. While conducting a thorough examination of the musculoskeletal system, the patient asks why such
detail is necessary. Which of the following is the nurse practitioner's best response?
1. I don't want to miss any signs of something serious.
2. The purpose of conducting this examination is to regulate your medications.
3. I am looking for symptoms that form a pattern.
4. This is routine for all patients over 65 years of age. - 2. Answer:
3 Page: 305
, Feedback
1.
The nurse practitioner is seeking symptoms that form a pattern, and in the thorough examination to do
that, she will find any abnormalities or areas of concern.
2.
Medications will be taken into consideration after examination findings.
3.
A goal of the nurse practitioner in gathering information from the older adult is to try and determine if
there is a pattern of symptoms.
4.
In an adult over 65 years old who is not presenting any musculoskeletal issues, this type of
examination may not be necessary.
3. Mrs. Wilbur reports the presence of pain in her lower and upper back. The nurse practitioner
responds by doing which of the following?
1. Determining where the pain is coming from.
2. Ignoring any history of injury.
3. Ruling out the presence of anything inflammatory.
4. Determining that this pain does not affect activities of daily living (ADLs), as the patient came in
independently. - 3. Answer: 1
Page: 305
Feedback
1.
Initially, the nurse practitioner will need to determine if the presenting symptoms arise from the joints,
tendons, muscles, or periarticular structures, such as bursae.
2.
Past trauma may now be manifesting itself as an articular degeneration. Because patients who have
had a structural deformity or amputation typically place excessive strain on the joints for years, as
older individuals they may now experience degeneration of the bone and surrounding musculature.
3.
Inflammatory and noninflammatory conditions can coexist in patients.
4.
It is important to ask questions and determine how the pain and stiffness are affecting function and
quality of life, regardless of how it appears.
4. When assessing a patient with a possible musculoskeletal condition, it is important to:
1. Know how much sleep the patient gets per night.
2. Be aware that older patients report any and all pains.
1. The nurse practitioner is serving in a clinic dedicated to patients over age 65 years. The nurse
practitioner observes several common characteristics in the posture of elderly patients. Which of the
following is common?
1. Increase in the length of the trunk in relationship to the upper extremities.
2. Head tips backward.
3. Disappearance of bony prominences.
4. Increase in the range of motion (ROM). - 1. Answer:
2 Page: 305
Feedback
1.
Aging often brings about a decrease in height, resulting from a decrease in the length of the trunk with
respect to the length of the extremities.
2.
An older person may tilt the head backward to compensate for the bend in the thoracic spine,
producing the typical posture of those in this age group.
3.
Because of the loss of subcutaneous fat caused by aging, bony prominences became more noticeable.
4.
Without continued use, muscles stiffen and ROM becomes impaired as an older person continues to
age.
2. While conducting a thorough examination of the musculoskeletal system, the patient asks why such
detail is necessary. Which of the following is the nurse practitioner's best response?
1. I don't want to miss any signs of something serious.
2. The purpose of conducting this examination is to regulate your medications.
3. I am looking for symptoms that form a pattern.
4. This is routine for all patients over 65 years of age. - 2. Answer:
3 Page: 305
, Feedback
1.
The nurse practitioner is seeking symptoms that form a pattern, and in the thorough examination to do
that, she will find any abnormalities or areas of concern.
2.
Medications will be taken into consideration after examination findings.
3.
A goal of the nurse practitioner in gathering information from the older adult is to try and determine if
there is a pattern of symptoms.
4.
In an adult over 65 years old who is not presenting any musculoskeletal issues, this type of
examination may not be necessary.
3. Mrs. Wilbur reports the presence of pain in her lower and upper back. The nurse practitioner
responds by doing which of the following?
1. Determining where the pain is coming from.
2. Ignoring any history of injury.
3. Ruling out the presence of anything inflammatory.
4. Determining that this pain does not affect activities of daily living (ADLs), as the patient came in
independently. - 3. Answer: 1
Page: 305
Feedback
1.
Initially, the nurse practitioner will need to determine if the presenting symptoms arise from the joints,
tendons, muscles, or periarticular structures, such as bursae.
2.
Past trauma may now be manifesting itself as an articular degeneration. Because patients who have
had a structural deformity or amputation typically place excessive strain on the joints for years, as
older individuals they may now experience degeneration of the bone and surrounding musculature.
3.
Inflammatory and noninflammatory conditions can coexist in patients.
4.
It is important to ask questions and determine how the pain and stiffness are affecting function and
quality of life, regardless of how it appears.
4. When assessing a patient with a possible musculoskeletal condition, it is important to:
1. Know how much sleep the patient gets per night.
2. Be aware that older patients report any and all pains.
