Ch. 35. Assessment of
Musculoskeletal Function (Brunner
and Suddarth's Textbook of Medical-
Surgical Nursing, 15th Ed)
A 10-year-old client is growing at a rate appropriate for the client's age. Which cells are
responsible for the secretion of bone matrix, which eventually results in bone growth?
A. Osteoblasts
B. Osteocytes
C. Osteoclasts
D. Lamellae - answerANS: A
Rationale: Osteoblasts function in bone formation by secreting bone matrix. Osteocytes
are mature bone cells, and osteoclasts are multinuclear cells involved in dissolving and
resorbing bone. Lamellae are circles of mineralized bone matrix.
A bone biopsy has just been completed on a client with suspected bone metastases.
The nurse should prioritize assessments for which common complication of bone
biopsy?
A. Dehiscence at the biopsy site
B. Pain
C. Hematoma formation
D. Infection - answerANS: B
Rationale: Bone biopsy can be painful, and the nurse should prioritize relevant
assessments. Dehiscence is not a possibility, because the incision is not linear. Signs
and symptoms of infection would not be evident in the immediate recovery period, and
hematoma formation is not a common complication.
A client has been experiencing an unexplained decline in knee function and has
consequently been scheduled for arthrography. The nurse should teach the client about
what process?
A. Injection of a contrast agent into the knee joint prior to ROM exercises
B. Aspiration of synovial fluid for serologic testing
C. Injection of corticosteroids into the client's knee joint to facilitate ROM
D. Replacement of the client's synovial fluid with a synthetic substitute - answerANS: A
Rationale: During arthrography, a radiopaque contrast agent or air is injected into the
joint cavity to visualize the joint structures such as the ligaments, cartilage, tendons, and
joint capsule. The joint is put through its range of motion to distribute the contrast agent
while a series of x-rays are obtained. Synovial fluid is not aspirated or replaced and
corticosteroids are not given.
, A client has been experiencing progressive increases in knee pain and diagnostic
imaging reveals a worsening effusion in the synovial capsule. The nurse should
anticipate what diagnostic procedure?
A. Arthrography
B. Knee biopsy
C. Arthrocentesis
D. Electromyography - answerANS: C
Rationale: Arthrocentesis (joint aspiration) is carried out to obtain synovial fluid for
purposes of examination or to relieve pain due to effusion. Arthrography, biopsy, and
electromyography would not remove fluid and relieve pressure.
A client has come to the clinic for a regular check-up. The nurse's initial inspection
reveals an increased thoracic curvature of the client's spine. The nurse should
document the presence of which condition?
A. Scoliosis
B. Epiphyses
C. Lordosis
D. Kyphosis - answerANS: D
Rationale: Kyphosis is the increase in thoracic curvature of the spine. Scoliosis is a
deviation in the lateral curvature of the spine. Epiphyses are the ends of the long bones.
Lordosis is the exaggerated curvature of the lumbar spine.
A client has had a cast placed for the treatment of a humeral fracture. The nurse's most
recent assessment shows signs and symptoms of compartment syndrome. What is the
nurse's most appropriate action?
A. Arrange for a STAT assessment of the client's serum calcium levels.
B. Perform active range of motion exercises.
C. Assess the client's joint function symmetrically.
D. Contact the primary provider immediately. - answerANS: D
Rationale: This major neurovascular problem is caused by pressure within a muscle
compartment that increases to such an extent that microcirculation diminishes, leading
to nerve and muscle anoxia and necrosis. Function can be permanently lost if the
anoxic situation continues for longer than 6 hours. Therefore, immediate medical care is
a priority over further nursing assessment. Assessment of calcium levels is
unnecessary.
A client has just had an arthroscopy performed to assess a knee injury. What nursing
intervention should the nurse perform following this procedure?
A. Wrap the joint in a compression dressing.
B. Perform passive range of motion exercises.
C. Maintain the knee in flexion for up to 30 minutes.
D. Apply heat to the knee. - answerANS: A
Rationale: Interventions to perform following an arthroscopy include wrapping the joint
in a compression dressing, extending and elevating the joint, and applying ice or cold
packs. Passive ROM exercises, static flexion, and heat are not indicated.
Musculoskeletal Function (Brunner
and Suddarth's Textbook of Medical-
Surgical Nursing, 15th Ed)
A 10-year-old client is growing at a rate appropriate for the client's age. Which cells are
responsible for the secretion of bone matrix, which eventually results in bone growth?
A. Osteoblasts
B. Osteocytes
C. Osteoclasts
D. Lamellae - answerANS: A
Rationale: Osteoblasts function in bone formation by secreting bone matrix. Osteocytes
are mature bone cells, and osteoclasts are multinuclear cells involved in dissolving and
resorbing bone. Lamellae are circles of mineralized bone matrix.
A bone biopsy has just been completed on a client with suspected bone metastases.
The nurse should prioritize assessments for which common complication of bone
biopsy?
A. Dehiscence at the biopsy site
B. Pain
C. Hematoma formation
D. Infection - answerANS: B
Rationale: Bone biopsy can be painful, and the nurse should prioritize relevant
assessments. Dehiscence is not a possibility, because the incision is not linear. Signs
and symptoms of infection would not be evident in the immediate recovery period, and
hematoma formation is not a common complication.
A client has been experiencing an unexplained decline in knee function and has
consequently been scheduled for arthrography. The nurse should teach the client about
what process?
A. Injection of a contrast agent into the knee joint prior to ROM exercises
B. Aspiration of synovial fluid for serologic testing
C. Injection of corticosteroids into the client's knee joint to facilitate ROM
D. Replacement of the client's synovial fluid with a synthetic substitute - answerANS: A
Rationale: During arthrography, a radiopaque contrast agent or air is injected into the
joint cavity to visualize the joint structures such as the ligaments, cartilage, tendons, and
joint capsule. The joint is put through its range of motion to distribute the contrast agent
while a series of x-rays are obtained. Synovial fluid is not aspirated or replaced and
corticosteroids are not given.
, A client has been experiencing progressive increases in knee pain and diagnostic
imaging reveals a worsening effusion in the synovial capsule. The nurse should
anticipate what diagnostic procedure?
A. Arthrography
B. Knee biopsy
C. Arthrocentesis
D. Electromyography - answerANS: C
Rationale: Arthrocentesis (joint aspiration) is carried out to obtain synovial fluid for
purposes of examination or to relieve pain due to effusion. Arthrography, biopsy, and
electromyography would not remove fluid and relieve pressure.
A client has come to the clinic for a regular check-up. The nurse's initial inspection
reveals an increased thoracic curvature of the client's spine. The nurse should
document the presence of which condition?
A. Scoliosis
B. Epiphyses
C. Lordosis
D. Kyphosis - answerANS: D
Rationale: Kyphosis is the increase in thoracic curvature of the spine. Scoliosis is a
deviation in the lateral curvature of the spine. Epiphyses are the ends of the long bones.
Lordosis is the exaggerated curvature of the lumbar spine.
A client has had a cast placed for the treatment of a humeral fracture. The nurse's most
recent assessment shows signs and symptoms of compartment syndrome. What is the
nurse's most appropriate action?
A. Arrange for a STAT assessment of the client's serum calcium levels.
B. Perform active range of motion exercises.
C. Assess the client's joint function symmetrically.
D. Contact the primary provider immediately. - answerANS: D
Rationale: This major neurovascular problem is caused by pressure within a muscle
compartment that increases to such an extent that microcirculation diminishes, leading
to nerve and muscle anoxia and necrosis. Function can be permanently lost if the
anoxic situation continues for longer than 6 hours. Therefore, immediate medical care is
a priority over further nursing assessment. Assessment of calcium levels is
unnecessary.
A client has just had an arthroscopy performed to assess a knee injury. What nursing
intervention should the nurse perform following this procedure?
A. Wrap the joint in a compression dressing.
B. Perform passive range of motion exercises.
C. Maintain the knee in flexion for up to 30 minutes.
D. Apply heat to the knee. - answerANS: A
Rationale: Interventions to perform following an arthroscopy include wrapping the joint
in a compression dressing, extending and elevating the joint, and applying ice or cold
packs. Passive ROM exercises, static flexion, and heat are not indicated.
