Chapter 22

Question 1

A patient is being assessed for range of joint movement. The nurse asks him to move his arm in toward the center of his body. This movement is called:
A)
flexion.
B)
abduction.
C)
adduction.
D)
extension.

Answer 1

C

Question 2

A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth. The nurse knows that for her to move her hand to her mouth, she must perform which movement?
A)
flexion.
B)
abduction.
C)
adduction.
D)
extension.

Answer 2

A

Question 3

The functional units of the musculoskeletal system are the:
A)
joints.
B)
bones.
C)
muscles.
D)
tendons.

Answer 3

A

Question 4

When reviewing the musculoskeletal system, the nurse recalls that hematopoiesis takes place in the:
A)
liver.
B)
spleen.
C)
kidneys.
D)
bone marrow.

Answer 4

D

Question 5

Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are called:
A)
bursa.
B)
tendons.
C)
cartilage.
D)
ligaments.

Answer 5

D

Question 6

The nurse notices that a woman in an exercise class is unable to jump rope. The nurse knows that to jump rope, one’s shoulder has to be capable of:
A)
inversion.
B)
supination.
C)
protraction.
D)
circumduction.

Answer 6

D

Question 7

The articulation of the mandible and the temporal bone is known as the:
A)
intervertebral foramen.
B)
condyle of the mandible.
C)
temporomandibular joint.
D)
zygomatic arch of the temporal bone.

Answer 7

C

Question 8

To palpate the temporomandibular joint, the nurse’s fingers should be placed in the depression _____ of the ear.
A)
distal to the helix
B)
proximal to the helix
C)
anterior to the tragus
D)
posterior to the tragus

Answer 8

C

Question 9

Of the 33 vertebrae in the spinal column, there are:
A)
5 lumbar.
B)
5 thoracic.
C)
7 sacral.
D)
12 cervical.

Answer 9

A

Question 10

An imaginary line connecting the highest point on each iliac crest would cross the _____ vertebra.
A)
first sacral
B)
fourth lumbar
C)
seventh cervical
D)
twelfth thoracic

Answer 10

B

Question 11

The nurse is explaining to a patient that there are “shock absorbers” in his back to cushion the spine and to help it move. The nurse is referring to his:
A)
vertebral column.
B)
nucleus pulposus.
C)
vertebral foramen.
D)
intervertebral disks.

Answer 11

D

Question 12

The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury. The nurse knows that a rotator cuff injury involves the:
A)
nucleus pulposus.
B)
articular process.
C)
medial epicondyle.
D)
glenohumeral joint.

Answer 12

D

Question 13

During an interview the patient states, “I can feel this bump on the top of both of my shoulders—it doesn’t hurt but I am curious about what it might be.” The nurse should tell the patient, “That is:
A)
your subacromial bursa.”
B)
your acromion process.”
C)
your glenohumeral joint.”
D)
the greater tubercle of your humerus.”

Answer 13

B

Question 14

The nurse is checking the range of motion in a patient’s knee and knows that the knee is capable of which movement(s)?
A)
Flexion and extension
B)
Supination and pronation
C)
Circumduction
D)
Inversion and eversion

Answer 14

A

Question 15

A patient is visiting the clinic for an evaluation of a swollen, painful knuckle. The nurse notices that the knuckle above his ring on the left hand is swollen and that he is unable to remove his wedding ring. This joint is called the _____ joint.
A)
interphalangeal
B)
tarsometatarsal
C)
metacarpophalangeal
D)
tibiotalar

Answer 15

C

Question 16

The nurse is assessing a patient’s ischial tuberosity. To palpate the ischial tuberosity, the nurse knows that it is best to have the patient:
A)
stand.
B)
flex the hip.
C)
flex the knee.
D)
in the supine position.

Answer 16

B

Question 17

The nurse is examining the hip area of a patient and palpates a flat depression on the upper, lateral side of the thigh when the patient is standing. The nurse interprets this finding as the:
A)
ischial tuberosity.
B)
greater trochanter.
C)
iliac crest.
D)
gluteus maximus muscle.

Answer 17

B

Question 18

The ankle joint is the articulation of the tibia, the fibula, and the:
A)
talus.
B)
cuboid.
C)
calcaneus.
D)
cuneiform bones.

Answer 18

A

Question 19

The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler. Where does lengthening of the bones occur?
A)
Bursa
B)
Calcaneus
C)
Epiphyses
D)
Tuberosities

Answer 19

C

Question 20

An 85-year-old patient comments during his annual physical that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because:
A)
long bones tend to shorten with age.
B)
of the shortening of the vertebral column.
C)
there is a significant loss of subcutaneous fat.
D)
there is a thickening of the intervertebral disks.

Answer 20

B

Question 21

A patient has been diagnosed with osteoporosis and asks the nurse, “What is osteoporosis?” The nurse explains to the patient that osteoporosis is defined as:
A)
increased bone matrix.
B)
loss of bone density.
C)
new, weaker bone growth.
D)
increased phagocytic activity.

Answer 21

B

Question 22

The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal women. Which of these actions is the best way to prevent or delay bone loss in this group?
A)
Taking calcium and vitamin D supplements
B)
Taking medications to prevent osteoporosis
C)
Performing physical activity, such as fast walking
D)
Assessing bone density annually

Answer 22

A

Question 23

The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal woman. A participant shows that she needs more instruction when she states, “I will:
A)
start swimming to increase my weight-bearing exercise.”
B)
try to stop smoking as soon as possible.”
C)
check with my doctor about taking calcium supplements.”
D)
get a bone-density test soon.”

Answer 23

A

Question 24

A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The nurse examines her hand and would expect a fracture if the girl complains:
A)
of a dull ache.
B)
that the pain in her wrist is deep.
C)
of sharp pain that increases with movement.
D)
of dull throbbing pain that increases with rest.

Answer 24

C

Question 25

A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for awhile, and then gets worse again if he sits for long periods of time. The nurse should assess for other signs of what problem?
A)
Tendinitis
B)
Osteoarthritis
C)
Rheumatoid arthritis
D)
Intermittent claudication

Answer 25

C

Question 26

A patient states, “I can hear a crunching or grating sound when I kneel.” She also states that “it is very difficult to get out of bed in the morning because of stiffness and pain in my joints.” The nurse should assess for signs of what problem?
A)
Crepitation
B)
A bone spur
C)
A loose tendon
D)
Fluid in the knee joint

Answer 26

A

Question 27

A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms; the nurse should suspect:
A)
crepitation.
B)
rotator cuff lesions.
C)
dislocated shoulder.
D)
rheumatoid arthritis.

Answer 27

B

Question 28

A professional tennis player comes into the clinic complaining of a sore elbow. The nurse will assess for tenderness at the:
A)
olecranon bursa.
B)
annular ligament.
C)
base of the radius.
D)
medial and lateral epicondyle.

Answer 28

D

Question 29

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen’s test. To perform this test, the nurse should instruct the patient to:
A)
dorsiflex the foot.
B)
plantarflex the foot.
C)
hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.
D)
hyperextend the wrists with the palmar surface of both hands touching and wait for 60 seconds.

Answer 29

C

Question 30

An 80-year-old woman is visiting the clinic for a checkup. She states, “I can’t walk as much as I used to.” The nurse is observing for motor dysfunction in her hip and should have her:
A)
internally rotate her hip while she is sitting.
B)
abduct her hip while she is lying on her back.
C)
adduct her hip while she is lying on her back.
D)
externally rotate her hip while she is standing.

Answer 30

B

Question 31

The nurse has completed the musculoskeletal examination of a patient’s knee and has found a positive bulge sign. The nurse interprets this finding to indicate:
A)
irregular bony margins.
B)
soft tissue swelling in the joint.
C)
swelling from fluid in the epicondyle.
D)
swelling from fluid in the suprapatellar pouch.

Answer 31

D

Question 32

During an examination, the nurse asks a patient to bend forward from the waist and notices that the patient has lateral tilting. When his leg is raised straight up, he complains of a pain going down his buttock into his leg. The nurse suspects:
A)
scoliosis.
B)
meniscus tear.
C)
herniated nucleus pulposus.
D)
spasm of paravertebral muscles

Answer 32

C

Question 33

A 40-year-old man has come into the clinic with complaints of “extreme tenderness in my toes.” The nurse notices that his toes are slightly swollen, reddened, and warm to the touch. His complaints would suggest:
A)
osteoporosis.
B)
acute gout.
C)
ankylosing spondylitis.
D)
degenerative joint disease.

Answer 33

B

Question 34

A young swimmer comes to the sports clinic complaining of a very sore shoulder. He was running at the pool, slipped on some wet concrete, and tried to catch himself with his outstretched hand. He landed on his outstretched hand and has not been able to move his shoulder since then. The nurse suspects:
A)
joint effusion.
B)
tear of rotator cuff.
C)
adhesive capsulitis.
D)
dislocated shoulder.

Answer 34

D

Question 35

A 68-year-old woman has come in for an assessment of her rheumatoid arthritis, and the nurse notices raised, firm, nontender nodules at the olecranon bursa and along the ulna. These nodules are most commonly diagnosed as:
A)
epicondylitis.
B)
gouty arthritis.
C)
olecranon bursitis.
D)
subcutaneous nodules.

Answer 35

C

Question 36

A woman who has had rheumatoid arthritis for years is starting to notice that her fingers are drifting to the side. The nurse knows that this condition is commonly referred to as:
A)
radial drift.
B)
ulnar deviation.
C)
swan neck deformity.
D)
Dupuytren’s contracture.

Answer 36

B

Question 37

A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her fingers. The nurse will assess for signs of what problems?
A)
Heberden’s nodes
B)
Bouchard’s nodules
C)
Swan neck deformities
D)
Dupuytren’s contractures

Answer 37

C

Question 38

A patient’s annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine; however, this curvature disappears with forward bending. The nurse knows that this abnormality of the spine is called:
A)
structural scoliosis.
B)
functional scoliosis.
C)
herniated nucleus pulposus.
D)
dislocated hip

Answer 38

B

Question 39

A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months. Which response by the nurse is appropriate?
A)
“If these symptoms persist, you may need arthroscopic surgery.”
B)
“You are experiencing degeneration of your knee, which may not resolve.”
C)
“Your disease is due to repeated stress on the patellar tendon. It is usually self-limited, and your symptoms should resolve with rest.”
D)
“Increasing your activity and performing knee-strengthening exercises will help to decrease the inflammation and maintain mobility in the knee.”

Answer 39

C

Question 40

When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What Grade should the nurse record using a 0 to 5 point scale?
A)
2
B)
3
C)
4
D)
5

Answer 40

D

Question 41

The nurse should use which test to check for large amounts of fluid around the patella?
A)
Ballottement
B)
Tinel sign
C)
Phalen’s test
D)
McMurray’s test

Answer 41

A

Question 42

A patient tells the nurse that “all my life I’ve been called ‘knock knees.’” The nurse knows that another term for “knock knees” is:
A)
genu varum.
B)
genu valgum.
C)
pes planus.
D)
metatarsus adductus.

Answer 42

B

Question 43

A patient has been diagnosed with a ganglion cyst over the dorsum of his left wrist. He asks the nurse, “What is this thing?” The nurse’s best answer would be, “It is:
A)
a common benign tumor.”
B)
a tumor that will have to be watched because it may turn malignant.”
C)
caused by chronic repetitive motion injury.”
D)
a skin infection that will need to be drained.”

Answer 43

A

Question 44

A man who has had gout for several years comes to the clinic with a problem with his toe. On examination, the nurse notices the presence of hard, painless nodules over the great toe; one has burst open with a chalky discharge. This finding is known as:
A)
a callus.
B)
a plantar wart.
C)
a bunion.
D)
tophi.

Answer 44

D

Question 45

When performing a musculoskeletal assessment, the nurse knows that the correct approach for the examination should be:
A)
proximal to distal.
B)
distal to proximal.
C)
posterior to anterior.
D)
anterior to posterior.

Answer 45

A