Hoffman- Ch 53: Coordinating Care for Patients With Musculoskeletal Disorders

Question 1

A patient with Duchenne muscular dystrophy has significant muscle damage. What is the primary reason for this destruction?
1) High body fat
2) Lack of dystrophin
3) Breakdown of collagen
4) Decreased body protein

Answer 1

2

Question 2

The nurse is reviewing orders written for a patient with muscular dystrophy. Which medication should the nurse expect to be prescribed for this patient?
1) Cortisol
2) Furosemide
3) Gabapentin
4) Acetaminophen

Answer 2

1

Question 3

A patient with osteoporosis asks why the health problem developed. What nursing response would be appropriate for this patient?
1) Osteoclasts break down bone with acids and enzymes.
2) Osteoclastic activity is greater than osteoblastic activity.
3) Osteoblastic activity is greater than osteoclastic activity.
4) Osteoblasts synthesize and add minerals to the bony matrix.

Answer 3

2

Question 4

A patient is suspected of having osteoporosis. Which diagnostic test should the nurse expect to be prescribed for this patient?
1) MRI
2) CT scan
3) Bone scan
4) DEXA scan

Answer 4

4

Question 5

A patient is prescribed alendronate (Fosamax). What instruction should the nurse provide to the patient about this medication?
1) Take at bedtime
2) Take with a full meal
3) Take on an empty stomach
4) Take two hours after breakfast

Answer 5

3

Question 6

A patient is diagnosed with Paget’s disease. What finding should the nurse expect when assessing this patient?
1) Pain
2) Edema
3) Hypotension
4) Abdominal cramps

Answer 6

1

Question 7

A patient with Paget’s disease is prescribed a bisphosphonate medication. Which additional medication should the nurse expect to be prescribed for this patient?
1) Anticholinergic
2) Thiazide diuretic
3) Antihypertensive
4) Calcium with vitamin D

Answer 7

4

Question 8

A patient recovering from total knee replacement surgery develops osteomyelitis. What teaching should the nurse prepare as a priority for this patient?
1) Antibiotic therapy
2) Pain management
3) Debridement of the wound
4) Removal of the knee prosthesis

Answer 8

4

Question 9

The nurse is evaluating dietary teaching provided to a patient recovering from osteomyelitis. Which meal choice indicates that additional teaching is required?
1) Green salad, meat loaf, brown rice, and broccoli
2) Caesar’s salad, pork loin slices, sauerkraut, baked potato, and sautéed carrots
3) Tossed salad, spaghetti with marinara sauce, Italian bread, and creamed spinach
4) Iceberg lettuce wedge, baked chicken breast, parsley red potatoes, and green beans

Answer 9

3

Question 10

A middle-aged person with scoliosis asks why exercises are prescribed when the pain is already severe. How should the nurse respond to this patient?
1) “Exercise will stop the pain caused by the deformity.”
2) “Pain medication should not be needed for people with scoliosis.”
3) “Exercise can reverse and prevent the progression of the spinal deformity.”
4) “Exercise helps with weight management, which is a major reason for the problem.”

Answer 10

3

Question 11

A patient with severe hip pain is diagnosed with osteoarthritis (OA). What information should the nurse provide to the patient about this disease process?
1) “OA causes an overgrowth of cartilage in the joints.”
2) “OA causes joint fluid to become bluish-white in color.”
3) “OA causes a decrease in joint fluid that affects the cartilage.”
4) “OA causes a build of fluid in the joints, hindering movement.”

Answer 11

3

Question 12

The blood pressure of a patient recovering from total hip replacement surgery is dropping. What should the nurse suspect is occurring with this patient?
1) Blood loss
2) Pain medication overdose
3) Development of a deep vein thrombosis
4) Development of a postoperative infection

Answer 12

1

Question 13

A patient recovering from total hip replacement surgery is having difficulty with position changes and ambulation. Which member of the interdisciplinary team should be consulted to address this patient’s issues?
1) Orthopedic nurse
2) Physical therapist
3) Orthopedic surgeon
4) Occupational therapist

Answer 13

2

Question 14

The manager notes that several nurses have been seen in employee health for low back pain over the last month. What type of education should the manager plan to help reduce the incidence of this health problem?
1) Safety
2) Body mechanics
3) Coordinating care
4) Stress management

Answer 14

2

Question 15

The nurse is preparing material about back pain for a community health fair. What should be included as a reason why this pain occurs most frequently in the lumbar region of the spine?
1) It contains peripheral nerves.
2) It is the most rigid area of the spine.
3) It is the most flexible area of the spine.
4) It anchors the weight of the lower body.

Answer 15

3

Question 16

A patient is experiencing severe lower back pain that radiates down the leg causing weakness. Which diagnostic test should be considered after an MRI?
1) CT scan
2) Bone scan
3) Spinal x-ray
4) Electromyography

Answer 16

4

Question 17

A patient is seeking medical treatment for chronic low back pain. Which approach will help speed this patient’s recovery?
1) Regular exercise
2) Spinal injections
3) Nonsteroidal anti-inflammatory agents (NSAIDs)
4) Transcutaneous electrical nerve stimulation (TENS)

Answer 17

1

Question 18

A patient with bone cancer is admitted for treatment. What finding should the nurse expect to observe when assessing this patient?
1) Limp
2) Muscle atrophy
3) Skin discoloration
4) Dependent edema

Answer 18

1

Question 19

A patient is diagnosed with a primary bone tumor. Which treatment should the nurse expect to be prescribed first for this patient?
1) Surgery
2) Amputation
3) Radiotherapy
4) Chemotherapy

Answer 19

3

Question 20

The nurse is planning care for a patient with osteosarcoma. What should be done before encouraging the patient to increase activity?
1) Assess for pain
2) Assess heart rate
3) Measure blood pressure
4) Provide assistive devices

Answer 20

1

Question 21

A patient recovering from surgery for bone cancer is scheduled for postoperative radiation treatments. What should the nurse emphasize when providing teaching before a treatment?
1) Apply lotion to the skin
2) Examine the condition of the skin
3) Coat the skin with protective cream
4) Lightly dust the skin with talcum powder

Answer 21

2

Question 22

The nurse is assigned to care for a patient with muscular dystrophy. What should the nurse expect to assess in this patient? Select all that apply.
1) Nausea and vomiting
2) Alteration in cardiac rhythm
3) Progressive muscle weakening
4) Reduction in respiratory excursion
5) Wasting of voluntary muscle groups

Answer 22

35

Question 23

The nurse is reviewing orders written for a patient with Paget’s disease. Which medications should the nurse expect to be prescribed? Select all that apply.
1) Etidronate (Didronel)
2) Ibandronate (Boniva)
3) Risedronate (Actonel)
4) Calcitonin (Miacalcin)
5) Zoledronic acid (Zoledronate)

Answer 23

235

Question 24

The nurse suspects that a home care patient recovering from hip replacement surgery is developing osteomyelitis. What findings caused the nurse to come to this conclusion? Select all that apply.
1) Fever
2) Bone deformity
3) Pain unrelieved by rest
4) Progressive muscle weakness
5) Tenderness and warmth at the surgical site

Answer 24

135

Question 25

A middle-aged person is surprised to learn of the development of scoliosis. What factors in the patient’s history increased the risk for this health problem? Select all that apply.
1) Body mass index 31.4
2) Plays tennis twice a week
3) Smokes 1 PPD of cigarettes
4) Cares for two aging parents
5) Employed as a factory worker

Answer 25

1345

Question 26

The nurse suspects a patient has scoliosis. What observations caused the nurse to make this decision?
Select all that apply.
1) Even gait
2) Uneven waist
3) Different arm lengths
4) Lateral curve of the spine
5) Uneven hem line at the knees

Answer 26

2345

Question 27

The nurse is planning care for a patient with osteoarthritis (OA). On what should the nurse focus when preparing teaching material for this patient? Select all that apply.
1) Weight management
2) Nonsteroidal therapy
3) Activity modification
4) Joint replacement surgery
5) Glucosamine and chondroitinNU

Answer 27

1235

Question 28

A patient is diagnosed with metastatic bone cancer. Which laboratory value should the nurse expect to see elevated for this patient? Select all that apply.
1) Serum calcium
2) Serum alkaline phosphatase
3) Lactate dehydrogenase (LD)
4) Erythrocyte sedimentation rate (ESR)
5) Serum aspartate aminotransferase (AST)

Answer 28

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