Musculoskeletal

Question 1

The treatment for sprains known as RICE stands for what?

Answer 1

Rest, Ice, Compression and Elevation

Question 2

What exactly is a sprain?

Answer 2

Torn ligaments that hold the bone together to form a joint

Question 3

What symptoms would be expected in a 1st degree sprain?

Answer 3

minimal swelling and loss of function, but no abnormal movement

Question 4

What characterizes a 3rd degree sprain?

Answer 4

3rd degree = complete tearing of tissue fibers and loss of function

Question 5

What symptoms would be present in a 2nd degree sprain?

Answer 5

Severe pain, especially with weight bearing, swelling and bleeding – with some loss of function

Question 6

What is the definition of a strain?

Answer 6

A strain is a pulling or tearing of either muscle, tendon or both

Question 7

A joint “dislocation” means what?

Answer 7

Stretching and tearing of ligaments around a joint with complete displacement of the bone.

Question 8

What is a joint subluxation?

Answer 8

A partial or incomplete displacement of the joint surface

Question 9

Carpal Tunnel syndrome occurs when?

Answer 9

When the median nerve in the wrist is compressed by and inflamed, edematous flexor tendon sheath

Question 10

What is a Phalen’s sign?

Answer 10

Phalen’s sign is said to be positive if there is numbness with wrist flexion.

Question 11

What is a positive Tinel’s sign?

Answer 11

Tapping over the median nerve the causes tingling and electric shock sensation.

Question 12

In a patient with Carpal Tunnel syndrome: what would the MRI show?

Answer 12

Compression and flattening of the median nerve

Question 13

What is a McMurray’s test?

Answer 13

Turning the foot side-to-side while bending the knee back and forth

Question 14

What is the most common injury to the knee?

Answer 14

An ACL injury

Question 15

What in the “common cause” of ACL injury?

Answer 15

twisting motion

Question 16

What test indicates ACL injury?

Answer 16

Lachman’s test

Question 17

What is crepitation?

Answer 17

A crackling or rattling sound made by the fractured ends of bone

Question 18

What is the difference in an open reduction and a closed reduction?

Answer 18

Open = surgical incision. Closed = manipulation

Question 19

How much calcium should an adult who is less than 50 years old consume daily?

Answer 19

1000 mg/day

Question 20

How much calcium should an adult who is over 50 years old consume daily?

Answer 20

1200 mg/day

Question 21

Calcium is rich in what foods?

Answer 21

1. Dairy
2. Green Leafy Veggies
3. Sardines
4. Canned Salmon
5. Broccoli
6. Fortified OJ

Question 22

A nurse with a lateral curvature of their spine has what medical condition?

Answer 22

Scoliosis

Question 23

Humpback is technically referred to as?

Answer 23

Kyphosis

Question 24

What effect does Vitamin D have?

Answer 24

It promotes calcium and phosphate absorption, increased serum calcium and phosphorus levels

Question 25

What is Fosamax given for?

Answer 25

Osteoporosis

Question 26

After age 50, which gender is more affected by Osteoarthritis?

Answer 26

Women

Question 27

What factor puts women at higher risk for Osteoarthritis?

Answer 27

Estrogen reduction at menopause

Question 28

OA results from damage to what?

Answer 28

Cartilage

Question 29

What is the big difference beween RA and OA?

Answer 29

RA is an auto-immune inflammatory disease; OA is not an auto-immune inflammatory disease--it is a degenerative disease.

Question 30

Are there systemic manifestations in OA or RA?

Answer 30

RA only; OA has no systemic manifestations

Question 31

In the early stages of OA, what helps the pain?

Answer 31

Rest

Question 32

What two nodes are frequently deformed in patients with OA?

Answer 32

Heberden's and Bouchard's nodes

Question 33

What is a test frequently performed in the diagnosis of OA?

Answer 33

Synovial Fluid Analysis: in patients with OA, the fluid will be clear yellow with no inflammation

Question 34

What is the primary intervention for patients with OA?

Answer 34

Non-pharmacological; drugs serve only as an adjunct

Question 35

Other than gender, what is a significant risk factor for OA?

Answer 35

Obesity

Question 36

What is the maximum dose of Tylenol to take in a 6-hour period?

Answer 36

1000 mg

Question 37

How much Tylenol can be taken in a 24-hour period?

Answer 37

4 grams (4000 mg)

Question 38

What is the characteristic trademark of Gout?

Answer 38

Hyperuricemia; excessive uric acid production or decreased uric acid excretion by the kidneys

Question 39

Uric acid is an end waste product of what?

Answer 39

Purine metabolism (breakdown)

Question 40

What is the most important nursing intervention for a patient with Gout?

Answer 40

Avoid pressure on the affected area

Question 41

What diet is recommended for patients with gout?

Answer 41

Low-purine: eggs, fruit, cheese, nuts, sugar, gello and veggies

Question 42

What food items should be recognized as "high-purine"?

Answer 42

Meat, shellfish, spinach, legumes and sweet breads

Question 43

What are the two types of skeletal muscle relaxants?

Answer 43

Centrally and peripherally acting

Question 44

Flexeril is contraindicated for patients with what conditions?

Answer 44

MAOI's and cardiac disorders

Question 45

Flexeril should be used cautiously in patient with what?

Answer 45

Urinary retention, glaucoma, and increased intraoccular pressure

Question 46

What is the MOA of Allopurinol?

Answer 46

Allopurinol inhibits the conversion of purine to uric acid

Question 47

The nurse should tell the patient on Allopurinol to immediately report signs of what?

Answer 47

Rash

Question 48

A patient taking Colchine should avoid what?

Answer 48

Grapefruit

Question 49

Colchicine is contraindicated for who?

Answer 49

Patients with renal, hepatic, cardiac or severe GI disorders

Question 50

What is the effect of Calcitonin?

Answer 50

Increases osetoblasts and slows bone loss

Question 51

What are S/E of Calcitonin?

Answer 51

Rhinitis, Sinusitis, Epistaxis and flushing of the face

Question 52

What is the MOA of Fosamax and Boniva?

Answer 52

inhibits osteclasts

Question 53

Fosamax and Boniva must be given 30-60 minutes before eating to avoid what?

Answer 53

Esophageal erosion

Question 54

What drug class is Evista?

Answer 54

Selective Estrogen Receptor Modulator

Question 55

What are severe side effects of Evista?

Answer 55

DVT and stroke in women with CAD

Question 56

What must a patient on Lortab be monitored for?

Answer 56

Respiratory depression

Question 57

What signs or symptoms seen in a post-operative total hip replacement patient require calling the doctor ASAP?

Answer 57

Shortening or rotation of the surgical leg (indicates subluxation or dislocation)

Question 58

What is the primary nursing priority post-op for a patient who had a total hip replacement?

Answer 58

Prevent hip dislocation

Question 59

What steps does the nurse caring for a post-op THR need to take to prevent dislocation?

Answer 59

Prevent hip adduction and hyperflexion

Question 60

What will post-arthroplasty patient need before procedures for the rest of their life?

Answer 60

Prophylactic antibiotics

Question 61

What exercises should a patient, post-op TKR, do to maintain ROM and muscle tone?

Answer 61

Isometric quadriceps flexing and straight leg raises

Question 62

What is plantar fasciitis?

Answer 62

inflamed tendon in the bottom of the foot that causes pain in the anterior medial aspect of the heel--that generally diminishes with stretching of the foot and the Achilles tendon

Question 63

What is hallux vulgus?

Answer 63

deformity of the big toe; bony enlargement of the first metatarsal head

Question 64

What is hallux rigidus?

Answer 64

Painful stiffness of the first MTP joint caused by osteoarthritis

Question 65

"Hammer toe" is characterized by what?

Answer 65

flexion deformity and callus formation on the 2nd through 5th toes

Question 66

What is osteomalacia?

Answer 66

softening of the bone

Question 67

What are the appropriate nursing interventions for a acute sprain?

Answer 67

RICE = rest, ice, compression and elevation

Question 68

What is appropriate nursing management of an acute dislocation or subluxation?

Answer 68

Nursing efforts should be pain relief with support and protection of the affected joint. The nurse MUST resist the impulse to immediately reduce a dislocation without evaluation by a clinician.

Question 69

What would be an indication of a dislocation?

Answer 69

Deformity, local pain and loss of function

Question 70

What are possible complications of a dislocation?

Answer 70

Avascular necrosis and compartment syndrome

Question 71

What is fat embolism?

Answer 71

It is when fat globules (that serve as emboli) enter the bloodstream after a traumatic skeletal injury

Question 72

What presentation would a patient experiencing fat embolism syndrome have?

Answer 72

Chest pain, tachypnea, dyspnea, apprehension: all of the symptoms of impaired oxygenation. Sudden onset petechiae is a important sign to notice as well.

Question 73

What are expected manifestations of carpal tunnel syndrome?

Answer 73

Weakness of the thumb, burning pain, impaired sensation and clumsiness performing fine hand movements

Question 74

What is the treatment for carpal tunnel?

Answer 74

Rest and immobilization (possible splinting of the wrist) and corticosteroid injection

Question 75

What is a transverse fracture?

Answer 75

Break straight across

Question 76

What is spiral fracture?

Answer 76

A break in a spiral; an "S" shape

Question 77

What is a greenstick fracture?

Answer 77

An incomplete fracture with one side splintered and the other bent

Question 78

What is a comminuted fracture?

Answer 78

A fracture with two or more fragments

Question 79

What is an oblique fracture?

Answer 79

The break is at an angle

Question 80

What is a pathologic fracture?

Answer 80

A spontaneous fracture at the site of bone damage

Question 81

What is a stress fracture?

Answer 81

Fracture that occurs in a bone subject to repeated stress (like running)