Musculoskeletal Flashcards Preview

► Med Notes > Musculoskeletal > Flashcards

Flashcards in Musculoskeletal Deck (532)
Loading flashcards...
1
Q

The musculoskeletal system consists of the body’s bones, joints, and muscles
A)true
B)false

A

.A

2
Q

1) for support to stand erect and
(2) for movement. The musculoskeletal system also functions
(3) to encase and pro/ec/thc inner vital organs (e.g., brain, spinal cord, heart), (
4) to prorluce the red blood cells in the bone marrow (hematopoiesis), and
(5) as a reservoir for storage of essential minerals, such as calcium and phosphorus in the bones.

A

Musculoskeletal system

3
Q

. It has 206 bones, which support the body like the posts and beams of a building.
A)true
B)false

A

.A

4
Q

Bone and cartilage are specialized forms of connective tissue. Bone is hard, rigid, and very dense. Its cells are continually turning over and remodeling.

The joint (or articulation) is the place of union of two or more bones. Joints are the functional units of the musculoskeletal system because they permit the mobility needed for activities of daily living

A

.

5
Q

In nonsynovial joints, the bones are united by fibrous tissue or cartilage and are immovable (e.g., the sutures in the skull) or only slightly movable (e.g., the vertebrae).

Synovial joints are freely movable because they have bones that are separated from each other and are enclosed in a joint cavity

A

.

6
Q

Just like grease on gears, synovial fluid allows sliding of opposing surfaces, and this sliding permits movement.

A

.

7
Q

is avascular; it receives nourishment from synovial fluid that circulates during joint movement. It is a very stable connective tissue with a slow cell turnover. It has a tough, firm consistency, yet is flexible. This cartilage cushions the bones and gives a smooth surface to facilitate movement.

A)cartilage
B)joint
C)muscles

A

Cartilage

8
Q

The joint is surrounded by a fibrous capsule and is supported by ligaments.

A

.

9
Q

are fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions

A)ligament
B)joint
C)both a and b

A

Ligament

10
Q

is an enclosed sac filled with viscous synovial fluid, much like a joint. Are located in areas of potential friction and help muscles and tendons glide smoothly over bone.

A)bursa
B)ligament
C)muscles

A

Bursa

11
Q

Muscles account for 40% to 50% of the body’s weight.
A)true
B)false

A

.true

12
Q

When they contract, they produce movement
A)muscles
B)joints
C)both a and b

A

Muscles

13
Q

Muscles are of three types: skeletal, smooth, and cardiac
A)true
B)false

A

.true

14
Q

Each skeletal muscle is composed of bundles of muscle fibers, or fasciculi.
The skeletal muscle is attached to bone by a tendon-a strong fibrous cord.
A)true
B)false

A

.

15
Q

The temporomandibular joint (TMJ) is the articulation of the mandible and the temporal bone
A)true
B)false, the joint articulates with the mandible and sphenoid bone

A

.true

16
Q

You can feel it in the depression anterior to the tragus of the ear.
A)temporalmandibular joint
B)mandible joint

A

Temporalmandibular joint

17
Q

The TMJ permits jaw function for speaking and chewing
A)temporalmandibular joint
B)mandible

A

Temporalmandibular. Joint

18
Q

The joint allows three motions: (l) hinge action to open and close the jaws; (2) gliding action for protrusion and retraction; and (3) gliding for side-to-side movement of the lower jaw
A)temporalmandibular joint
B)mandible

A

Temporalmandibular joint

19
Q

The vertebrae are 33 connecting bones stacked in a vertical column
A)true
B)false

A

Ture

20
Q

Humans have 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3 or 4 coccygeal vertebrae.
A)true
B)false

A

True

21
Q

SPINE

A

.

22
Q

The spinous processes of C7 and Tl are prominent at the base of the neck.
A)true
B)false

A

.true

23
Q

The inferior angle of the scapula normally is at the level of the interspace between T7 and T8
A)true
B)false

A

.true

24
Q

An imaginary line connecting the highest point on each iliac crest crosses L4.
A)true
B)false

A

.true

25
Q

An imaginary line joining the two symmetric dimples that overlie the posterior superior iliac spines crosses the sacrum
A)true
B)false

A

.true

26
Q

A lateral view shows that the vertebral column has four curves (a double-S-shape)
A)true
B)false

A

.true

27
Q

1.cervical and lumbar curves are concave (inward or anterior), and
2.the thoracic and sacrococcygeal curves are convex
A)true
B)true for the first one
C)false
D)true for the second one

A

.true

28
Q

The intervertebral disks are elastic fibrocartilaginous plates that constitute one fourth of the length of the column
A)true
B)false

A

True

29
Q
Each disk center has a\_\_\_\_\_\_\_\_\_\_\_\_\_  made of soft, semifluid, mucoid material that has the consistency of toothpaste in the young adult. 
A)nucleus pulposus
B)spinal nucleus 
C)nucleus spine
D)all the above
A

Nucleus pulposus

30
Q

The disks cushion the spine like a shock absorber and help it move
A)intervertebral disk
B)intercostal disk
C)all the above

A

Intervertebral disk

31
Q

The disk then can rupture and the nucleus pulposus can herniate out of the vertebral column, compressing on the spinal nerves and causing pajn
A)true
B)false

A

True

32
Q

SHOULDER

A

.

33
Q

The glenohumeral joint is the articulation of the humerus with the glenoid fossa of the scapula
A)true
B)false

A

True

34
Q

The joint is enclosed by a group of four powerful muscles and tendons that support and stabilize it. Together these are called the rotator cuff of the shoulder.
A)shoulder
B)hip
C)both a and b

A

Shoulder

35
Q
The large subacromial bursa helps during abduction of the arm, so that the greater tubercle of the humerus moves easily under the acromion process of the scapula
A)shoulder
B)subacromial bursa
C)both a and b
D)clavicle
A

Subacromial bursa

36
Q

The scapula and the clavicle connect to form the shoulder girdle.
A)true
B)false

A

True

37
Q

You can feel the bump of the scapula’s acromion process at the very top of the shoulder
A)true
B)false

A

True

38
Q

The next bump is the greater tubercle of the humerus a few centimeters down and laterally, and from that the coracoid process of the scapula is a few centimeters medially
A)true
B)false

A

True

39
Q

ELBOW

A

.

40
Q

The elbow joint contains the three bony articulations of the humerus, radius, and ulna of the forearm
A)true
B)false

A

True

41
Q
Its hinge action moves the forearm (radius and ulna) on one plane, a!Jowing flexion and extension. The olecranon bursa lies between the olecranon process and the skin
A)shoulder
B)elbow
C)hip
D)wrist
A

Elbow

42
Q

The sensitive ulnar nerve runs between the olecranon process and the medial epicondyle.
A)true
B)false

A

True

43
Q

The radius and ulna articulate with each other at two radioulnar joints, one at the elbow and one at the wrist These move together to permit pronation and supination of the hand and forearm.
A)true
B)false

A

True

44
Q

WRIST AND CARPALS

A

.

45
Q

Of the body’s 206 bones, over half are in the hands and feet.
A)true
B)false

A

True

46
Q

Its condyloid action permits movement in two planes at right angles: flexion and extension, and side-to-side deviation.
A)true
B)false

A

True

47
Q

The midcarpal joint is the articulation between the two parallel rows of carpal bones. It allows flexion, extension, and some rotation. The metacarpophalangeal and the interphalangeal joints permit finger flexion and extension. The flexor tendons of the wrist and hand are enclosed in synovial sheaths.
A)true
B)false

A

True

48
Q

HIP

A

.

49
Q

The hip joint is the articulation between the acetabulum and the head of the femur
A)true
B)false

A

.

50
Q

Palpation of these bony landmarks will guide your examination. You can feel the entire iliac crest, from the anterior superior iliac spine to the posterior. The isd1ial tuberosity lies under the gluteus maximus muscle and is palpable when the hip is flexed. The greater trochanter of the femur is normally the width of the person’s palm below the iliac crest and halfway between the anterior superior iliac spine and the ischial tuberosity. Feel it when the person is standing, in a flat depression on the upper lateral side of the thigh.
A)true
B)false
C)ball and socket joint

A

True

51
Q

KNEE

A

.

52
Q

The knee joint is the articulation of three bones-the femur, the tibia, and the patella (kneecap)-in one common articular cavity
A)true
B)false

A

True

53
Q
The knee joint is the articulation of three bones
A)the femur, the tibia, and the patella
B)knee cap
C)femur, tibia and the fibula 
D)femur, tibia and knee
A

A fumur tibia and patella

54
Q
lt is the largest joint in the body and is complex
A)shoulder
B)knee
C)hip
D)all the above
A

Knee

55
Q

Two wedge-shaped cartilages, called the medial and lateral menisci
A)cushion the tibia and femur.
B)balance the femur
C)both a and b

A

A

56
Q

The cruciate ligaments (not shown) crisscross within the knee;
A) they give anterior and posterior stability and help control rotation.
B)aide in the contraction of the knee
C) both a and b

A

A

57
Q

prepatellar bursa, lies between the patella and the skin
A)true
B)false

A

True

58
Q

Landmarks of the knee joint start with the large quadriceps muscle, which you can feel on your anterior and lateral thigh
A)true
B)false

A

True

59
Q

ANKLE AND FOOT

A

.

60
Q

The ankle, or tibiotalar joint, is the articulation of the tibia, fibula, and talus
A)true
B)false

A

True

61
Q

It is a hinge joint, limited to flexion (dorsiflexion) and extension (plantar flexion) on one plane.
A)true
B)false

A

TURE

62
Q

Landmarks are two bony prominences on either sidethe medial malleolus and the lateral malleolus.
A)true
B)false

A

True

63
Q

The subtalar joint permits inversion and eversion of the foot
A)true
B)false

A

True

64
Q

DEVELOPMENTAL COMPETENCE

A

.

65
Q

Infants and Children

A

.

66
Q

By 3 months’ gestation, the fetus has formed a “scale model” of the skeleton that is made up of cartilage.
A)true
B)false

A

True

67
Q

Bone growth continues after birth-rapidly during infancy and then steadily during childhood-until adolescence, when both boys and girls undergo a rapid growth spurt.
A)true
B)false

A

True

68
Q

growth spurt. Long bones grow in two dimensions.
A)false
B)true

A

True

69
Q

. Lengthening occurs at the epiphyses, or growth plates. These specialized growth centers are transverse disks located at the ends of long bone. Any trauma or infection at this location puts the growing child at risk for bone deformity. This longitudinal growth continues until closure of the epiphyses; the last closure occurs at about age 20 years.
A)true
B)false

A

True

70
Q

At birth, the spine has a single
A)C-shaped curve
B)S-shaped curve
C)both a and b

A

C shaped curve

71
Q

At 3 to 4 months, raising the baby’s head from prone position develops the anterior curve in the cervical neck region
A)true
B)false

A

TURE

72
Q

From 1 year to 18 months, standing erect develops the anterior curve in the lumbar region.
A)true
B)false

A

True

73
Q

growth is marked during the adolescent growth spurt
A)true
B)false

A

True

74
Q

muscles respond to increased secretion of growth hormone, to adrenal androgens, and in boys, to further stimulation by testosterone.
A)true
B)false

A

True

75
Q

This is due to genetic programming, nutrition, and exercise
A)lifestyles
B)Muscles vary in size and strength in different people
C)African Americans have more muscle

A

Muscles vary in size and strength in different people.

76
Q

The Pregnant Woman

A

.

77
Q

Increased levels of circulating hormones (estrogen, relaxin from the corpus luteum, and corticosteroids) cause increased mobility in the joints.
A)true
B)false

A

True

78
Q
Increased mobility in the sacroiliac, sacrococcygeal, and symphysis pubis joints in the pelvis contributes to the noticeable changes in maternal posture.
A)true
B)the pregnant women
C)both a and b
D)flase
A

Both a and b

79
Q

The most characteristic change is progressive lordosis, which compensates for the enlarging fetus; otherwise, the center of balance would shift forward.
A)the pregnant women
B)false
C)young adult

A

The pregnant women

80
Q

Anterior flexion of the neck and slumping of the shoulder girdle are other postural changes that compensate for the lordosis.
A)the pregnant woman
B)teen mom
C)both a and b

A

The pregnant women

81
Q
These upper back changes may put pressure on the ulnar and median nerves during the \_\_\_\_\_\_\_\_\_\_ trimester. Nerve pressure creates aching, numbness, and weakness in the upper extremities in some women
A)1
B)3
C)2
D)all the above
A

3

82
Q

The Aging Adult

A

.

83
Q

Bone remodeling is a cyclic process of bone resorption and deposition. The balance favors deposition until skeletal maturity at 25 to 35 years when bones mass reaches its peak.
A)true
B)false

A

25-35bone reaches its max

84
Q

After age 40, loss of bone matrix (resorption) occurs more rapidly than new bone formation. The net effect is a gradual loss of
bone density, or osteoporosis.
A)true
B)flase

A

Bone starts breaking down at age 40

85
Q

women have more bone loss than men because for 5 years after menopause, the lack of estrogen leads to accelerated bone loss.
A)true
B)false

A

True

86
Q

Postural changes are evident with aging, and decreased height is the most noticeable.
A)true
B)false

A

True

87
Q

Long bones do not shorten with age.
A)true
B)flase

A

True

88
Q

Decreased height in the aging adult is due to?
A)shortening of the vertebral column. caused by loss of water content and thinning of the intervertebral disks and by a decrease in the height of individual vertebrae from osteoporosis.
B)shortening of long bones

A

Decreased height is due to shortening of the vertebral column. This is caused by loss of water content and thinning of the intervertebral disks and by a decrease in the height of individual vertebrae from osteoporosis.
A

89
Q

Both men and women can expect a progressive decrease in height beginning at age 40 years in males and age 43 years in females, although this is not significant until age 60 years
A)true
B)false

A

True

90
Q

A greater decrease occurs in the 70s and 80s as a result of osteoporotic collapse of the vertebrae The result is a shortening of the trunk and long extremities. Other postural changes are kyphosis, a backward head tilt to compensate for the kyphosis, and a slight flexion of hips and knees.
A)true
B)false

A

True

91
Q

Usually, men and women gain weight in their 40s and 50s.
A)true
B)false

A

True

92
Q
They begin to lose fat in the face and deposit it in abdomen and hips.
A)the aging adult
B)aging women
C)aging men
D)none
A

A

93
Q

In the 80s and 90s, fat further decreases in the periphery, which is especially noticeable in the forearms and apparent over the abdomen and hips.
A)true
B)flase

A

True

94
Q

Loss of subcutaneous fat leaves bony prominences more marked (e.g., tips of vertebrae, ribs, iliac crests) and body hollows deeper (e.g., cheeks, axillae).
A)pregnant woman
B)the aging adult
C)both a and b

A

B the aging adult

95
Q

; a sedentary lifestyle hastens musculoskeletal changes of aging
A)false
B)true

A

True

96
Q

However, physical exercise increases skeletal mass and helps prevent or delay osteoporosis. Physical activity delays or prevents bone loss in postmenopausal women in a dose-dependent manner. Fast walking is the best prevention for osteoporosis; the faster the pace, the higher the preventive effect on the risk for hip fracture.
A)true
B)false

A

True

97
Q

The other positive effects of physical activity are improving muscle strength to prevent falls, balance and posture control, decrease in back pain, increase in quality of life, and prevention of cardiovascular disease, cancer, and depression.
A)true
B)false

A

True.

98
Q

CULTURE AND GENETICS

A

.

99
Q

African-American adults have a decreased risk for fracture when compared with white adults, and Hispanic women have a decreased risk for fractures than white women have.
A)true
B)false

A

True

100
Q

African-American and Hispanic children have shown significantly higher bone strength than white children.This is due to structural properties-greater bone density at specific bone sites in African-American and Hispanic children.
A)true
B)false

A

True

101
Q

greater bone mass and bone mineral density (BMD) among AfricanAmerican men than among their white counterparts.
A)true
B)false

A

True

102
Q

Younger Hispanic men had similar bone strength as African Americans, but older Hispanic men had more rapid loss of BMD and strength. The increased bone strength helps explain fracture risk.
A)false
B)true

A

True

103
Q

In the spine, women of all races gained BMD up to 30 to 33 years of age.3 But at the femoral neck in Lhe hip joint, BMD peaked earlier among white women years) than among African Americans (2 l years) and Hispanics (20 years)
A)true
B)flase

A

True

104
Q

SUBJECTIVE DATA

A

.

105
Q
Joints Pain Stiffness Swelling, heat, redness Limitation of movement, Muscles Pain (cramps) Weakness, Bones Pain Deformity,Trauma (fractures, sprains, dislocations), Functional assessment (activities of daily living [ADLs]),Self-care behaviors 
Are all.?
A)objective data
B)subjective data
C)both a and b
A

Subjective data

106
Q

• Any problems with your joints? Any pain?
A)Joint pain and loss of function are the most common musculoskeletal concerns that prompt a person to seek care.
B)no

A

A

107
Q

Location: Which joints? On one side or both sides?
A)tender
B)Rheumatoid arthritis (RA) involves symmetric joints; other musculoskeletal illnesses involve isolated or unilateral joints.

A

B

108
Q

Quality: What does the pain feel like: aching, stiff, sharp or dull, shooting? Severity: How strong is the pain?
A)Exquisitely inflammation. tender with acute
B)free of pain

A

A

109
Q

Timing: What time of day does the pain occur? How long does it last? How often does it occur?
A)RA pain is worse in morning when arising; osteoarthritis is worse later in the day; tendinitis is worse in morning, improves during the day.
B)arthritis

A

A

110
Q

RA pain is worse in morning when arising;
A)true
B)false

A

True

111
Q

osteoarthritis is worse later in the day;
A)true
B)false

A

True

112
Q

tendinitis is worse in morning, improves during the day.
A)true
B)flase
C)worse at day improves at morning

A

True

113
Q

Is the pain aggravated by movement, rest, position, weather? Is the pain relieved by rest, medications, application of heat or ice?

A)Movement increases most joint pain except in RA, in which movement decreases pain.
B)call the doctor

A

A

114
Q

Is the pain associated with chills, fever, recent sore throat, trauma, repetitive activity?
A)Joint pain 10 to 14 days after an untreated strep throat suggests rheumatic fever. joint injury occurs from trauma, repetitive motion.
B) flase

A

A

115
Q

Joint pain 10 to 14 days after an untreated strep throat suggests rheumatic fever. joint injury occurs from trauma, repetitive motion.
A)true
B)flase

A

True

116
Q

Any stiffness in your joints?
A)RA stiffness occurs in morning and after rest periods.
B)false

A

A

117
Q

Any swelling, heat, redness in the joints? The nurse would expect
A)pain
B)acute inflammation
C)none

A

BSuggests acute inflammation

118
Q

Any limitation of movement in any joint? Which joint? The nurse would suspect?
A)Decreased ROM may be due to joint injury to cartilage or capsule or to muscle contracture
B)Increase in ROM may be due to joint flexibility

A

A

119
Q

Any problems in the muscles, such as any pain or cramping? Which muscles? The nurse would suspect which of the following?
A)Myalgia
B)arthalgia
C)both a and b

A

Myalgia is usually felt as cramping or aching. A

120
Q

If in calf muscles: Is the pain with walking? Does it go away with rest? The nurse would suspect, which the following?
A)Suggests intermittent claudication
B)Suggests myalgia

A

A

121
Q

Are your muscle aches associated with fever, chills, the “flu”? The nurse knows that?
A)Viral illness often includes myalgia
B)Weakness may involve musculoskeletal or neurologic systems

A

A

122
Q

Any weakness in muscles? The nurse knows too suspect which abnormal finding, in what two two system?
A)Weakness may involve musculoskeletal or neurologic systems
B)atrophy

A

A

123
Q
Do the muscles look smaller there? What term describes this.
A)atrophy
B)diminishing 
C)building
D)catabolism
A

A

124
Q

Any bone pain? Is the pain affected by movement? The knows that which of the following statements might be answered to the question?
A)Fracture causes sharp pain that increases with movement. Other bone pain usually feels “dull” and “deep” and is unrelated to movement.
B)Functional assessment screens the safety of independent living, the need for home health services, and quality of life

A

A

125
Q

Functional assessment screens the safety of independent living, the need for home health services, and quality of life?
A)true
B)flase

A

True

126
Q

-Bathing-getting in and out of the tub, turning faucets?
-Toileting-urinating, moving bowels, able to get self on/off toilet, wipe self? •
-Dressing-doing buttons, zipper, fasten opening behind neck, pulling dress or sweater over head, pulling up pants, tying shoes, getting shoes that fit?
-Grooming-shaving, brushing teeth, brushing or fixing hair, applying makeup?
-Eating-preparing meals, pouring liquids, cutting up foods, bringing food to mouth, drinking? •
-Mobility-walking, walking up or down stairs, getting in/out of bed, getting out of house?
-Communicating-talking, using phone, writing?
All of the following are relevant to helping the nurse figure out what assessment on the patient?
A)complete assessment
B)functional assessment
C)ADL

A

B functional assessment

127
Q

any repetitive motion or chronic stress to joints, the nurse will?
A)Assess risk for back pain or carpal tunnel syndrome.
B)look for books
C)perform hand hygiene

A

A

128
Q

If person has chronic disability or crippling illness: the nurse ask, How has your illness affected you, by doing this the nurse will asses for?
A)Self-esteem disturbance, Loss of independence
B) Body image disturbance, Role performance disturbance
C) Social isolation
D)all the above

A

D

129
Q

Additional History for Infants and Children

A

.

130
Q

Were you told about any trauma to infant during labor and delivery? Did the baby come head first? Was there a need for forceps? The nurse will be asking these questions because?
A)Traumatic delivery increases risk for fractures, (e.g., humerus, clavicle).
B)for the mom to feel safe

A

A

131
Q

Did the baby need resuscitation? The nurse ask because?
A)Period of anoxia may result in hypotonia of muscles.
B)hypotension
C)both a and b

A

A

132
Q

Additional History for Adolescents

A

.

133
Q

Involved in any sports at school or after school? How frequently (times per week)? The nurse ask this question for adolescents group too?
A)Assess safety of sport for child. Note if child’s height and weight are adequate for the particular sport (e.g., football).
B)to assess vitals

A

A

134
Q

Use of safety equipment and presence of adult supervision decrease risk for sports injuries?
A)true
B)false

A

True

135
Q

Lack of adequate warm-up increases -risk for sports injury.
A)true
B)false

A

True

136
Q
Students may not report injury or pain for fear of limiting participation in sport. In which age group? 
A)adolescents 
B)preschool 
C)young adults 
D)older adults 
E)infants
A

A

137
Q

Additional History for the Aging Adult

A

.

138
Q

Use what assessment on the aging adult to elicit any loss of function, self-care deficit, or safety risk that may occur as a process of aging or musculoskeletal illness.
A)complete assessment
B)functional assessment
C)both of none of the above

A

.

139
Q

OBJECTIVE DATA

A

.

140
Q

A screening musculoskeletal examination suffices for most people? The nurse does which of the following?
A) Inspection and palpation of joints integrated with each body region
B)Observation of ROM as person proceeds through motions described earlier
C) Age-specific screening measures, such as Ortolani sign for infants or scoliosis screening for adolescents
D)all the above

A

D

141
Q

During the assessment the nurse should?
A)Support each joint at rest. Muscles must be soft and relaxed to assess the joints under them accurately.
B) Take care when examining any inflamed area where rough manipulation could cause pain and muscle spasm. To avoid this, use firm support, gentle movement, and gentle return to a relaxed state
C)both a and b
D)a and second part of b

A

C

142
Q

Presence of swelling is significant and signals joint irritation.
A)true
B)false

A

True

143
Q

Swelling may be excess joint fluid (effusion), thickening of the synovial lining, inflammation of surrounding soft tissue (bursae, tendons), or bony enlargement.
A)true
B)flase

A

True

144
Q

(complete loss of contact between the two bones in a joint)
A)dislocation
B)subluxation
C)contracture

A

A

145
Q

(two bones in a joint stay in contact but their alignment is off);
A)subluxation
B)contracture
C)ankylosis

A

A

146
Q

(shortening of a muscle leading to limited ROM of in a joint)
A)contracture
B)ankylosis
C)none

A

A

147
Q

or ankylosis (stiffness or fixation of a joint).
A)subluxation
B)contracture
C)ankylosis

A

C

148
Q

The nurse Palpates each joint, including its skin for temperature, its muscles, bony articulations, and area of joint capsule, an abnormal finding would be?
A)Warmth and tenderness that signal inflammation.
B) warmth and normal

A

A

149
Q

The synovial membrane normally is not palpable. A small amount of fluid is present in the normal joint, but y.it is not palpable.
A)true
B)flase

A

True

150
Q

The synovial membrane, When thickened, it feels .
A) “doughy” or “boggy.”
B) “hard” or “painful”

A

A

151
Q

Palpable fluid is abnormal. Because fluid is contained in an enclosed sac, if you push on one side of the sac, the fluid will shift and cause a visible bulging on another side.
A)false
B)true

A

B

152
Q

What is the most sensitive sign of joint disease.
A)Limitation in ROM
B)Increase in ROM

A

A

153
Q

Articular disease (Inside the joint capsule [e.g., arthritis) produces swelling and tenderness around the whole joint, and it limits all planes of ROM in both active and passive motion.
A) articular disease
B)Extra-articular

A

A

154
Q

(injury to a specific tendon, ligament, nerve) produces swelling and tenderness to that one spot in the joint and affects only certain planes of ROM, especially during active (voluntary) motion
A)articular disease
B)extra-articular disease

A

B

155
Q

Do not confuse crepitation with the normal discrete “crack” heard as a tendon or ligament slips over bone during motion, such as when you do a knee bend.
A)true
B)false

A

A

156
Q

is an audible and palpable crunching or grating that accompanies movement. It occurs when the articular surfaces in the joints are roughened, as with rheumatoid arthritis?
A)crepitation
B)dislocation
C)both a and b

A

A

157
Q

Test the strength of the prime mover muscle groups for each joint.Muscle strength should be equal bilaterally and should fully resist your opposing force.
A)true
B)false

A

A

158
Q

5 Full ROM against gravity, full 100 Normal resistance
4 Full ROM against gravity, some 75 Good resistance
3 Full ROM with gravity 50 Fair
2 Full ROM with gravity eliminated 25 Poor (passive motion
1 Slight contraction 10 Trace 0 No contraction 0 Zero

A

Muscle testing know it

159
Q

TEMPOROMANDIBULAR JOINT

A

.

160
Q

Swelling looks like a round bulge over the joint, although it must be moderate or marked to be visible.
A)true
B)false

A

True

161
Q

Crepitus and pain occur with temporomandibular joint dysfunction
A)true
B)false

A

True

162
Q

Instructions to Person and Motion and Expected Range

A

.

163
Q

Open mouth maximally.
A)Normal is 3 to 6 cm, or three fingers inserted sideways.
B)Normal is 1 to 9 cm, or three fingers inserted sideways.
C)Normal is 2 to 4 cm, or three fingers inserted sideways.

A

Normal is 3 to 6 cm, or three fingers inserted sideways. A

164
Q

Partially open mouth, protrude lower jaw, and move it side to side.
A)Lateral motion. Normal extent is 1 to 2 cm
B)Lateral motion. Normal extent is .5 to 2 m
C)both a and b

A

ALateral motion. Normal extent is 1 to 2 cm

165
Q

Lateral motion may be lost earlier and more significantly than vertical.
A)in the TMJ
B) in the mandible

A

A

166
Q

Stick out lower jaw.
A)Protrude without deviation.
B)Protrude without rotation.
C)Protrude without both a and b

A

A

167
Q

CERVICAL SPINE

A

.

168
Q

The spine should be straight and the head erect.
A)false
B)true

A

True

169
Q

Palpate the spinous processes and the sternomastoid, trapezius, and paravertebral muscles. They should feel firm, with no muscle spasm or tenderness.
A)true
B)flase

A

True

170
Q

Abnormal findings of the cervical spine the nurse would find?(select all that apply)
A) Head tilted to one side.
B)Asymmetry of muscles.
C)Tenderness and hard muscles with muscle spasm.
D)head straight forward

A

A,B,C

171
Q

Instructions to Person and Motion and Expected Range of cervical spine

A

.

172
Q

Touch chin to chest. Normal finding?
A)Flexion of 45 degrees
B)Flexion of 90 degrees
C)Flexion of 30 degrees

A

A

173
Q

Lift the chin toward the ceiling. Normal finding?
A)Hyperextension of 45 degrees.
B)Hyperextension of 90 degrees.
C)Hyperextension of 55 degrees.

A

C

174
Q

Touch each ear toward the corresponding shoulder. Do not lift up the shoulder. Normal finding?
A)Lateral bending of 40 degrees
B)Lateral bending of 50 degrees
C)Lateral bending of 70 degrees

A

A

175
Q

Turn the chin toward each shoulder. Normal finding?
A)Rotation of 70 degrees
B)Rotation of 90 degrees
C)Rotation of 180 degrees

A

A

176
Q

The person normally can maintain flexion against your full resistance. This also tests the integrity of cranial nerve Xl (spinal). Abnormal findings would be?
A)The person cannot hold flexion.
B)The person can hold flexion

A

A

177
Q

Shoulder

A

.

178
Q

Check the size and contour of the joint, and compare shoulders for equality of bony landmarks. Normally, no redness, muscular atrophy, deformity, or swelling is present.
A)true
B)false

A

True

179
Q

Check the anterior aspect of the joint capsule and the subacromial bursa for abnormal swelling.
A)true
B)false

A

True

180
Q

Dislocated shoulder
A)loses the normal rounded shape and looks flattened laterally
B)gains the normal rounded shape and looks flattened laterally

A

True a

181
Q

Swelling of a shoulder is best seen?
A) anteriorly. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose.
B) posterily. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose

A

A

182
Q

Be aware that shoulder pain may be from local causes or it may be referred pain from a hiatal hernia or a cardiac or pleural condition, which could be potentially serious.
A) true
B)false

A

True

183
Q

Swelling of subacromial bursa
A)is localized under deltoid muscle and may be accentuated when the person tries to abduct the arm
B)localized under trapezes muscle and may be accentuated when the person tries to abduct the arm

A

A)

184
Q

The nurse is aware that, Pain from a local cause is reproducible during the examination by palpation or motion?
A)false
B)true

A

True B

185
Q

Start at the clavicle and methodically explore the acromioclavicular joint, scapula, greater tubercle of the humerus, area of the subacromial bursa, the biceps groove, and the anterior aspect of the glenohumeral joint. Palpate the pyramid-shaped axilla; no adenopathy or masses should be present.
A)false
B) true

A

True b

186
Q

Abnormal findings of the shoulder would be?
A)Hard muscles with muscle spasm.
B) Tenderness or pain.
C)both a and b

A

C

187
Q

Instructions to Person and Motion and Expected Range of the shoulder

A

.

188
Q

With arms at sides and elbows extended, move both arms forward and up in wide vertical arcs and then move them back. Normal finding?
A)Forward flexion of 180 degrees. Hyperextension up to 50 degrees
B)Forward flexion of 200 degrees. Hyperextension up to 50 degrees
C)Forward flexion of 90 degrees. Hyperextension up to 50 degrees
D) all the above

A

AForward flexion of 180 degrees. Hyperextension up to 50 degrees

189
Q

Rotate arms internally behind back, place back of hands as high as possible toward the scapulae. Normal finding?
A)Rotate arms internally behind back, place back of hands as high as possible toward the scapulae
B)Rotate arms externally behind back, place back of hands as high as possible toward the scapulae
C)both a and b

A

A

190
Q

With arms at sides and elbows extended, raise both arms in wide arcs in the corona] plane. Touch palms together above head. Normal finding?
A)Abduction of 180 degrees. Adduction of 30 degrees
B)Abduction of 180 degrees. Adduction of 60 degrees
C)Abduction of 90 degrees. Adduction of 50 degrees
D)Abduction of 180 degrees. Adduction of 50 degrees

A

Abduction of 180 degrees. Adduction of 50 degrees D

191
Q

Touch both hands behi.nd the head with elbows flexed and rotated posteriorly. Normal finding?
A)Touch both hands behind the head with elbows flexed and rotated posteriorly.
B)Touch one hand behind the head with elbows flexed and rotated posteriorly.

A

A

192
Q

Rotator cuff lesions may cause limited ROM, pain, and muscle spasm during abduction, whereas forward flexion stays fairly normal.
A)true
B)flase

A

True

193
Q

The shoulder shrug also tests the integrity of cranial nerve ________ the spinal accessory.
A)11
B)12
C)6

A

A

194
Q

. Elbow

A

.

195
Q

Check the olecranon bursa and the normally present hollows on either side of the olecranon process for abnormal swelling.
A) true
B) false

A

True

196
Q

Subluxation of the elbow shows the forearm dislocated?
A) anteriorly
B) posteriorly.

A

BSubluxation of the elbow shows the forearm dislocated posteriorly.

197
Q

Swelling and redness of olecranon bursa are localized and easy to observe because of the close proximity of the bursa to skin
A)true
B)false

A

True

198
Q

Effusion or synovial thickening shows first as a bulge or fullness in groove on either side of the olecranon process, and it occurs with
A) gouty arthritis.
B) gout elbowitis
C)both a and b

A

A

199
Q

Palpate with the elbow flexed about 70 degrees and as relaxed as possible.Use your left hand to support the person’s left forearm, and palpate the extensor surface of the elbow-the olecranon process and the medial and lateral epicondyles of humerus-with your right thumb and fingers.
A)true
B) flase

A

True

200
Q

Epicondyles, head of radius, and tendons are common sites of inflammation and local tenderness, or “tennis elbow.”
A)true
B)false

A

True

201
Q

With your thumb in the lateral groove and your index and middle fingers in the mectial groove, palpate either side of the olecranon process using varying pressure. Normally, present tissues and fat pads feel fairly solid. Check for any synovial thickening, swelling, nodules, or tenderness.
A)true
B)flase

A

True

202
Q

Abnormal finding in the elbow would be?
A)Soft, boggy, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
B)Hard, swelling, or fluctuant swelling in both grooves occurs with synovial thickening or effusion

A

ASoft, boggy, or fluctuant swelling in both grooves occurs with synovial thickening or effusion

203
Q

Subcutaneous nodules are raised, firm, and nontender, and overlying skin moves freely. Common sites are
A)in the olecranon bursa and along extensor surface of the ulna. These nodules occur with RA
B) in the radial bursa and along extensor surface of the ulna.

A

A

204
Q

lnstructions to Person and Motion and Expected Range of the elbow

A

.

205
Q

Bend and straighten the elbow, normal finding?
A)Flexion of 150 to 160 degrees; extension at 0. Some healthy people lack 5 to l0 degrees of full extension, and others have 5 to 10 degrees of hyperextension.
B)none

A

A

206
Q

Movement of 90 degrees in pronation and supination, normal finding?
A)Hold the hand midway; then touch front and back sides of hand to table
B) halfway and touch back to front sides of hand to table

A

A

207
Q

Wrist and Hand

A

.

208
Q

The normal functional position of the hand shows the wrist in slight extension. This way, the fingers can flex efficiently and the thumb can oppose them for grip and manipulation. The fingers lie straight in the same axis as the forearm. Normally, no swelling or redness, deformity, or nodules are present.
A)true
B)flase

A

True

209
Q

Abnormal findings of the wristband hand would be?(select all that apply)
A)Subluxation (partial dislocation) of wrist.
B)Ulnar deviation; fingers list to ulnar side.
C)Dupuytren contracture; flexion contracture of finger(
D)Swan-neck or boutonniere deformity in fingers
E)Atrophy of the thenar eminence

A

A,b,c,d,e

210
Q

Use your thumb and index finger in a pinching motion to palpate the sides of the interphalangeal joints (Fig. 22-25). Normally, no synovial thickening, tenderness, warmth, or nodules are present. But in a abnormal finding the nurse would suspect to which finding?
A)Heberden and Bouchard nodules are hard and nontender and occur with osteoarthritis
B)Heberden
C)Bouchard nodules
D)osteoarthritis

A

A

211
Q

Instructions to Person and Motion and Expected Range of wrist and hand

A

.

212
Q

Bend the hand up at the wrist.normal finding?
A)Hyperextension of 70 degrees (Fig. 22-26, A).
B) Palmar flexion of 90 degrees. Flexion of 90 degrees. Hyperextension of 30 degrees (Fig. 22-26, B).
C) Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
D)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)

A

A

213
Q

Bend hand down at the wrist. Normal finding?
A)Palmar flexion of 90 degrees.
B)Flexion of 90 degrees. Hyperextension of 30 degrees (Fig. 22-26, B).
C)Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
D)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)

A

A

214
Q

Bend the fingers up and down at metacarpophalangeal joints. Normal finding?
A)Flexion of 90 degrees. Hyperextension of 30 degrees
B)Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
C)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)

A

A

215
Q

With palms flat on table, turn them outward and in.normal finding?
A)Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
B)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)

A

A

216
Q

Spread fingers apart; make a fist. Normal finding?
A)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally.
B)Hyperextension of 70 degrees

A

A

217
Q

Touch the thumb to each finger and to the base of little finger. Normal finding?
A)The person is able to perform, and the responses are equal bilaterally
B)The person is able to perform, and the responses are equal unilaterally

A

A

218
Q

For muscle testing, position the person’s forearm supinated (palm up) and resting on a table (Fig. 22-27). Stabilize by holding your hand at the person’s midforearm. Ask the person to flex the wrist against your resistance at the palm.
A)wrist
B)hand
C)both a and b

A

C

219
Q

Ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand. The test is called?
A)Tinsel Test
B)Phalen Test.

A

BPhalen Test. Ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand

220
Q
A patient with carpal tunnel syndrome the nurse will perform what test to conclude abnormal finding?
A) tinsel test
B) wrist test
C) hand test
D) phalen test
A

DPhalen test reproduces numbness and burning in a person with carpal tunnel syndrome

221
Q

. Direct percussion of the location of the median nerve at the wrist produces no symptoms in the normal hand. Is what test the nurse is performing?
A)phaglen test
B)Tinel Sign
C)both a and b

A

Tinel Sign B In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Tine! sign.

222
Q

In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Of what test?
A)tinel test
B) phaglen test
C) both a and b

A

In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Tine! sign. A

223
Q

Hip

A

.

224
Q

Instructions to Person and Motion and Expected Range of the HIP

A

.

225
Q
Raise each leg with knee extended. Normal finding?
A)Hip flexion of 90 degrees 
B)Hip flexion of 180 degrees 
C)Hip flexion of 45 degrees 
D)Hip flexion of 100  degrees (F
A

A

226
Q

Bend each knee up to the chest while keeping the other leg straight. Normal finding?
A)Hip flexion of 180degrees. The opposite thigh should remain on the table
B)Hip flexion of 120 degrees. The opposite thigh should remain on the table
C)Hip flexion of 90 degrees. The opposite thigh should remain on the table

A

BHip flexion of 120 degrees. The opposite thigh should remain on the table

227
Q

Flex knee and hip to 90 degrees. Stabilize by holding the thigh with one hand and the ankle \vith the other hand. Swing the foot outward. Swing the foot inward. (Foot and thigh move in opposite directions.) normal finding?
A)Internal rotation of 40 degrees. External rotation of 45 degrees
B)Internal rotation of 30 degrees. External rotation of 45 degrees
C)Internal rotation of 15 degrees. External rotation of 30 degrees

A

AInternal rotation of 40 degrees. External rotation of 45 degrees

228
Q

Swing leg laterally, then medially, with knee straight. Stabilize pelvis by pushing down on the opposite anterior superior iliac spine. Normal finding?
A)Abduction of 40 to 50 degrees. Adduction of 10 to 30 degrees
B)Abduction of 40 to 45 degrees. Adduction of 20 to 30 degrees

A

Abduction of 40 to 45 degrees. Adduction of 20 to 30 degrees B

229
Q

When standing (later in examination), swing straight leg back behind body. Stabilize pelvis to eliminate exaggerated lumbar lordosis. The most efficient way is to ask person to bend over the table and to support the trunk on the table. Or the person can lie prone on the table. Normal finding?
A)Hyperextension of 15 degrees when stabilized.
B)Hyperextension of 20 degrees when stabilized.

A

AHyperextension of 15 degrees when stabilized.

230
Q

Flexion flattens the lumbar spine; if this reveals a flexion deformity in the opposite hip, it represents a positive Thomas test.
A)true
B)flase

A

True

231
Q

The nurse that a patient with Limited internal rotation of hip is an early and reliable sign of
A)bone disease
B)hip disease
C)both a and b

A

BLimited internal rotation of hip is an early and reliable sign of hip disease

232
Q

Limitation of abduction of the hip while supine is the most common motion dysfunction found in
A)hip disease.
B)bone disease

A

ALimitation of abduction of the hip while supine is the most common motion dysfunction found in hip disease.

233
Q

Knee

A

.

234
Q

The person should remain supine with legs extended, although some examiners prefer the knees to be flexed and dangling for inspection. The skin normally looks smooth, with even coloring and no lesions.
A) true
B)false

A

True

235
Q
Abnormalities of the Knee?
A)Lesions (e.g., psoriasis). Angulation deformity: 
B)Genu varum {bowlegs) 
C) Genu valgum (knock knees)
D)Flexion contracture 
E)all the above
A

E
Abnormalities of the Knee, p. 613). Lesions (e.g., psoriasis). Angulation deformity: • Genu varum {bowlegs) (see p. 601) • Genu valgum (knock knees) • Flexion contracture

236
Q

Genu varum
A){bowlegs)
B)(knock knees)

A

A
Abnormalities of the Knee, p. 613). Lesions (e.g., psoriasis). Angulation deformity: • Genu varum {bowlegs) (see p. 601) • Genu valgum (knock knees) • Flexion contracture

237
Q

• Genu valgum
A) (knock knees)
B) {bowlegs)

A

A
Abnormalities of the Knee, p. 613). Lesions (e.g., psoriasis). Angulation deformity: • Genu varum {bowlegs) (see p. 601) • Genu valgum (knock knees) • Flexion contracture

238
Q

Inspect the knee’s shape and contour. Normally distinct concavities, or hollows, are present on either side of the patella. Check them for any sign of fullness or swelling. Note other locations, such as the prepatellar bursa and the suprapatellar pouch, for any abnormal swelling.
A) true
B)false

A

True

239
Q

Hollows disappear; of the knee then the nursebshould know that?
A)they may bulge with synovial thickening or effusion.
B)that this is normal
C)report to the doctor

A

A

240
Q

Check the quadriceps muscle in the anterior thigh for any atrophy. Because it is the prime mover of knee extension, this muscle is important for joint stability during weight-bearing?
A)true
B)False

A

True

241
Q

Because it is the prime mover of knee extension, this muscle is important for joint stability during weight-bearing?
A)rectus femoris
B)quadriceps
C) hamstrings

A

Check the quadriceps muscle in the anterior thigh for any atrophy. Because it is the prime mover of knee extension, this muscle is important for joint stability during weight-bearing
B

242
Q

Abnormal finding of the quadriceps muscle?
A)Atrophy occurs with disuse or chronic disorders. First, it appears in the medial part of the muscle, although it is difficult to note because the vastus medialis is relatively small.
B)Atrophy occurs with disuse or acute disorders. First, it appears in the medial part of the muscle, although it is difficult to note because the vastus medialis is relatively small.

A

A
Atrophy occurs with disuse or chronic disorders. First, it appears in the medial part of the muscle, although it is difficult to note because the vastus medialis is relatively small.

243
Q

The muscles and soft tissues should feel solid, and the join t should feel smooth, with no warmth, tenderness, thickening, or nodularity.
A)true
B)flase

A

True

244
Q

The joint feels Feels fluctuant or boggy with synovitis of suprapatellar pouch.
A) true
B) false

A

True

245
Q

When swelling occurs at the knee joint,the nurse needs to distinguish whether it is due to?
A) soft tissue swelling or increased fluid in the joint.
B) vital signs

A

A

When swelling occurs, you need to distinguish whether it is due to soft tissue swe!Ung or increased fluid in the joint.

246
Q

For swelling in the suprapatellar pouch, the __________confirms the presence of small amounts of fluid as you try to move the fluid from one side of the joint to the other. Firmly stroke up on the medial aspect of the knee two or three times to displace any fluid (Fig. 22-32, A). Tap the lateral aspect (Fig. 22-32, B). Watch the medial side in the hollow for a distinct bulge from a fluid wave. Normally, none is present
A)phaglen test
B)tinel test
C)bulge Sign.

A

C
Bulge Sign. For swelling in the suprapatellar pouch, the bulge sign confirms the presence of small amounts of fluid as you try to move the fluid from one side of the joint to the other. Firmly stroke up on the medial aspect of the knee two or three times to displace any fluid (Fig. 22-32, A). Tap the lateral aspect (Fig. 22-32, B). Watch the medial side in the hollow for a distinct bulge from a fluid wave. Normally, none is present

247
Q

A positive bulge sign occurs with?
A) no amounts of effusion, 10 to 20 mL, from fluid flowing across the joint
B)very small amounts of effusion, 4 to 8 mL, from fluid flowing across the joint

A

B

The bulge sign occurs with very small amounts of effusion, 4 to 8 mL, from fluid flowing across the joint

248
Q

This test is reliable when larger amounts of fluid are present. Use your left hand to compress the suprapatellar pouch to move any fluid into the knee joint. With your right hand, push the patella sharply against the femur. If no fluid is present, the patella is already snug against the femur?
A)Ballottement of the Patella.
B)Ballottement of the knee
C)Ballottement of the knee and femur

A

A
Ballottement of the Patella. This test is reliable when larger amounts of fluid are present. Use your left hand to compress the suprapatellar pouch to move any fluid into the knee joint. With your right hand, push the patella sharply against the femur. If no fluid is present, the patella is already snug against the femur (

249
Q

Irregular bony margins occur with osteoarthritis
A)true
B)false

A

True

250
Q

Check for crepitus by holding your hand on the patella as the knee is flexed and extended. Some crepitus in an otherwise asymptomatic knee is not uncommon.
A)true
B)false

A

True

251
Q

Pronounced crepitus is significant, and it occurs with degenerative diseases of the knee.
A)true
B) false

A

True

252
Q

Instructions to Person and Motion and Expected Range of the KNEE

A

.

253
Q

Bend each knee. normal finding?
A)Flexion of 130 to 150degrees
B)Flexion of 1440 to 160degrees

A

AFlexion of 130 to 150 degrees

254
Q

Extend each knee. normal finding?
A)A straight line of 0 degrees in some persons; a hyperextension of 15 degrees in others
B)A straight line of 0 degrees in some persons; a hyperextension of 20 degrees in others

A

AA straight line of 0 degrees in some persons; a hyperextension of 15degrees in others

255
Q

Sudden locking-the person is unable to extend the knee fully. This usually occurs with a painful and audible “pop” or “click.
A)true
B)false

A

True

256
Q

Sudden buckling, or “giving way,” occurs with ligament injury, which causes weakness and instability.
A)true
B)false

A

True

257
Q

Perform this test when the person has reported a history of trauma followed by locking, giving way, or local pain in the knee. Position the person supine as you stand on the affected side. Hold the heel, and flex the knee and hip. Place your other hand on the knee with fingers on the medial side. Rotate the leg in and out to loosen the joint. Externally rotate the leg, and push a valgus (inward) stress on the knee. Then slowly extend the knee. Normally, the leg extends smoothly with no pain.
A)McMurray Test.
B)pahlegen test

A

A
McMurray Test. Perform this test when the person has reported a history of trauma followed by locking, giving way, or local pain in the knee. Position the person supine as you stand on the affected side. Hold the heel, and flex the knee and hip. Place your other hand on the knee with fingers on the medial side. Rotate the leg in and out to loosen the joint. Externally rotate the leg, and push a valgus (inward) stress on the knee. Then slowly extend the knee. Normally, the leg extends smoothly with no pain

258
Q

If you hear or feel a “click,” McMurray test is positive for a
A)torn meniscus.
B)joint disease
C)knee disese

A

A

If you hear or feel a “click,” McMurray test is positive for a tom meniscus.

259
Q

Ankle and Foot

A

.

260
Q

The foot should align with the long axis of the lower leg; an imaginary line would fall from mid patella to between the first and second toes.Most feet have a longitudinal arch, although that can vary normally from “flat feet” to a high instep
A)true
B)false

A

A

261
Q

The toes point straight forward and lie flat. The ankJes (malleoli) are smooth bony prominences. Normally, the skin is smooth, with even coloring and no lesions.
A)normal findings
B)abnormal findings

A

A normal findingss

262
Q

In hallux valgus, the distal part of the great toe is directed
A)abnormal fiinding, toward the body midline
B) abnormal finding, away from the body midline

A

B

In hallux valgus, the distal part of the great toe is directed away from the body midline

263
Q

Support the ankJe by grasping the heel with your fingers while palpating with your thumbs.They should feel smooth and depressed, with no fullness, swelling, or tenderness.
A)normal findings of the ankle and the foot
B)abnormal finding of the ankle and the foot

A

A

They should feel smooth and depressed, with no fullness, swelling, or tenderness.

264
Q

Using a pinching motion of your thumb and forefinger, the nurse can palpate the
A)interphalangeal joints on the medial and lateral sides of the toes.
B)false the nurse can not palpate

A

A

265
Q

Instructions to Person and Motion and Expected Range of the ANKLE AND FOOT

A

.

266
Q

Point toes toward the floor. normal finding?
A)Plantar flexion of 45 degrees
B)Plantar flexion of 90 degrees

A

A

267
Q

Point toes toward the nose.normal finding???
A)Dorsiflexion of 20 degrees
B)Dorsiflexion of 30 degrees

A

A

268
Q

Turn soles of feet out, then in. (Stabilize the ankle with one hand, hold heel with the other to test the subtalar joint.) normal finding?
A)Eversion of 20 degrees. Inversion of 30 degrees
B)Eversion of 10 degrees. Inversion of 20 degrees

A

A

269
Q

Flex and straighten toes. normal finding?
A)true
B)falsse

A

A

270
Q

SPINE

A

.

271
Q

Inspect and note whether the spine is straight
(1) by following an imaginary vertical line from the head through the spinous processes and down through the gluteal cleft and (2) by noting equal horizontal positions for the shoulders, scapulae, iliac crests, and gluteal folds and equal spaces between the arm and lateral thorax on the two sides (Fig. 22-41, A). The person’s knees and feet should be aligned with the trunk and should be pointing forward.
A)true
B)false

A

True

272
Q

difference in shoulder elevation and in level of scapulae and iliac crests occurs with scoliosis.
A)true
B)false

A

true

273
Q

note the normal convex thoracic curve and concave lumbar curve.
A)true
B)false

A

true

274
Q

An enhanced thoracic curve, or kyphosis, is common in aging people.
A)true
B)false

A

true

275
Q

. A pronounced lumbar curve, or lordosis, is common in obese people.
A)true
B)false

A

true

276
Q

Lateral tilting and forward bending occur with a herniated nucleus pulposus.
A)true
B)false

A

Ture

277
Q

Chronic axial skeletal pain occurs with Fibromyalgia Syndrome.
A)true
B)false

A

true

278
Q

Check ROM of the spine by asking the person to bend forward and touch the toes. Look for flexion of 75 to 90 degrees and smoothness and symmetry of movement.
A)true
B)false

A

True

279
Q

Note that the concave lumbar curve should disappear with this motion and the back should have a single convex C-shaped curve.
A)true
B)false

A

true

280
Q

If the dots fonn a slight S-shape when the person stands, a spinal curve is present.
A)true
B)false

A

true

281
Q

Instructions to Person and Motion and Expected Range of the SPINE

A

.

282
Q

Bend sideways. normal findings?
A)Lateral bending of 35 degrees
B)lateral bending of 45 degrees

A

A

283
Q

Bend backward. normaling?
A)Hyperextension of 30 degrees.
B)hyperextension of 45 degrees

A

A

284
Q

Twist shoulders To one side, then the other. normal findings?
A)Relation of 30 degrees, bilaterally
B)Relation of 40 degrees, bilaterally

A

A

285
Q

These maneuvers reproduce back and leg pain and help confirm the presence of a herniated nucleus pulposus. Straight leg raising while keeping the knee extended normally produces no pain. Raise the affected leg just short of the point where it produces pain. Then dorsiflex the foot. this test is called?
A)Straight Leg Raising or Lasegue Test.
B)tienl test

A

A

286
Q

A test that is positive if it reproduces sciatic pain. If lifting the affected leg reproduces sciatic pain, it confirms the presence of a herniated nucleus pulposus. the test called?
A)Lasegue test
B)phaglen test

A

A
Lasegue test is positive if it reproduces sciatic pain. If lifting the affected leg reproduces sciatic pain, it confirms the presence of a herniated nucleus pulposus.

287
Q

If lifting the unaffected leg reproduces sciatic pain, it strongly suggests a herniated nucleus pulposus.
A)true
B)false

A

true

288
Q

For true leg le11gth, measure between fixed points, from the anterior iliac spine to the medial malleolus, crossing the medial side of the knee (Fig. 22-45). Normally, these measurements are equal or within 1 em, indicating no true bone discrepancy.
A)true
B)false

A

true

289
Q

For nppnre111 leg length, measure from a nonfixcd point (the umbilicus) to a fixed point (medial malleolus) on each leg.
A)true
B)false

A

true

290
Q

True leg lengths are equal, but apparent leg lengths unequal-this condition occurs with pelvic obliquity or adduction or flexion deformity in the hip.
A)abnormal finding
B)normal finding

A

normal finding A

291
Q

DEVELOPMENTAL COMPETENCE

A

.

292
Q

Infants

A

.

293
Q

Start with the feet and work your way up the extremities.
A)true
B)false

A

true

294
Q

Often the newborn’s feet are not held straight but, instead, in a varus (apart) or valgus (together) position. It is important to distinguish whether this position is flexible (and thus usually self-correctable) or fixed.
A)true
B)false

A

true

295
Q

A true deformity is fixed and assumes a right angle only with forced manipulation or not at all.
A)abnormal findings
B)normal findings

A

A abnormal normal findings

296
Q

Commonly, the hindfoot is in alignment with the lower leg and just the forefoot angles inward. This forefoot adduction is metatarsus ndductus. It is usually present at birth and usually resolves spontaneously by age 3 years.
A)true
B)false

A

true

297
Q

Metatarsus varus
A)adduction and inversion of forefoot.
B)abduction and eversion of forefoot

A

A

298
Q

Check for tibial torsion, a twisting of the tibia. Place both feet flat on the table, . and push to flex up the knees. With the patella and the tibial tubercle in a straight line, place your fingers on the malleoli. In an infant, note that a line connecting the four malleoli is parallel to the table.
A)true
B)false

A

true

299
Q

More than 20 degrees of deviation; or if lateral malleolus is anterior to medial malleolus, it indicates tibial torsion.
A)true
B)false

A

trrue

300
Q

Tibial torsion may originate from intrauterine positioning and then may be exacerbated at a later age by continuous sitting in a reverse tailor position, the “TV squat”
A)true
B)false

A

true

301
Q

which should be done at every professional visit until the infant is l year old. With the infant supine, flex the knees holding your thumbs on the inner mid-thighs and your fingers outside on the hips touching the greater trochanters. Adduct the legs until your thumbs touch (Fig. 22-46, A). Then gently Lift and abduct, moving the knees apart and down so their lateral aspects touch the table (Fig. 22-46, B). This normally feels smooth and has no sound.
A)Ortolani maneuver,
B)phaglen test

A

A

302
Q

With a dislocated hip, the head of the femur is not cupped in the acetabulum but rests posterior to it. Hip instability feels like a clunk as the head of the femur pops back into place. This is a positive Ortolani sign and warrants referral.
A)Ortolani maneuver,
B)tienl test

A

A

303
Q

The Allis test also is used to check for hip dislocation by comparing leg lengths (Fig. 22-47). Place the baby’s feet flat on the table and flex the knees up. Scan the tops of the knees; normally, they are at the same elevation.
A)true
B)false

A

true

304
Q

is used to check for hip dislocation by comparing leg lengths (Fig. 22-47). Place the baby’s feet flat on the table and flex the knees up. Scan the tops of the knees; normally, they are at the same elevation.
A)The Allis test
B)Phaglen test

A

AThe Allis test also is used to check for hip dislocation by comparing leg lengths (Fig. 22-47). Place the baby’s feet flat on the table and flex the knees up. Scan the tops of the knees; normally, they are at the same elevation.

305
Q

Finding one knee significantly lower than the other is a positive indication of Allis’ sign and suggests hip dislocation.
A)true
B)false

A

A

306
Q

Unequal gluteal folds may accompany hip dislocation after 2 to 3 months of age
A)true
B)false

A

trrue

307
Q

Polydactyly is the presence of extra fingers or toes.
Syndactyly is webbing between adjacent fingers or toes
A)true
B)false

A

true

308
Q

_____________ is a single palmar crease that occurs with Down syndrome, accompanied by short broad fingers, incurving of little fingers, and low-set thumbs.
A)down syndrome
B)simian crease
C)none

A

BA simian crease is a single palmar crease that occurs with Down syndrome, accompanied by short broad fingers, incurving of little fingers, and low-set thumbs.

309
Q

Palpate the length of the clavicles because the clavicle is the bone most frequently fractured during birth. The clavicles should feel smooth, regular, and without crepitus. Also note equal ROM of arms during Moro’s reflex.
A)true
B)false

A

A true Palpate the length of the clavicles because the clavicle is the bone most frequently fractured during birth. The clavicles should feel smooth, regular, and without crepitus. Also note equal ROM of arms during Moro’s reflex.

310
Q
what bone is most fractured during brith?
A)clavicle
B)hip bone
C)fingers and toes
D) shoulder
A

clavicle A

311
Q

Abnormal findings will include?
A)Fractured clavicle: Note irregularity at the fracture site, crepitus, and angulation.The site has rapid callus formation with a palpable lump within a few weeks. Observe limited arm ROM and unilateral response to More’s reflex.
B)hydraated

A

A

312
Q

Note the normal single Ccurve of the newborn’s spine.
A)true
B)false

A

true

313
Q

2 months of age, the infant can lift the head while prone. This builds the concave cervical spinal curve and indicates normal forearm strength.
A)true
B)false

A

true

314
Q

A tuft of hair over a dimple in the midline may indicate
A)incision
B)spina bifida
C)scoliosis

A

B

A tuft of hair over a dimple in the midline may indicate spina bifida

315
Q

small dimple in the midline anywhere from the head to the coccyx suggests
A)dermoid sinus.
B)spina bifida

A

A

316
Q

A baby with normal muscle strength wedges securely between your hands.
A)true
B)false

A

true

317
Q

A baby starts to slip between your hands shows weakness of the shoulder muslce?
A)true
B)false

A

true

318
Q

Preschool-Age and School-Age Children -

A

.

319
Q

Lordosis is marked with
A)muscular dystrophy and rickets.
B)heart pain
C)both a and b

A

Lordosis is marked with muscular dystrophy and rickets.

A

320
Q

A “bowlegged” stance (genu varum) is a lateral bowing of the legs (Fig. 22-50, A). It is present when you measure a persistent space of more than 2.5 em between the knees when the medial malleoli are together. Genu varum is normal for 1 year after the child begins walking. The child may walk with a waddling gait. This resolves with growth; no treatment is indicated
A)true
B)false

A

true

321
Q

Severe bowing or unilateral bowing also occurs with?
A) rickets.
B)hypokalemia.
C)both a and b

A

A

322
Q

Knock knees” (genu valgum) are present when there is more than 2.5 cm between the medial malleoli when the knees are together (Fig. 22-50, 8). It occurs normally between 2 and 3 and a half years of age. Also, treatment is not indicated.
A)true
B)false

A

true

323
Q
Genu valgum also occurs with 
A)rickets.
B)poliomyelitis.
C) syphilis. 
D)all the above
A

D

324
Q

Flatfoot (pes planus) is pronation, or turning in, of the medial side of the foot. The young child may look flatfooted because the normal longitudinal arch is concealed by a fat pad until age 3 years. When standing begins, the child takes a broad-based stance, which causes pronation. Thus pronation is common between 12 and 30 months. You can see it best from behind the child, where the medial side of the foot drops down and in.
A)true
B)false

A

true

325
Q
Flatfoot (pes planus) is pronation, or turning in, of the medial side of the foot. The young child may look flatfooted because the normal longitudinal arch is concealed by a fat pad until age 3 years. When standing begins, the child takes a broad-based stance, which causes pronation. Thus pronation is common between 12 and 30 months. You can see it best from behind the child, where the medial side of the foot drops down and in. but an abonormal finding would be?
A)Pronation beyond 30 months
B)Pronation beyond 15 months
C)Pronation beyond 18 months
D)Pronation beyond 20 months
A

A

326
Q

Pigeon toes, or toeing in, are demonstrated when the child tends to walk on the lateral side of the foot, and the longitudinal arch looks higher than normal. It often starts as a forefoot adduction, which usually corrects spontaneously by age 3 years, as long as the foot is flexible.
A)true
B)false

A

true

327
Q

Toeing in from forefoot adduction that is fixed, or lasts beyond age 3 years.
A)pigeon toe
B)bird toed

A

A

328
Q

From 1 to 2 years of age, expect a broad-based gait, with arms out for balance. Weight bearing falls on the inside of the foot.
A)true
B)false

A

true

329
Q

From 3 years of age, the base narrows and the arms are closer to the sides. Inspect the shoes for spots of greatest wear to aid your judgment of the gait. Normally, the shoes wear more on the outside of the heel and the inside of the toe.
A)true
B)false

A

true

330
Q
Limp, usually caused by 
A)trauma
B)fatigue
C)hip disease
D)all the above
A

D

331
Q

to screen progressive subluxation of the hip. Watching from behind, ask the child to stand on one leg, then the other (Fig. 22-Sl,A). Watch the buttocks and iliac crests; they should stay level when weight is shifted. Remember that you are testing the side that is bearing weight.
A)Check the Trendelenburg sign
B)Check the phaglen sign
C)both a and B

A

A
Check the Trendelenburg sign to screen progressive subluxation of the hip. Watching from behind, ask the child to stand on one leg, then the other (Fig. 22-Sl,A). Watch the buttocks and iliac crests; they should stay level when weight is shifted. Remember that you are testing the side that is bearing weight.

332
Q

severe subluxation of one hip. When the child stands on the good leg, the pelvis looks level. When the child stands on the affected leg, the pelvis drops toward the “good” side and the opposite buttock falls. The hip abductors on the standing side are too weak to hold the pelvis level. the test will be positive what is the test called?
A)Trendelenburg sign
B) the test is not postive

A

A

333
Q

Start with the feet and hands of the child from 2 to 6 years of age because the child is happy to show these off, and proceed through the examination described earlier.
A)True
B)False

A

TRUE

334
Q

Inability to supinate the hand while the arm is flexed, together with pain in elbow, indicates subluxation of the head of the radius.
A)true
b)false

A

A

335
Q

Pain or tenderness in extremities is usually caused by trauma or infection.
A)false
B)true

A

B true

336
Q

Fractures are usually due to trauma and are exhibited as an inability to use the area, a deformity, or an excess motion in the involved bone with pain and crepitation.
A)true
B)false

A

True

337
Q
Enlargement of the tibial tubercles with tenderness suggests
A) Osgood-Schlatter disease 
B)hypertibal tubercles disease
C)macrotibal diseas
D)all  the above
E)both a and b
A

A

338
Q

Adolescents

A

.

339
Q

Kyphosis is common during adolescence because of chronic poor posture. Be aware of the risk for sports-related injuries with the adolescent, because sports participation and competition often peak with this age-group
A)ture
B)false

A

true

340
Q

Scoliosis is most apparent during the preadolescent growth spurt. Asymmetry suggests scoliosis-ribs hump up on one side as child bends forward, and with unequal landmark elevation
A)true
B)flase

A

true

341
Q

The Pregnant Woman

A

.

342
Q

Expected postural changes in pregnancy include progressive lordosis and, toward the third trimester, anterior cervical flexion, kyphosis, and slumped shoulders.
A)pregnant woman
B)adolescents

A

A

343
Q

When the pregnancy is at term, the protuberant abdomen and the relaxed mobility in the joints create the characteristic “waddling” gait
A)true
B)false

A

true

344
Q

The Aging Adult

A

.

345
Q

Postural changes include a decrease in height, more apparent in the eighth and ninth decades
A)the aging adult
B)Pregnant women

A

a

346
Q

Lengthening of the arm-trunk axis” describes this shortening of the trunk with comparatively long extremities.
A)the aging adult
B)young adult
C)pregnant woman

A

A

347
Q

Kyphosis is common, with a backward head tilt to compensate. This creates the outline of a figure 3 when you view this older adult from the left side. Slight flexion of hips and knees is also common.
A)the aging adult
B)the pregnant woman
C)young aadut

A

A

348
Q

Contour changes include a decrease of fat in the body periphery and fat deposition over the abdomen and hips. The bony prominences become more marked.
A)the pregnant women
B)the aging adult
C)young adult

A

B

349
Q

ROM and muscle strength are much the same as with the younger adult, provided no musculoskeletal illnesses or arthritic changes are present.
A)true
B)false

A

true

350
Q

For those with advanced aging changes, arthritic changes, or musculoskeletal disability, perform a
A)functional assessment for ADLs.
B)complete assessment for ADLs.

A

A

351
Q

Instructions to Person and Common Adaptation for Aging Changes of the aging adult

A

.

352
Q

Walk (with shoes on) ?
A)Shuffling pattern; swaying; arms out to help balance; broader base of support; person may watch feet.
B)false

A

A

353
Q

Climb up stairs.
A)Person holds hand rail; may haul body up with it; may lead with favored (stronger) leg
B)false

A

A

354
Q

Walk down stairs.
A)Holds hand rail, sometimes with both hands.
B) If the person is weak, he or she may descend sideways, lowering the weaker leg first. If the person is unsteady, he or she may watch feet
C)both a and b

A

C

355
Q

Pick up object from floor.
A)Person often bends at waist instead of bending knees; holds furniture to support while bending and straightening.
B)false

A

A

356
Q

Rise up from sitting in chair
A)Person uses arms to push off chair arms, upper trunk leans forward before body straightens, feet planted wide in broad base of support
B)none

A

.

357
Q

Rise up from lying in bed
A)May roll to one side, push with arms to lift up torso, grab bedside table to increase leverage.
B)jump up

A

A

358
Q

PROMOTING A HEAL THY LIFESTYLE: PREVENTING OSTEOPOROSIS Don’t Overlook Osteoporosis!

A

.

359
Q

Five Steps to Bone Health and Osteoporosis Prevention
A)diet,exercise, lifestyle,medical options and supplements
B)diet, exercise, mental health, socialecomnomics, friends

A

A

360
Q

a. Drink milk. Low-fat and skim milk, nonfat yogurt, and reduced-fat cheese are healthy sources of calcium. Fortified milk products also contain vitamin D, which is needed to absorb calcium.
b. Go fish. Canned salmon and sardines that are packed with their bones are also rich in calcium. Further, oily fish such as mackerel is rich in vitamin D.
c. Eat greens with gusto. Leafy green vegetables have a lot of calcium. Rll up on broccoli, kale, Swiss chard, turnip greens, and bok choy. In addition to the calcium, you will also get the benefits of potassium and vitamin K, which help block calcium loss from bones.
d. Try soy. Soy contains calcium and plant estrogens. Try substituting soy flour for regular flour in recipes, nibbling on soybean “nuts,” or drinking soy milk.
e. Limit caffeine. Caffeine causes the body to excrete calcium more readily. Caffeine is in coffee, tea, hot chocolate, and many sodas.
f. Eat onions. Although onions are not known to have any nutritive value, they appear to reduce the bone breakdown process that can lead to osteoporosis.

A

diet

361
Q

About 15 minutes of sunshine a day is all that is needed to maintain a good vitamin D supply.

A)true
B)false

A

true

362
Q

Avoid smoking and excessive alcohol, and seek help for depression. Smokers have twice the risk for spinal and hip fractures
a)true
B)false

A

true

363
Q

fractures heal slower in smokers and are more apt to heal improperly. Too much alcohol prevents your body from absorbing calcium
A)true
B)false

A

A

364
Q

loss of 1 to 2 inches is an early sign of undiagnosed vertebral fractures and osteoporosis.
A)true
B)false

A

True

365
Q
Also, remember that other medications may contribute to bone loss. These medications include 
A)corticosteroids
B)anticoagulants, thyroid supplements
C)certain anticonvulsants.
D)all the above
A

D

366
Q

19 to 50 years: 1000 mg calcium; 200 IU vitamin D
51 to 70 years: 1200 mg calcium; 400 IU vitamin D
Older than 70 years: 1200 mg calcium; 600 IU vitamin D

A

supplements normss

367
Q

Abnormalities Affecting Multiple Joints

A

.

368
Q

This is a chronic, systemic inflammatory disease of joints and surrounding connective tissue. Inflammation of synovial membrane leads to thickening; then to fibrosis, which limits motion; and finally to bony ankylosis. The disorder is symmetric and bilateral and is characterized by heat, redness, swelling, and painful motion of the affected joints. Is associated with fatigue, weakness, anorexia, weight loss, low grade fever, and lymphadenopathy.
A)Rheumatoid Arthritis (RA)
B)Osteoarthritis (Degenerative Joint Disease)
C)Ankylosing Spondylitis

A

A

369
Q

Chronic, progressive inflammation of spine, sacroiliac, and larger joints of the extremities, leading to bony ankylosis and deformity. A form of RA, this affects primarily men by a 10: l ratio, in late adolescence or early adulthood. Spasm of paraspinal muscles pulls spine into forward flexion, obliterating cervical and lumbar curves. Thoracic curve exaggerated into single kyphotic rounding. Also includes AeKion deformities of hips and knees.
A)Rheumatoid Arthritis (RA)
B)Osteoarthritis (Degenerative Joint Disease)
C)Ankylosing Spondylitis

A

C

370
Q

Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone (osteophytes) at joint surfaces. Aging increases incidence; nearly all adults older than 60 years have some radiographic signs of osteoarthritis. Asymmetric joint involvement commonly affects hands, knees, hjps, and lumbar and cervical segments of the spine. Affected joints have stiffness, swelling with hard, bony protuberances, pain with motion, and limitation of motion
A)Osteoporosis
B)Osteoarthritis (Degenerative Joint Disease)
C)Rheumatoid Arthritis (RA)

A

B

371
Q

Decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation. The weakened bone state increases risk for stress fractures, especially at wrist, hip, and vertebrae. Occurs primarily in postmenopausal white women. Osteoporosis risk also is associated with smaller height and weight, younger age at menopause, lack of physical activity, and lack of estrogen in women.
A)Osteoporosis
B)Osteoarthritis (Degenerative Joint Disease)
C)Rheumatoid Arthritis (RA)

A

A

372
Q

Abnormalities of the Shoulder

A

.

373
Q

Loss of muscle mass is exhibited as a lack of fuUness surrounding the deltoid muscle. also occurs from disuse, muscle tissue damage, or motor nerve damage.
A)Atrophy
B) Dislocated Shoulder
C)Joint Effusion

A

A

374
Q

Swelling from excess fluid in the joint capsule, here from rheumatoid arthritis. Best observed anteriorly. Fluctuant to palpation. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose.
A)Atrophy
B)Dislocated Shoulder
C)Joint Effusion

A

C

375
Q

Anterior dislocation (95%) is exhibited when hunching the shoulder forward and the tip of the clavicle dislocates. It occurs with trauma involving abduction, extension, and rotation (e.g., falling on an outstretched arm or diving into a pool)
A)Atrophy
B)Dislocated Shoulder
C)Joint Effusion

A

B

376
Q

Characteristic “hunched” position and limited abduction of arm. Occurs from traumatic adduction while arm is held in abduction, or from fall on shoulder, throwing, or heavy lifting. Positive drop arm test: if the arm is passively abducted at the shoulder, the person is unable to sustain the position and the arm falls to the side
A)Tear of Rotator Cuff
B)Subacromial Bursitis
C)Frozen Shoulder-Adhesive Capsulitis

A

A

377
Q

Inflammation and swelling of subacromial bursa over the shoulder cause limited ROM and pain with motion. Localized swelling under deltoid muscle may increase by partial passive abduction of the arm. Caused by direct trauma, strain during sports, local or systemic inflammatory process, or repetitive motion with injury.
A)Tear of Rotator Cuff
B)Frozen Shoulder-Adhesive Capsulitis
C)Subacromial Bursitis

A

C

378
Q

Fibrous tissues form in the joint capsule, causing stiffness, progressive limitation of motion, and pain. Motion limited in abduction and external rotation; unable to reach overhead. It may lead to atrophy of shoulder girdle muscles. Gradual onset; unknown cause. It is associated with prolonged bedrest or shoulder immobiJity. May resolve spontaneously.
A)Tear of Rotator Cuff
B)Frozen Shoulder-Adhesive Capsulitis
C)Subacromial Bursitis

A

B

379
Q

Abnormalities of the Elbow

A

.

380
Q

Large, soft knob, or “goose egg,” and redness from inflammation of olecranon bursa. Localized and easy to see because bursa Lies just under skin.
A)Olecranon Bursitis
B)Gouty Arthritis
C)Subcutaneous Nodules

A

A

381
Q

Joint effusion or synovial thickening, seen first as bulge or fullness in grooves on either side of olecranon process. Redness and heat can extend beyond area of synovial membrane. Soft, boggy, or fluctuant fullness to palpation. Limited extension of elbow.
A)Gouty Arthritis
B)Epicondylitis-Tennis Elbow
C)Subcutaneous Nodules

A

A

382
Q

Raised, firm, no tender nodules that occur with rheumatoid arthritis. Common sites are in the olecranon bursa and along extensor surface of Arm. The skin slides freely over the nodules.
A)Subcutaneous Nodules
B)Epicondylitis-Tennis Elbow

A

A

383
Q

Chronic disabling pain at lateral epicondyle of humerus, radiates down extensor surface of forearm. Pain can be located with one finger. Resisting extension of the hand will increase the pain. Occurs with activities combining excessive pronation and supination of forearm with an extended wrist (e.g., racquet sports or using a screwdriver)
A)Subcutaneous Nodules
B)Epicondylitis-Tennis Elbow

A

B

384
Q

Medial epicondylitis is rarer and is due to activity of forced palmar flexion of wrist against resistance.
A)true
B)false

A

True

385
Q

cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist. Flexion makes it more prominent. A common benign tumor; it does not become malignant.
A)Ganglion Cyst Round,
B)Ankylosis

A

A

386
Q

Wrist in extreme flexion, due to severe rheumatoid arthritis. This is a functionally useless hand because when the wrist is palmar flexed, a good deal of power is lost from the fingers and the thumb cannot oppose the fingers.
A)Ganglion Cyst Round,
B) Ankylosis

A

B

387
Q

Nonarticular fracture of distal radius, with or without fracture of ulna at styloid process. Usually from a fall on an outstretched hand; occurs more often in older women. Wrist looks puffy with “silver fork” deformity, a characteristic hump when viewed from the side.
A)Colles Fracture
B)Carpal Tunnel Syndrome

A

A

388
Q

Atrophy occurs from interference with motor function from compression of the median nerve inside the carpal tunnel. Caused by chronic repetitive motion; occurs between 30 and 60 years of age and is five times more common in women than in men. Symptoms of carpal tunnel syndrome include pain, burning and numbness, positive findings on Phalen test, positive indication of Tine! sign, and often atrophy of thenar muscles
A)Colles Fracture
B)Carpal Tunnel Syndrome with Atrophy of Thenar Eminence

A

B

389
Q

Chronic hyperplasia of the palmar fascia causes flexion contractures of the digits, first in the 4th digit, then the 5th digit, then the 3rd digit. Note the bands that extend from the mid palm to the digits and the puckering of palmar skin. The condition occurs commonly in men older than 40 years and is usually bilateral. It occurs with diabetes, epilepsy, and alcoholic liver disease and as an inherited trait. The contracture Is painless but impairs hand function.
A)Dupuytren Contracture
B)hyperplasia

A

A

390
Q

Abnormalities of the Wrist and Hand-cont’d CONDITIONS CAUSED BY CHRONIC RHEUMATOID ARTHRITIS

A

.

391
Q

Flexion contracture resembles curve of a swan’s neck- Note flexion contracture of metacarpophalangeal joint, then hyperextension of the proximal interphalangeal joint, and flex.ion of the distal interphalangeal joint. It occurs with chronic rheumatoid arthritis and is often accompanied by ulnar drift of the fingers
A)Swan-Neck
B)Boutonniere Deformity

A

A

392
Q

the knuckle looks as if it is being pushed through a buttonhole. It is a relatively common deformity and includes flexion of proximal interphalangeal joint with compensatory hyperextension of distal interphalangeal joint.
A)Swan-Neck
B)Boutonniere Deformity

A

B

393
Q

Osteoarthritis is characterized by hard, non tender nodules, 2 to 3 mm or more. These osteophytes (bony overgrowths) of the distal interphalangeal joints are called Heberde11 11ories, and those of the proximal interphalangeal joints are called Bouchard 11odes.
A)Degenerative Joint Disease, or Osteoarthritis
B)Ulnar Deviation

A

A

394
Q

Drift Fingers drift to the ulnar side because of stretching of the articular capsule and muscle imbalance. Also note subluxation and swelling in the joints and muscle atrophy on the dorsa of the hands. This is caused by chronic rheumatoid arthritis.
A)Ulnar Deviation
B)Acute Rheumatoid Arthritis

A

A

395
Q

Painful swelling and stiffness of joints, with fusiform or spindle-shaped swelling of the soft tissue of proximal interphalangeal joints. Fusiform swelling is usua!Jy symmetric, the hands are warm, and the veins arc engorged. The inflamed joints have a limited range of motion.
A)Acute Rheumatoid Arthritis
B)joint effusion
C)Arthritis

A

A

396
Q

Extra digits are a congenital deformity, usually occurring at the fifth finger or the thumb. Surgical removal is considered for cosmetic appearance. The 6th finger shown here was not removed because it had full ROM and sensation and a normal appearance.
A)Polydactyly
B)Syndactyly

A

A

397
Q

Webbed fingers are a congenital deformity, usually requiring surgical separation. The metacarpals and phalanges of the webbed fingers are different lengths, and the joints do not line up. To leave the fingers fused would thus limit their flexion and extension.
A)Syndactyly
B)polydactyl

A

A

398
Q

Abnormalities of the Knee

A

.

399
Q

Localized soft swelling from cyst in lateral meniscus shows at the midpoint of the anterolateral joint line. Semiflexion of the knee makes swelling more prominent.
A)Swelling of Menisci
B)arthalgia

A

A

400
Q

Loss of normal hollows on either side of the patella, which are replaced by mild distention. Occurs with synovial thickening or effusion (excess Auid). Also note mild distention of the suprapatellar pouch.
A)Mild Synovitis
B)Prepatellar Bursitis

A

A

401
Q

Localized swelling on anterior knee between patella and skin. A tender, fluctuant mass indicates swelling; in some cases, infection spreads to surrounding soft tissue. The condition is limited to the bursa, and the knee joint itself is not involved. Overlying skin may be red, shiny, atrophic, or coarse and thickened.
A)Osgood-Schlatter Disease
B)Prepatellar Bursitis

A

B

402
Q

Painful swelling of the tibial tubercle just below the knee, probably from repeated stress on the patellar tendon. Occurs most in puberty during rapid growth and most often in males. Pain increases with kicking, running, bike riding, stair climbing, or kneeling. The condition is usually self-limited, and symptoms resolve with rest
A)Osgood-Schlatter Disease
B)Post Polio

A

A

403
Q

Right leg and foot muscle atrophy as a result of childhood polio. Poliomyelitis epidemics peaked in the United States in the 1940s and 1950s. The development of the oral polio vaccine (1962) has almost eradicated the disease. However, thousands of polio survivors have this muscle atrophy.
A)Post Polio Muscle Atrophy
B)Achilles Tenosynovitis

A

A

404
Q

Abnormalities of the Ankle and Foot

A

.

405
Q

Inflammation of a tendon sheath near the ankle (here, the Achilles tendon) produces a superficial linear swelling and a localized tenderness along the route of the sheath. Movement of the involved tendon usually causes pain.
A)Achilles Tenosynovitis
B)Tophi with Chronic Gout Hard,

A

A

406
Q

Hard, painless nodule (tophi) over metatarsophalangeal joint of first toe. Tophi are collections of sodium urate crystals due to chronic gout in and around the joint that cause extreme swelling and joint deformity. They sometimes burst with a chalky discharge.
A)Tophi with Chronic Gout
B)acute gout

A

A

407
Q

Acute episode of gout usually involves first the metatarsophalangeal joint. Clinical fi ndings consist of redness, swelling, heat, and extreme tenderness. Gout is a metabolic disorder of disturbed purine metabolism, associated with elevated serum uric acid. It occurs primarily in men older than 40 years
A)Callus
B)Acute Gout

A

B

408
Q

Hypertrophy of the epithelium develops because of prolonged pressure, conunonly on the plantar surface of the first metatarsal head in the haUux valgus deformity or as shown here over the bony prominences of the joints in hammertoes. The condition is not painful
A)Callus
B)Ingrown Toenail

A

A

409
Q

A misnomer; the nail does not grow in, but the soft tissue grows over the nail and obliterates the groove. It occurs almost always on the great toe on the medial or lateral side. It is due to trimming the nail too short or toe-crowding in tight shoes. The area becomes infected when the nail grows and its corner penetrates the soft tissue.
A)Ingrown Toenail
B)Plantar Wart

A

A

410
Q

Vascular papillomatous growth is probably due to a virus and occurs on the sole of the foot, commonly at the ball. The condition is extremely painful.
A)Plantar Wart
B)ingrown toenail

A

A

411
Q

is a common deformity from rheumatoid arthritis. It is a lateral or outward deviation of the great toe with medial prominence of the head of the first metatarsal.
A)bunion
B)Hallux valgus

A

B

412
Q

is the inflamed bursa that forms at the pressure point. The great toe loses power to push off while walki11g; this stresses the second and third metatarsal heads, and they develop calluses and pain. Chronic sequelae include corns, calluses, hammertoes, and joint subluxation
A)bunion
B)Claus

A

A

413
Q

deformities in the 2nd, 3rd, 4Th, and 5th toes. Often associated with hailux valgus, hammertoe includes hyperextension of the metatarsophalangeal joint and flexion of the proximal interphalangeal joint.
A)hammertoe
B)bunion

A

A

414
Q

(thickening of soft tissue) develop on the dorsum over the bony prominence from prolonged pressure from shoes.
A)corns
B)bunion

A

A

415
Q

Abnormalities of the Spine

A

.

416
Q

Scoliosis
A)Lateral curvature of thoracic and lumbar segments of the spine, usually with some rotation of involved vertebral bodies
B)none

A

A

417
Q

scoliosis is flexible; it is apparent with standing and disappears with forward bending. lt may be compensatory for other abnormalities such as leg length discrepancy
A)functional
B)structural

A

A

418
Q

scoliosis is fixed; the curvature shows both on standing and on bending forward. Note rib hump with forward flexion. When the person is standing, note unequal shoulder elevation, unequal scapulae, obvious curvature, and unequal hip level. At greatest risk are females 10 years of age through adolescence, during the peak of the growth spurt.
A)Structural
B)functional

A

A

419
Q

The nucleus pulposus (at the center of the intervertebral disk) ruptures into the spinal canal and puts pressure on the local spinal nerve root. Usually occurs from stress, such as lifting, twisting, continuous flexion with lifting, or fall on buttocks. Occurs mostly in men 20 to 45 years of age. Lumbar herniations occur mainly in interspaces L4 to LS and LS to S I. Note: Sciatic pain, numbness, and paresthesia of involved dermatome; listing away from affected side; decreased mobility; low back tenderness; and decreased motor and sensory function in leg. Straight leg raising tests reproduce sciatic pain.
A)Herniated Nucleus Pulposus
B)scoliosis

A

A

420
Q

Common Congenital or Pediatric Abnormalities

A

.

421
Q

Head of the femur is displaced out of the cup-shaped acetabulum. The degree of the condition varies; subluxation may occur as stretched ligaments allow partial displacement of femoral head, and acetabular dysplasia may develop because of excessive laxity of hip joint capsule. Occurrence is I: 500 to 1: 1000 births; common in girls by 7: I ratio. Signs include limited abduction of flexed thigh, positive indications of Ortolani and Barlow signs, asymmetric s!Un creases or gluteal folds, limb length discrepancy, and positive indication of Trendelenburg sign in older children.
A)Congenital Dislocated Hip
B)Talipes Equinovarus (Clubfoot) Congenital,

A

A

422
Q

Talipes Equinovarus
A) (Clubfoot)
B) pigeon toe

A

A

423
Q

) Congenital, rigid, and fixed malposition of foot, including ( 1) inversion, (2) forefoot adduction, and (3) fool pointing downward (equinus). A common birth defect, with an incidence of I : 1000 to 3: 1000 live births. Males are affected twice as frequently as females.
A)Talipes Equinovarus (Clubfoot)
B)Spina Bifida

A

A

424
Q

Incomplete closure of posterior part of vertebrae results in a neural tube defect. Seriousness varies from skin defect along the spine to protrusion of the sac containing meninges, spinal fluid, or malformed spinal cord. The most serious type is myelomeningocele (shown here), in which the meninges and neural tissue protrude. In these cases, the child is usually paralyzed below the level of the lesion.
A)Spina Bifida
B)Coxa Plana (Legg-Calve-Perthes Syndrome) )

A

A

425
Q

Avascular necrosis of the femoral head, occurring primarily in males between 3 and 12 years of age, with peak at age 6 years. In initial inflammatory stage, interruption of blood supply to femoral epiphysis occurs, halting growth. Revascularization and healing occur later, but significant residual deformity and dysfunction may be present.
A)Coxa Plana (Legg-Calve-Perthes Syndrome)
B)Fibromyalgia Syndrome

A

A

426
Q

Fibromyalgia Syndrome

A

.

427
Q

Chronic disorder of unknown cause characterized by widespread musculoskeletal pain lasting 3 months or longer, associated with fatigue, insomnia, and psychosocial distress. Most patients (90%) are adult women. There are two major diagnostic criteria30: (1) pain on both sides of the body, above and below the waist, and axial skeletal pain (cervical, thoracic, lumbar spine, or anterior chest); and (2) point tenderness on digital palpation in 11 of 18 specified sites shown above. The examiner presses the thumb of the dominant hand with a force of 4 kg (same as needed to blanch or whiten the nail bed). Burden of illness is high with one third to one fourth of patients receiving disability compensation.
A)Fibromyalgia Syndrome
B)myalgia

A

A

428
Q
Lower cervical 
Second rib
Lateral epicondyle 
Supraspinatus 
Greater trochanter 
Knee
Occipital 
Trapezius 
Gluteal
These are all ?
A)LOCATION OF TENDER POINTS 
B) ARE NOT LOCATION OF TENDER POINTS
A

A

429
Q
Summary Checklist: Musculoskeletal Examination 
For each joint to be examined: 
I. Inspection 
 Size and contour of joint 
 Skin color and characteristics 
2. Palpation of joint area 
 Skin 
 Muscles 
 Bony articulations 
Joint capsule 
 3. ROM 
  Active 
  Passive (if limitation in active ROM is present) 
Measure with goniometer (if abnormality in ROM is present)
 4. Muscle testing
A

True

430
Q

EXTRA INFORAMTION

A

.

431
Q

support and movement primary function
A)musculoskeletal system
B)neurological system

A

A

432
Q

bone and cartilage are
A)connective tissue
B)muscles

A

A

433
Q
function uint of the musculoskeletal  system is the
A) joint
B)muscle
A

A

434
Q

voluntary muscles are also callled
A)skeletal muscles
B)smooth muscle

A

A

435
Q

growth surpts happen at adolescents age
A)true
B)false

A

A

436
Q

bone lengthinng occurs at the epiphysis or growth plates
A)true
B)false

A

A

437
Q

the most charccteristic postural change in pregenccy is progressive
A) lordosis
B)kyphosis

A

A

438
Q

at age 40 you start losing bone mass
A)true
B)false

A

A

439
Q

tmj maain focus is to assess
A) lateral and vertical
B)tmj

A

A

440
Q

cervical spine main focus is to assess
A) flexion extension lateraal bending and rotation
B) forwordd flexion hyperextension internal rotation abduction adduction

A

A

441
Q

shoulders main funtion is to asess for
A)forward flexion hyperextension internal rotationn abduction adduction
B)false

A

A

442
Q

elbow main focus is to asses?
A)flexion extensiion pronation and supination
B)false

A

A

443
Q

wrist and hands main focus is to assess
A)extension and flexionn and hyperexxtensionn and flexion unlar devation and radial deviation,adduction
B)false

A

A

444
Q

to detect carpal tunnel syndrome perform what test?
A)Phalens test and asess tinel sign percusssion on the wrist
B)false

A

A

445
Q

in hips main focus is to assess
A) flexion extesion internal and external rotaation abductioon aand adduction
B) false

A

A

446
Q

knees main focus is to assess
A)flexion and extension
B)hyperextension

A

A

447
Q

perform mcmurrays test for possible
A) meniscus tears
B)joint tears

A

A

448
Q

ankeles and feet focus is assessing
A) plantar flexion and Dorsiflexion and inversion and eversion
B flexion extension lateral bending

A

A

449
Q

Spine main focus is assessing
A) flexion, extension, lateral bendding and rotation
B)none

A

A

450
Q

test patient on the lesegues test
A)which you have patient supine, then rise the leg and if lower back pain occurs then patient most likey have nucleus pulposus
B) false

A

A

451
Q

oestoprosis is common in
A)women
B)European descent
C) both a and b

A

C

452
Q

is hard, rigid, and very dense. Its cells are continually turning over and remodeling.
A)bone
B)cartilage
C)joint

A

A

453
Q

The ______(or articulation) is the place of union of two or more bones.
A)bone
B)joint
C)cartilage

A

B

454
Q
In which of the following ethnic groups has the lowest incidence of osteoporosis?
A)African Americans
B)Whites
C)Asians
D)Native Americans
A

A

455
Q

Heberden and bouchard nodes are hard and non-tender and are associated with
A)osteoarthritis
B)rheumatoid arthritis
C)both a and b

A

A

456
Q

when testing for muscle strength the examiner should
A)observe muscles for the degree of contraction when the individual lifts a heavy object
B)apply an opposing force when the individual puts a joint in flexion or extension
C)measure the degree of force that takes to overcome joint flexion or extension
D)all the above

A

B

457
Q
the knee joint is in articulation with what three bones?
A)femur tibia fibula
B)femur tibia patella
C)femur fibula tibia
D)femur fibula patella
A

B

458
Q

when assessing for the presence of a herniated nucleus pulposus, the examiner
A)raise each of the patients legs straight while keeping the knee extended
B)instruct the patient to bend and touch the floor
C)have the patient perform lateral flexon

A

A

459
Q

crepitaton is an audible sound that is produced by?
A)roughened articular surfaces moving over each other
B)tendons and ligaments that slip over each other during motion
C)both a and b

A

A

460
Q

bundles of muscle fibers that are compose of skeletal muscle are identified as
A)fasciuli
B)ligaments
C)tendons

A

A

461
Q
the production of RBC in the bone marrow
A)hemolysis
B)hematopoiesis
C)hematopisa
D)both b and c
A

B

462
Q

the musculoskeletal system functions as
A)protection and storage
B)storage and contol

A

A

463
Q
Low muscle tone is called
A)hypostenia
B) hypotonia
C)hypomuscle
D)all the above
A

B

464
Q
A nurse performs a test on an infant, upon results the nurse hears a click sound of an congenital dislocation of the hip. It is noted as when the hip slips into or out of the socket(acetabulum and femur). This test is called?
A)Thomas test
B)Ortolani test
C)Bulge test
D)Lasegue test
A

B

465
Q
Abnormal stiffening and immobility of a joint due to fusion of bones is called?
A)ankylosis 
B)effusion
C)both a and b
D) subluxation
A

A

466
Q
A grading sound or sensation produced by friction between bone and cartilage or fractured parts of a bond is called?
A)crepitus
B)dislocation
C)subluxation 
D)all the above
A

A

467
Q
What test is used to rule out hip flexion contracture?
A)Ortolani test
B)Bulge test
C)Thomas test
D)Allis test
A

C

468
Q
The patient lies on the examination table and brings one knee in the direction to the chest /flexes hip, while the other leg remains extended. This test is called?
A)Thomas test
B)Bulge test 
C)Lasegue test 
D)all the above
A

A

469
Q
What test is used to determine the presence of fluid in the knee joint.
A)Ortolani test
B)Thomas test
C)Bulge test
D)all the above
A

C

470
Q

When the knee “gives way” it is because of which of the best following?
A)bone injury
B)ligament injury
C)none

A

B

471
Q
What test can the nurse perform to reveal meniscal injury on a patient?
A)Thomas test
B)Bulge test
C)Ortolani test
D)Mcmurrays test
A

D

472
Q
Straight leg rise test that is to determine if the patient has an herniated disk is called?
A)Thomas test
B)Lasegue test
C)Bulge test
D)Mcmurrays test
A

B

473
Q
A single transverse crease in the palm, a minor variation associated with Down syndrome?
A)simian crease 
B)dermoid sinus
C)dermoid crease 
D)both a and d
A

A

474
Q

To check startle reflex and to see if the baby feels like it is falling(arms abducted, adducted and crying) is called what test?
A)Moros reflex
B)Thomas reflex
C)both a and b

A

A

475
Q
Most common genetic background with flat feet are?
A)Asian Americans 
B)Native Americans 
C) Hispanic Americans 
D)African Americans
A

D

476
Q
Which of the following are types of connective tissue? Select all that apply.
Select all that apply:
A)Skeletal muscle
B)Tendons
C)Ligaments
D)Articulations
E)Bone
A

B,C,E

477
Q

The musculoskeletal system is composed of skeletal muscle and five types of connective tissue: bone, cartilage, ligaments, tendons, and fascia.
A)true
B)false also skeletal muscle

A

A

478
Q

A patient has rheumatoid arthritis most prominent in her hands, where she has decreased range of motion (ROM), pain, and tenderness. What is an appropriate nursing diagnosis for this patient?
Choose one of the following
A)Risk for depression related to immobility
B)Risk for falls related to degenerative joint disease
C)Risk for infection related to pain and inflammation
D)Impaired physical mobility related to reduced strength and ROM

A

D

479
Q

After assessing the patient for posture and body alignment, how would the nurse document head position in relation to the spine if alignment is normal with noticeable defect?
Choose one of the following
A)The head is straight up and down in accordance with the spine
B)The head is equally distributed on the neck
C)The head is midline and aligned with the spine
D)The head is centered and in line with the backbone

A

C
The correct documentation would be “the trunk and head are erect with weight distributed equally on both feet. The head is midline and aligned with the spine.”

480
Q

An elderly woman fell in her bathroom and is brought to the ED. Upon examination, the nurse notices that the right leg is externally rotated. This finding is indicative of a fractured femur.
Choose one of the following
A)True
B)False

A

A

481
Q

When lying supine, external rotation of the lower leg and foot indicates a fractured femur.
A)true
B)false

A

A

482
Q
Increased lumbar curvature, which compensates for the enlarging uterus in pregnant women, is called what?
Choose one of the following
A)Kyphosis
B)Scoliosis
C)Lordosis
D)Keracytosis
A

C

483
Q
A nurse has just performed the test for Allis' sign on a newborn; the result is positive. What did the nurse observe while performing this test?
Choose one of the following
A)A clicking sound is heard
B)No clicking sound is heard
C)One knee is lower than the other
D)Knees are at equal height
A

C
Rationale
The examiner tests for Allis’ sign by placing the infant supine with flexed hips and knees and both feet flat on the table. A negative Allis’ sign is when the knees are at equal heights. A positive Allis’ sign is when one knee is lower than the other, indicating hip dysplasia. In the Barlow-Ortolani maneuver, the infant is supine with flexed knees and hips so that the heels touch the buttocks. The examiner places his or her fingers on the baby’s greater trochanter of the humerus and adducts the legs, moving the knees down and laterally. This maneuver is negative when the movement is smooth, with no clicking sound. If a clicking sound is audible, the maneuver is considered a positive indication of hip dislocation.

484
Q

A 58-year-old woman comes to the ED after falling and breaking her right hip and right wrist. She has been diagnosed with osteoporosis. The nurse is aware that Caucasian women have the lowest risk of developing problems from loss of bone density.
Choose one of the following
A)True
B)False

A

B
Rationale
Caucasian women have the highest risk of developing problems from loss of bone density.

485
Q
Assessment of the musculoskeletal system usually proceeds from general to specific and from?
Choose one of the following
A)Head to toe
B)Right to left
C)Bottom to top
D)Anterior to posterior
A

A

486
Q

Focused assessments may be more appropriate when the patient reports an injury to a specific area or joint.
A)true
B)false

A

A

487
Q

The nurse is assessing a 68-year-old man with a new onset of dementia. The nurse is using the Morse Fall Scale; the patient’s score is 63. What does this tell the nurse?
Choose one of the following
A)That the patient is at moderate risk for falling
B)That the patient is at high risk for falling
C)That the patient needs to be restrained for his own safety
D)That the patient is at low risk for falling

A

B

488
Q
Moving a part of the body away from the midline is called?
Choose one of the following
A)Abduction
B)Adduction
C)Extension
D)Rotation
A

A

489
Q

A patient is being discharged home from the hospital. This patient has a history of falling at home. A caregiver is not able to stay with the patient all the time. What can be done to decrease the risk for falling at the patient’s home? Select all that apply.

Select all that apply:
A)Place colorful throw rugs near the exits
B)Install grab bars in the bathroom
C)Correct environmental hazards in the home
D)Make sure house hallways are well lit
E)Have the patient go to a physical therapy three times a week

A

B,C,D
Patients should correct environmental hazards such as slippery surfaces, uneven floors, poor lighting on stairs, loose rugs, unstable furniture, and objects on floors. The nurse can recommend installation of grab bars in restrooms for patients with poor balance. Participation in physical therapy might help patients with gait and balance problems, but the nurse cannot implement this intervention independently.

490
Q

Bone marrow cavities serve as sites of hematopoiesis or the manufacturing of blood cells.
A)true
B)false it is hematolysis

A

A

491
Q
A 28-year-old woman has been diagnosed with carpal tunnel syndrome. What type of working conditions may have contributed to this diagnosis?
Choose one of the following
A)Frequent repetitive movements
B)Substantial physical activity
C)Prolonged sitting
D)Heavy lifting
A

A
Some working conditions present potential risks to the musculoskeletal system. Workers required to lift heavy objects may strain and injure their backs. Jobs requiring substantial physical activity, such as construction work and fire fighting, increase the likelihood of sprains, strains, and fractures. Frequent repetitive movements may lead to misuse disorders such as carpal tunnel syndrome, pitcher’s elbow, or vertebral degeneration. Musculoskeletal injuries may also occur when people sit for long periods at desks with poor ergonomic design.

492
Q
How many vertebrae make up the spinal column?
Choose one of the following
A)33
B)31
C)37
D)32
A

A

493
Q
The nurse is testing a patient for carpal tunnel syndrome. The patient flexes the wrists at an angle of 90° and holds the backs of the hands to each other for 60 seconds. The patient tells the nurse that he is experiencing a burning pain as a result. Which test is the nurse performing on this patient?
Choose one of the following
A)McMurray's
B)Ballottement
C)Tinel's
D)Phalen's
A

D

494
Q
Loss of bone density that occurs with greatest frequency in postmenopausal women is called?
Choose one of the following
A)Kyphosis
B)Lordosis
C)Scoliosis
D)Osteoporosis
A

D

495
Q

The nurse is examining a 77-year-old man. During the physical assessment, the patient appears to be getting fatigued. What can the nurse do to help the patient finish the assessment?
Choose one of the following
A)Halt the assessment, and finish when the patient has enough strength
B)Omit tests
C)Divide the assessment into portions
D)Rush through each activity to finish more quickly

A

C
Examiners should allow extra time for older adults to complete each activity. They may divide the assessment into portions if an older patient appears fatigued.

496
Q

The hip joint is the articulation between the acetabulum and the head of the humerus.
Choose one of the following
A)True
B)False

A

B

497
Q

What test does the nurse performs called when, the nurse firmly strokes up the medial aspect of the knee two or three times to displace any fluid.taps the lateral aspect.
A)bulge test
B)Thomas test
C)ballottement of the patella

A

A

498
Q

Pushing the patell against the femur is called what test?
A)ballottement of the patella
B)frim-nase of the patella

A

A

499
Q
Kock knee also called genu valgum normally occurs at what age
A)3-6
B)2-3 1/2
C)2-7
D)12 months-6
A

B

500
Q
Genu varum also means Bowleg are how many more than \_\_\_\_\_\_ between the knees when the medial malleoli are together.
A)6.7
B)2.5
C)2
D)2.9
A

B

501
Q

Postive test of severe subluxation of the hip is called what test
A)Trendelenburg test
B)Thomas test
C)bulge test

A

A

502
Q

The patient is placed supine and the uninvolved hip and knee are placed in maximum flexion (in a knee-to-chest position). When a flexion contracture of the opposite hip is present, the thigh will spontaneously elevate, thus indicating the amount of contracture present
A) Bluge test
B) Thomas test
C) both a and b

A

B

503
Q

The axial skeletal is made up of the skull and neck bones,trunk,and pelvis?
A)true
B)false

A

true

504
Q

The appendicular skeletal is made up of bones of the upper and lower extremities?
A)true
B)false

A

true

505
Q

joint pain is the most common condition when patient seek help?
A)true
B)false

A

true

506
Q

pressure on the dorsum of the foot on bony prominence is called?
A)corns
B)callus
C)both a and b

A

A

507
Q

pressure on the plantar section of the foot on bony prominence is called?
A)callus
B)Corn
C)both a and b

A

A

508
Q
The nurse examining a patient with normal  muscle strength would document the Grade\_\_\_\_\_\_\_?
A)0
B)1
C)3
D)5
A

D

509
Q
The nurse is assessing a 72-y/o spinal column. Which  spinal finding would be consider normal for a 72-y/o patient?
A)lordosis
B)kyphosis
C)both a and b
D)scoliosis
A

B

510
Q
The nurse is trying o assess a patients risk for osteoporosis. the nurse knows that the following groups have the highest  incidence of osteoporosis?select all the apply?
A)asian females 
B)white males
C)American indians
D)african americans
E)postmenopasual women
F)patients who had fractures in the past
A

A,E,F

511
Q

which statement regarding the comparison of the circumference between the right and left extremities is true?
A)measurements between the right and left sides should be identical
B)measurements differences are less than 1cm
C)measurements difference are within 2 cm
D)all the above

A

B

512
Q

the nurse is assessing a patient muscle strength of the trapezius muscle. the nurse will apply resisting force while the patient?
A)shrugs her shoulders
B)moves her jaw

A

A

513
Q
the nurse is assessing a patient using a goniometer. what is this instrument used for/?
A)muscle strength 
B)range of motion 
C)joint symmetry
D)length of extremity
A

B

514
Q

which patient condition increases the risk of osteomyelitis?
A)sever osteoporosis
B)an open fracture of the radius

A

B

515
Q

Gout is caused by the accumulation of uric acid in the joint?
A)true
B)false

A

true

516
Q

RA is joint inflammation?
A)true
B)false

A

true

517
Q

An open fracture allows the entry of microorganism into an bone?
A)osteomyelitis
B)false

A

A

518
Q

the nurse is assessing a patient internal rotation of the shoulder joint. how should the nurse direct the patient?
A)place your right hand against the small of your back
B)rotate the palm of your hand up and down
C)elevate your right arm over your head

A

A

519
Q

the nurse is assessing a new born hips and hears a click this means??
A)an indication of congenital hip dislocation
B)indication of spina bifida

A

A

520
Q
a patient complain of pain and clicking in the jaw with movement. these symptoms are consistent with
A)gout in the jaw
B)TMJ syndrome 
C)RA in the jaw
D)all the above
A

B

521
Q

•Rotation:
A) moving head around central axis
B)moving body part forward, parallel to ground
C)moving body part backward, parallel to ground

A

A

522
Q

•Protraction:
A)moving head around central axis
B)moving body part forward, parallel to ground
C)moving body part backward, parallel to ground

A

B

523
Q

Retraction:
A) moving body part backward, parallel to ground
B) moving body part forward, parallel to ground

A

A

524
Q

By 3 months fetus has formed skeleton of cartilage
A)true
B)false by 2 months

A

A true

525
Q

Longitudinal growth continues until closure of epiphyses; last closure occurs about age 20
A)true
B)false

A

True

526
Q

Purpose of musculoskeletal examination is to assess function for ADLs and to screen for abnormalities
A)true
B)false

A

True

527
Q

ØAge-specific screening measures, such as Ortolani’s sign for what age group?
A)infants
B)adolescents

A

A

528
Q

ØAge-specific screening measures, such as scoliosis for what age group.
A)adolescents
B)infants

A

A

529
Q

ØPalpate contracted temporalis and masseter muscles as person clenches teeth
A)true
B)false

A

A

530
Q

ØAsk person to move jaw forward and laterally against your resistance, and to open mouth against your resistance
•This tests integrity of cranial nerve V (trigeminal nerve)
A)true
B)false

A

A

531
Q

•Flatfoot (pes planus): pronation, or turning in, of medial side of foot because normal longitudinal arch concealed by fat pad until age 3 years
A)true
B)false

A

True

532
Q

MUSCULOSKELETAL

A

.