Muscular 4

1. 11. A female patient tells the nurse that she has pain and numbness to her thumb, first finger, and second finger of the right hand. The nurse discovers that the patient is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the patient could possibly have what?

A) Carpel tunnel syndrome

B) Tendonitis

C) Impingement syndrome

D) Dupuytren's contracture

2. 1. The nurse is caring for a 35-year-old man diagnosed with a back strain. What would be important to discuss with this patient?

A) Avoid lifting more than one-third of his body weight without assistance.

B) Focus on using back muscles during lifting.

C) Lift objects while holding the object away from the body.

D) Tighten the abdominal muscles and lock the knees during the lifting of an object.

3. 17. The nurse is caring for a patient who is 12 hours postop from foot surgery. The nurse assesses the presence of edema in the foot. What nursing measure will the nurse implement to control the edema?

A) Elevate the foot on several pillows.

B) Apply warm compresses intermittently to the surgical area.

C) Administer a diuretic.

D) Increase circulation through frequently ambulation.

4. 20. A patient presents to the free clinic complaining of a leg ulcer that isn't healing. A culture is taken from the wound site, which is found to be caused by osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what?

A) Staphylococcus aureus

B) Proteus

C) Pseudomonas

D) Escherichia coli

5. 35. A 39-year-old diabetic patient is at the clinic having a foot check done by the nurse. The nurse notes that the patient's right foot is pale and mottled, cool to touch, with a capillary refill of > 3 seconds. What would the nurse suspect the patient has?

A) Hematogenous osteomyelitis

B) Osteomyelitis with vascular insufficiency

C) Contiguous-focus osteomyelitis

D) Osteomyelitis with muscular deterioration

6. 3. A 42-year-old man presents at the clinic complaining of pain in his heel so bad it inhibits his ability to walk. The patient is diagnosed with plantar fasciitis. Patient teaching provided by the nurse would include what instructions to decrease the pain associated with this condition?

A) Wrapping the affected area in lamb's wool or gauze

B) Gently stretching the foot and the Achilles tendon

C) Wearing open-toed shoes

D) Application of keratolytic ointment

7. 16. A patient has returned to the unit after undergoing limb-sparing surgery to remove a bone tumor. The nurse providing postoperative care assesses for what complication from surgery?

A) Nutritional deficiency

B) Delayed wound healing

C) Loss of body weight

D) Pathologic fractures

8. 6. The nursing instructor is discussing osteomalacia with her nursing students. The instructor gives the student the assignment of planning a day's menu for a patient with osteomalacia. What would be the best choice for breakfast for a patient with osteomalacia?

A) Cereal with milk, a scrambled egg, and grapefruit

B) Fresh fruit with granola sprinkled on the fruit

C) Waffles with fresh strawberries and powdered sugar

D) A bagel topped with vegetable cream cheese and a side dish of grapes

9. 13. Studies for pre-nursing students include the anatomy and physiology of the human body. What hormone do the students learn inhibits bone resorption and promotes bone formation?

A) Estrogen

B) Parathyroid

C) Calcitonin

D) Progesterone

10. 30. A 72-year-old woman is admitted to the orthopedic unit with a possible diagnosis of osteoporosis. Routine x-rays have been ordered. As the nurse caring for the patient, you know that osteoporosis may be undetectable on routine x-rays until there has been demineralization to what extent?

A) 15% to 30%

B) 25% to 40%

C) 35% to 50%

D) 45% to 60%

11. 34. The health care team is caring for a patient with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What is the usual treatment for osteomalacia cause by malabsorption?

A) Supplemental calcium and increased doses of vitamin D

B) Supplemental calcium and increased doses of vitamin E

C) Supplemental potassium and increased doses of vitamin D

D) Supplemental potassium and increased doses of vitamin E

12. 39. An elderly female with osteoporosis has been hospitalized. Prior to discharge, when teaching the patient, the nurse should include information about which major complication of osteoporosis?

A) Bone fracture

B) Loss of estrogen

C) Negative calcium balance

D) Dowager's hump

13. 19. The Nursing Instructor is talking with her clinical group about osteomalacia. What would the instructor teach her students about a patient with osteomalacia who is being treated with vitamin D supplements and their risk for what?

A) Hypocalcemia

B) Hypernatremia

C) Hypermagnesemia

D) Hypochloremia

14. 10. A patient presents at the clinic complaining of back pain that goes all the way down the back of the leg to the foot. What is this type of pain referred to as?

A) Bursitis

B) Radiculopathy

C) Sciatica

D) Tendonitis

15. 15. An 80-year-old man in a long-term care facility has a chronic leg ulcer. When the Nurse Practitioner makes his rounds, the man states that the area has become increasingly painful. The Nurse Practitioner assesses the area and notes that the wound bed of the ulcer is unchanged, but the site is now swollen and warm to the touch. The Nurse Practitioner notifies the physician of these symptoms as the patient may have developed what?

A) Osteomyelitis

B) Osteoporosis

C) Osteomalacia

D) Infectious arthritis

16. 8. You are assisting with assessments on a group of medical-surgical patients. What patient do you recognize as being at the highest risk for the development of osteomyelitis?

A) A middle-age adult who takes ibuprofen daily for rheumatoid arthritis

B) An elderly patient with an infected pressure ulcer in the sacral area

C) A 17-year-old football player who had orthopedic surgery 6 weeks prior

D) An infant diagnosed with jaundice

17. 4. A nurse is providing an educational class to a group of older adults at a community senior center. The topic of the class is nutrition. The nurse informs the group that the recommended adequate intake (RAI) level of calcium daily is what?

A) 1000 mg

B) 1100 mg

C) 1200 mg

D) 1300 mg

18. 37. You are preparing a patient who underwent foot surgery for discharge. You are discussing the use of assistive devices for a portion of your rehabilitation with the patient and their family. What does the choice of assistive devices depend on?

A) Patient's general condition, balance, and weight-bearing prescription

B) Patient's general condition, strength, and weight restrictions

C) Patient's motivation, balance, and weight-bearing prescription

D) Patient's weight-bearing prescription, motivation, and balance

19. 18. A 36-year-old diabetic woman is attending a class on the prevention of associated diseases. When the nurse talks about osteoporosis, the woman asks the nurse what steps she may take to prevent osteoporosis. What should the nurse advise her to do?

A) Include adequate intake of vitamin E.

B) Walk 20 to 30 minutes 3 days a week.

C) Engage in isometric exercises 20 to 30 minutes 3 days a week.

D) Include an average daily intake of 300 mg of calcium.

20. 2. The nurse is discussing conservative management of tendonitis with a patient. Which of the following may be an effective approach to managing tendonitis?

A) Weight reduction

B) Stress reduction

C) Intermittent application of ice and heat to the affected joint

D) Range of motion of the affected joint

21. 23. You are providing an educational class for a group of patients who suffer from low-back pain. What would you include as major goals for patients who have low back pain?

A) Improved pain detection

B) Use of back-muscle techniques

C) Improved self-satisfacton

D) Weight reduction

22. 9. The nurse is caring for a patient with a bone tumor. The nurse provides education that teaches the patient to implement measures to reduce the risk for pathologic fractures. What intervention will assist the patient in fracture prevention?

A) Strive to achieve the maximum weight-bearing capabilities.

B) Instruct the patient to strengthen the affected muscles through weight training.

C) Support the affected extremity with external supports (splints).

D) Limit the use of reliance of on assistive devices.

23. 22. A nurse is caring for a patient who has been hospitalized with complaints of low back pain. The patient is scheduled for diagnostic testing in the morning. What is a diagnostic test for low back pain?

A) Electroencephalogram

B) Arteriogram

C) ABG

D) Ultrasound

24. 31. When discussing diseases of the bone with his nursing students the nursing instructor gives the students a list of risk factors for osteoporosis. What risk factors should be included in that list?

A) Mobility

B) Lap-banding surgery

C) Small-framed, nonobese Caucasian women

D) A diet high in calcium and vitamin D

25. 29. A patient diagnosed with osteoporosis has bones that become progressively porous, brittle, and fragile; they fracture easily under stresses that would not break normal bone. This increased susceptibility to fractures manifest most commonly as what?

A) Fractured tibias

B) Dislocated shoulders

C) Boxer's fractures

D) Compression fractures of the spine

26. 32. A nurse is presenting her research on osteomalacia at an international conference. When would the nurse tell the attendees that an osteotomy may be performed?

A) When a cure would be effected

B) When persistent infection is evident

C) To correct long bone deformity

D) With persistent orthopedic deformities

27. 28. A patient with foot problems is diagnosed with Charcot-Marie-Tooth disease. What manifestation would you expect the patient to manifest with Charcot-Marie-Tooth disease?

A) Pes cavus

B) Hallux valgus

C) Morton's neuroma

D) Onychocryptosis

28. 14. A patient has been admitted to the orthopedic unit with a suspected diagnosis of osteomalacia. The nurse expects to find which of the following laboratory study results to be present?

A) High serum calcium and low phosphatase level

B) High serum calcium and high phosphatase level

C) Low serum calcium and high phosphorus level

D) Low serum calcium and low phosphorus level

29. 27. A patient presents at the clinic stating they have hallux valgus. What signs and symptoms would the nurse expect this patient to manifest?

A) Deviation of a great toe laterally

B) A great toe pulled in an upward position

C) An abnormally high arch of the foot

D) A diminished longitudinal arch of the foot

30. 5. The nurse is providing a class on osteoporosis at the local senior citizens center. Which of the following statements related to osteoporosis is correct?

A) Osteoporosis is a disease of the elderly.

B) A non-modifiable risk factor for osteoporosis is a person's level of activity.

C) Secondary osteoporosis occurs in women after menopause.

31. 38. A patient has come to the clinic for a routine annual physical. The Nurse Practitioner notes a large projection of bone at the shoulder. The Nurse Practitioner knows that this is most likely what?

A) An osterosarcoma

B) An osteochondroma

C) An osteoblast

D) An osteitis

32. 26. A 54-year-old male patient presents at the clinic with complaints of a dull aching discomfort, morning numbness, cramping, and stiffness in their fourth and fifth fingers. What disease process would the nurse suspect?

A) Tendonitis

B) A ganglion

C) Carpal tunnel syndrome

D) Dupuytren's disease

33. 21. Patients who suffer from Paget's disease have more than one pharmacologic option to treat their disease process. What type of drug is the drug of choice for Paget's disease?

A) Antineoplastic

B) Antirheumatoid

C) Anticholinergic

D) Antiosteoclastic

34. 12. A clinic nurse is admitting a patient who reports a throbbing burning feeling in the right foot during the day but notes that the pain is relieved with rest. What might the nurse suspect the patient may have?

A) Morton's neuroma

B) Pes cavus

C) Hallux valgus

D) Onychocryptosis

35. 24. The emergency department nurse is caring for a patient who has presented with complaints of back pain. What would be the most appropriate diagnostic test to detect degenerative disk or disk protrusions?

A) Myelogram

B) Bone scan

C) Epidural venogram

D) Electromyogram

36. 25. A 32-year-old patient comes to the clinic complaining of shoulder tenderness, pain, and limited movement. Upon assessment the nurse finds edema. An MRI shows hemorrhage of the rotator cuff tendons. The patient is diagnosed with what stage impingement syndrome?

A) Stage I

B) Stage II

C) Stage III

D) Stage IV

37. 36. You are precepting a new graduate nurse who has just started working on the orthopedic unit. Today the two of you are providing care for a patient who has just returned from having foot surgery with percutaneous pins. The graduate nurse is discussing the potential for infection in patients who undergo foot surgery. What would you tell the graduate nurse about the potential for infection?

A) Dressing changes are done under strict sterile technique.

B) Surgical site can be soaked in hot bath water for up to 10 minutes.

C) Use soap and clorox to clean pin sites.

D) Care must be taken to protect the surgical wound from dirt and moisture.

38. 7. A nurse, caring for a patient with Paget's disease, is analyzing her patient's laboratory values. Which of the following values is most often seen in a patient with Paget's disease?

A) An elevated serum alkaline phosphatase level and elevated serum calcium levels

B) A low serum alkaline phosphatate level and a low serum calcium level

C) An elevated serum alkaline phosphatase level and a normal serum calcium level

D) A normal serum alkaline phosphatase level and a low serum calcium level

39. 33. What is the drug of choice used to treat osteomyelitis?

A) Calcitonin

B) Mithracin

C) Alkaline phosphatase

D) Potassium hydrochloride