Which of the following would the nurse understand as causing damage to the joints of a
client with rheumatoid arthritis?
a
The development of Heberden nodes in the joint capsule
b
The deterioration of cartilage by the enzyme hyaluronidase
c
Invasion of pannus into the joint capsule and subchondral bone
D
Bony ankylosis after inflammation of the joints in HLA-B27-positive individuals
A client with rheumatoid arthritis is experiencing articular in volvement of the joints. The
nurse recognizes that these characteristic changes include which of the following?
(Select all the apply.)
A. Bamboo-shaped fingers
B. Metatarsal head dislocation in feet
C. Noninflammatory pain in large joints
D. Asymmetrical involvement of small joints
E. E
Morning stiffness lasting 60 minutes or more
3. Which of the following would the nurse teach to a client with anky.losing spondylitis?
A. Avoid extremes in environmental temperatures.
B. Continue with physical activity during flare-ups.
C. Apply cool compresses for relief of local symptoms.
D. Maintain proper posture and engage in regular exercise.
4. When the nurse administers medications to clients with gout, which of the following
would the nurse recognize as a treatment for
acute disease.
A. Colchicine
B. Sulphasalazine
C. Allopurinol
D. Cyclosporin
5. The nurse is teaching a client with SLE about the disorder. The nurse understands
that the pathophysiology of SLE includes which of the following?
A. Circulating immune complexes formed from IgG autoantibod-les reacting with
IgG
B. An autoimmune T-cell reaction that results in destruction of the deep dermal skin
layer
C. Immunological dysfunction leading to chronic inflammation in the cartilage and
bones
D. The production of a variety of autoantibodies directed against constituents of the
cell nucleus
6. The nurse is caring for a client with Sjögren syndrome. Which of the following
autoimmune disorders may the client also develop?
A. Uveitis
B. Ulcerative colitis
C. Glomerulonephritis
D. Hashimoto thyroiditis
Which of the following should be considered in the management of systemic exertion
intolerance disease (SEID)? (Select all that apply.)
A. Dark green vegetables in diet
B. DMARDs to reduce symptoms
C. Total rest during acute exacerbations
D. SSRIs or tricyclic antidepressants
E. Behavioural therapy
A client with osteomyelitis is treated with surgical debridement with implantation of
antiblotic beads. When the client asks why the beads are used, how should the nurse
answer? (Select all that apply)
A. The beads are used to directly deliver antibiotics to the area of the infection
B. There are no effective oral or I antibiotics to treat most cases the bone infection
C. This is the safest method of delivering long term antibiotic theraoy for a bone
infection ‘
D. d. The beads are used for deep infections in addition to removing the damaged
tissue and oral and IV antibiotics.
E. The lack of blood flow and the bone death that occur with osteomyelitis make iv
antibiotics less effective
2. The nurse is teaching a client with osteopenia. What is important to include in the
teaching plan?
A. Lose weight
B. stop smoking
C. Eat a high-protein diet.
D. Start swimming for exercise.
3. Which of the following individuals does the nurse identily as being at high risk for low
back pain? (Select all that apply.)
A. A 63-vear-old man who is a long-distance truck driver
B. A 36-year-old construction worker who is 190 cm tall and weighs 118 kg
C. A 28-year-old female yoga instructor who is 170 cm tall and weighs 59kg
D. a 30 year old male nurse who works on an orthopedic unit and smokes
E. a 44 year old female chef with prior compression fracture of the spine
4. What is the primary nursing responsibility in caring for a dies with a suspected disc
herniation who is experiencing acute pain anmuscle spasms?
A. Encourage total bed rest for several days.
B. Teach the principles of back-strengthening exercises
C. Stress the importance of straight- leg raises to decrease pain
D. Promote the use of cold and hot compresses and pain medication
When caring for a clientatter a spedatusion, which of the following symptoms would the
nurse immediately report to the physician?
A. The client experiences a single episode of emesis.
B. The client is unable to move the lower extremities
C. The client is nauseated and has not voided in 4 hours.
D. The client reports pain at the bone graft donor site.
6. What instructions should the nurse give the client who is being dis charged from
same-day surgery after surgical correction of bilateral hallux valgus?
a
b
c
d
Rest frequently, with the feet elevated.
Soak the feet in warm water several times a day.
Expect the feet to be numb for several days postoperatively.
Expect continued pain in the feet, since this is not uncommon
7. A client has been diagnosed with osteosarcoma of the humerus Which of the
following statements would indicate that he has an understanding of his treatment
options?
A. "I accept that I have to lose my arm with surgery"
B. "The chemotherapy before surgery will shrink the tumour"
C. "This tumour is related to the melanoma I had 3 years ago."
D. "I'm glad they can take out the cancer with such a small scar
The number of the question corresponds to the same-numbered obiective at the
beginning of the chapter.
1. When would the nurse suspect an ankle sprain for the client being seen at the urgent
care centre?
a. Client was hit by another soccer player on the field.
b. Client has ankle pain after sprinting around the track.
c. Client dropped a 4.5-kg weight on his lower leg at the health
d. Client had a twisting injury while running bases during a baseball game.
2. The nurse explains to a client with a distal tibial fracture returning for a 3-week
checkup that healing is indicated by which of the following g
a. Callus formation
b. Complete bony union
c. cHematoma arthe tractire sire
d. Presence of granulation tissue
3. A client with a comminuted fracture of the femur is to have an open reduction with
internal fixation (ORIF) of the fracture. In which of the following situations is an ORIF
indicated?
a. The client is able to tolerate prolonged immobilization.
b. The client cannot tolerate the surgery for a closed reduction.
c. A temporary cast would be too unstable to provide normal mobility
d. Adequate alignment cannot be obtained by other nonsurgical methods
Which of the following indicates a neurovascular condition during the nurses
assessment of a client with a fracture?
a. Exaggeration of extremity movement
b. Increased redness and heat below the injury
c. Decreased sensation distal to the fracture site
d. Purulent drainage at the site of an open fracture
5. A client with a stable, closed fracture of the humerus caused by trauma to the arm
has a temporary splint with bulky padding applied with an elastic bandage. For which of
the following symptoms would the nurse suspect compartment syndrome and notify the
health care provider?
a. Increasing edema of the limb
b. Muscle spasms of the lower arm
c. Rebounding pulse at the fracture site
d. Pain when passively extending the fingers
6. Which of the following symptoms should the nurse be monitoring for in a client with
pelvic fracture?
a
Changes in urinary output
b
Petechiae on the abdomen
c
A palpable lump in the buttock
d
Sudden increase in blood pressure
7. During the postoperative period, what should the client with an above-the-knee
amputation be told about the negative effect of rou tinely elevating the residual limb?
a. The flexed position can promote hip flexion contracture.
b. This position reduces the development of phantom pain.
c. This position promotes clot formation at the incision site and thigh.
d. Unnecessary movement of the extremity can cause wound dehiscence
A dient with rheumatoid arthritis is scheduled for an arthroplasty. all that apply.)
How should the nurse explain the purpose of this procedure? (Select
a. To fuse the joint
b. To replace the joint
c. To prevent further damage
d. To improve or maintain ROM
e. To decrease the amount of destruction in the joint
What should the nurse teach a client recovering from a total hip replacement to avoid?
a. Sleeping on the abdomen
b. Sitting with the legs crossed
c. Abduction exercises of the affected leg
d. Bearing weight on the affected leg for 6 weeks
1. What are the bone cells that function in the breakdown of bone tissue (resorption)
called?
a. Osteoids
b. Osteocytes
c. Osteoclasts
d. Osteoblasts
2. While performing passive range-of-motion exercises for a client, the nurse puts the
ankle joint through the movements of which of the following? (Select all that apply.)
a. Flexion and extension
b. Inversion and eversion
c. Pronation and supination
d. Abduction, and adduction
e. Dorsiflexion and plantar flexion
To prevent muscle atropy, the nurse teaches the client with a leg immobilized in traction
to preform wich of the following menouvers?
a. Flexion contractions
b. Isotonic contractions
c. Isometric contractions
d. Extension contractions
A client with bursitis of the shoulder asks the nurse what the burs does. What does the
nurse tell the client about the function of the bursa?
a. Bursae connect bone to bone.
b. Bursae separate muscle from muscle.
c. Bursae lubricate joints with synovial fluid.
d. Bursae relieve friction between moving parts.
Why are many older people at increased risk for falls? (Select all that apply.)
a. Changes in balance
b. Decrease in bone mass
c. Loss of ligament elasticity
d. Loss of strength
e. Erosion of articular cartilage
6. While the nurse is obtaining subjective assessment data related to the
musculoskeletal system, which of the following conditions requires the nurse to ask
about family history?
a. Osteomyelitis
b. Osteomalacia
c. Low back pain
d. Rheumatoid arthritis
7. When a nurse grades muscle strength with a score of 2, what does that indicate?
a. Active movement against gravity
b. A barely detectable flicker of contraction
c. Active movement with elimination of gravity
d. Active movement against full resistance without evident fatigue
Which of the following is a normal finding in the assessment of the musculoskeletal
system?
a. Muscle strength of 4
b. A lateral curvature of the spine
c. Angulation of bone toward midline
d. Full range of motion of all joints without pain
9. Which of the following are nursing considerations for a client undergoing magnetic
resonance imaging (MRI)? (Select all that apply.)
a. Ensuring that the client has no metal on clothing
b. Informing the client that the procedure is painless
c. Checking for history of claustrophobia
d. Ensuring that the client is on NPO status at least 8 hours before the study
Administering a fluid bolus immediately before the study