PVN 135EMusculoskeletal Nursing Care

REVIEW #1

Multiple Response (MR)

• Functions of the skeletal system include:– A. Protection– B. Temperature regulation– C. Movement– D. Hematopoesis

Multiple Choice (MC)

• The bones serve as a storage specifically for 2 minerals. These are:– A. Sodium and potassium– B. Phosphorus and calcium– C. Sodium and calcium– D. Potassium and phosphorus

MC

• Blood cell formation takes place in the ___ of bones:– A. Shaft– B. Haversian Canals– C. Red marrow– D. Yellow marrow

MC

• The cranium, thorax, and vertebrae make up the ___ skeleton.– A. Spongy– B. Appendicular– C. Compact– D. Axial

MC

• The appendicular skeleton is made up of:– A. Pelvis, hips, vertebrae, and extremities– B. Vertebrae, extremities, shoulders, and hips– C. Limbs, shoulders, pelvis, and hips– D. Ribs, hips, pelvis, and legs

MR

• There are 4 classifications of bones in the body. Which of the following are included?– A. Spongy– B. Long– C. Short– D. Flat

T/F

• The vertebrae is an example of irregular bones.

Other

• List 3 examples of flat bones.

Other

• Projections are different shapes of bones that help them to connect with other bones. For each of the following, cite the name of the projection and give 1 example:

• Rounded Knob

Other

• Projections cont.

– Large projection

Other

• Projections cont.

– Crest

Other

• Projection cont.

– Spine

Other

• What action does each of the following bone cells perform?

– A. Osteoblasts

– B. Osteoclasts

Other

• Complete the definitions for each of the following:– A. Foramen

– B. Sinus

– C. Fossa

T/F

• Bones stop growing in length by the late teens, early 20’s.

Other

• How many vertebrae are present in each of the following sections?– A. Cervical spine ____– B. Thoracic spine ____– C. Lumbar spine ____– D. Sacral spine ____

MR

• Which of the following are connective tissue or connective tissue structures?– A. Fascia– B. Ligaments– C. Bursa– D. Tendons

Match

• Freely moveable ___

• Slightly moveable ___

• Immoveable ___

• A. Synarthrosis

• B. Diarthrosis

• C. Amphiarthrosis

Other

• Give one example of a synarthrosis joint.

MR

• Which of the following functions does the muscular system perform?– A. Motion– B. Protection– C. Maintenance of posture– D. Support of blood vessels and nerves– E. Heat production

MC

• Voluntary muscles come in ____ pairs.– A. 24– B. Agonistic– C. Antagonistic pairs– D. Involuntary pairs

MC

• Nerve impulses pass through the _______ and _____ are released that cause the muscle to ______.– A. Axionic connection, rapid impulses, contract– B. Dendritic connection, chemicals, relax– C. Haversian canals, chemicals, cramp– D. Neuromuscular junction, chemicals, contract

MC

• There are 2 movements of muscle in the body overall. These are:

– A. Smooth, striated– B. Contraction, relaxation– C. Voluntary, involuntary– D. Upper and Lower extremities

MC

• The muscle type that is responsible for making the walls of body organs and works in wavelike motion is called:

– A. Voluntary– B. Contractile– C. Smooth– D. Striated

MC

• The type of muscle that is self-excitatory, striated, and works involuntarily is:

– A. Skeletal muscle– B. Smooth muscle– C. Axial muscle– D. Cardiac muscle

MR

• The human body can accomplish which of the following types of body movement?

– A. Flexion/extension– B. Abduction/adduction– C. Dorsi/plantar extension– D. Supination/pronation

MR

• Which two properties of muscle are needed for a response to stimuli?

– A. Excitability– B. Transportability– C. Contractility– D. Action potential

MC

• ____ plays a significant role in the contracion and relaxation of muscle:

– A. Potassium– B. Calcium– C. Magnesium– D. Sodium

MR

• From the following, identify the benefits of exercise on the musculoskeletal system:

– A. Improves circulation– B. Bones and muscles get stronger– C. Weight Loss– D. Reduction of risk for heart attack

Other

• When the nurse was admitting Mr. H. to a long term care facility, she looked for what features in her musculoskeletal assessment of this resident? List 4.

MR

• Structural disorders of the musculoskeletal system include which of the following?

– A. Cleft palate– B. Scoliosis– C. Lung sounds– D. Flatfeet

MR

• When assessing articular joint status, the nurse should look for:

– A. Deformities– B. ROM– C. Long bone integrity– D. Skin integrity

MR

• Following trauma, surgery, casting, splinting, & bandaging, a neurovascular assessment should be completed to check for:

– A. Pulselessness– B. Parathesias– C. Pain– D. Pallor

T/F

• Skeletal changes in aging include: loss of calcium, increased protein in bone; decreased collagen in bone, and loss of height.

MC

• A _____ is a radiographic study that locates small cavities, foreign bodies, and lesions that are overshadowed by opaque structures.

– A. Scanography– B. Xray– C. Laminography– D. Arthroscopy

MC

• An xray study in which dye is injected into the spinal fluid and outlines the spinal cord making it visible on xray is:– A. Bone Scan– B. EMG– C. Myelogram– D. CT scan

MC

• ____ is the most common side effect of a myelogram:

– A. Infection– B. Headache– C. Meningitis– D. Seizure

MR

• To determine the electrical potential associated with skeletal muscle contraction, a physician may order which test?

– A. Myelography– B. Electromyography (EMG)– C. MRI– D. CT scan

MC

• _____ involves the use of magnetism and radio waves to make images of cross sections of the body.

– A. EMG– B. CT Scan– C. MRI– D. Scanography

MR

• In preparing Mr. C. for his MRI, the nurse would know that he cannot have an MRI if any of the following are present:– A. Artificial heart valve– B. Orthopedic device– C. Cardiac pacemaker– D. Dental fillings

MC

• The nurse is preparing Mr. C. for his MRI and will have him remove:

– A. any metal– B. any glass– C. any plastic– D. any polyester clothing

T/F

• A CT scanner does not produce radiation.

MC

• Prior to a CT Scan, the nurse will check for which allergy if contract dye will be used:

– A. Citrus foods– B. Nuts, wheat– C. Iodine, shellfish– D. Eggs

MR

• Which of the following exams requires a signed consent form?

– A. MRI– B. Xray– C. Myelogram– D. EMG

MC

• For this test, a radioactive tracer substance is injected into a vein in the arm. The tracer travels through the bloodstream and into the bones.– A. Scanography– B. Bone Scan– C. Bone Mineral Density study– D. Arthroscopy

MC

• ___ measures the bone mass of the spine and other bones.

– A. Bone Scan– B. Laminography– C. Bone Mineral Density study– D. arthrocentesis

MC

• An endoscopic exam visualizes the internal structures of the body. When this procedure is done on the knee, it is called:

– A. Arthrocentesis– B. Arthroscopy– C. Arthrodesis– D. ORIF

Other

• Pass out Lab/Diagnostic Quiz!

MR

• Skeletal muscle relaxants are used to prevent or relieve muscle spasms by acting:

– A. Directly on the neuromuscular junction– B. Indirection on the CNS– C. By blocking lactic acid production– D. By blocking calcium reuptake

MC

• Some of the side effects of skeletal muscle relaxants include dizziness, drowsiness, and:

– A. Dry mouth– B. Sweating– C. Tachycardia– D. Urticaria

MR

• Identify 2 skeletal muscle relaxants:

– A. Flexeril– B. Elavil– C. Robaxin– D. Bensonatate

MC

• The major focus of antigout medications is:

– A. Decrease inflammation– B. Increase mobility– C. Reduce blood dyscrasias– D. Prevent sore gums and headaches

Other

• Name 2 antigout medications:

MC

• Two significant medications used to reduce symptoms of arthritis are:

– A. Tylenol and ASA– B. ASA and NSAIDS– C. Gold and Tylenol– D. NSAIDS and Tylenol

MR

• Name 2 antiarthritic Medications (not mentioned previously ) :

Other

• Biphosphonates inhibit osteoclast mediated bone resorption increased bone mass.

• Name 1 common biphosphonate medication and the condition it is used to treat:

MC

• Jeff, the LPN, was caring for a 72 year old female, status post hip fracture with pinning. Overall, her health was good except for changes in her bones. What medical diagnosis would you expect to see on her chart?– A. Chronic renal disease– B. Osteoporosis– C. Pernicious Anemia– D. Fibromyalgia

MR

• Clinical characteristics or manifestations of osteoporosis would include:

– A. Flatfeet– B. Short bones– C. Porous, brittle bones– D. Dowager’s Hump

MR

• Mrs. K., the 72 year old patient with a repaired hip fracture is getting ready to be discharged home with home health services. As the nurse working with her and her daughter, and knowing that her underlying disease process is osteoporosis, what education would you provide to reduce a recurrence of fractures?– A. Calcium, Vitamin D supplements– B. Weight-bearing exercises– C. Dietary intake of dairy; limit caffeine– D. No added salt– E. Home safety Eval by PT

MC

• During your initial interview and assessment with Mary, a 65 year old client, she tells you that she has a lot of chronic muscle pain, fatigue, and insomnia. You, as the nurse, realize that she is describing:– A. Rheumatoid Arthritis– B. Osteoporosis– C. Fibromyalgia– D. Lyme Disease

MC

• The inflammation of the fluid filled sac that allows joint movement is called:

– A. Synovitis– B. Bursitis– C. Arthritis– D. Gout

MC

• RA is a chronic systemic inflammation of the joints that is most common in women of childbearing age. What process describes RA?– A. chronic inflammation of the synovia membrane

of the diarthrodial joints– B. Inflammation of the fluid filled sacs that allow

joint movement– C. Asymmetrical joint swelling– D. Boney enlargement

MR

• RA is characterized by periods of exacerbation and remission. During exacerbations, the nurse can expect to find which of the following clinical manifestations?– A. Full range of motion– B. Edema and tenderness of joints– C. Muscle weakness– D. Pain and generalized aching

MR

• Laboratory tests to confirm a diagnosis of RA would include:

– A. ESR– B. RF– C. CRP (C-Reactive Protein)– D. ANA

MR

• Nursing interventions for a patient with RA may include:– A. Administration of medication– B. Exercise: gently ROM– C. Application of prescribed splints– D. Absolute bedrest

MC

• _____ is a progressive degeneration of joints that is non-systemic and non-inflammatory. It may be caused by trauma or years of “wear and tear” on a given joint(s). This condition is known as:– A. Anklyosing Spondilitis– B. Osteoarthritis– C. Gouty arthritis– D. Osteomyelitis

MC

• One clinical manifestation of osteoarthritis would be:

– A. Urate crystal deposits in joints– B. Heberden’s nodes– C. Inflamed synovial membranes– D. tachycardia

MR

• People with osteoarthritis can benefit from gait enhancers. Such gait enhancers would include:– A. Walkers– B. Canes– C. Joint replacements– D. balancing excercises

MC

• _____ is a metabolic disease that results from excessive uric acid in the blood and leaves urate crystal deposits in joints.

– A. Lyme Disease– B.Chondromalasia– C. Gout– D. Osteomyelitis

MC

• Medications used to treat gouty arthritis include:– A. Cholchicine, Allopurinol– B. Broad spectrum antibiotics– C. Enbrel– D. Imuran

MC

• As a part of the patient education for a client with gouty arthritis, the nurse would recommend specific dietary restrictions. These would include:– A. no animal fats, citrus fruit, or breads– B. Gluten-free diet– C. No wine, cheese, or organ meats– D. No beef, liver, or shellfish

MC

• Local or generalized infection of the bone and bone marrow in which bacteria invade the bone. This is often seen after an open fracture and is called:– A. Osteomyelitis– B. Osteoarthritis– C. Ankylosing Spondylitis– D.Perimysiumitis

MR

• Diagnostic and serum lab tests that may be done to confirm a diagnosis of osteomyelitis include:– A. CBC, ESR, blood cultures– B. Laminography– C. Bone Scan– D. Incision and drainage

MR

• Nursing interventions for a client with a medical diagnosis of osteomyelitis would include:– A. Administration broad-spectrum antibiotic (s)– B. Surgical removal of necrotic bone– C. Wound Care– D. CMS checks of the affected extremity