Musculoskeletal Disorders Chapter 12 Test Bank

Chapter 12 Musculoskeletal Disorders

Multiple Choice

1. The nurse practitioner is serving in a clinic dedicated to patients over age 65 years. The nurse practitioner observes several common characteristics in the posture of elderly patients. Which of the following is common?

1. Increase in the length of the trunk in relationship to the upper extremities.

2. Head tips backward.

3. Disappearance of bony prominences.

4. Increase in the range of motion (ROM).

2. While conducting a thorough examination of the musculoskeletal system, the patient asks why such detail is necessary. Which of the following is the nurse practitioner’s best response?

1. I don’t want to miss any signs of something serious.

2. The purpose of conducting this examination is to regulate your medications.

3. I am looking for symptoms that form a pattern.

4. This is routine for all patients over 65 years of age.

3. Mrs. Wilbur reports the presence of pain in her lower and upper back. The nurse practitioner responds by doing which of the following?

1. Determining where the pain is coming from.

2. Ignoring any history of injury.

3. Ruling out the presence of anything inflammatory.

4. Determining that this pain does not affect activities of daily living (ADLs), as the patient came in independently.

4. When assessing a patient with a possible musculoskeletal condition, it is important to:

1. Know how much sleep the patient gets per night.

2. Be aware that older patients report any and all pains.

3. Determine ROM in all limbs.

4. Not refer to past injuries or conditions.

5. Mr. Cummins, a 69-year-old Caucasian male, presents with an inability to move his right arm sufficiently. The nurse practitioner tells him that she will perform a physical examination and order tests to rule out which of the following?

1. Gout

2. Rheumatoid arthritis (RA)

3. Muscle weakness from a systemic condition

4. Osteoarthritis (OA)

6. Mrs. Cameron is a 72-year-old woman who comes to see her nurse practitioner for pain in her right thigh. The nurse practitioner assesses that Mrs. Smith has bruises on her thigh and muscle weakness distally, near the knee. The nurse practitioner suspects which of the following?

1. Musculoskeletal lesions

2. Tendon rupture

3. Gout

4. Arthritis

7. The nurse practitioner calls Mr. Smith to come into the examining room. As he is coming in, the nurse practitioner observes his gait to assess for musculoskeletal conditions. One abnormal sign is:

1. Unbalance in gait.

2. Lack of a lurch.

3. Symmetrical leg movement.

4. Ability to sit in and get out of a chair without using arms.

Multiple Response

8. Mr. Weisner is a 65-year-old male who is experiencing pain in his joints. The nurse practitioner assesses which of the following? Select all that apply.

1. Movement of the joint in a relaxed position.

2. Movement of the joint in flexion.

3. Movement of the joint in extension.

4. Appearance of the limb being normal for his age.

5. Absence of any curvatures in the limb.

9. Tom Brown is 62 years old and plays golf twice a week. He experiences pain in his shoulder and goes to the urgent care center to be seen by his nurse practitioner. The nurse practitioner asks which of the following questions? Select all that apply.

1. Does the shoulder hurt when you are not playing golf?

2. Is there any swelling, redness, or pain?

3. Is there any family history of arthritis?

4. Is there a history of taking ibuprofen?

5. Does your pain affect your golf game?

10. Mrs. Rivets is an 80-year-old female who comes to the emergency department with complaints of a low-grade fever and pain in her lower leg that is aggravated by movement. Which early treatment does the nurse practitioner implement? Select all that apply.

1. Protection of the lower leg, rest, and application of an ice pack.

2. Salt compresses and an antibiotic.

3. Compression dressing and an antibiotic.

4. Compression dressing and warm compresses.

5. Elevation of the leg and pain medication.

11. Mr. Jamison, a 67-year-old male, is being seen in the clinic for complaints of pain in his thigh. There is swelling in the soft tissue, dislocation, altered ROM, bruising, local tenderness, and pain with any motion. The nurse practitioner suspects a femoral neck fracture. What could have contributed to this fracture? Select all that apply.

1. Direct injury to the femur.

2. Sleeping on his side.

3. Osteoporosis.

4. Heavy lifting.

5. Bending over at the waist.

12. Miss Benton is a 65-year-old female who complains of a painful big toe on the right foot. She asks the nurse practitioner if this is normal for older people. The nurse practitioner explains that this appears to be gout, and gives her what information? Select all that apply.

1. Gout is an inflammatory condition of joints, tissues, and kidneys.

2. Gout is a problem with a protein called purine.

3. Gout is rare in older people.

4. Gout is localized to the big toe.

5. Long-term use of some medications can lead to gout.

13. A 65-year-old woman seeks relief from pain and swelling in her hands. She consults with a nurse practitioner for diagnosis and treatment. The nurse practitioner conducts an examination and interview about the patient’s ADLs and how this pain and swelling inhibits her activity. Which of the following diagnostic tests will be ordered? Select all that apply.

1. Radiology of both hands.

2. Blood tests for conditions such as rheumatic factor.

3. Anti-cyclic citrullinated peptide (anti-CCP) antibodies.

4. Urinalysis.

5. Abdominal ultrasound.

14. The nurse practitioner is asked to order medication for pain and disease control for a 60-year-old patient who has suffered with RA for years. Which is the most common treatment? Select all that apply.

1. Corticosteroids

2. NSAIDs

3. Analgesics

4. Biological disease-modifying antirheumatic drugs (DMARDs)

5. Tumor necrosis factor (TNF) receptor antagonists

15. Mrs. Owen, 70 years old, is being discharged from the rehabilitation center to go home. Her RA pain is under currently control. What does the nurse practitioner include in the follow-up instructions? Select all that apply.

1. Get plenty of rest during the day.

2. Exercise and move throughout the day.

3. Learn about the side effects of your medication.

4. Read literature for antidotes that cure RA.

5. Keep your regular health-care visits, as there are no support organizations for RA.

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