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Musculoskeletal System Exam Prep Ch.23

Health & Physical Assessment in Nursing, 4e (Fenske/Watkins/Saunders/D'Amico/Barbarito)

Chapter 23 Musculoskeletal System

The nurse is caring for a client with a right femur fracture. Which category of bone should the nurse identify the femur as when discussing the fracture with the client?

1. Short.

2. Long.

3. Flat.

4. Irregular.

Page Ref: 536

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Promotion/Disease Prevention

Standards: QSEN Competencies: III.A.1. Demonstrate knowledge of basic scientific methods and processes. | AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal education into nursing practice. | NLN Competencies: Knowledge and Science: Relationships between knowledge/science and quality and safe patient care. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23.1: Describe the anatomy and physiology of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

The client is recovering from the surgical repaid of a fractured arm. When discussing the effects of the fracture with the client, which skeletal bone functions should the nurse include in the teaching? Select all that apply.

1. Provide a body framework.

2. Provide movement.

3. Maintain posture.

4. Generate heat.

5. Calcium storage.

Page Ref: 536

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Promotion/Disease Prevention

Learning Outcome: 23.1: Describe the anatomy and physiology of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

The nurse assessing a client experiencing pain in their right foot observes swelling and inflammation of the foot and deviation of the big toe from the midline associated with crowding of the remaining toes. Which condition does the nurse suspect?

1. Flat foot.

2. Gouty arthritis.

3. Hammertoe.

4. Bunion.

Page Ref: 583

Cognitive Level: Analyzing

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Standards: QSEN Competencies: III.A.5. Explain the role of evidence in determining best clinical practice. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse asks the client to point their toes up towards their nose during an examination of the lower extremities. Which type of movement is the nurse assessing?

1. Inversion.

2. Plantar flexion.

3. Eversion.

4. Dorsiflexion.

Page Ref: 541

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.4: Outline the techniques for assessment of the musculoskeletal system.

MNL Learning Outcome: 23.3. Utilize the appropriate techniques and tools for physical assessment of the musculoskeletal system.

Which instructions should the nurse provide a client to assess the lateral flexion? Select all that apply.

1. "Tilt your head back and look at the ceiling."

2. "Lean your head to the side and attempt to touch your ear to your shoulder."

3. "Bend sideways to the right and to the left while I stabilize your pelvis."

4. "Attempt to raise your shoulders up toward your ears."

5. "Attempt to rotate your head in a circular manner."

Page Ref: 575

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.4: Outline the techniques for assessment of the musculoskeletal system.

MNL Learning Outcome: 23.3. Utilize the appropriate techniques and tools for physical assessment of the musculoskeletal system.

The nurse is caring for a client with a knee injury. When documenting this injury in the medical record, the nurse identifies the knee as which type of joint?

1. Saddle.

2. Hinge.

3. Pivot.

4. Plane.

Page Ref: 540

Cognitive Level: Understanding

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.5: Generate the appropriate documentation to describe the assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse is preparing to assess the posterior spine of a client. Which landmark should the nurse use to determine symmetry?

1. Iliac crests.

2. Twelfth thoracic vertebrae.

3. Posterior superior iliac spine.

4. Paravertebral muscles.

Page Ref: 574

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.2: Identify the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

MNL Learning Outcome: 23.3. Utilize the appropriate techniques and tools for physical assessment of the musculoskeletal system.

Which degree of wrist movement is an expected finding when assessing extension?

1. 90 degrees.

2. 70 degrees.

3. 30 degrees.

4. 20 degrees.

Page Ref: 564

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Learning Outcome: 23.2: Identify the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The school nurse is assessing adolescent females for scoliosis. Which area of the spine does the nurse plan to assess?

1. Thoracic.

2. Lumbar.

3. Cervical.

4. Sacral.

Page Ref: 564

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.2: Identify the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

The nurse is preparing to perform the bulge test on a client's left knee. When performing the test, which area of the knee should the nurse assess for bulging?

1. Posterior.

2. Medial.

3. Lateral.

4. Anterior.

Page Ref: 569

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.4: Outline the techniques for assessment of the musculoskeletal system.

MNL Learning Outcome: 23.3. Utilize the appropriate techniques and tools for physical assessment of the musculoskeletal system.

A client comes to the emergency department (ED) complaining of a painful injury to the right knee received while playing basketball. Which examination techniques will the nurse include during the physical assessment of this client? Select all that apply.

1. Inspection.

2. Palpation.

3. Bulge sign testing.

4. Auscultation.

5. Percussion.

Page Ref: 569

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.4: Outline the techniques for assessment of the musculoskeletal system.

MNL Learning Outcome: 23.3. Utilize the appropriate techniques and tools for physical assessment of the musculoskeletal system.

The nurse is preparing to assess a client's spine for abnormalities. Which instruction should the nurse provide the client?

1. Sit down and then stand as the nurse looks from the front of the client.

2. Stand, bend back slowly, and then bend to the right and left while the nurse looks from the back.

3. Bend over, stand tall, and stretch arms over the head.

4. Sit down and then lean forward and dangle the arms at the sides of the body.

Page Ref: 575-576

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Techniques of Physical Assessment

Learning Outcome: 23.4: Outline the techniques for assessment of the musculoskeletal system.

MNL Learning Outcome: 23.3. Utilize the appropriate techniques and tools for physical assessment of the musculoskeletal system.

A client tells the nurse they feel numbness and tingling in their hands after they were instructed to bend their wrist downward and press their hands together. Which condition should the nurse suspect?

1. Arthritis of the wrists.

2. Carpal tunnel syndrome.

3. Crepitus of the wrists.

4. Dupuytren contracture.

Page Ref: 565

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse is assessing a client with the inability to move their fourth and fifth fingers. The nurse notes severe flexion in both of the affected fingers but no complaints of pain during palpation. Based on this data, which diagnosis should the nurse suspect?

1. Dupuytren contracture.

2. Carpal tunnel syndrome.

3. Bursitis.

4. Osteoarthritis.

Page Ref: 565

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse notes a round mass on the back of a client's wrist. Which question should the nurse ask the client?

1. Do you have a history of rheumatoid arthritis?

2. Do you have a history of osteoarthritis?

3. Do you have a history of ganglion cysts?

4. Do you have a history of carpal tunnel syndrome?

Page Ref: 562

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.3: Determine which questions about the musculoskeletal system to use for the focused interview.

MNL Learning Outcome: 23.2. Plan questions about the musculoskeletal system for the focused interview.

The nurse notes there is a grating sound in a client's joint when they bend and straighten it. Which terminology should the nurse use when documenting this finding?

1. Subluxation.

2. Grinding.

3. Crepitation.

4. Joint dislocation.

Page Ref: 554

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.5: Generate the appropriate documentation to describe the assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse assesses a client with tenderness and stiffness in the wrist and elbow. The client reports that their discomfort is worsened with activity. Which condition should the nurse suspect?

1. Carpal tunnel syndrome.

2. Osteoarthritis.

3. Crepitus of the wrists.

4. Dupuytren contracture.

Page Ref: 578

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

When assessing the strength of a client's upper extremities, a full range of motion against gravity with moderate resistance is noted. Which should the nurse document the finding as?

1. Poor.

2. Normal.

3. Fair.

4. Good.

Page Ref: 558

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Learning Outcome: 23.5: Generate the appropriate documentation to describe the assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse notes swelling and tenderness of the olecranon process during the palpation. Which condition should the nurse suspect?

1. Arthritis.

2. Bursitis.

3. Epicondylitis.

4. Crepitus.

Page Ref: 558

Cognitive Level: Analyzing

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse observes an exaggerated lumbar curve while inspecting the spine of a client. Which term should the nurse use when documenting the finding?

1. Lordosis.

2. Scoliosis.

3. Kyphosis.

4. Flattened curve.

Page Ref: 580

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.5: Generate the appropriate documentation to describe the assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse notes asymmetry of the iliac crests and gluteal folds while inspecting the spine of a client. The spine has a slight curvature to the right but the client denies complaints of pain. Which term should the nurse use when documenting this finding?

1. Kyphosis.

2. Scoliosis.

3. Spinal list.

4. Lordosis.

Page Ref: 579

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.5: Generate the appropriate documentation to describe the assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse assessing a client's big toe notes hardened nodules on the lateral aspect of the toe, as well as redness, swelling, and pain. Which condition should the nurse suspect?

1. Bunion.

2. Synovitis.

3. Hammertoe.

4. Gout.

Page Ref: 583

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse is assessing a client with suspected rheumatoid arthritis (RA). Which musculoskeletal changes would contribute to a positive diagnosis of RA? Select all that apply.

1. Ulnar deviation.

2. Bouchard nodes.

3. Heberden's nodes.

4. Swan-neck deformity.

5. Symmetrical loss of function in extremities.

Page Ref: 561, 582

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse is reviewing the records of a child with a protein deficiency and a fractured tibia. Which should the nurse be concerned with?

1. Bone growth.

2. Low bone density.

3. Bone healing.

4. Tissue healing.

Page Ref: 550

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

A client tells the nurse they have just lost 75 pounds after gastric bypass surgery. Which condition should the nurse recognize the client is at risk for?

1. Protein deficiency.

2. Vitamin D deficiency.

3. Osteoporosis.

4. Osteoarthritis.

Page Ref: 550

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity; Nutrition and Oral Hydration

Standards: QSEN Competencies: I.B.1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

The nurse is preparing to assess a client with a suspected tear of the rotator cuff. Which range of motion will the client be unable to perform without lifting or shrugging their shoulders?

1. Flex the elbow.

2. Adduct the shoulder.

3. Abduct the shoulder

4. Supinate or pronate the hands

Page Ref: 556

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity; Mobility/Immobility

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

A client expresses discomfort when attempting to flex their wrist against resistance. Which should the nurse suspect the client is experiencing?

1. Tendonitis.

2. Subluxation.

3. Medial epicondylitis.

4. Lateral epicondylitis.

Page Ref: 558

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

A client expresses discomfort during a Durkan's test. Which condition should the nurse suspect?

1. Ganglion.

2. Osteoarthritis.

3. Carpal tunnel syndrome.

4. Epicondylitis.

Page Ref: 564

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.4. Differentiate normal and abnormal variations of the musculoskeletal system observed during physical assessment.

The nurse is evaluating a client's ability to bend the elbow by bringing the forearm forward and touching the fingers to the shoulder. Which degree of flexion should the nurse anticipate?

1. 90°.

2. 160°.

3. 180°.

4. 200°.

Page Ref: 559

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise, and evidence. | AACN Essentials Competencies: VII.3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 23.2: Identify the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

A client asks the nurse what a shoulder dislocation is. Which response should the nurse provide the client?

1. "Your tendons and muscles have been damaged."

2. "You have a muscle tear at the shoulder."

3. "Your shoulder bone has come apart from the shoulder joint."

4. "Your shoulder is fractured and separated from the joint."

Page Ref: 579

Cognitive Level: Understanding

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

The nurse is discharging a client with osteoarthritis. Which information should the nurse include in this client's discharge teaching? Select all that apply.

1. Obesity increases the risks of bone, muscle, and joint disorders.

2. Musculoskeletal health is influenced by the diet.

3. Exercise is important in the prevention of osteoarthritis.

4. Smoking and alcohol contribute to the development of osteoarthritis.

5. As the condition progresses, the hands may develop contractures that resemble swan necks.

Page Ref: 550

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.6: Identify abnormal findings in the physical assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

The nurse is assessing a pregnant client. Which finding should the nurse anticipate when assessing the spine?

1. Kyphosis.

2. Scoliosis.

3. Lordosis.

4. Flattened lumbar curve.

Page Ref: 573, 579

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Health Screening

Learning Outcome: 23.2: Identify the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

MNL Learning Outcome: 23.1. Consider the anatomic, physiologic, developmental, psychosocial, and cultural variations that guide assessment of the musculoskeletal system.

33) The nurse is preparing to interview a client with osteoporosis. Which question related to symptoms should the nurse include?

1. "Do you have difficulty breathing?"

2. "Have you had any recent weight gain or loss?"

3. "Are you currently taking any medications?"

4. "Do you feel you get adequate sleep at night?"

Page Ref: 549

Cognitive Level: Applying

Client Need & Sub: Physiological Adaptation; Alterations in Body Systems

Learning Outcome: 23.3: Determine which questions about the musculoskeletal system to use for the focused interview.

MNL Learning Outcome: 23.2. Plan questions about the musculoskeletal system for the focused interview.

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DOCX

Chapter Number:

Created Date:

Aug 21, 2025

Chapter Name:

Chapter 23 Musculoskeletal System

Author:

Cynthia Fenske

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Musculoskeletal System Exam Prep Ch.23

Health & Physical Assessment in Nursing, 4e (Fenske/Watkins/Saunders/D'Amico/Barbarito)

Chapter 23 Musculoskeletal System

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