Chapter 04 Care of the Patient with a Musculoskeletal Disorder

Chapter 04  Care of the Patient with a Musculoskeletal Disorder

MULTIPLE CHOICE

1. The movement of an extremity away from the midline of the body is called a. abduction.

b. adduction. c. flexion.
d. extension.

ANS: A
Abduction is movement of an extremity away from the midline of the body.

DIF: Cognitive Level: Knowledge REF: Page 113, Box 4-2 OBJ: 6 TOP: Movements KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. The large, fan-shaped muscle that covers the anterior chest from the sternum to the proximal end of the humerus and acts on the joint of the shoulder to flex, adduct, and rotate is

1. serratus anterior.
2. intercostal.
3. transversus abdominis.
4. pectoralis major.

ANS: D
Pectoralis major is the large, fan-shaped muscle that covers the anterior chest and is an adductor muscle, which will cause the shoulder to flex.

DIF: Cognitive Level: Knowledge REF: Page 112, Table 4-1, Figure 4-5 OBJ: 5 TOP: Muscle functions
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

3. Which diagnostic exam is used to find pathological abnormalities of the brain?

1. CT scan
2. Nuclear medicine scan
3. MRI
4. Radiograph

ANS: C
Magnetic resonance imaging (MRI) is used to detect pathological conditions of the cerebrum and spinal cord.

DIF: Cognitive Level: Knowledge REF: Page 115 OBJ: 9
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 4-2

TOP: Diagnostic examinations KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

4. The term unicompartmental knee arthroplasty is also referred to as

1. partial knee replacement.
2. removal of the kneecap.
3. total knee replacement.
4. total knee replacement bilaterally.

ANS: A
Unicompartmental knee arthroplasty is also referred to as partial knee replacement.

DIF: Cognitive Level: Knowledge REF: Pages 133, 172
OBJ: 15 TOP: Knee replacement
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

5. A patient, age 89, has had a right below-the-knee amputation. He is progressing well but continues to complain of pain in the toes on his right foot. The physician told him that he is suffering from “phantom pain” in his amputated extremity. He asks the nurse to explain phantom pain. The most appropriate response would be

1. “Phantom pain does not exist except in your mind.”
2. “I can’t answer that. You’ll have to ask the physician.”
3. “Phantom pain occurs because the nerve tracts that register pain in the amputated

   limb continue to send a message to the brain.”

4. “Phantom pain occurs when you start thinking about your loss. It’s best to keep

   your mind occupied with other things.”

ANS: C
Phantom pain (pain felt in the missing extremity as if it were still present) may occur and be frightening to the patient. Phantom pain occurs because the nerve tracts that register pain in the amputated area continue to send a message to the brain (this is normal).

DIF: Cognitive Level: Analysis REF: Pages 168-169
OBJ: 21 TOP: Amputation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

6. A patient, age 79, fell at home and suffered an intracapsular fracture of his left hip. The orthopedic surgeon inserted a prosthetic implant for a bipolar hip replacement. The physician has instructed the nurse to turn him every 2 hours. The nurse understands that the correct nursing intervention is to keep the legs

1. together so they don’t separate while turning.
2. from rubbing together.
3. abducted so the prosthesis does not become dislocated.
4. abducted to prevent additional pain for the patient with turning.

ANS: C

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 4-3

Nursing interventions also involve postoperative maintenance of leg abduction by using an abduction splint for 7 to 10 days to prevent dislocation of the prosthesis.

DIF: Cognitive Level: Application
REF: Pages 139, 142 Patient Teaching box, Figure 4-15 OBJ: 16 TOP: Fractured hip KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity