Chapter 14 Musculoskeletal System

Chapter 14  Musculoskeletal System

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which description of pain from the patient makes a nurse suspect the patient’s pain is originating from a muscle?
a.
“Crampy”
b.
“Dull and deep”
c.
“Boring and intense”
d.
“Sharp upon movement”

ANS: A

Feedback
A
Muscle pain is often described as “crampy.”
B
Bone pain typically is described as “deep” and “dull.”
C
Bone pain typically is described as “boring” and “intense.”
D
Muscle pain usually remains crampy on movement.

DIF: Cognitive Level: Understand REF: 301
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems

2. A nurse asks a patient to describe his new onset of leg pain. He slept well through the night, but this morning he suddenly developed pain in his left lower leg that is red and too painful to touch. Nothing relieves the pain. Based on these data, the nurse suspects which disorder is causing this pain?
a.
Rheumatoid arthritis
b.
Osteoarthritis
c.
Gout
d.
Tendonitis

ANS: C

Feedback
A
Patients with rheumatoid arthritis often have morning stiffness lasting 1 to 2 hours.
B
Patients with osteoarthritis experience pain when bearing weight that is relieved by rest.
C
Sudden onset of pain and erythema in the great toe, ankle, and lower leg suggests gout (also called gouty arthritis).
D
Tendonitis may awaken the patient, especially when the patient is lying on the affected limb.

DIF: Cognitive Level: Apply REF: 301| 332
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems

3. During a history, the patient reports having gout. Based on this information, what findings does the nurse anticipate during a focused assessment?
a.
Warm, tender, and deformed wrists and peripheral interphalangeal (PIP) joints bilaterally
b.
Edema, warmth, and redness of one great toe and pea-like nodules in the ear lobes
c.
Enlarged and tender PIP or distal interphalangeal (DIP) joints on one or several fingers
d.
Tenderness with pronation and supination of the elbow and point tenderness on the lateral epicondyle

ANS: B

Feedback
A
This is a description of findings of a patient who has rheumatoid arthritis. Bilateral joint involvement is common.
B
This is a description of gout. The pealike nodules are tophi, collections of uric acid in subcutaneous tissue.
C
This is a description of findings of a patient who has osteoarthritis. Enlarged and tender PIP joints refer to Heberden nodes and DIP joints refer to Bouchard nodes.
D
This is a description of epicondylitis (tennis elbow).

DIF: Cognitive Level: Apply REF: 301| 332
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems

4. A patient reports joint pain interfering with sleep and morning joint stiffness for the first hour after getting out of bed. Considering this report, what abnormal findings does the nurse anticipate during the examination?
a.
Abrupt onset of local tenderness, edema, and decreased range of motion of the shoulder and hip bilaterally
b.
Decreased range of motion of one hip and knee with pain on flexion and crepitus during movement of these joints
c.
Erythema in one great toe, ankle, and lower leg that is painful to the touch
d.
Hot, painful, deformed, and edematous wrists and peripheral interphalangeal joints bilaterally

ANS: D

Feedback
A
This examination finding is more consistent with bursitis.
B
This examination finding is more consistent with osteoarthritis.
C
This examination finding is more consistent with gout.
D
The history and these examination findings are consistent with rheumatoid arthritis. Joints are involved bilaterally in rheumatoid arthritis because it is a systemic autoimmune disorder.

DIF: Cognitive Level: Analyze REF: 301| 318| 332
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body Systems