Chapter 27 Musculoskeletal Care

Chapter 27  Musculoskeletal Care

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. A nurse working in an urgent care center is caring for a 15-year-old football player who came for an evaluation. After some diagnostic testing, the physician informs the client that the injury is a “bad sprain.” The nurse recognizes that the injury involves
A.
Torn ligaments.
B.
A fine crack in the ankle bone.
C.
Injury to a long bone.
D.
Damage to cartilage tissue.

____ 2. The potential need for amputation will most likely be discussed as part of the medical and surgical care for
A.
A 27-year-old in a car accident with a comminuted fracture of the left femur.
B.
A 64-year-old with severe peripheral vascular disease and multiple open lesions.
C.
A 71-year-old with osteoarthritis in both knees.
D.
A 54-year-old with a newly developed diabetic foot ulcer.

____ 3. A nurse working in the emergency room is providing care for a patient with a history of prostate cancer who reports, “I heard a snap while I was delivering newspapers and my arm just flopped. I think it is broken.” The nurse expects which of the following to be ordered?
A.
A magnetic resonance imagining scan (MRI).
B.
A computed tomography (CT) scan.
C.
An x-ray.
D.
A bone scan.

____ 4. The nurse is providing care for a patient with an Ilizarov frame. The nurse would chart
A.
“Rod, wires, and screw ring intact without evidence of redness or drainage.”
B.
“Petaling performed to outer cast edge.”
C.
“Weight suspended at 90 degrees.”
D.
“Patient using abduction pillow as instructed.”

____ 5. A motor vehicle accident resulting in a comminuted fracture of the right fibula has left the right leg shorter than the left. Which of the following could be used to stimulate bone lengthening?
A.
Plaster casting
B.
Skin traction
C.
Ilizarov frame
D.
Internal fixators

Chapter 27. Musculoskeletal Care
Answer Section

MULTIPLE CHOICE

1. ANS: A

Feedback
A
A sprain is an injury to a joint that results in damage to muscles and ligaments. Severe sprains may cause ligaments to be completely torn. Chapter Objective: Define key terms associated with musculoskeletal care.
B
A fine crack in the ankle bone is not involved in a sprain.
C
Injury to a long bone is not involved in a sprain.
D
Damage to cartilage tissue is not involved in a sprain.

PTS: 1 REF: Chapter: 27 | Page: 592 OBJ: Chapter Objective: 27-1
KEY: Content Area: Mobility/Immobility | Integrated Process: Nursing Process/Assessment | Client Need: Basic Care and Comfort | Cognitive Level: Comprehension

2. ANS: B

Feedback
A
The comminuted fracture involves multiple bone pieces, but it should heal without amputation.
B
When a limb is so damaged by trauma that it cannot be saved, it will be amputated, or surgically removed. Other reasons for amputation include severely decreased blood flow to the limb and gangrene of a limb. The poor circulation with severe peripheral vascular disease will compromise healing and eventual amputation may be necessary if infection or necrosis cannot be prevented. Chapter Objective: Describe nursing care of patients with musculoskeletal conditions, including casts, traction, joint replacement, and amputation.
C
Osteoarthritis would be treated with joint replacement, not amputation.
D
Amputation may be necessary in diabetic patients, but medical treatment would be instituted first.

PTS: 1 REF: Chapter: 27 | Page: 592 OBJ: Chapter Objective: 27-6
KEY: Content Area: Alterations in Body Systems | Integrated Process: Nursing Process/Planning | Client Need: Physiological Adaptation | Cognitive Level: Analysis

3. ANS: A

Feedback
A
MRI is used when pathological fractures occur because they are usually associated with bone tumors. Chapter Objective: Differentiate between indications for use of x-rays, CT scans, and MRIs to diagnose musculoskeletal conditions.
B
CT scan is not the best test to evaluate the patient’s condition.
C
X-ray is not the best test to evaluate the patient’s condition.
D
Bone scan is not the best test to evaluate the patient’s condition.

PTS: 1 REF: Chapter: 27 | Page: 593 OBJ: Chapter Objective: 27-4
KEY: Content Area: Diagnostic Tests | Integrated Process: Nursing Process/Planning | Client Need: Reduction of Risk Potential | Cognitive Level: Application

4. ANS: A

Feedback
A
The Ilizarov frame is composed of metal rings on the outside of the limb, with rods and wires that attach to those rings. Chapter Objective: Describe nursing care of patients with musculoskeletal conditions, including casts, traction, joint replacement, and amputation.
B
Casts are not used with an Ilizarov frame.
C
Weights are used for skeletal traction.
D
An abduction pillow is used after hip replacement surgery.

PTS: 1 REF: Chapter: 27 | Page: 594 OBJ: Chapter Objective: 27-6
KEY: Content Area: Mobility/Immobility | Integrated Process: Communication and Documentation | Client Need: Basic Care and Comfort | Cognitive Level: Application

5. ANS: C

Feedback
A
Plaster casting will not stimulate bone growth.
B
Skin traction will not stimulate bone growth.
C
The Ilizarov frame is also used in situations in which one leg has been left shorter than the other after trauma. By turning screws in the frame, the rings separate slightly; over time, the bone grows to fill in the gap. Chapter Objective: Enumerate six types of immobilizing devices used for musculoskeletal disorders.
D
Internal fixators will not stimulate bone growth.

PTS: 1 REF: Chapter: 27 | Page: 594 OBJ: Chapter Objective: 27-5
KEY: Content Area: Mobility/Immobility | Client Need: Basic Care and Comfort | Cognitive Level: Comprehension | Integrated Process: N/A