Chapter 68 Management of Patients With Musculoskeletal Disorders

Multiple Choice

1. The nurse is caring for a 35-year-old man diagnosed with a back strain. What would be important to discuss with this patient?
A) Avoid lifting more than one-third of his body weight without assistance.
B) Focus on using back muscles during lifting.

C) Lift objects while holding the object away from the body.
D) Tighten the abdominal muscles and lock the knees during the lifting of an object.

Ans: A
Chapter: 68
Client Needs: D-3
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Teaching/Learning Objective: 1
Page and Header: 2056, Low Back Pain

Feedback: The nurse will instruct the patient on the safe and correct way to lift objects—using the strong quadriceps muscles of the thighs, with minimal use of the weak back muscles. To prevent recurrence of acute low back pain, the nurse may instruct the patient to avoid lifting more than one-third of his weight without help. The patient should be informed to place the feet

a hip-width apart to provide a wide base of support, the person should bend the knees, tighten the abdominal muscles, and lift the object close to the body with a smooth motion, avoiding twisting and jerking.

2. The nurse is discussing conservative management of tendonitis with a patient. Which of the following may be an effective approach to managing tendonitis?
A) Weight reduction
B) Stress reduction

C) Intermittent application of ice and heat to the affected joint D) Range of motion of the affected joint

Ans: C
Chapter: 68
Client Needs: D-4
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Teaching/Learning
Objective: 2
Page and Header: 2057, Common Upper Extremity Problems

Feedback: Conservative management of tendonitis includes rest of the extremity, intermittent ice and heat to the joint, and nonsteroidal anti-inflammatory drugs to control the inflammation and pain. Weight reduction, stress reduction, and range-of-motion exercises are not part of conservative management of tendonitis.

3. A 42-year-old man presents at the clinic complaining of pain in his heel so bad it inhibits his ability to walk. The patient is diagnosed with plantar fasciitis. Patient teaching provided by the nurse would include what instructions to decrease the pain associated with this condition?
A) Wrapping the affected area in lamb’s wool or gauze

B) Gently stretching the foot and the Achilles tendon C) Wearing open-toed shoes
D) Application of keratolytic ointment

Ans: B
Chapter: 68
Client Needs: D-3
Cognitive Level: Application Difficulty: Difficult
Integrated Process: Teaching/Learning Objective: 3

Page and Header: 2060, Common Foot Problems

Feedback: Plantar fasciitis leads to pain that is localized to the anterior medial aspect of the heel and diminishes with gentle stretching of the foot and Achilles tendon.

4. A nurse is providing an educational class to a group of older adults at a community senior center. The topic of the class is nutrition. The nurse informs the group that the recommended adequate intake (RAI) level of calcium daily is what?
A) 1000 mg

B) 1100 mg C) 1200 mg D) 1300 mg

Ans: C
Chapter: 68
Client Needs: D-2
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 5
Page and Header: 2063, Metabolic Bone Disorders

Feedback: The RAI level of calcium for adults 51 years of age and older is 1200 mg per day. The RAI level of calcium for ages 9 to 19 years of age is 1300 mg per day. The RAI level for adults 19 to 50 years of age is 1000 mg per day.

5. The nurse is providing a class on osteoporosis at the local senior citizens center. Which of the following statements related to osteoporosis is correct?
A) Osteoporosis is a disease of the elderly.
B) A non-modifiable risk factor for osteoporosis is a person’s level of activity.

C) Secondary osteoporosis occurs in women after menopause.
D) Slow discontinuation of your corticosteroid therapy will halt the progression of the osteoporosis, but not restore the lost bone mass.

Ans: D
Chapter: 68
Client Needs: B
Cognitive Level: Application Difficulty: Difficult
Integrated Process: Teaching/Learning

Objective: 4
Page and Header: 2063, Metabolic Bone Disorders

Feedback: When corticosteroid therapy is discontinued, the progression of osteoporosis is halted, but restoration of lost bone mass does not occur. Osteoporosis is not a disease of the elderly because its onset occurs earlier in life, when bone mass peaks and then begins to decline. A person’s level of physical activity is a modifiable factor that influences peak bone mass. Lack of activity increases the risk for the development of osteoporosis. Primary osteoporosis occurs in women after menopause.