Chapter 53: Care of Patients with Musculoskeletal Problems Flashcards Quizlet PDF

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Chapter 53: Care of Patients with Musculoskeletal Problems Flashcards | Quizlet

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Chapter 53: Care of Patients with Musculoskeletal Problems Terms in this set (25) What is the pathophysiologic

ANS: B

process leading to the

Bone health is a dynamic process throughout life,

development of osteoporosis?

dependent on bone-forming osteoblastic activity in

A. Lack of erythropoietin

balance with bone resorption osteoclastic activity. As

production by aging kidneys

people age, osteoclastic activity occurs more rapidly

B. Rate of osteoclastic activity

than osteoblastic activity.

exceeding the rate of osteoblastic activity C. Insufficient intestinal absorption

Chapter 53: Care of Patients with Musculoskeletal Pr…

Study

muscle modeling processes as a

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Chapter 53: Care of Patients with Musculoskeletal Problems Flashcards | Quizlet

s is

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ANS: B

most at risk for secondary

Osteoporosis is more prevalent in postmenopausal

osteoporosis?

women, and certain medications, such as corticosteroids,

A. 33-year-old man recovering

increase the risk of secondary osteoporosis.

from a fractured wrist B. 55-year-old woman taking prednisone for asthma C. 72-year-old man who resides in a nursing home D. 25-year-old woman taking oral contraceptives

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While performing a physical

ANS: C

assessment on a client with

A client with known osteoporosis accompanied by

osteoporosis, the nurse notes that

tenderness to spinal palpation should be evaluated for

the client changes position slowly

one or more compression fractures.

and there is tenderness to palpation of the spinal vertebra at T8. What conclusion can the nurse draw from this data? A. The client has phallophobia. B. The client is developing kyphosis. C. The client has a compression fracture. D. The client has scoliosis.

A client has had a urinary

ANS: A

pyridinium crosslinks assay to

A urinary pyridinium crosslinks assay measures urinary

evaluate bone resorption. What

concentrations of pyridinium, a collagen substance

outcome result would the nurse

found in bone and cartilage. If bone loss is present,

expect to find in a client with

urinary levels of pyridinium increase.

osteoporosis? Increased A. Urinary pyridinium level B. Serum calcium level C. Urinary calcitonin level D. Serum parathyroid hormone level

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The client is scheduled to have

ANS: D

dual-energy x-ray absorptiometry

The test is a painless scan that requires no preparation or

scan (DEXA). What information

follow-up care.

regarding preparation for this test should be given to the client? A. "You will need to drink at least 500 mL of fluid 1 to 2 hours before the scan." B. "You will be given a sedative just prior to the scan to reduce any pain or anxiety." C. "You should consume increased amounts of calcium-rich foods for the 48 hours preceding the scan." D. "There is no special preparation required for this test."

A client has been advised to take

ANS: A

supplemental calcium carbonate.

Calcium carbonate should be taken with food, because

What instructions should be given

gastric acid is necessary for absorption.

to this client regarding this medication? A. "Take this medication with food." B. "These tablets should not be crushed." C. "Take this medication on an empty stomach." D. "The medication should not be swallowed with milk or other calcium products."

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A client with osteoporosis has

ANS: C

been prescribed raloxifene

Raloxifene (Evista) can cause liver function tests to rise or

(Evista). What laboratory data

worsen pre-existing hepatic disease. The nurse should

would suggest an adverse effect

monitor the client's liver function tests.

of this drug? A. Decreased serum calcium level B. Elevated cholesterol level C. Elevated liver function tests D. Decreased serum potassium level

To prevent bone density loss,

ANS: B

which exercise should the nurse

Weight-bearing, nonjarring exercises have been proven

recommend to a client at risk for

to reduce or slow bone loss without causing vertebral

osteoporosis?

compression

A. High-impact aerobics 45 minutes once weekly B. Walking 30 minutes three times weekly C. Jogging 30 minutes four times weekly D. Bowling for 1 hour twice weekly

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Which of the following

ANS: B

interventions should the nurse

Severe osteoporosis causes such bone density loss that

implement to prevent injury to the

pathologic fractures can easily occur when lifting or

client with severe osteoporosis?

pulling a client. Use of a lift sheet when positioning

A. Provide passive ROM to all

reduces this risk.

weight-bearing joints. B. Use a lift sheet to reposition the client. C. Place a pillow between the client's knees when in the sidelying position. D. Position the client as upright as possible when sitting to promote lung expansion.

Which of the following clients

ANS: B

would be most at risk for the

Clients with liver or pancreatic disease have decreased

development of osteomalacia?

vitamin D metabolism.

A. 72-year-old man with congestive heart failure B. 55-year-old woman with Laënnec's cirrhosis C. 22-year-old woman with type 1 diabetes D. 45-year-old woman with asthma

Which radiographic finding is

ANS: C

considered to be diagnostic for

The classic diagnostic finding on radiographs for

osteomalacia?

osteomalacia is Looser's lines. These lines represent

A. The presence of vertebral bone

nonmineralized stress fractures.

chip fractures B. The presence of mineralized fractures C. The presence of Looser's lines D. The presence of a string sign https://quizlet.com/68040423/chapter-53-care-of-patients-with-musculoskeletal-problems-flash-cards/

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Which clinical manifestation

ANS: D

indicates therapy for osteomalacia

The hypophosphatemia associated with osteomalacia

is successful?

decreases the amount of adenosine triphosphate

A. A weight gain of 5 pounds

available for muscle contraction and causes muscle

B. A serum calcium level of 8.8

weakness. An increase in lower extremity muscle strength

mg/dL

indicates that the condition is responding to the

C. An increased range of shoulder

treatment.

motion D. An increase in lower extremity muscle strength

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A client recently diagnosed with

ANS: C

Paget's disease of the bone asks

The disease may be the result of a latent viral infection

the nurse how this disease was

contracted in young adulthood and manifesting as

acquired. What is the rationale for

disease 20 to 40 years later.

the nurse's response? This disease A. Occurs in postmenopausal women who have a sedentary lifestyle. B. Is a chromosomal abnormality. C. Is thought to be the result of a latent viral infection. D. Can be acquired from intestinal parasites.

What is the primary complaint of a

Bone pain is the most common problem for symptomatic

client with severe Paget's disease?

clients with Paget's disease.

A. Visual disturbances B. Decreased energy C. Falls D. Pain ANS: D

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A client with Paget's disease has

ANS: B

been prescribed treatment with a

Etidronate (Didronel) is poorly absorbed from the small

6-month course of etidronate

intestine. It should be taken on an empty stomach 1 to 2

(Didronel). What instructions

hours after breakfast or at bedtime with water or juice.

would be most important for the nurse to provide to this client? A. "This medication may make you feel light-headed or sleepy." B. "Take this medication with water or juice 1 to 2 hours after breakfast." C. "This dosage will be increased over the course of therapy." D. "The medication may cause diarrhea."

A client with Paget's disease and

ANS: C

severe hypercalcemia is receiving

Mithramycin can affect kidney and liver function. It also

mithramycin intravenously. Which

can cause decreased numbers of platelets. The nurse

of the following should the nurse

monitors all these parameters. When liver enzyme levels

monitor for complications of this

become very high, treatment may be interrupted

therapy?

temporarily.

A. Pulse oximetry B. T3 and T4 levels C. Liver enzyme levels D. Heart rate and rhythm

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Which clinical manifestation would

ANS: A

serve to alert the nurse that a

Fever, swelling, and erythema are far less common in

client's osteomyelitis is chronic,

chronic osteomyelitis, whereas ulceration, sinus tract

rather than acute?

formation, and localized pain are more characteristic.

A. Ulceration of the skin B. Temperature more than 101° F (38° C) C. Erythema of the affected area D. Swelling around the affected area

A client is about to begin drug

ANS: B

therapy for osteomyelitis. What

Typically, osteomyelitis requires treatment with IV

information regarding this

antibiotics for several weeks. The client will leave the

treatment would be most

hospital with a central IV catheter for home infusion of

appropriate for the nurse to

the medication. Oral antibiotics for several more weeks

provide to the client?

usually follow the IV regimen.

A. "You will need to remain in the hospital for the duration of the treatment." B. "You will need to undergo treatment with IV antibiotics for several weeks." C. "Only close family members may be permitted to visit while you are receiving treatment." D. "Once the IV medications are completed, the infection is considered cured, and no further treatment is needed."

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Which of the following diagnostic

ANS: B

procedures can determine

Although different types of imaging can provide

whether a bone tumor is benign or

information associated with benign or malignant bone

malignant?

tumors, only a biopsy can confirm the tumor type.

A. Bone scan B. Bone biopsy C. Computed tomography D. Magnetic resonance imaging

A client has been diagnosed with

ANS: A

a primary bone tumor. What

A chondrosarcoma is characterized by dull pain and

information in the client's history

swelling of the affected area for a long period.

would lead the nurse to believe that this tumor is a chondrosarcoma? A. Dull pain and swelling of the affected area for a long period B. Pain and swelling of the affected area for a short period C. Local pain accompanied by muscle atrophy D. Local tenderness with a palpable mass

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A client diagnosed with Ewing's

ANS: C

sarcoma of the right leg confides

Ewing's sarcoma typically strikes young adults. The client

fears surrounding the loss of

needs assurance that these feelings of loss and grief are

independence with the loss of the

normal and are part of making the transition to adapting

limb to the nurse. What is the

to the illness. The nurse performs ongoing psychological

nurse's best response?

assessments and can initiate referral to a professional

A. "Physical therapy will assist you

counselor if needed.

to regain function once you are fitted with a prosthesis." B. "It is natural to feel this way, but you are young and will adjust to it." C. "Many people experience a feeling of grief and mourn this loss." D. "This surgery was necessary to save your life."

Clients with chronic, unremitting

ANS: A

osteomyelitis may benefit from the

The goal of hyperbaric oxygen therapy is to increase

use of hyperbaric oxygen (HBO).

tissue perfusion with a high concentration of oxygen that

The purpose of HBO is to

infuses into tissues to promote healing.

A. Increase tissue perfusion. B. Provide a bacteriocidal effect. C. Decrease the client's pain. D. Increase the client's mobility.

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The client is 8 hours postoperative

ANS: B

from limb salvage surgery for a

A rapid deterioration in circulatory status of the affected

tumor of the left thigh. On

extremity alerts the nurse to notify the physician

assessment, the nurse notes that

immediately.

the toes of the left foot are more edematous than they were 1 hour before, cooler to the touch, and have a slower capillary refill. What is the nurse's priority action at this time? A. Elevate the left foot. B. Notify the physician. C. Loosen the pressure dressing. D. Apply ice to the distal extremity.

Which of the following signs alerts

ANS: C

the nurse to the possibility of

Phalen's maneuver produces paresthesia in the median

carpal tunnel syndrome?

nerve within 60 seconds. Eighty percent of individuals

A. A positive Trousseau's sign

with CST have a positive Phalen's maneuver result

B. A positive Cullen's sign C. A positive Phalen's maneuver D. A positive Turner's sign

What maneuver should the nurse

ANS: A

ask the client with carpal tunnel

Motor changes begin with a weak pinch and progress to

syndrome to perform to assess for

muscle weakness and wasting. Asking the client to pick

early motor

up a coin is an example of testing the ability to pinch.

A. Ask the client to pick up a coin. B. Ask the client to grasp his or her hand. C. Ask the client to pick up a 5pound weight. D. Ask the client to place the backs of the hands together and flex the wrists.changes?

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