TB-Chapter 23 Musculoskeletal System PDF

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK

TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

337

Chapter23:MusculoskeletalSystem MULTIPLECHOICE 1.Apatientisbeingassessedforrange-of-jointmovement.Thenurseaskshimtomovehisarmintowardthe centerofhisbody.Thismovementiscalled: a.

Flexion.

b.

Abduction.

c.

Adduction.

d.

Extension.

ANS:C Movingalimbtowardthemidlineofthebodyiscalledadduction;movingalimbawayfromthemidlineof thebodyiscalledabduction.Flexionisbendingalimbatajoint;andextensionisstraighteningalimbata joint. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 2.Apatienttellsthenursethatsheishavingahardtimebringingherhandtohermouthwhensheeatsortries NURSINGTB.COM tobrushherteeth.Thenurseknowsthatforhertomoveherhandtohermouth,shemustperformwhich movement? a.

Flexion

b.

Abduction

c.

Adduction

d.

Extension

ANS:A Flexion,orbendingalimbatajoint,isrequiredtomovethehandtothemouth.Extensionisstraighteninga limbatajoint.Movingalimbtowardthemidlineofthebodyiscalledadduction;abductionismovingalimb awayfromthemidlineofthebody. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 3.Thefunctionalunitsofthemusculoskeletalsystemarethe: a.

Joints.

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b.

Bones.

c.

Muscles.

d.

Tendons.

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ANS:A Jointsarethefunctionalunitsofthemusculoskeletalsystembecausetheypermitthemobilityneededto performtheactivitiesofdailyliving.Theskeleton(bones)istheframeworkofthebody.Theotheroptionsare notcorrect. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 4.Whenreviewingthemusculoskeletalsystem,thenurserecallsthathematopoiesistakesplaceinthe: a.

Liver.

b.

Spleen.

c.

Kidneys.

d.

Bonemarrow.

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ANS:D Themusculoskeletalsystemfunctionstoencaseandprotecttheinnervitalorgans,tosupportthebody,to produceredbloodcellsinthebonemarrow(hematopoiesis),andtostoreminerals.Theotheroptionsarenot correct. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 5.Fibrousbandsrunningdirectlyfromonebonetoanotherthatstrengthenthejointandhelpprevent movementinundesirabledirectionsarecalled: a.

Bursa.

b.

Tendons.

c.

Cartilage.

d.

Ligaments.

ANS:D Fibrousbandsrunningdirectlyfromonebonetoanotherthatstrengthenthejointandhelppreventmovement

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inundesirabledirectionsarecalledligaments.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 6.Thenursenoticesthatawomaninanexerciseclassisunabletojumprope.Thenurseisawarethattojump rope,onesshoulderhastobecapableof: a.

Inversion.

b.

Supination.

c.

Protraction.

d.

Circumduction.

ANS:D Circumductionisdefinedasmovingthearminacirclearoundtheshoulder.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 7.Thearticulationofthemandibleandthetemporalboneisknownasthe: NURSINGTB.COM

a.

Intervertebralforamen.

b.

Condyleofthemandible.

c.

Temporomandibularjoint.

d.

Zygomaticarchofthetemporalbone.

ANS:C Thearticulationofthemandibleandthetemporalboneisthetemporomandibularjoint.Theotherresponsesare notcorrect. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 8.Topalpatethetemporomandibularjoint,thenursesfingersshouldbeplacedinthedepression__________ oftheear. a.

Distaltothehelix

b.

Proximaltothehelix

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c.

Anteriortothetragus

d.

Posteriortothetragus

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ANS:C Thetemporomandibularjointcanbefeltinthedepressionanteriortothetragusoftheear.Theotherlocations arenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 9.Ofthe33vertebraeinthespinalcolumn,thereare: a.

5lumbar.

b.

5thoracic.

c.

7sacral.

d.

12cervical.

ANS:A NURSINGTB.COM

Thereare7cervical,12thoracic,5lumbar,5sacral,and3to4coccygealvertebraeinthespinalcolumn. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 10.Animaginarylineconnectingthehighestpointoneachiliaccrestwouldcrossthe__________vertebra. a.

Firstsacral

b.

Fourthlumbar

c.

Seventhcervical

d.

Twelfththoracic

ANS:B Animaginarylineconnectingthehighestpointoneachiliaccrestcrossesthefourthlumbarvertebra.Theother optionsarenotcorrect. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 11.Thenurseisexplainingtoapatientthatthereareshockabsorbersinhisbacktocushionthespineandto

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helpitmove.Thenurseisreferringtohis: a.

Vertebralcolumn.

b.

Nucleuspulposus.

c.

Vertebralforamen.

d.

Intervertebraldisks.

ANS:D Intervertebraldisksareelasticfibrocartilaginousplatesthatcushionthespinesimilartoshockabsorbersand helpitmove.Thevertebralcolumnisthespinalcolumnitself.Thenucleuspulposusislocatedinthecenterof eachdisk.Thevertebralforamenisthechannel,oropening,forthespinalcordinthevertebrae. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 12.Thenurseisprovidingpatienteducationforamanwhohasbeendiagnosedwitharotatorcuffinjury.The nurseknowsthatarotatorcuffinjuryinvolvesthe: a.

Nucleuspulposus.

b.

Articularprocesses.

c.

Medialepicondyle.

d.

Glenohumeraljoint.

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ANS:D Arotatorcuffinjuryinvolvestheglenohumeraljoint,whichisenclosedbyagroupoffourpowerfulmuscles andtendonsthatsupportandstabilizeit.Thenucleuspulposusislocatedinthecenterofeachintervertebral disk.Thearticularprocessesareprojectionsineachvertebraldiskthatlockontothenextvertebra,thereby stabilizingthespinalcolumn.Themedialepicondyleislocatedattheelbow. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 13.Duringaninterviewthepatientstates,Icanfeelthisbumponthetopofbothofmyshouldersitdoesnthurt butIamcuriousaboutwhatitmightbe.Thenurseshouldtellthepatientthatitishis: a.

Subacromialbursa.

b.

Acromionprocess.

c.

Glenohumeraljoint.

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d.

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Greatertubercleofthehumerus.

ANS:B Thebumpofthescapulasacromionprocessisfeltattheverytopoftheshoulder.Theotheroptionsarenot correct. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 14.Thenurseischeckingtherangeofmotioninapatientskneeandknowsthatthekneeiscapableofwhich movement(s)? a.

Flexionandextension

b.

Supinationandpronation

c.

Circumduction

d.

Inversionandeversion

ANS:A NURSINGTB.COM

Thekneeisahingejoint,permittingflexionandextensionofthelowerlegonasingleplane.Thekneeisnot capableoftheothermovementslisted. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 15.Apatientisvisitingtheclinicforanevaluationofaswollen,painfulknuckle.Thenursenoticesthatthe knuckleabovehisringonthelefthandisswollenandthatheisunabletoremovehisweddingring.Thisjoint iscalledthe_________joint. a.

Interphalangeal

b.

Tarsometatarsal

c.

Metacarpophalangeal

d.

Tibiotalar

ANS:C Thejointlocatedjustabovetheringonthefingeristhemetacarpophalangealjoint.Theinterphalangealjointis locateddistaltothemetacarpophalangealjoint.Thetarsometatarsalandtibiotalarjointsarefoundinthefoot andankle. DIF:CognitiveLevel:Understanding(Comprehension)

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343

MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 16.Thenurseisassessingapatientsischialtuberosity.Topalpatetheischialtuberosity,thenurseknowsthatit isbesttohavethepatient: a.

Standing.

b.

Flexingthehip.

c.

Flexingtheknee.

d.

Lyinginthesupineposition.

ANS:B Theischialtuberosityliesunderthegluteusmaximusmuscleandispalpablewhenthehipisflexed.Theother optionsarenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 17.Thenurseisexaminingthehipareaofapatientandpalpatesaflatdepressionontheupper,lateralsideof thethighwhenthepatientisstanding.Thenurseinterpretsthisfindingasthe: a.

Ischialtuberosity.

b.

Greatertrochanter.

c.

Iliaccrest.

d.

Gluteusmaximusmuscle.

NURSINGTB.COM

ANS:B Thegreatertrochanterofthefemurispalpatedwhenthepersonisstanding,anditappearsasaflatdepression ontheupperlateralsideofthethigh.Theiliaccrestistheupperpartofthehipbone;theischialtuberositylies underthegluteusmaximusmuscleandispalpablewhenthehipisflexed;andthegluteusmuscleispartofthe buttocks. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 18.Theanklejointisthearticulationofthetibia,fibula,and: a.

Talus.

b.

Cuboid.

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c.

Calcaneus.

d.

Cuneiformbones.

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ANS:A Theankleortibiotalarjointisthearticulationofthetibia,fibula,andtalus.Theotherboneslistedarefoot bonesandnotpartoftheanklejoint. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:General 19.Thenurseisexplainingthemechanismofthegrowthoflongbonestoamotherofatoddler.Wheredoes lengtheningofthebonesoccur? a.

Bursa

b.

Calcaneus

c.

Epiphyses

d.

Tuberosities NURSINGTB.COM

ANS:C

Lengtheningoccursattheepiphyses,orgrowthplates.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 20.Awomanwhois8monthspregnantcommentsthatshehasnoticedachangeinherpostureandishaving lowerbackpain.Thenursetellsherthatduringpregnancy,womenhaveapostureshifttocompensateforthe enlargingfetus.Thisshiftinpostureisknownas: a.

Lordosis.

b.

Scoliosis.

c.

Ankylosis.

d.

Kyphosis.

ANS:A Lordosiscompensatesfortheenlargingfetus,whichwouldshiftthecenterofbalanceforward.Thisshiftin balance,inturn,createsastrainonthelowbackmuscles,feltaslowbackpainduringlatepregnancybysome women.Scoliosisislateralcurvatureofportionsofthespine;ankylosisisextremeflexionofthewrist,as observedwithsevererheumatoidarthritis;andkyphosisisanenhancedthoraciccurvatureofthespine.

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:HealthPromotionandMaintenance 21.An85-year-oldpatientcommentsduringhisannualphysicalexaminationthatheseemstobegetting shorterasheages.Thenurseshouldexplainthatdecreasedheightoccurswithagingbecause: a.

Longbonestendtoshortenwithage.

b.

Thevertebralcolumnshortens.

c.

Asignificantlossofsubcutaneousfatoccurs.

d.

Athickeningoftheintervertebraldisksdevelops.

ANS:B Posturalchangesareevidentwithaging;decreasedheightismostnoticeableandisduetoshorteningofthe vertebralcolumn.Longbonesdonotshortenwithage.Intervertebraldisksactuallygetthinnerwithage. Subcutaneousfatisnotlostbutisredistributedtotheabdomenandhips. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 22.Apatienthasbeendiagnosedwithosteoporosisandasksthenurse,Whatisosteoporosis?Thenurse NURSINGTB.COM explainsthatosteoporosisisdefinedas: a.

Increasedbonematrix.

b.

Lossofbonedensity.

c.

New,weakerbonegrowth.

d.

Increasedphagocyticactivity.

ANS:B Afterage40years,alossofbonematrix(resorption)occursmorerapidlythannewboneformation.Thenet effectisagraduallossofbonedensity,orosteoporosis.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 23.Thenurseisteachingaclassonpreventingosteoporosistoagroupofperimenopausalwomen.Whichof theseactionsisthebestwaytopreventordelaybonelossinthisgroup? a.

TakingcalciumandvitaminDsupplements

b.

Takingmedicationstopreventosteoporosis

NURSINGTB.COM

PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

c.

Performingphysicalactivity,suchasfastwalking

d.

Assessingbonedensityannually

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ANS:C Physicalactivity,suchasfastwalking,delaysorpreventsbonelossinperimenopausalwomen.Thefasterthe paceofwalking,thehigherthepreventiveeffectisontheriskofhipfracture.Theotheroptionsarenotcorrect DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:HealthPromotionandMaintenance 24.Ateenagegirlhasarrivedcomplainingofpaininherleftwrist.Shewasplayingbasketballwhenshefell andlandedonherlefthand.Thenurseexaminesherhandandwouldexpectafractureifthegirlcomplainsof a: a.

Dullache.

b.

Deeppaininherwrist.

c.

Sharppainthatincreaseswithmovement.

d.

Dullthrobbingpainthatincreaseswithrest. NURSINGTB.COM

ANS:C Afracturecausessharppainthatincreaseswithmovement.Theothertypesofpaindonotoccurwitha fracture. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 25.Apatientiscomplainingofpaininhisjointsthatisworseinthemorning,betterafterhemovesaroundfor awhile,andthengetsworseagainifhesitsforlongperiods.Thenurseshouldassessforothersignsofwhat problem? a.

Tendinitis

b.

Osteoarthritis

c.

Rheumatoidarthritis

d.

Intermittentclaudication

ANS:C Rheumatoidarthritisisworseinthemorningwhenapersonarises.Movementincreasesmostjointpain,excep

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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 8TH EDITION JARVIS TEST BANK TestBank-PhysicalExaminationandHealthAssessment8e(byJarvis)

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thepainwithrheumatoidarthritis,whichdecreaseswithmovement.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation 26.Apatientstates,IcanhearacrunchingorgratingsoundwhenIkneel.Shealsostatesthatitisverydifficul togetoutofbedinthemorningbecauseofstiffnessandpaininmyjoints.Thenurseshouldassessforsignsof whatproblem? a.

Crepitation

b.

Bonespur

c.

Loosetendon

d.

Fluidinthekneejoint

ANS:A Crepitationisanaudibleandpalpablecrunchingorgratingthataccompaniesmovementandoccurswhen articularsurfacesinthejointsareroughened,aswithrheumatoidarthritis.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation NURSINGTB.COM

27.Apatientisabletoflexhisrightarmforwardwithoutdifficultyorpainbutisunabletoabducthisarm becauseofpainandmusclespasms.Thenurseshouldsuspect: a.

Crepitation.

b.

Rotatorcufflesions.

c.

Dislocatedshoulder.

d.

Rheumatoidarthritis.

ANS:B Rotatorcufflesionsmaylimitrangeofmotionandcausepainandmusclespasmsduringabduction,whereas forwardflexionremainsfairlynormal.Theotheroptionsarenotcorrect. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PhysiologicInte...