Musculoskeletal System

A 55-year-old Caucasian female is being assessed for osteoporosis risk. Which findings increase her risk? A. Smoking history B. Diet low in calcium C. High estrogen levels D. Inadequate weight-bearing exercise E. Daily alcohol intake

A, B, D, E

A patient demonstrates full range of motion against gravity but cannot tolerate any added resistance. How should muscle strength be graded? A. 2/5 B. 3/5 C. 4/5 D. 5/5

B. 3/5

Which assessment is specifically recommended during a musculoskeletal screening for adolescents? A. Bone density screening B. Scoliosis screening C. Katz Index D. Deep tendon reflex testing

B. Scoliosis screening

A patient reports a locking sensation in the knee. What is the nurse’s priority concern? A. Diet B. Safety C. Motor milestones D. Calcium intake

B. Safety

To reduce osteoporosis risk, what daily intake should be recommended for a postmenopausal woman? A. Calcium 500 mg, Vit D 200 IU B. Calcium 1000–1300 mg, Vit D 400–800 IU C. Calcium 2000 mg, Vit D 1000 IU D. Calcium 800 mg, Vit D 200 IU

B. Calcium 1000–1300 mg, Vit D 400–800 IU

Which bedside test helps confirm a suspected lumbar herniated nucleus pulposus? A. Shoulder shrug B. Toe touch C. Straight leg raise D. TMJ palpation

C. Straight leg raise

What is the correct approach for a musculoskeletal physical exam? A. Distal to proximal B. Head to toe, proximal to distal C. Only affected side D. Random order

B. Head to toe, proximal to distal

Bilateral hand pain, morning stiffness, and ulnar deviation are findings of: A. Osteoarthritis B. Rheumatoid arthritis C. Herniated disk D. Scoliosis

B. Rheumatoid arthritis

Hard bony nodules at the distal interphalangeal joints are documented as: A. Bouchard’s nodes B. Heberden’s nodes C. Swan-neck deformity D. Boutonnière deformity

B. Heberden’s nodes

How does the nurse assess trapezius muscle strength? A. Elbow flexion B. Shoulder shrug against resistance C. Chin protrusion D. Toe flexion

B. Shoulder shrug against resistance

A hunched thoracic spine curvature in an older adult is called: A. Kyphosis B. Lordosis C. Scoliosis D. HNP

A. Kyphosis

Why does the nurse ask about a sore throat 10–14 days before sudden joint pain? A. Osteoporosis screening B. Rheumatic fever risk C. OA diagnosis D. Calcium deficiency

B. Rheumatic fever risk

Which tool best assesses functional ability in an older adult with chronic MSK disability? A. OLD CARTS B. Katz Index C. Muscle strength scale D. Scoliosis screening

B. Katz Index

Smooth, symmetric arm swing and rhythmic walking indicate normal: A. Posture B. Gait C. Range of motion D. Muscle strength

B. Gait

A fracture with bone protruding through the skin is classified as: A. Closed fracture B. Open fracture C. Pathologic fracture D. Stress fracture

B. Open fracture

Which hip motion is most commonly limited in hip disease? A. Abduction B. Flexion C. Internal rotation D. Extension

A. Abduction

Palpating anterior to the tragus while opening and closing the mouth assesses the: A. TMJ B. Cervical spine C. Shoulder girdle D. Zygomatic joint

A. TMJ

Why is weight-bearing exercise recommended for bone health? A. Prevents RA B. Maintains bone density C. Prevents scoliosis D. Prevents fractures

B. Maintains bone density

What is the expected thoracic/lumbar spine flexion when touching toes? A. 30° B. 35° C. 50° D. 75°

D. 75°

Which muscle type is the focus of the musculoskeletal exam? A. Smooth B. Cardiac C. Skeletal D. Involuntary

C. Skeletal

Which question best assesses safety risk in an aging adult? A. Calcium intake B. Presence of nodes C. Increase in falls or stumbling D. Joint deformity

C. Increase in falls or stumbling

What is the correct joint assessment sequence? A. Palpate, inspect, strength, ROM B. Inspect, palpate, ROM, strength C. Strength, ROM, palpate, inspect D. ROM, strength, inspect, palpate

B. Inspect, palpate, ROM, strength

What is the expected curvature of the spine? A. Straight line B. Normal cervical-thoracic-lumbar curves C. Flat back D. Lateral S-curve

B. Normal cervical-thoracic-lumbar curves

At what angle should the elbow be positioned for optimal palpation? A. 0° B. Fully flexed C. 70° D. 90°

C. 70°

Which wrist/hand finding is expected? A. Bogginess B. Smooth skin with knuckle wrinkles C. Ulnar deviation D. Nodules

B. Smooth skin with knuckle wrinkles

During foot assessment, weight-bearing should fall on the: A. Heels B. Big toe C. Middle of the foot D. Outer edges

C. Middle of the foot

A hip fracture caused by severe osteoporosis after turning in bed is classified as: A. Open fracture B. Pathologic fracture C. Traumatic fracture D. Comminuted fracture

B. Pathologic fracture

Which factors increase the risk for osteoarthritis? A. Overweight B. Repetitive joint use C. Autoimmune disease D. Joint injury E. Increasing age

A, B, D, E

Which statement correctly differentiates RA from OA? A. OA is bilateral, RA unilateral B. RA is autoimmune, OA degenerative C. RA affects weight-bearing joints only D. OA causes fever

B. RA is autoimmune, OA degenerative

Ankle dorsiflexion and plantar flexion against full resistance is graded as: A. 3/5 B. 4/5 C. 5/5 D. 1/5

C. 5/5