Nursing Care of Clients With Musculoskeletal and Connective Tissue Disorders

This set of flashcards covers key vocabulary and definitions related to the nursing care of clients with musculoskeletal and connective tissue disorders, including definitions of various fractures, disorders, and care methods.

An LPN is monitoring a client with a suspected leg fracture. Which finding is the most characteristic sign of a fracture?

A) Hypertension
B) Deformity and pain
C) Increased range of motion
D) Bradycardia

B) Deformity and pain.

Rationale: Signs of a fracture include pain, decreased range of motion, swelling, and deformity.

A client is diagnosed with Osteomyelitis. The LPN should explain that this condition is typically caused by which of the following?

A) Bone mineral loss
B) An infection of the bone
C) Uric acid buildup
D) Nerve compression

B) An infection of the bone.

Rationale: Osteomyelitis is defined as an infection of the bone, often requiring long-term antibiotic therapy.

Which of the following patients is at the highest risk for developing Osteoporosis?

A) A 25-year-old male runner
B) A 70-year-old female with low calcium intake
C) A 40-year-old pregnant woman
D) A 15-year-old with a transverse fracture

B) A 70-year-old female with low calcium intake.

Rationale: Risk factors for Osteoporosis include aging, female gender, family history, and low calcium intake.

A client complains of hand pain and numbness that worsens at night. The LPN suspects Carpal\ Tunnel\ Syndrome. This is caused by compression of which nerve?

A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Sciatic nerve

C) Median nerve.

Rationale: Carpal\ Tunnel\ Syndrome is caused by median nerve compression in the wrist.

When treating a soft tissue injury using the RICE method, what does the 'E' stand for?

A) Extension
B) Exercise
C) Elevation
D) Evaluation

C) Elevation.

Rationale: RICE stands for Rest, Ice, Compression, and Elevation.

A client has overstretched a muscle during a workout. How should the LPN document this injury?

A) Sprain
B) Strain
C) Bursitis
D) Fracture

B) Strain.

Rationale: A strain is a stretch or tear in a muscle or tendon.

The LPN is caring for an athlete who has a tear in a ligament. This injury is best described as a:

A) Strain
B) Sprain
C) Dislocation
D) Transverse break

B) Sprain.

Rationale: A sprain is a stretch or tear in a ligament.

A client arrives in the ER with a shoulder injury where the bone has slipped out of its normal position. The LPN recognizes this as a:

A) Fracture
B) Strain
C) Dislocation
D) Bursitis

C) Dislocation.

Rationale: A dislocation occurs when a bone slips out of its normal position in a joint.

The LPN is teaching a client about Bursitis. What is the definition of this condition?

A) Inflammation of the bone
B) Inflammation of the fluid-filled sacs that cushion joints
C) Compression of the median nerve
D) Buildup of uric acid in the great toe

B) Inflammation of the fluid-filled sacs that cushion joints.

Rationale: Bursitis involves the inflammation of the bursae that cushion joints.

Which medication is commonly administered to a client with Rheumatoid\ Arthritis to reduce significant inflammation?

A) Allopurinol
B) Corticosteroids
C) Antibiotics
D) Vitamin D

B) Corticosteroids.

Rationale: Corticosteroids are used in managing rheumatoid arthritis to reduce inflammation.

A client presents with severe pain and swelling in the great toe. Laboratory results show a buildup of uric acid. Which condition does the LPN suspect?

A) Osteoporosis
B) Gout
C) Osteomyelitis
D) Carpal Tunnel Syndrome

B) Gout.

Rationale: Gout is a systemic connective tissue disorder characterized by the buildup of uric acid crystals.

The X-ray results of a client show that the bone is shattered into 4 pieces. This type of fracture is documented as:

A) Transverse
B) Comminuted
C) Greenstick
D) Impacted

B) Comminuted.

Rationale: A comminuted fracture is one where the bone is shattered into 3 or more pieces.

A client has a fracture that is a horizontal break straight across the bone. The LPN identifies this as a:

A) Spiral fracture
B) Transverse fracture
C) Comminuted fracture
D) Compound fracture

B) Transverse fracture.

Rationale: A transverse fracture is a horizontal break straight across the bone.

What is the priority assessment for an LPN to perform on a limb that has been recently casted?

A) Skin integrity under the cast
B) Range of motion to the joint
C) Neurovascular checks
D) Weight-bearing ability

C) Neurovascular checks.

Rationale: Neurovascular checks assess blood flow and nerve function (paresthesia, pain, pallor, paralysis, pulselessness) to prevent complications.

A student nurse asks about the primary therapeutic goals for managing a fracture. The LPN correctly responds:

A) Immediate weight bearing and exercise
B) Realignment of bone ends and immobilization
C) Frequent massage and cold packs for 48 hours
D) High-protein diet and bed rest only

B) Realignment of bone ends and immobilization.

Rationale: The main goals include realignment (reduction) and immobilization of the bone ends.

Following the surgical placement of metal pins and plates inside the body to hold a bone together, the LPN recognizes this procedure as:

A) External Fixation
B) Internal Fixation
C) Closed Reduction
D) Traction

B) Internal Fixation.

Rationale: Internal fixation involves metal devices placed inside the body to hold broken bones together.

A client has a frame outside of the leg with pins inserted into the bone. What is the LPN's priority when caring for this client?

A) Adjusting the frame weekly
B) Monitoring pin sites for signs of infection
C) Removing the frame for bathing
D) Encouraging the client to walk without assistance

B) Monitoring pin sites for signs of infection.

Rationale: In external fixation, pins are inserted into the bone and connected to an external frame; monitoring for infection is crucial.

The LPN is providing education on Osteoporosis prevention. Which of the following should be included?

A) Avoid all forms of exercise
B) Increase calcium and Vitamin D intake
C) Limit protein intake to 10 grams per day
D) Decrease fluids to prevent swelling

B) Increase calcium and Vitamin D intake.

Rationale: Low calcium intake is a risk factor; increasing intake helps maintain bone mass.

During a neurovascular check, the LPN assesses which of the following?

A) Visual acuity and hearing
B) Blood flow and nerve function
C) Lung sounds and heart rate
D) Bowel sounds and abdominal girth

B) Blood flow and nerve function.

Rationale: Neurovascular checks assess the circulation and sensation in a limb.

When applying 'Ice' as part of the RICE method, what is the primary goal?

A) To increase blood flow to the area
B) To reduce swelling and pain
C) To stretch the ligaments
D) To warm the muscle fibers

B) To reduce swelling and pain.

Rationale: Ice causes vasoconstriction, which helps reduce swelling and numbs the area to reduce pain.

A client with Gout asks why their toe is so painful. The LPN explains it is due to:

A) Infection of the bone marrow
B) Median nerve compression
C) Buildup of uric acid crystals
D) Loss of bone density

C) Buildup of uric acid crystals.

Rationale: Gout involves the accumulation of uric acid in connective tissues and joints.

Which finding is considered a medical emergency during a neurovascular check for a fracture?

A) Mild swelling
B) Capillary refill of 2 seconds
C) Absence of a distal pulse
D) Warm skin temperature

C) Absence of a distal pulse.

Rationale: Pulselessness is a critical sign of compromised blood flow and requires immediate intervention.

A client is scheduled for Internal\ Fixation of a hip fracture. The LPN knows this involves:

A) A cast and traction only
B) Surgical placement of screws or plates
C) Stretching the muscles with weights
D) External pins and a metal cage

B) Surgical placement of screws or plates.

Rationale: Internal fixation uses surgical hardware inside the body to stabilize bones.

What is a characteristic of a Strain injury?

A) It involves the ligaments
B) It involves the muscle or tendon
C) It results in a bone infection
D) It is treated with long-term antibiotics

B) It involves the muscle or tendon.

Rationale: A strain specifically affects muscles or tendons, whereas a sprain affects ligaments.

The LPN knows that Osteomyelitis can occur after a fracture because:

A) Bone mass increases after a break
B) Pathogens can enter the bone through an open wound or surgery
C) Uric acid levels rise during bone healing
D) The median nerve is compressed during trauma

B) Pathogens can enter the bone through an open wound or surgery.

Rationale: Osteomyelitis is a bone infection that can occur if bacteria enter the bone.

Which client is at the highest risk for a Comminuted\ Fracture?

A) A child who falls on a soft surface
B) An elderly patient with severe trauma or crushing injury
C) A marathon runner with a stress injury
D) A person with a minor wrist strain

B) An elderly patient with severe trauma or crushing injury.

Rationale: Comminuted fractures (shattered bone) typically result from high-impact trauma.

A client with Bursitis asks how they can reduce symptoms at home. What does the LPN recommend?

A) Vigorous weight lifting
B) Rest and anti-inflammatory measures
C) Increasing salt intake
D) Keeping the joint in a dependent position

B) Rest and anti-inflammatory measures.

Rationale: Managing Bursitis involves resting the joint and reducing inflammation of the bursae.

The LPN is assessing a client for Carpal\ Tunnel\ Syndrome. Which test is typically used?

A) Assessing for Phalen's sign (numbness with wrist flexion)
B) Checking for blood in the urine
C) Measuring bone density
D) Drawing a serum uric acid level

A) Assessing for Phalen's sign (numbness with wrist flexion).

Rationale: Carpal\ Tunnel is related to nerve compression in the wrist; Phalen's sign addresses the numbness/pain associated with it.

A client asks why Elevation is important after a sprain. The LPN explains it helps to:

A) Increase the heart rate
B) Decrease edema by promoting venous return
C) Strengthen the ligament
D) Align the bone ends

B) Decrease edema by promoting venous return.

Rationale: Elevation helps reduce swelling (edema) by using gravity to move fluid away from the injury site.

A client is prescribed Corticosteroids for an acute flare-up of connective tissue inflammation. The LPN should monitor for:

A) Increased risk of infection
B) Extremely low blood sugar
C) Decreased uric acid
D) Rapid bone growth

A) Increased risk of infection.

Rationale: Corticosteroids reduce inflammation but can also suppress the immune system, increasing infection risk.

The LPN notes that a client's fracture is described as Transverse. The LPN knows this means the break is:

A) At an angle
B) Straight across the bone width
C) Spiraling around the bone
D) Only on one side of the bone

B) Straight across the bone width.

Rationale: A transverse fracture is a horizontal, straight-across break.

Which of the following is a symptom of Gout?

A) Numbness in the median nerve distribution
B) Severe joint pain and redness from uric acid deposits
C) Progressive loss of height due to bone mass loss
D) Fever caused by bone infection

B) Severe joint pain and redness from uric acid deposits.

Rationale: Gout is characterized by systemic connective tissue disorder and uric acid buildup in joints.

For a client with External\ Fixation, the LPN should prioritize which assessment?

A) Assessing the client's hearing
B) Checking the stability of the external frame and pin sites
C) Monitoring for low uric acid levels
D) Checking the client's blood type

B) Checking the stability of the external frame and pin sites.

Rationale: External fixation requires monitoring of the pins and frame that are outside the body.

A client with Osteoporosis has a 'dowager's hump'. The LPN knows this is due to:

A) Uric acid in the spine
B) Nerve compression in the wrist
C) Vertebral fractures related to low bone mass
D) Inflammation of the bursae

C) Vertebral fractures related to low bone mass.

Rationale: Osteoporosis leads to increased fractures, particularly in the vertebrae, causing postural changes.

During the first 24 to 48 hours after a Sprain, the LPN should instruct the client to:

A) Apply heat to the area
B) Use the RICE method
C) Perform heavy weight-bearing exercises
D) Stop all medications

B) Use the RICE method.

Rationale: RICE (Rest, Ice, Compression, Elevation) is the standard treatment for soft tissue injuries like sprains.

A client has a Comminuted fracture. This means the bone is:

A) Cracked but not broken through
B) Broken into more than 2 pieces
C) Broken straight across
D) Stretched but not broken

B) Broken into more than 2 pieces.

Rationale: A comminuted fracture involves the bone shattering into 3 or more pieces.

Which of the following is a common symptom of Osteomyelitis?

A) High calcium levels
B) Pain, fever, and swelling at the bone site
C) Numbness in the fingers
D) Excessive bone density

B) Pain, fever, and swelling at the bone site.

Rationale: As an infection, Osteomyelitis often presents with pain and systemic signs of infection like fever.

What is the primary purpose of 'Compression' in the RICE method?

A) To increase swelling
B) To support the injury and limit swelling
C) To stop blood flow to the limb
D) To realign the bone

B) To support the injury and limit swelling.

Rationale: Compression wraps help provide support and minimize the accumulation of fluid in the tissues.

A patient with a wrist split for Carpal\ Tunnel\ Syndrome asks why they have it. The LPN explains:

A) It is a bacterial infection of the bone
B) It is caused by the buildup of uric acid
C) It is caused by the median nerve being squeezed at the wrist
D) It is due to a lack of calcium in the diet

C) It is caused by the median nerve being squeezed at the wrist.

Rationale: Carpal\ Tunnel\ Syndrome results from median nerve compression.

What is the most important LPN action before moving a client with a suspected fracture?

A) Administering a corticosteroid
B) Immobilizing the limb
C) Checking a bone density scan
D) Encouraging the client to walk to the X-ray room

B) Immobilizing the limb.

Rationale: Immobilization is a key therapeutic goal to prevent further injury and manage pain after a fracture.