Health Assessment Jarvis Ch 23: Musculoskeletal System

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:

Adduction

A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth. The nurse knows that for her to move her hand to her mouth she must perform which movement?

Flexion

The functional unites of the musculoskeletal system are the:

Joints

When reviewing the musculoskeletal system, the nurse recalls that hematopoiesis takes place in the:

Bone Marrow

Fibrous brands running directly from one bone to another that strengthen the joint to help prevent movement in undesirable directions are called:

Ligaments

the nurse notices that a woman in an exercise class is unable to jump rope. The nurse knows that to jump rope, ine's shoulder has to be capable of:

circumduction

The articulation of the mandible and the temporal bone is known as the:

temporomandibular joint

to palpate the temporomandibular joint, the nurse's fingers should be places in the depression _______ of the ear.

anterior to the tragus

Of the 33 vertebrae in the spinal column, there are:

5 lumbar

An imaginary line connecting the highest point on each iliac crest would cross the _____ vertebra.

Fourth lumbar

The nurse is explaining to a patient that there are "shock absorbers" in his back to cushion the spine and to help it move. The nurse is referring to his:

intervertabral disks

The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury. The nurse knowns that rotator cuff injury involves the:

Glenohumeral joint

During an interview the patient states, "I can feel this bump on the top of both of my shoulders--it doesn't hurt but I am curious about what it might be." The nurse should tell the patient that is:

your acromion process

The nurse is checking the range of motion in a patient's knee and knows that the knee is capable of which movement(s)?

Flexion and extension

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.

metacarpophalangeal

The nurse is assessing a patient's ischial tuberosity. To palpate the ischial tuberosity, the nurse knows that it is best to have the patient:

flex the hip

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:

Greater trochanter

The ankle joint is the articulation of the tibia, the fibula, and the:

talus

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?

Epiphyses

A woman who is 8 months pregnant comments that she had noticed a change in 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:

Lordosis

An 85-year-old patient comments during his annual physical that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because:

of the shortening of the vertebral column

A patient has been diagnosed with osteoporosis and asks the nurse, "What is osteoporosis?" The nurse explains to the patient that osteoporosis is defined as:

loss of bone density

The nurse is teaching a class on osteoporosis prevention to a group of post-menopausal women. Which of these actions is the best way to prevent or delay bone loss in this group?

Taking calcium and vitamin D supplements

The nurse is teaching a class o osteoporosis prevention to a group of post-menopausal woman. A participant shows that she needs more instruction when she states, " I will:

start swimming to increase my weight-bearing exercise."

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 sharp pain that increases with movement

A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for awhile, and then gets worse again if he sits for long period of time. The nurse should assess for other signs of what problem?

Rheumatoid arthritis

A patient states, "I can hear a crunching or grating sound when I kneel." she also states that "it is very difficult 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?

Crepitation

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:

rotator cuff lesions.

A professional tennis player comes into the clinic complaining of a sore elbow. The nurse will assess for tenderness at the:

medial and lateral epicondyle

The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen's test. To perform this test, the nurse should instruct the patient to:

Hold both hands back to back while flexing the wrists 90 degrees for 60 seconds.

An 80-year-old woman is visiting the clinic for a checkup. She states, "I can't walk as much as I used to." The nurse is observing for motor dysfunction in her hips and should have her:

abduct her hip while she is lying on her back

The nurse has completed the musculoskeletal examination of a patient's knee and has found a positive bulge sign. The nurse interprets this finding to indicate.:

swelling from fluid in the suprapatellar pouch.

During an examination, the nurse asks a patient to bend forward from the waist and notices that the patient has lateral tilting. When his leg is raised straight up, he complains of a pain going down his buttock into his leg. The nurse suspects:

herniated nucleus pulposus

The nurse is examining a 3-month-old infant. While holding the thumbs on the infant's inner mid thighs and the fingers outside on the hips, touching the greater trochanter, the nurse adducts the legs until the nurse's thumbs touch and then abducts the legs until the infant's knees touch the table. the nurse does not notice any "clunking" sounds and is confident to record a:

negative Ortolani's sign

During a neonatal examination, the nurse notices that the newborn infant has six toes. This finding is documented as:

polydactyly.

A mother brings her newborn baby boy in for a check-up she tells the nurse that he doesn't seem to be moving his right arm as much as his left and that he seems to have pain when she lifts him up under the arm. The nurse suspects a fractured clavicle and would observe for:

limited range of motion during the Moro's reflex.

A 40-year-old man had come into the clinic with complaints of "Extreme tenderness in my toes." The nurse notices that his toes are slightly swollen, reddened, and warm to the touch. His complaints would suggest:

acute gout

A young swimmer comes to the sports clinic complaining of a very sore shoulder. He was running at the pool, slipped on some wet concrete, and tried to catch himself with his outstretched hand. He landed on his outstretched hand and had not been able to move his shoulder since then. The nurse suspects:

dislocated shoulder

A 68-year-old woman has come in for an assessment of her rheumatoid arthritis, and the nurse notices raised, firm, nontender nodules at the olecranon bursa and along the ulna. These nodules are most commonly diagnosed as:

olecranon bursitis

A woman who has had rheumatoid arthritis for years is starting to notice that her fingers are drifting to the side. The nurse knows that this condition is commonly referred to as:

ulnar deviation

A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her fingers. The nurse will assess for signs for what problems?

Swan neck deformities

A patient's annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine; however, this curvature disappears with forward bending. The nurse knows that this abnormality of the spine is called:

Functional scoliosis

A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months. Which response by the nurse is appropriate?

"Your disease is due to repeated stress on the patellar tendon. It is usually self-limited and your symptoms should resolve with rest."

When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What grade should the nurse record using a 0 to 5 point scale?

5

The nurse is examining a 6-month-old infant and place the infant's feet flat on the table and flexes his knees up. The nurse notes that the right knee is significantly lower than the left. Which of these statements is true of this finding?

This is a positive Allis sign and suggest hip dislocation.

The nurse is assessing a 1-week-old infant and is testing his muscle strength. The nurse lifts the infant with hands under the axillae and notices that the infant starts to "slip" between the hands. The nurse should:

suspect that the infant may have weakness of the shoulder muscles

The nurse is examining a 2-month-old infant and notices asymmetry of the infant's gluteal folds. The nurse should assess for other signs of what disorder?

hip dislocation

The nurse should use which test to check for large amounts of fluid around the patella?

Ballottement

A patient tells the nurse that "all my life I've been called 'Knock Knees'." The nurse knows that another term for "knock knees" is:

Genu valgum

A patient has been diagnosed with a ganglion cyst over the dorsum of his left wrist. He asks that nurse, "What is this thing?" The nurse's best answer would be, "It is:

a common benign tumor"

A man who has had gout for several years comes to the clinic with a problem with his toe. On examination, the nurse notices the presence of hard, painless nodules over the great toe; one has burst open with a chalky discharge. This finding is known as:

tophi

When performing a musculoskeletal assessment, the nurse knows that the correct approach for the examination should be"

proximal to distal

The nurse is assessing the joints of a woman who has stated," I have a long family history of arthritis, and my joints hurt." THe nurse suspects that she has osteoarthritis. Which of these are symptoms of osteoarthritis?

Asymmetric joint involvement
Pain with motion of affected joints
Affected joints are swollen with hard, Bony protuberances.