Musculoskeletal System

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Question 1

Free

Multiple Choice

Which description of pain from the patient makes a nurse suspect the patient's pain is originating from a muscle?

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"Crampy"

"Dull and deep"

"Boring and intense"

"Sharp upon movement"

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Question 2

Free

Multiple Choice

A nurse asks a patient to describe his new onset of leg pain. He slept well through the night, but this morning he suddenly developed pain in his left lower leg that is red and too painful to touch. Nothing relieves the pain. Based on these data, the nurse suspects which disorder is causing this pain?

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Rheumatoid arthritis

Osteoarthritis

Gout

Tendonitis

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Question 3

Free

Multiple Choice

During a history, the patient reports having gout. Based on this information, what findings does the nurse anticipate during a focused assessment?

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Warm, tender, and deformed wrists and peripheral interphalangeal (PIP) joints bilaterally

Edema, warmth, and redness of one great toe and pealike nodules in the ear lobes

Enlarged and tender PIP or distal interphalangeal (DIP) joints on one or several fingers

Tenderness with pronation and supination of the elbow and point tenderness on the lateral epicondyle

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Question 4

Free

Multiple Choice

A patient reports joint pain interfering with sleep and morning joint stiffness for the first hour after getting out of bed. Considering this report, what abnormal findings does the nurse anticipate during the examination?

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Abrupt onset of local tenderness, edema, and decreased range of motion of the shoulder and hip bilaterally

Decreased range of motion of one hip and knee with pain on flexion and crepitus during movement of these joints

Erythema in one great toe, ankle, and lower leg that is painful to the touch

Hot, painful, deformed, and edematous wrists and peripheral interphalangeal joints bilaterally

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Question 5

Free

Multiple Choice

In assessing a patient with a history of poliomyelitis, the nurse suspects the right leg muscles are smaller than the left leg. What is the best approach for the nurse to confirm or reject this suspicion?

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Palpating both legs using the pads of the thumb and index fingers and comparing one side with another

Using a tape to measure each leg's circumference at the same location, above or below the nearest joint

Using a goniometer to measure the upper and lower legs with the patient in supine and standing positions

Palpating the legs using the tips of the thumb and index fingers, and comparing the findings with the Lovett scale

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Question 6

Multiple Choice

In assessing the joint range of motion of a patient's knees, the nurse notices the flexion is less than expected in both knees. What is the next appropriate action for the nurse?

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Documenting this finding as expected for this patient because it occurs in both knees

Palpating the suprapatellar pouch on each side of the quadriceps for contour, tenderness, and edema

Using a goniometer to measure the flexion in both knees and comparing the results with expected flexion

Applying opposing force to the lower leg while the patient tries to maintain flexion and extension

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Question 7

Multiple Choice

The nurse asks the patient to hold the arms straight out, perpendicular to the floor, and the nurse tries to push the patient's arms down. This procedure tests the strength of which muscles?

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Triceps

Biceps

Trapezius

Deltoid

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Question 8

Multiple Choice

To assess the triceps and biceps muscle strength, the nurse applies resistance to the patient's arm. What should be done to ensure the appropriate muscle is being assessed?

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The patient pushes up against the nurse's hand to abduct the triceps muscle and pushes down against the nurse's hand to adduct the biceps muscle.

The patient pushes forward against the nurse's hand to extend the triceps muscle and pulls backward against the nurse's hand to flex the biceps muscle.

The patient pulls backward against the nurse's hand to flex the triceps muscle and pushes forward against the nurse's hand to extend the biceps muscle.

The patient pushes up against the nurse's hand to abduct the biceps muscle and pushes down against the nurse's hand to adduct the triceps muscle.

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Question 9

Multiple Choice

The nurse notes that there is an audible clicking sound when the patient opens and closes the mouth. What is the appropriate response of the nurse at this time?

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Recording this as an abnormal finding, requiring additional assessment

Measuring the distance between each side of the mandible and the eyes

Applying resistance to the maxilla and asking the patient to repeat the motion

Documenting this finding as expected if no other signs or symptoms are found

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Question 10

Multiple Choice

A nurse palpates the patient's jaw movement by placing two fingers in front of each ear and asking the patient to slowly open and close the mouth. What movement does the nurse ask the patient to do next?

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Move the jaw side to side.

Swallow.

Smile.

Clench the teeth together.

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Question 11

Multiple Choice

When assessing the neck of a healthy adult, a nurse expects which findings?

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A convex contour of the posterior cervical spine

Bending of the head to the right and left (ear to shoulder) 15 degrees

Turning the chin to the right shoulder and then the left shoulder

Hyperextension of the head 30 degrees from midline

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Question 12

Multiple Choice

A patient asks, "Why is touching my toes necessary? This is a sports physical examination, not exercise class." What is the most appropriate response by the nurse?

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"This is the best way to check for symmetry of your arms."

"I am looking at the stretch of your hamstrings."

"This allows me to see how straight your spinal column is."

"I am assessing the flexion of your spine."

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Question 13

Multiple Choice

A patient reports a history of compression of the left cranial nerve XI (spinal accessory nerve) from an old sports injury. Based on this information, what technique does the nurse include in the focused assessment?

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Asking the patient to rotate the head against resistance of the nurse's hand on the patient's chin

Asking the patient to flex the chin to the chest against resistance of the nurse's hand on the patient's forehead

Asking the patient to extend the head back against resistance of the nurse's hand on the back of the patient head

Asking the patient to shrug the shoulders while the nurse attempts to push them down

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Question 14

Multiple Choice

When a nurse asks a patient to place the right arm behind the back, so that the back of the hand is touching the lower spine, the nurse is testing for which range of motion?

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Pronation of the elbow

Hyperextension of the elbow

Internal rotation and adduction of the shoulder

External rotation and abduction of the shoulder

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Question 15

Multiple Choice

When a nurse asks a patient to place the right arm behind the head, the nurse is testing for which range of motion?

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Flexion of the elbow

Hyperextension of the shoulder

Internal rotation and adduction of the shoulder

External rotation and abduction of the shoulder

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Question 16

Multiple Choice

The nurse asks the patient to rest the left arm on a table and to move the lower arm so that the palm of the hand is up and then down. What motion is the nurse testing?

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Adduction and abduction of the wrist

Supination and pronation of the wrist

Adduction and abduction of the elbow

Supination and pronation of the elbow

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Question 17

Multiple Choice

On inspection of a patient's hands, the nurse notices ulnar deviation and swan-neck deformities bilaterally and correlates this finding with which disorder?

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Osteoarthritis

Osteoporosis

Rheumatoid arthritis

Gout

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Question 18

Multiple Choice

With the patient lying supine, a nurse raises the patient's leg to flex the hip. The patient complains of pain when the leg is raised to 40 degrees. The nurse correlates this finding with which disorder?

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Lumbar nerve compression

Cervical disk herniation

Osteoarthritis

Bursitis

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Question 19

Multiple Choice

With the patient in a supine position, how does a nurse test the external rotation of the patient's right hip?

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Asking the patient to move the right leg laterally with the right knee straight

Asking the patient to flex the right knee and turn medially toward the left side (inward)

Asking the patient to place the right heel on the left patella

Asking the patient to raise the right leg straight up and perpendicular to the body

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Question 20

Multiple Choice

What movement from the patient does a nurse request to assess for hyperextension of the hip?

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Raise one leg at a time while lying prone.

Raise one leg at a time while lying supine.

Move one leg at a time laterally, away from midline, while lying prone.

Move one leg at a time medially, toward midline, while lying supine.

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