NCLEX : Musculoskeletal Conditions
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Example Questions
Example Question #1151 : Nclex
All of the following are common findings in osteoarthritis except __________.
bony protuberances of affected joints
symmetrical joint involvement
asymmetrical joint involvement
stiffness and pain in affected joints
symmetrical joint involvement
Osteoarthritis generally presents as asymmetrical joint stiffness and pain, often with bony protuberances (osteophytes) that are either palpable or visible on imaging. Symmetrical joint involvement is more typical in rheumatoid arthritis. Joints will present with signs of inflammation: redness, heat, pain, and swelling, due to the inflammatory nature of this condition.
Example Question #1 : Symptoms And Test For Musculoskeletal Conditions
A positive anterior drawer test of the knee would be indicative of injury to which of the following structures?
Medial collateral ligament
Posterior cruciate ligament
Lateral collateral ligament
Anterior cruciate ligament
Anterior cruciate ligament
The anterior drawer test of the knee checks for injury to or instability of the anterior cruciate ligament. During this test the patient lies supine position with knees bent to 90 degrees. The practitioner sits on the both feet of the subject and places both hands around the upper tibia of the patient's symptomatic leg, then pulls anteriorly on the proximal tibia. A positive finding would be excessive anterior translocation or a soft end-feel, indicating a sprain or tear of the anterior cruciate ligament.
Example Question #1 : Musculoskeletal Condition Follow Up
Lambert-Eaton syndrome is associated with what malignancy?
Melanoma
Colon cancer
Gastric carcinoma
Small cell lung cancer
Small cell lung cancer
Example Question #351 : Conditions And Treatments
A post-menopausal female client presents to the client after being newly diagnosed with osteoporosis. The client is here to discuss with the nurse what type of lifestyle modifications she will need to treat the disease.
Which of the following should the nurse include when educating the client?
Engage in low impact exercises
Start a low carbohydrate high protein diet
Lose 10 pounds
Quit smoking
Drink one glass of wine with dinner
Quit smoking
Smoking and alcohol ingestion are risk factors for developing osteopenia or osteoporosis. These activities should be discontinued to help prevent against bone loss. Diet and exercise are important factors, but losing 10 pounds or low impact exercise will not increase bone mass.
Example Question #3 : Musculoskeletal Condition Follow Up
The nurse cares for a 16-year-old patient in the emergency department. He has returned to the hospital after having a fiberglass cast applied to his right ulna from a fracture the day before. Which of the following manifestations in the patient should most concern the nurse?
Itching under the cast
Capillary refill of 3 seconds in the right fingertips
Warm fingers and palm in the right hand
Pain in the right shoulder
Severe pain in the right arm
Severe pain in the right arm
The nurse should be aware of potential complications of cast placement, such as compartment syndrome, which can cause nervous, vascular, and muscle damage. Signs and symptoms include tingling distal to the cast placement, severe pain in the casted region, swelling in the cast and distal to the casted region, pallor in the affected region, and muscle weakness. These signs and symptoms would indicate immediate cast removal to prevent further damage to the tissue. Itching under the cast is common and expected, and pain in supporting shoulder of the arm can occur due to the increased weight and positioning of the cast. 3 seconds for capillary refill is within normal limits; extended time for capillary refill in the distal region would be concerning. Warmth in the hand and fingers distal for the casted region would indicate normal circulation as well, but congestion and swelling in the extremity would be worrisome.
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