Chapter 43: Musculoskeletal System Introduction

MULTIPLE CHOICE

1. A nurse is collecting a health history from a patient with a connective tissue disease. What is
the most important inquiry by the nurse?
a. Family history of atherosclerosis
b. Last time the patient had his or her blood tested
c. History of a prior injury to a specific body part
d. Family history of a fracture

ANS: C
Previous injuries may be relevant to a patient’s current problem.

DIF: Cognitive Level: Comprehension REF: p. 847 OBJ: 2

TOP: Connective Tissue Disease Assessment
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. A nurse is educating an osteoporotic patient taking alendronate (Fosamax). Which instruction

should the nurse stress?
a. Take the drug after breakfast.
b. Avoid the use of supplemental vitamin D.
c. Decrease fluid intake.
d. Sit or stand for 30 minutes after administration.

ANS: D
After taking the drug Fosamax with 8 oz of fluid, the patient should sit or stand for 30 minutes
so the drug will be evenly distributed. The drug is taken on an empty stomach.

DIF: Cognitive Level: Application REF: p. 856 OBJ: 4

TOP: Fosamax KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

3. Which diagnostic test result should the nurse expect for a patient with polymyositis?
a. Muscle biopsy positive for muscle degeneration
b. Positive antinuclear antibody (ANA) blood test result
c. Positive 24-hour urine test result for urate crystals
d. Urate crystals in the synovial fluid

ANS: A
A biopsy, positive for muscle degeneration, is the only result that pertains to polymyositis.

DIF: Cognitive Level: Comprehension REF: p. 851 OBJ: 3

TOP: Polymyositis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

4. A nurse is educating a patient with gout about the medication probenecid (Benemid). What
active effect should the nurse relay when explaining why this medication is prescribed?
 a. Reduces inflammation in the affected joint
b. Relieves pain
c. Diminishes swelling
d. Increases excretion of uric acid
ANS: D
Probenecid (Benemid) increases the excretion of uric acid to reduce the symptoms of gout.

DIF: Cognitive Level: Comprehension REF: p. 855 OBJ: 4

TOP: Probenecid KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

5. The physician orders antinuclear antibodies for a patient with suspected rheumatoid arthritis.
What information will the nurse provide to the patient in preparation for this study?
a. Fast for 8 hours before test.
b. Refrain from exercise the day before test.
c. Do not take medications 24 hours before test.
d. Void prior to test.

ANS: A
Patients should be instructed to fast for 8 hours before antinuclear antibodies.

DIF: Cognitive Level: Application REF: p. 849 OBJ: 3

TOP: Antinuclear antibodies KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

6. A patient is preparing for tomography as ordered to enhance visualization of tissue hidden by

bone. What assessment by the nurse should be immediately addressed?
a. History of recent urinary tract infection
b. Allergy to Sulfa
c. Reports of claustrophobia
d. Diagnosis of bipolar disorder

ANS: C
Tomography requires lying in a cylindric scanner. The nurse should assess for claustrophobia
and inform the radiologist.

DIF: Cognitive Level: Analysis REF: p. 850 OBJ: 3

TOP: Tomography KEY: Nursing Process Step: Implementation
MSC: NCLEX:: Physiological Integrity: Physiological Adaptation

MULTIPLE RESPONSE

1. A nurse questions an older patient about the age-related changes she has experienced in her
connective tissue, which have lessened her mobility. What do these changes most commonly
include? (Select all that apply.)
a. Loss of bone mass, which may cause fragile bones
b. Decline in muscle mass, causing loss of strength
c. Bony deposits in the joints, causing pain and altered movement
 d. Loss of cartilage, causing more friction in joints
e. Diminished energy, causing decreased activity

ANS: A, B, C, D
Reduced energy, although observed in older adults, is not caused by a change in connective
tissue.

DIF: Cognitive Level: Comprehension REF: p. 846 OBJ: 1

TOP: Age-Related Changes in Connective Tissue
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

COMPLETION

1. Immobility reduces muscle contractions and can produce muscle ______.

ANS:
atrophy

Immobility reduces muscle contractions and can produce muscle atrophy.

DIF: Cognitive Level: Comprehension REF: p. 845 OBJ: 1

TOP: Immobility KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. A(n) ______ measures the range of movement of the joints.

ANS:
goniometer

A goniometer measures the range of movement of the joints.

DIF: Cognitive Level: Knowledge REF: p. 847 OBJ: 2

TOP: Joint Motion KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

3. ______ uses sound waves to determine the presence of pulses in the extremities.

ANS:
Doppler ultrasound

Doppler ultrasound uses sound waves to determine the presence of pulses in the extremities.

DIF: Cognitive Level: Comprehension REF: p. 848 OBJ: 2

TOP: Diagnostic Tests KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease