ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 60 : Introduction to the Musculoskeletal System Questions
Question 1 of 5
A client is scheduled to have an x-ray examination of the shoulder in which the synovial fluid will be aspirated and sent to the laboratory for analysis. This will be followed by administration of a contrast medium and x-rays. The nurse understands that the client will be undergoing which test(s)?
Correct Answer: B,C
Rationale: An arthrogram is a radiographic examination of a joint usually the knee or shoulder. The health care provider first injects a local anesthetic and then inserts a needle into the joint space. Fluoroscopy may be used to verify correct placement of the needle. The synovial fluid in the joint is aspirated and sent to the laboratory for analysis. A contrast medium is then injected, and x-ray films are taken. Arthroscopy is the internal inspection of a joint using an arthroscope. Arthrocentesis is the aspiration of synovial fluid. The client involves local anesthesia just before this procedure. The health care provider inserts a large needle into the joint and removes the fluid. This can be done during an arthrogram or arthroscopy. Bone densitometry estimates bone density using radiography or advanced radiographic techniques. Electromyography tests the electrical potential of the muscles and nerves leading to the muscles.
Question 2 of 5
The client who is about to undergo arthroscopy of the knee begins to describe the procedure to the nurse. What statement(s) indicate to the nurse that the client understands the procedure?
Correct Answer: B,C,D
Rationale: If the client describes the procedure as one in which a needle is inserted into the joint space, with a special scan possibly being done to verify needle placement, to take fluid from the joint for laboratory analysis, the nurse can confirm that the client understands the arthroscopy procedure. Before the procedure, the provider first injects a local anesthetic. The client should expect the crackling or clicking noises to resolve after 2 days. Noises beyond this time are abnormal, the client should report them.
Question 3 of 5
A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?
Correct Answer: B
Rationale: Tendons are cordlike structures that attach muscles to the periosteum of the bone. Ligaments consisting of fibrous tissue connect two adjacent, freely movable bones. Cartilage is a firm dense type of connective tissue that reduces friction between articular surfaces, absorbs shock, and reduces the stress on joint surfaces. A joint is the junction between 2 or more bones.
Question 4 of 5
A client scheduled to undergo an electomyrography asks the nurse what this test will evaluate. What is the correct response from the nurse?
Correct Answer: A
Rationale: Electomyrography tests the electric potential of the muscles and nerves leading to the muscles. It is done to evaluate muscle weakness or deterioration, pain, disability, and to differentiate muscle and nerve problems. A bone biopsy is done to identify bone composition. Bone densitometry is done to evaluate bone density. A bone scan would be appropriate to detect metastatic bone lesions.
Question 5 of 5
The nurse is taking an initial history of a new client with a musculoskeletal problem. Which factor is most important for the nurse to keep in mind for this assessment?
Correct Answer: C
Rationale: The focus of the initial history depends on the nature of the musculoskeletal problem, whether the client has a chronic disorder or a recent injury. If the disorder is long-standing, the nurse obtains a thorough medical, drug, and allergy history. If the client is injured, the nurse finds out when and how the trauma occurred. The client's age, lifestyle, or duration and location of discomfort or pain, although important, have little influence on the focus of the initial history and assessment of the client.