Musculoskeletal

Front 1

Bone is classified according to structure as _______ (compact and dense) or _______ (spongy).

Back 1

cortical, cancellous

Front 2

Cylinder-shaped structural units (______ ______) fit closely together in compact bone, creating a dense bone structure.

Back 2

Haversian systems

Front 3

________ synthesize organic bone matrix (collagen) and are the basic bone-forming cells.

Back 3

Osteoblasts

Front 4

________ are the mature bone cells.

Back 4

Osteocytes

Front 5

________ participate in bone remodeling by assisting in the breakdown of bone tissue.

Back 5

Osteoclasts

Front 6

______ ________ is the removal of old bone by osteoclasts (resorption) and the deposition of new bone by osteoblasts (ossification).

Back 6

Bone remodeling

Front 7

The ________, the widened area found at each end of a long bone, is composed primarily of cancellous bone.

Back 7

epiphysis

Front 8

The _______is the flared area between the epiphysis and the diaphysis. Like the epiphysis, it is composed of cancellous bone.

Back 8

metaphysis

Front 9

The _______ _____, or growth zone, is the cartilaginous area btwn the epiphysis and metaphysis. It actively produces bone to allow longitudinal growth in children.

Back 9

epiphyseal plate

Front 10

The _______ is composed of fibrous connective tissue that covers the bone. Tiny blood vessels penetrate ________ to provide nutrition to underlying bone. (same word)

Back 10

periosteum

Front 11

Pain in posterior leg when running or walking initially; can progress to pain at rest; possibly caused by cumulative stress on Achilles tendon resulting in inflammation

Back 11

Achilles tendonitis

Front 12

Stiffness and fixation of a joint; possibly caused by chronic joint inflammation (e.g. rhematoid arthritis)

Back 12

Ankylosis

Front 13

Shortened stride with as little wt bearing as possible on the affected side;possibly caused by pain or discomfort in the lower extremity on wt bearing; can be r/t trauma or other disorders

Back 13

Antalgic gait

Front 14

Staggering, uncoordinated gait often with sway; possibly caused by Neurogenic disorders (e.g. spinal cord lesion)

Back 14

Ataxic gait

Front 15

Flabby appearance of muscle leading to decreased function and tone; possibly caused by muscle denervation, contracture, prolonged disuse as a result of immobilization

Back 15

Atrophy

Front 16

Finger abnormality, flexion of proximal interphalangeal (pip) joint and hyperextension of the distal interphalangeal (dip) joint of the fingers; typical deformity of rheumatoid and psoriatic arthritis caused by rupture of extensor tendons over the fingers

Back 16

Boutonniere deformity

Front 17

Resistance of movement of muscle or joint as a result of fibrosis of supporting soft tissues;possibly caused by shortening of muscle or ligaments, tightness of soft tissue, incorrect positioning of immoblized extremity

Back 17

Contracture

Front 18

Audible crackling sound with palpable grating that accompanies movement; possibly caused by fracture, dislocation, temporomandibular joint dysfunction, osteoarthritis

Back 18

Crepitation (crepitus)

Front 19

Bone is displaced from its normal joint; possibly caused by trauma, disorders of surrounding soft tissues

Back 19

Dislocation

Front 20

While walking, the neck, trunk, and knees flex while the body is rigid; delayed start with short, quick, shuffling steps; speed may increase as if pt is unable to stop (festination);possibly caused by neurogenic disorders (e.g., Parkinson's disease)

Back 20

Festinating gait

Front 21

Small fluid-filled bump or mass over a tendon sheath or joint, usually on dorsal surface of wrist or foot; possibly caused by inflammation of tissues around a joint, can increase in size or disappear

Back 21

Ganglion cyst

Front 22

Foward bending of thoracic spine, slight flexion of knees; exaggerated thoracic curvature; possibly caused by poor posture, tuberculosis, arthritis, osteoporosis, growth disturbance of vertebral epiphysis

Back 22

Kyphosis (dowager's hump)

Front 23

Dull ache along outer aspect of elbow, worsens with twisting and grasping motions; possibly caused by partial tearing of tendon at its insertion on epicondyle

Back 23

Lateral epicondylitis (tennis elbow)

Front 24

Joint does not achieve the expected degrees of motion;possibly caused by injury, inflammation, contracture

Back 24

Limited range of motion (ROM)

Front 25

Asymmetric scapulae and shoulders, exaggerated lumbar curvature; secondary to other spinal deformities possibly caused by muscular dystrophy, obesity, flexion contracture of hip, congenital dislocation of hip

Back 25

Lordosis (swayback)

Front 26

Increased muscle tone (rigidity) with sustained muscle contractions (spasms); stiffness or tightness may interfere with gait, movement, speech; possibly caused by neuromuscular disorders such as MS or cerebral palsy

Back 26

Muscle spasticity

Front 27

General muscle tenderness and pain; possibly caused by chronic rheumatic syndromes (e.g. fibromyalgia)

Back 27

Myalgia

Front 28

Numbness and tingling, often described as a "pins and needles" sensation; possibly caused by compromised sensory nerves, often due to edema in a closed space such as a cast or bulky dressing

Back 28

Paresthesia

Front 29

Abnormal flatness of the sole and arch of the foot; possibly caused by hereditary, muscle paralysis, mild cerebral palsy, early muscular dystrophy, injury to posterior tibial tendon

Back 29

Pes planus (flat foot)

Front 30

Burning, sharp pain on sole of foot; worse in the morning; chronic degenerative;reparative cycle resulting in inflammation

Back 30

Plantar fasciitis

Front 31

__________ is an aminoglycoside type of antibiotic that is often used to treat osteomyelitis. The medication is given by the intravenous route for several weeks and blood levels are monitored periodically to ensure that they are therapeutic

Back 31

Gentamicin

Front 32

A gradual but measurable loss of height and the development of kyphosis or "dowager's hump" is indicative of the presence of _________, in which the rate of bone resorption is greater than bone deposition.

Back 32

osteoporosis

Front 33

The rate of progression of osteoporosis can be slowed if the patient takes _________ supplements and/or foods high in _______, and engages in regular ________ .

Back 33

calcium, calcium, exercise

Front 34

The nurse determines that dietary teaching for a 75-year-old patient with osteoporosis has been most successful when the patient selects which of the following highest calcium meals?
A. Ham and Swiss cheese sandwich on whole wheat bread, steamed broccoli, and an apple
B. Chicken stir-fry with 1 cup each onions and snap peas, and 1 cup of steamed rice
C. A sardine (3 oz) sandwich on whole wheat bread, 1 cup of fruit yogurt, and 1 cup of skim milk
D. A two-egg omelet with 2 oz of American cheese, one slice of whole wheat toast, and a half grapefruit

Back 34

C. A sardine (3 oz) sandwich on whole wheat bread, 1 cup of fruit yogurt, and 1 cup of skim milk

The highest calcium content is present in this lunch containing milk and milk products, and small fish with bones (sardines).

Front 35

_________ is an infection of bone and bone marrow that can occur with trauma, surgery, or extension of nearby infection. Because it is an infection, the patient will exhibit typical signs of inflammation and infection, including localized pain and redness.

Back 35

Osteomyelitis

Front 36

The standard treatment for acute osteomyelitis consists of several weeks of intravenous ________ therapy. This is because bone is denser and less vascular than other tissues, and it takes time for the ________ therapy to eradicate all of the microorganisms. (same word)

Back 36

antibiotic

Front 37

A 67-year-old patient hospitalized with osteomyelitis has an order for bed rest with bathroom privileges, with the affected foot elevated on 2 pillows. The nurse would place highest priority on which of the following interventions?
A. Ambulate the patient to the bathroom every 2 hours.
B. Ask the patient about preferred activities to relieve boredom.
C. Perform frequent position changes and range-of-motion exercises.
D. Allow the patient to dangle legs at the bedside every 2 to 4 hours.

Back 37

C. Perform frequent position changes and range-of-motion exercises

The patient is at risk for atelectasis of the lungs and for contractures because of prescribed bed rest. For this reason, the nurse should change the patient's position frequently to promote lung expansion and perform range-of-motion exercises to prevent contractures.

Front 38

The nurse identifies a nursing diagnosis of pain related to muscle spasms for a 45-year-old patient who has low back pain from herniated lumbar disk. Which of the following would be an appropriate nursing intervention to treat this problem?
A. Elevate the head of the bed 20 degrees and flex the knees.
B. Provide gentle range of motion to the lower extremities.
C. Place the bed in reverse Trendelenburg with the feet firmly against the footboard.
D. Place a small pillow under the patient's upper back to gently flex the lumbar spine.

Back 38

A. Elevate the head of the bed 20 degrees and flex the knees

The nurse should elevate the head of the bed 20 degrees and flex the knees to avoid extension of the spine and increasing the pain. The slight flexion provided by this position often is comfortable for patients with herniated lumbar disks.

Front 39

The nurse is admitting a patient who complains of a new onset of lower back pain. To differentiate between the pain of lumbar herniated disk and lower back pain from other causes, which of the following would be the best question for the nurse to ask the patient?
A. “Is the pain worse in the morning or in the evening?”
B. “Is the pain totally relieved by analgesics, such as acetaminophen (Tylenol)?”
C. “Is the pain sharp or stabbing, or burning or aching?”
D. “Does the pain radiate down the buttock or into the leg

Back 39

D. “Does the pain radiate down the buttock or into the leg?”
Lower back pain associated with herniated lumbar disk is accompanied by radiation along the sciatic nerve and can be commonly described as traveling through the buttock, to the posterior thigh, or down the leg. This is because the herniated disk causes compression on spinal nerves as they exit the spinal column. The other questions asked by the nurse do not elicit this data

Front 40

The nurse is admitting a 45-year-old patient to the nursing unit with a history of herniated lumbar disk and low back pain. In completing a more thorough pain assessment, the nurse would ask the patient if which of the following items aggravates the pain?
A. Sitting in a fully extended recliner
B. Bending or lifting
C. Application of warm moist heat
D. Sleeping in a side-lying position

Back 40

B. Bending or lifting

Back pain that is related to herniated lumbar disk often is aggravated by events and activities that increase the stress and strain on the spine, such as bending or lifting, coughing, sneezing, and lifting the leg with the knee straight (straight leg raising test)

Front 41

The nurse has reviewed proper body mechanics with a 45-year-old patient with a history of low back pain caused by a herniated lumbar disk. Which of the following statements made by the patient indicates a need for further teaching?
A. “I should pick up items by leaning forward without bending my knees.”
B. “I should exercise at least 15 minutes every morning and evening.”
C. “I should try to keep one foot on a stool whenever I have to stand for a period of time.”
D. “I should sleep on my side or back with my hips and knees bent

Back 41

A. “I should pick up items by leaning forward without bending my knees.”

The patient should avoid leaning forward without bending the knees. Bending the knees helps to prevent lower back strain and is part of proper body mechanics when lifting

Front 42

The nurse is planning health promotion teaching for a 45-year-old patient with asthma, low back pain from herniated lumbar disk, and schizophrenia. The nurse determines that which of the following would be the best exercise to include in an individualized exercise plan for the patient?
A. Yoga
B. Walking
C. Weight lifting
D. Calisthenics

Back 42

B. Walking

The patient would benefit from an aerobic exercise that takes into account the patient's health status and fits the patient's lifestyle. The best exercise of those listed is walking, which builds strength in the back and leg muscles without putting undue pressure or strain on the spine

Front 43

The nurse is caring for a patient hospitalized with exacerbation of asthma and herniated lumbar disk. Which of the following breakfast choices would be most appropriate for the nurse to encourage the patient to check on the breakfast menu?
A. Scrambled eggs
B. Puffed rice cereal
C. Bran muffin
D. Buttered white toast

Back 43

C. Bran muffin

Each meal should contain one or more sources of fiber, which will reduce the risk of constipation and straining at stool, which will increase back pain. Bran is typically a high fiber food choice and is appropriate for selection from the menu.

Front 44

_________ is a degeneration or breakdown of the articular cartilage in synovial joints. The condition has also been referred to as degenerative joint disease

Back 44

Osteoarthritis (OA)

Front 45

A regular low-impact exercise, such as walking is important in helping to maintain joint mobility in the patient with _________ .

Back 45

osteoarthritis

Front 46

______ is characterized predominantly by joint pain upon movement and is a classic feature of the disease.

Back 46

Osteoarthritis

Front 47

The nurse is caring for a patient who has osteoarthritis (OA) of the knees. The nurse teaches the patient that the most beneficial measure to protect the joints is to do which of the following?
A. Use a wheelchair to avoid walking as much as possible.
B. Eat a well-balanced diet to maintain a healthy body weight.
C. Use a walker for ambulation to relieve the pressure on her hips.
D. Sit in chairs that do not cause her hips to be lower than her knees.

Back 47

B. Eat a well-balanced diet to maintain a healthy body weight.

Because maintaining an appropriate load on the joints is essential to the preservation of articular cartilage integrity, the patient should maintain an optimal overall body weight or lose weight if overweight.

Front 48

When reinforcing health teaching about the management of osteoarthritis (OA), the nurse determines that the patient needs additional instruction after making which of the following statements?
A. "I should take the celecoxib (Celebrex) as prescribed to help control the pain."
B. "I should try to stay standing all day to keep my joints from becoming stiff."
C. "I can use a cane if I find it helpful in relieving the pressure on my back and hip."
D. "A warm shower in the morning will help relieve the stiffness I have when I get up."

Back 48

B. "I should try to stay standing all day to keep my joints from becoming stiff."

It is important to maintain a balance between rest and activity to prevent overstressing the joints with osteoarthritis.

Front 49

The nurse is discharging a patient admitted with a transient ischemic attack (TIA). Which of the following medications might the nurse expect to provide discharge instructions for? (Select all that apply.)
A. Clopidogrel (Plavix)
B. Enteric-coated aspirin (Ecotrin)
C. Tissue plasminogen activator (tPa)
D. Dipyridamole (Persantine)

Back 49

A. Clopidogrel (Plavix)
B. Enteric-coated aspirin (Ecotrin)
D. Dipyridamole (Persantine)

Aspirin is the most frequently used antiplatelet agent. Other drugs to prevent clot formation include clopidogrel (Plavix), ticlopidine (Ticlid), dipyridamole (Persantine), combined dipyridamole and aspirin (Aggrenox), and anticoagulant drugs, such as oral warfarin (Coumadin). Tissue plasminogen activator is a fibrinolytic medication used to treat ischemic stroke, not prevent

Front 50

When providing community health care teaching regarding the early warning signs of Alzheimer's disease, which of the following signs would the nurse advise family members to report? (Select all that apply.)
A. Difficulty performing familiar tasks
B. Problems with performing basic calculations
C. Misplacing car keys
D. Becoming lost in a usually familiar environment

Back 50

A. Difficulty performing familiar tasks
B. Problems with performing basic calculations
D. Becoming lost in a usually familiar environment

Difficulty performing familiar tasks, problems with performing basic calculations, and becoming lost in a usually familiar environment are all part of the early warning signs of Alzheimer's disease. Misplacing car keys is a normal frustrating event for many people

Front 51

The nurse is reinforcing general health teaching with a 64-year-old patient with osteoarthritis (OA) of the hip. Which of the following points would the nurse include in this review of the disorder? (Select all that apply.)
A. Joint degeneration with pain and disability occurs in the majority of people by the age of 60.
B. OA can be prevented from progressing when well controlled with a regimen of exercise, diet, and medication.
C. OA is more common with aging, but usually it remains confined to a few joints and does not cause crippling.
D. OA is an inflammatory disease of the joints that may present symptoms at any age.

Back 51

B. OA can be prevented from progressing when well controlled with a regimen of exercise, diet, and medication.
C. OA is more common with aging, but usually it remains confined to a few joints and does not cause crippling.

OA occurs with greater frequency with increasing age, but it usually remains confined to a few joints and can be managed with a combination of exercise, diet, and medication. OA can lead to significant disability.

Front 52

Drug used for osteoporosis. Pt should sit upright for at least 30 min, after taking to prevent esophagitis or esophageal ulcers; Biophosponate

Back 52

alendronate (Fosamax)

Front 53

A ________ is an injury to tendinoligamentous structures surrounding a joint, usually caused by a wrenching or twisting motion.

Back 53

sprain

Front 54

A _______-________ (_____) sprain involves tears of only a few fibers resulting in mild tenderness and minimal swelling.

Back 54

first-degree (mild)

Front 55

A _________-________ (________) sprain is partial disruption of the involved tissue with more swelling and tenderness.

Back 55

second-degree (moderate)

Front 56

A ______-_______ (_______) sprain is a complete tearing of the ligament in assoc. with moderate to severe swelling.

Back 56

third-degree (severe)

Front 57

A ______ is an excessive stretching of a muscle and its fascial sheath. It often involves the tendon. May be classified as first degree (mild or slightly pulled muscle), second degree (moderate or moderately torn muscle), and third degree (severely ruptured or torn muscle).

Back 57

strain

Front 58

The clinical manifestations of sprains and strains are similar and include ______, ______, ______ __ _______, and ________.

Back 58

pain, edema, decrease in function, and contusion.

Front 59

A ________ is a disruption or break in the continuity of the structure of bone.

Back 59

fracture