Musculoskeletal Test Questions (NLE 1-5)

Musculoskeletal Test Questions

1. When caring for a client experiencing an acute gout attack, the nurse anticipates administering which medication?

a. allopurinol (Zyloprim)
b. colchicines
c. prednisone (Deltasone)
d. propoxyphene hydrochloride (Darvon)

2. During a senior citizen health screening, the nurse observes a 75-year-old female with a severely increased thoracic curve, or "humpback". What is this condition called?

a. Lordosis
b. Kyphosis
c. Scoliosis
d. Genus varum

3. Musculoskeletal test questions about a nurse who is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

a. Head of the bed elevated 45 degrees
b. Prone
c. Supine with feet raised
d. Supine with the head lower than the trunk

4. During a scoliosis screening in a college heath center, a student asks the public health nurse about the consequences of untreated scoliosis. The nurse would be accurate by identifying one of the direct complications as:

a. osteoporosis of the vertebra.
b. impingement on pulmonary function.
c. spontaneous spinal cord injury.
d. pituitary hyposecretion.

5. A client is on bed rest after sustaining injuries in a car accident. Which nursing action would help the client avoid complications of immobility?

a. Decreasing fluid intake to ease dependent edema
b. Turning the client every 2 hours and massaging bony prominences
c. Raising the head of the bed to maximize the client's lung inflation
d. Bathing and feeding the client to decrease energy expenditure

Musculoskeletal Test Questions:
Answers and Rationale

1) B
- The physician usually prescribes colchicine for a client experiencing an acute gout attack. This drug decreases leukocyte motility, phagocytosis, and lactic acid production, thereby reducing urate crystal deposits and relieving inflammation. Allopurinol is used to decrease uric acid production in clients with chronic gout. Although corticosteroids are prescribed to treat gout, the nurse wouldn't give them because they must be administered interarticularly to this client. Propoxyphene, a narcotic, may be used to treat osteoarthritis.

2) B
- Kyphosis refers to an increased thoracic curvature of the spine, or "humpback." Lordosis is an increase in the lumbar curve or swayback. Scoliosis is a lateral deformity of the spine. Genus varum is a bow-legged appearance of the legs.

3) A
- After a myelogram, answer to musculoskeletal test questions about positioning will depend on the dye injected. When a water-soluble dye such as metrizamide is injected, the head of the bed is elevated to a 45-degree angle to slow the upward dispersion of the dye. The other positions are contraindicated when a water-soluble contrast dye is used. If an air-contrast study were performed, the client should be positioned supine with the head lower than the trunk.

4) B
- As untreated scoliosis progresses, the thoracic spinal curvature can impinge on the lungs and affect pulmonary function. Osteoporosis, spinal cord injury, and pituitary hyposecretion aren't directly attributed to untreated scoliosis.

5) B
- To avoid pressure ulcers in an immobilized client, the nurse must assess the skin thoroughly and use such preventive measures as regular turning, massage of bony prominences, a low-air-loss mattress, and a trapeze (if the client's condition allows). The nurse should increase, not decrease, the client's fluid intake to help prevent renal calculi, which may result from immobility. To prevent atelectasis, another complication of immobility, having the client cough, deep breathe, and use an incentive spirometer would be more effective than raising the head of the bed. Instead of bathing and feeding the client, the nurse should promote independent self-care activities whenever possible to prepare the client for a return to the previous health status.

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