ATI Med Surg Management of Patients with Musculoskeletal Disorders 100% Correct Answers, test Latest Verified Questions and all Correct Answers with Explanations Download to Score A

ATI Med Surg Management of Patients with
Musculoskeletal Disorders 100% Correct Answers,
test Latest Verified Questions and all Correct
Answers with Explanations Download to Score A
1. A nurse is caring for an adult patient diagnosed with a back strain. What health education should the
nurse provide to this patient?
A) Avoid lifting more than one-third of body weight without assistance.
B) Focus on using back muscles efficiently when lifting heavy objects.
C) Lift objects while holding the object a safe distance from the body.
D) Tighten the abdominal muscles and lock the knees when lifting of an object.
Ans: A
Feedback:
The nurse will instruct the patient on the safe and correct way to lift objects using the strong quadriceps
muscles of the thighs, with minimal use of the weak back muscles. To prevent recurrence of acute low
back pain, the nurse may instruct the patient to avoid lifting more than one-third of his weight without
help. The patient should be informed to place the feet a hip-width apart to provide a wide base of
support, the person should bend the knees, tighten the abdominal muscles, and lift the object close to
the body with a smooth motion, avoiding twisting and jerking.
2. A nurse is discussing conservative management of tendonitis with a patient. Which of the following
may be an effective approach to managing tendonitis?
A) Weight reduction
B) Use of oral opioid analgesics
C) Intermittent application of ice and heat
D) Passive range of motion exercises
Ans: C
Feedback:
Conservative management of tendonitis includes rest of the extremity, intermittent ice and heat to the
joint, and NSAIDs. Weight reduction may prevent future injuries but will not relieve existing tendonitis.
Range-of-motion exercises may exacerbate pain. Opioids would not be considered a conservative
treatment measure.
3. A patient presents at a clinic complaining of pain in his heel so bad that it inhibits his ability to walk.
The patient is subsequently diagnosed with plantar fasciitis. This patients plan of care should include
what intervention?
A) Wrapping the affected area in lambs wool or gauze to relieve pressure
B) Gently stretching the foot and the Achilles tendon
C) Wearing open-toed shoes at all times
D) Applying topical analgesic ointment to plantar surface each morning
Ans: B
Feedback:
Plantar fasciitis leads to pain that is localized to the anterior medial aspect of the heel and diminishes
with gentle stretching of the foot and Achilles tendon. Dressings of any kind are not of therapeutic
benefit and analgesic ointments do not address the pathology of the problem. Open-toed shoes are of
no particular benefit.
4. A nurse is providing an educational class to a group of older adults at a community senior center. In an
effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the
recommended adequate intake of what nutrients? Select all that apply.
A) Vitamin B12
B) Potassium
C) Calcitonin
D) Calcium
E) Vitamin D
Ans: D, E
Feedback:
A diet rich in calcium and vitamin D protects against skeletal demineralization. Intake of vitamin B12and
potassium does not directly influence the risk for osteoporosis. Calcitonin is not considered to be a
dietary nutrient.
5. A nurse is providing a class on osteoporosis at the local seniors center. Which of the following
statements related to osteoporosis is most accurate?
A) Osteoporosis is categorized as a disease of the elderly.
B) A nonmodifiable risk factor for osteoporosis is a persons level of activity.
C) Secondary osteoporosis occurs in women after menopause.
D) Slow discontinuation of corticosteroid therapy can halt the progression of the osteoporosis.
Ans: D
Feedback:
When corticosteroid therapy is discontinued, the progression of osteoporosis is halted, but restoration
of lost bone mass does not occur. Osteoporosis is not a disease of the elderly because its onset occurs
earlier in life, when bone mass peaks and then begins to decline. A persons level of physical activity is a
modifiable factor that influences peak bone mass. Lack of activity increases the risk for the development
of osteoporosis. Primary osteoporosis occurs in women after menopause.
6. A nurse is teaching a patient with osteomalacia about the role of diet. What would be the best
choice for breakfast for a patient with osteomalacia?
A) Cereal with milk, a scrambled egg, and grapefruit
B) Poached eggs with sausage and toast
C) Waffles with fresh strawberries and powdered sugar
D) A bagel topped with butter and jam with a side dish of grapes
Ans: A
Feedback:
The best meal option is the one that contains the highest dietary sources of calcium and vitamin D. The
best selection among those listed is cereal with milk, and eggs, as these foods contain calcium and
vitamin D in a higher quantity over the other menu options.
7. A nurse is caring for a patient with Pagets disease and is reviewing the patients most recent
laboratory values. Which of the following values is most characteristic of Pagets disease?
A) An elevated level of parathyroid hormone and low calcitonin levels
B) A low serum alkaline phosphatase level and a low serum calcium level
C) An elevated serum alkaline phosphatase level and a normal serum calcium level
D) An elevated calcitonin level and low levels of parathyroid hormone
Ans: C
Feedback:
Patients with Pagets disease have normal blood calcium levels. Elevated serum alkaline phosphatase
concentration and urinary hydroxyproline excretion reflect the increased osteoblastic activity associated
with this condition. Alterations in PTH and calcitonin levels are atypical.
8. Which of the following patients should the nurse recognize as being at the highest risk for the
development of osteomyelitis?
A) A middle-age adult who takes ibuprofen daily for rheumatoid arthritis
B) An elderly patient with an infected pressure ulcer in the sacral area
C) A 17-year-old football player who had orthopedic surgery 6 weeks prior
D) An infant diagnosed with jaundice
Ans: B
Feedback:
Patients who are at high risk of osteomyelitis include those who are poorly nourished, elderly, and
obese. The elderly patient with an infected sacral pressure ulcer is at the greatest risk for the
development of osteomyelitis, as this patient has two risk factors: age and the presence of a soft-tissue
infection that has the potential to extend into the bone. The patient with rheumatoid arthritis has one
risk factor and the infant with jaundice has no identifiable risk factors. The patient 6 weeks postsurgery
is beyond the usual window of time for the development of a postoperative surgical wound infection.
9. A nurse is caring for a patient with a bone tumor. The nurse is providing education to help the
patient reduce the risk for pathologic fractures. What should the nurse teach the patient?
A) Strive to achieve maximum weight-bearing capabilities.
B) Gradually strengthen the affected muscles through weight training.
C) Support the affected extremity with external supports such as splints.
D) Limit reliance on assistive devices in order to build strength.
Ans: C
Feedback:
During nursing care, the affected extremities must be supported and handled gently. External supports
(splints) may be used for additional protection. Prescribed weight-bearing restrictions must be followed.
Assistive devices should be used to strengthen the unaffected extremities.
10. A patient presents at a clinic complaining of back pain that goes all the way down the back of the
leg to the foot. The nurse should document the presence of what type of pain?
A) Bursitis
B) Radiculopathy
C) Sciatica
D) Tendonitis
Ans: C
Feedback:
Sciatica nerve pain travels down the back of the thigh to the foot of the affected leg. Bursitis is
inflammation of a fluid-filled sac in a joint. Radiculopathy is disease of a nerve root. Tendonitis is
inflammation of muscle tendons.
11. A patient tells the nurse that he has pain and numbness to his thumb, first finger, and second finger
of the right hand. The nurse discovers that the patient is employed as an auto mechanic, and that the
pain is increased while working. This may indicate that the patient could possibly have what health
problem?
A) Carpel tunnel syndrome
B) Tendonitis
C) Impingement syndrome
D) Dupuytrens contracture
Ans: A
Feedback:
Carpel tunnel syndrome may be manifested by numbness, pain, paresthesia, and weakness along the
median nerve. Tendonitis is inflammation of muscle tendons. Impingement syndrome is a general term
that describes all lesions that involve the rotator cuff of the shoulder. Dupuytrens contracture is a slowly
progressive contracture of the palmar fascia.
12. A nurse is assessing a patient who reports a throbbing, burning sensation in the right foot. The
patient states that the pain is worst during the day but notes that the pain is relieved with rest. The
nurse should recognize the signs and symptoms of what health problem?
A) Mortons neuroma
B) Pescavus
C) Hallux valgus
D) Onychocryptosis
Ans: A
Feedback:
Mortons neuroma is a swelling of the third (lateral) branch of the median plantar nerve, which causes a
throbbing, burning pain, usually relieved with rest. Pescavus refers to a foot with an abnormally high
arch and a fixed equinus deformity of the forefoot. Hallux valgus (bunion) is a deformity in which the
great toe deviates laterally and there is a marked prominence of the medial aspect of the first
metatarsal- phalangeal joint and exostosis. Onychocryptosis (ingrown toenail) occurs when the free edge
of a nail plate penetrates the surrounding skin, laterally or anteriorly.
13. A nurse is reviewing the pathophysiology that may underlie a patients decreased bone density.
What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?
A) Estrogen
B) Parathyroid hormone (PTH)
C) Calcitonin
D) Progesterone
Ans: C
Feedback:
Calcitonin inhibits bone resorption and promotes bone formation, estrogen inhibits bone breakdown,
and parathyroid increases bone resorption. Estrogen, which inhibits bone breakdown, decreases with
aging. Parathyroid hormone (PTH) increases with aging, increasing bone turnover and resorption.
Progesterone is the major naturally occurring human progestogen and plays a role in the female
menstrual cycle.
14. A patient is undergoing diagnostic testing for osteomalacia. Which of the following laboratory
results is most suggestive of this diagnosis?
A) High chloride, calcium, and magnesium
B) High parathyroid and calcitonin levels
C) Low serum calcium and magnesium levels
D) Low serum calcium and low phosphorus level
Ans: D
Feedback:
Laboratory studies will reveal a low serum calcium and low phosphorus level.
15. An 80-year-old man in a long-term care facility has a chronic leg ulcer and states that the area has
become increasingly painful in recent days. The nurse notes that the site is now swollen and warm to
the touch. The patient should undergo diagnostic testing for what health problem?
A) Osteomyelitis
B) Osteoporosis
C) Osteomalacia
D) Septic arthritis
Ans: A
Feedback:
When osteomyelitis develops from the spread of an adjacent infection, no signs of septicemia are
present, but the area becomes swollen, warm, painful, and tender to touch. Osteoporosis is the most
prevalent bone disease in the world. Osteomalacia is a metabolic bone disease characterized by
inadequate mineralization of bone. Septicarthritis occurs when joints become infected through spread
of infection from other parts of the body (hematogenous spread) or directly through trauma or surgical
instrumentation.
16. A patient has returned to the unit after undergoing limb-sparing surgery to remove a metastatic
bone tumor. The nurse providing postoperative care in the days following surgery assesses for what
complication from surgery?
A) Deficient fluid volume
B) Delayed wound healing
C) Hypocalcemia
D) Pathologic fractures
Ans: B
Feedback:
Delayed wound healing is a complication of surgery due to tissue trauma from the surgery. Nutritional
deficiency is usually due to the effects of chemotherapy and radiation therapy, which may cause weight
loss. Pathologic fractures are not a complication of surgery.
17. A nurse is caring for a patient who is 12 hours postoperative following foot surgery. The nurse
assesses the presence of edema in the foot. What nursing measure will the nurse implement to control
the edema?
A) Elevate the foot on several pillows.
B) Apply warm compresses intermittently to the surgical area.
C) Administer a loop diuretic as ordered.
D) Increase circulation through frequent ambulation.
Ans: A
Feedback:
To control the edema in the foot of a patient who experienced foot surgery, the nurse will elevate the
foot on several pillows when the patient is sitting or lying. Diuretic therapy is not an appropriate
intervention for edema related to inflammation. Intermittent ice packs should be applied to the surgical
area during the first 24 to 48 hours after surgery to control edema and provide some pain relief.
Ambulation will gradually be resumed based on the guidelines provided by the surgeon.
18. A patient with diabetes is attending a class on the prevention of associated diseases. What action
should the patient perform to reduce the risk of osteomyelitis?
A) Increase calcium and vitamin intake.
B) Perform meticulous foot care.
C) Exercise 3 to 4 times weekly for at least 30 minutes.
D) Take corticosteroids as ordered.
Ans: B
Feedback:
Diabetic foot ulcers have a high potential for progressing to osteomyelitis. Meticulous foot care can help
mitigate this risk. Corticosteroids can exacerbate the risk of osteomyelitis. Increased intake of calcium
and vitamins as well as regular exercise are beneficial health promotion exercises, but they do not
directly reduce the risk of osteomyelitis.
19. A nurse is planning the care of an older adult patient with osteomalacia. What action should the
nurse recommend in order to promote vitamin D synthesis?
A) Ensuring adequate exposure to sunlight
B) Eating a low-purine diet
C) Performing cardiovascular exercise while avoiding weight-bearing exercises
D) Taking thyroid supplements as ordered
Ans: A
Feedback:
Because sunlight is necessary for synthesizing vitamin D, patients should be encouraged to spend some
time in the sun. A low-purine diet is not a relevant action and thyroid supplements do not directly affect
bone function. Action must be taken to prevent fractures, but weight-bearing exercise within safe
parameters is not necessarily contraindicated.
20. A patient presents to a clinic complaining of a leg ulcer that isnt healing; subsequent diagnostic
testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause
osteomyelitis is what?
A) Staphylococcus aureus
B) Proteus
C) Pseudomonas
D) Escherichia coli
Ans: A
Feedback:
S. aureus causes over 50% of bone infections. Proteus, Pseudomonas, and E. coli are also causes, but to
a lesser extent.
21. A nurse is providing care for a patient who has a recent diagnosis of Pagets disease. When planning
this patients nursing care, interventions should address what nursing diagnoses? Select all that apply.
A) Impaired Physical Mobility
B) Acute Pain
C) Disturbed Auditory Sensory Perception
D) Risk for Injury
E) Risk for Unstable Blood Glucose
Ans: A, B, C, D Feedback:
Patients with Pagets disease are at risk of decreased mobility, pain, hearing loss, and injuries resulting
from decreased bone density. Pagets disease does not affect blood glucose levels.