Musculoskeletal System Disorders Challenge Exam (Quiz #2: 25 Questions)

A 68-year-old retired schoolteacher, living independently, has been recently diagnosed with osteoporosis. She has a history of a minor fracture from a simple fall two years ago. The physiotherapist recommended a set of weight-bearing exercises to incorporate into her daily routine. During a follow-up visit to the clinic, the nurse inquires about her adherence to the exercises, only to find out she’s noncompliant. The patient, looking a bit discouraged, expresses doubts regarding the effectiveness of these exercises. Which response by the nurse is most appropriate?

In a community healthcare center, the nurse is preparing to host a seminar on osteoporosis management for a diverse group of patients. Among the attendees are a 60-year-old professional dancer recently diagnosed with osteoporosis, a 75-year-old gentleman who has been managing osteoporosis for a decade, and a 68-year-old woman expressing concerns about the recent discontinuation of her hormone replacement therapy. Given the varied experiences and backgrounds of the patients, the nurse must carefully consider the content of the educational session. Which interventions should the nurse include in the teaching? Select all that apply.

On the 6th floor of Rosewood Hospital, Nurse Alex is assigned to Mrs. Jackson, a 72-year-old woman with advanced osteoporosis. Mrs. Jackson, who has a history of chronic kidney disease and gastrointestinal reflux, recently started receiving intravenous bisphosphonate therapy due to intolerance to oral bisphosphonates. As Nurse Alex reviews Mrs. Jackson’s medical history and current medications, they are reminded of the unique considerations associated with IV bisphosphonates and potential complications they need to be vigilant about. To ensure the patient’s safety and treatment effectiveness, which assessments should the nurse prioritize? Select all that apply.

In the bustling orthopedic unit of Springvale Medical Center, Nurse Jamie is prepping Mr. Robbins, an 81-year-old patient with osteoporosis who, after a mild fall in his garden, suffered a hip fracture. His surgery is scheduled for the next morning. Nurse Jamie recognizes the vulnerability of this patient population and the risks associated with surgery. Recollecting her training and experiences, she considers the most immediate and crucial interventions needed in this preoperative stage. Which interventions should the nurse implement during the preoperative phase? Select all that apply.

On a chilly morning, Nurse Alex visits the residence of Ms. Smith, a 58-year-old patient with osteoporosis. As she enters the cozy living room, Alex observes a few loose rugs on the wooden floor, dim lighting in the hallway, and notes a pair of slippery, worn-out slippers near the entrance. Remembering Ms. Smith’s reduced bone density and impaired balance, Nurse Alex realizes that these are potential fall hazards and starts thinking about the critical interventions she should recommend to enhance safety and prevent potential falls. Which interventions should the nurse implement to enhance safety? Select all that apply.

Nurse Miller works in a bustling medical ward of St. Martha’s Metropolitan Hospital. It’s a chilly Tuesday morning, and the ward is alive with the sounds of medical devices and muffled conversations. She is now attending to Ms. Johnson, a middle-aged woman with rheumatoid arthritis. As the sun streams in, casting a soft glow across the room, Ms. Johnson describes the intense morning stiffness she feels, making even pulling her blanket away an ordeal. Nurse Miller is keenly aware of how the manifestations of rheumatoid arthritis can be exacerbated in the morning, and she ponders on the most effective intervention to alleviate Ms. Johnson’s discomfort. Which nursing intervention should be implemented?

A 58-year-old male patient, Mr. Smith, who has been diagnosed with moderate to severe rheumatoid arthritis (RA), presents to an outpatient rheumatology clinic. He complains of joint stiffness in the morning, especially in his hands and wrists, and expresses difficulty in performing daily tasks such as buttoning his shirt. On physical examination, there is notable swelling, tenderness, and warmth in the metacarpophalangeal and proximal interphalangeal joints. After discussing various therapeutic options, the rheumatologist prescribes methotrexate to Mr. Smith. As the nurse in charge of providing patient education, which information regarding methotrexate is essential for Mr. Smith to understand? Select all that apply.

Ms. Rivera, a 46-year-old female, presents to the outpatient rheumatology clinic with a history of progressively worsening joint pain and stiffness over the past six months. On evaluation, there is swelling, redness, and decreased range of motion in her wrists, knees, and several smaller joints in her hands and feet. After confirming the diagnosis of rheumatoid arthritis through laboratory and imaging studies, the rheumatologist initiates treatment with prednisone to rapidly control the inflammation and symptoms. As the primary nurse responsible for Ms. Rivera’s care, you recognize the necessity to provide comprehensive education regarding the medication. Which points are crucial to include in this education? Select all that apply.

Mrs. Anderson, a 32-year-old woman in her second trimester of pregnancy, visits the rheumatology clinic for a scheduled follow-up. She has a documented history of rheumatoid arthritis (RA) and has been managing her condition with medications. During her consultation, Mrs. Anderson expresses her desire to breastfeed her baby once born. She expresses concerns about the effects of her RA medications on the baby during breastfeeding and seeks advice. Recognizing the need for proper patient education, which of the following pieces of information should the nurse provide to Mrs. Anderson? Select all that apply.

Mrs. Diaz, a 50-year-old woman, arrives at the outpatient rheumatology clinic with an acute exacerbation of her rheumatoid arthritis (RA). Over the past week, she reports increased pain, swelling, and limited mobility in her wrists, ankles, and metacarpophalangeal joints. She states that her usual self-management strategies haven’t been effective in alleviating the discomfort. On examination, the affected joints are visibly swollen, tender, warm to touch, and have limited range of motion. Given the current clinical presentation, which nursing intervention should be prioritized for Mrs. Diaz?

A 58-year-old male patient with a 10-year history of rheumatoid arthritis (RA) is admitted to the rheumatology unit of a tertiary care hospital. He is currently experiencing an exacerbation of his symptoms, with notable severe joint pain in his hands, knees, and elbows. The patient has been on a regimen of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and is now being introduced to a new medication by his rheumatologist. Intrigued and somewhat overwhelmed, he inquires of the attending nurse, “Why do I need to take disease-modifying antirheumatic drugs (DMARDs) if I already take pain medications?” Which is the best response by the nurse?

A 40-year-old woman with a recent diagnosis of rheumatoid arthritis (RA) is seen in the outpatient rheumatology clinic. She reports significant joint pain, particularly in her hands, that has been affecting her ability to perform daily tasks. Due to the aggressive nature of her disease, her rheumatologist prescribes methotrexate as part of her treatment regimen. As the nurse prepares to provide education about this medication, the patient expresses concern, having heard that methotrexate is a powerful drug. The nurse responds, “Methotrexate is indeed a potent medication and there are some essential instructions you should be aware of.” Which instruction should the nurse prioritize?

A 52-year-old female patient with a long-standing history of rheumatoid arthritis (RA) is being discharged from a specialty rheumatology clinic. Her disease has shown moderate to severe activity despite conventional treatments. Therefore, her rheumatologist has decided to initiate a biologic therapy to better control the disease. As the nurse prepares the patient for discharge, she reviews essential education points related to the new biologic medication. The patient, eager to take charge of her health, provides feedback on her understanding of the therapy. Which statement by the patient indicates a need for further teaching?

A 48-year-old male teacher presents to the outpatient rheumatology clinic with a five-year history of rheumatoid arthritis (RA). His main complaint during this visit, besides joint pain, is persistent fatigue which is affecting his ability to keep up with his teaching duties and to engage in social activities. He mentions that fatigue differs from just feeling tired, describing it as an overwhelming sense of exhaustion. The nurse, after listening to his concerns, prepares to suggest an intervention to address his fatigue. Which nursing intervention is most appropriate for this patient?

A 63-year-old female patient, known to have rheumatoid arthritis (RA) for the past 15 years, is admitted to the rheumatology department for a routine check-up. Her primary concern has been increasing joint pain and swelling over the last few months. As the nurse conducts a thorough assessment of the patient’s joints, she makes note of multiple findings. Among these findings, which one should the nurse report to the healthcare provider immediately?

A 68-year-old retired construction worker presents to the orthopedic outpatient clinic. He has a known diagnosis of osteoarthritis (OA) in both knees, with the left knee being more symptomatic. Over the past few months, he has noticed a gradual worsening of pain in his left knee, especially after prolonged sitting or upon waking up in the morning. While he used to manage with occasional over-the-counter pain medications, he now finds it challenging to get relief. The nurse evaluates his current condition and plans to implement an intervention to address his worsening symptoms. Which nursing intervention should be initiated for this patient?

A 57-year-old librarian with a recent diagnosis of osteoarthritis (OA) in her hands and knees attends a joint protection workshop at a local community health center. During the session, she is introduced to various strategies to minimize joint stress and prevent the exacerbation of symptoms. At the end of the teaching session, the nurse checks for the patient’s understanding of the provided instructions. Which statement by the patient indicates a need for further teaching?

A 72-year-old retired ballet dancer, with a long-standing history of osteoarthritis (OA) affecting her right hip, is admitted to the orthopedic ward for an upcoming total hip replacement surgery. Over the years, conservative treatments have become less effective, and her mobility has significantly declined, prompting the decision for surgical intervention. As the surgery date approaches, the nurse plans a preoperative intervention to optimize the patient’s readiness for the procedure. Which preoperative nursing intervention should be implemented?

A 66-year-old male teacher, with a 10-year history of osteoarthritis affecting his hands and knees, visits the outpatient clinic. He has recently been struggling with increased morning stiffness, which hampers his routine activities such as getting ready for work and writing on the board during his first classes. He mentions that the stiffness lasts for about an hour every morning and is impacting his quality of life. Considering his symptoms and daily routine, which nursing intervention should be implemented to alleviate his morning stiffness?

A 68-year-old woman, a former marathon runner, with a diagnosis of osteoarthritis in her right hip and knee, attends a rehabilitation clinic. Her mobility has declined over the past two years, and she is seeking guidance on using assistive devices to maintain independence. After a session on the selection and use of various mobility aids, the nurse assesses the patient’s understanding. Which statement by the patient indicates a need for further teaching?

A 75-year-old male patient, a retired bartender with a history of mild alcohol consumption over the years, presents to the clinic with worsening symptoms of osteoarthritis in his hands and lower back. His primary care physician has prescribed acetaminophen as part of his pain management regimen. Given his medical history and the medication prescribed, the nurse plans her assessments. Which finding should the nurse prioritize when monitoring the patient?

A 58-year-old librarian, an active walker, presents to the orthopedic unit for an arthroscopic surgery on her right knee due to osteoarthritis. Her medical history indicates a mild allergy to morphine, causing her to experience itching and hives. As she recovers from the procedure, the nurse evaluates postoperative interventions to optimize the patient’s comfort and healing. Which postoperative nursing intervention should be implemented for this patient?

A 65-year-old retired school teacher, diagnosed with osteoarthritis in both knees, attends a rehabilitation clinic. She expresses the desire to remain active and participate in her weekly dance class, albeit with some modifications due to her condition. During one of her physical therapy sessions, the therapist explained the importance of a therapeutic exercise program tailored to her needs. Later, the nurse assesses the patient’s comprehension of the program. Which statement by the patient indicates an understanding of the therapeutic exercise program?

A 70-year-old former professional dancer, now a dance instructor, visits the clinic. Having been recently diagnosed with osteoarthritis in her hips, she is keen on exploring alternative therapies and has been reading about the potential benefits of glucosamine and chondroitin supplements. The physician prescribes these supplements in addition to her current regimen. The nurse steps in to provide further education to ensure the patient has a comprehensive understanding of the role and effects of these supplements. Which information should the nurse include in the patient’s education?

A 55-year-old librarian, who has managed her osteoarthritis with occasional pain medications, visits the emergency department in the late evening. She describes an unexpected flare-up of severe joint pain in her right knee after standing for extended hours during a book fair. Given the acute nature of her symptoms and her discomfort, the nurse must determine the most immediate and appropriate nursing intervention. Which nursing intervention should be implemented?