Musculoskeletal RN NCLEX Questions

Musculoskeletal RN NCLEX Questions Related

Review Musculoskeletal RN NCLEX Questions related questions and content

The following scenario applies to the next 1 items
Item 1 of 1
History and Physical
17-year-old male arrives at the emergency department following playing baseball. He slid into a base, felt a ‘pop’, and had pain in his right ankle. The client reports pain of 7 out of 10 in his right ankle, which is described as throbbing. Right pedal pulse was 2+, and the sensation was intact. The client had a limited and painful range of motion in his ankle. Significant swelling and bruising in the ankle were observed.
The client does not have a medical or surgical history. He takes no medications.

Diagnostic Results
X-Ray: bimalleolar fracture of the right ankle

Orders
Crutches
Non-weight bearing status
Apply a splint to the ankle
Acetaminophen-Oxycodone 5/325 mg PO

While teaching the client how to use crutches, the nurse should instruct the client to ambulate using the

  • A. Two-point gait
  • B. Three-point gait
  • C. Four-point gait
  • D. Ankle having to be splinted.
  • E. Non-weight bearing status.
  • F. Prescribed pain medication.
Correct Answer: B

Rationale: A three-point gait is appropriate for non-weight bearing status, as with a splinted bimalleolar fracture, allowing the client to keep weight off the injured ankle using crutches and the unaffected leg.

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The nurse is caring for a client who is in Buck traction. Which of the following actions should the nurse take?

  • A. Ensure that weight is between 15 to 30 lb (6.8 to 13.6 kg)
  • B. Turn the client using a foam wedge every two hours
  • C. Ensure that a client's heels are supported with a pillow
  • D. Elevate the foot of the bed to provide counter traction
Correct Answer: D

Rationale: Elevating the foot of the bed provides counter traction to maintain alignment in Buck traction. Excessive weight risks injury, turning disrupts traction, and heel support is good but not the priority.

The nurse is planning a staff development conference regarding contractures. Which of the following information should the nurse include? Select all that apply.

  • A. Range-of-motion exercises of the extremities help prevent contractures.
  • B. Splinting the extremities may increase the risk of contractures.
  • C. Too many pillows under the head may cause a neck flexion contracture.
  • D. Using multiple staff members to reposition a client may prevent a contracture.
  • E. Contractures after a hip arthroplasty can be prevented with an abduction pillow.
Correct Answer: A, C, E

Rationale: Range-of-motion exercises maintain joint flexibility and help prevent contractures. Too many pillows under the head can cause the neck to remain flexed, increasing the risk of a flexion contracture. An abduction pillow keeps the legs properly aligned and prevents adduction contractures after hip surgery.

The nurse is teaching a client with osteomalacia regarding ways to strengthen their bones. Which statement by the client would necessitate further teaching by the nurse?

  • A. I've started to walk more frequently under the sun.'
  • B. I don't like dairy products so I've stopped eating them.'
  • C. I've enrolled myself in an exercise program for seniors at the community center.'
  • D. I've been taking Vitamin D supplements lately.'
Correct Answer: B

Rationale: Avoiding dairy removes a key calcium source, critical for bone strength in osteomalacia. Sun exposure, exercise, and vitamin D supplements all support bone health.

The nurse is caring for a client who sustained a fractured tibia and fibula and has a cast applied to the extremity. Which of the following findings would indicate the client has developed compartment syndrome?

  • A. The development of petechiae over the chest
  • B. A new onset of dyspnea and chest pain
  • C. Severe pain that is unrelieved by an opioid analgesic
  • D. Localized bone pain with a fever
Correct Answer: C

Rationale: Severe, unrelieved pain is a hallmark of compartment syndrome, caused by increased pressure within a muscle compartment compromising circulation and nerve function. Petechiae and dyspnea suggest fat embolism, and bone pain with fever may indicate infection.

The nurse is developing a self-management teaching plan for a client with low back pain. Which of the following should the nurse include?

  • A. Avoid bending at the waist and lifting heavy objects.'
  • B. Weight-bearing exercises are recommended.'
  • C. Wear shoes with a higher heel.'
  • D. Lay on your stomach four times daily and flex your legs.'
Correct Answer: A

Rationale: Avoiding bending at the waist and heavy lifting prevents back strain. Weight-bearing exercises help bones but not always back pain, high heels strain the back, and stomach lying with leg flexion can worsen pain.

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