Nclex-Rn Practice Questions-Care of Adults Musculoskeletal Management
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Question 1 |
The client is being seen in the clinic for a second- degree ankle sprain. Which treatments should the nurse plan?
A | Rest, elevate the extremity, apply ice intennittently, and apply a compression bandage. |
B | Do range of motion to determine the extent of injury, apply heat, and check circulation. |
C | Use moist heat and then apply ice; check circulation, motion, and sensation; and elevate. |
D | Refer to an orthopedic surgeon, apply ice, give an analgesic, elevate, and encourage rest. |
Question 2 |
While caring for multiple clients, the nurse delegates client skin care to the UAP on a muscu- loskeletal unit. Which client is most. appropriate for the nurse to delegate skin care to the UAP?
A | The client with osteomyelitis of the tibia who needs a wound dressing change |
B | The client with an inoperable hip fracture who is in Buck’s traction |
C | The client with a pelvic fracture who is in skeletal traction |
D | The client with a femur fracture who has an external fixator in place |
Question 3 |
The client with a lower leg amputation has edema, so the NA elevates the client‘s residual left limb on pillows. What is the most appropriate action by the nurse when observing that the client’s leg has been elevated?
A | Thank the nursing assistant (NA) for being so observant and intervening appropriately to treat the client’s edema of the residual limb. |
B | Remove the pillows, raise the foot of the bed, and inform the NA that the limb should not be elevated on pillows because it could cause a flexion contracture. |
C | Inform the NA that this was the correct action at this time in the client’s recovery, but once the client’s incision heals, the leg should not be elevated- |
D | Report the incident to the surgeon and tell the NA to complete a variance report because the client’s leg should not have been elevated. |
Question 4 |
The nurse is analyzing the serum laboratory report for the client diagnosed with lung cancer that has metastasized to the pelvic bone. Which specific finding should the nurse anticipate?
A | Elevated calcium |
B | Decreased hemoglobin |
C | Elevated creatinine (SCr) |
D | Elevated creatine kinase (CK) |
Question 5 |
The nurse is teaching the client with carpal tunnel syndrome how best to utilize a wrist splint. Which statement is most appropriate for the nurse to include in the teaching?
A | Leave the splint in place even when bathing- |
B | Wear the splint as tight as can be tolerated. |
C | Remove the splint intermittently throughout the day. |
D | Only wear the splint when doing work that stresses the fingers. |
Question 6 |
The nurse is caring for the client who had a surgical repair of a right Dupuytren’s contracture. Which intervention should the nurse plan?
A | Elevate the right lower extremity above the level of the heart |
B | Assist the client with bathing, dressing, grooming, and toileting |
C | Instruct about wearing low-heeled and properly fitting shoes |
D | Frequently rewrap the elastic bandage on the right extremity |
Question 7 |
One month after discharge, the client who had a left THR calls a clinic reporting acute, constant pain in the left groin and hip area and feeling like the left leg is shorter than the right. The nurse advises the client to come to the clinic immediately, suspecting which problem?
A | An infection of the wound |
B | Deep vein thrombosis (DVT) |
C | Dislocation of the prosthesis |
D | Aseptic loosening of the prosthesis |
Question 8 |
The client, who is diagnosed with CA, tells the clinic nurse about the inability to ambulate and about staying on bedrest due to hip stiffness. In addition to teaching the client measures to reduce joint stiffness, which referral for the client should the nurse plan to discuss with the IICP?
A | Psychiatrist |
B | Social worker |
C | Physical therapist |
D | Arthritis Foundation |
Question 9 |
The client and spouse were involved in a motorcycle accident in which the spouse was killed. The client, being treated for multiple rib fractures and a broken leg, asks the nurse in which room his wife is located. Which response is most appropriate?
A | “Unfortunately, your wife is not in the hospital at this time.” |
B | “I’m sorry, but your wife did not survive the motorcycle accident.” |
C | “Let me get your family so that you can talk to them about your wife.” |
D | “The doctor will be talking to you to let you know where she is located.” |
Question 10 |
The client just underwent a left THR. After a family member assists the client with repositioning in bed, the client states hearing a “pop” and has increased pain at the surgical site. Which is the most appropriate initial action by the nurse?
A | Check the position of the left lower extremity. |
B | Elevate the head of the client’s bed. |
C | Adjust the pillow used for abduction. |
D | Administer the prescribed pain medication. |
Question 11 |
An hour ago the HCP split the client’s fore- arm cast due to severe arm pain, throbbing, and tingling. Which most important action should be taken by the nurse when the client’s symptoms return?
A | Administer an intravenous pain medication. |
B | Notify the health care provider immediately. |
C | Cut the cast padding and spread the cast Men |
D | Elevate the arm on pillows above the heart level. |
Question 12 |
The nurse is discharging the client home with a plaster of Paris cast to the lower leg. Which self- care recommendation should the nurse include?
A | Sprinkle powder in the cast to decrease moisture from sweating. |
B | Direct cool air from a hair dryer into the cast to relieve itching. |
C | Cover the cast with a plastic wrap before you bathe in a tub. |
D | Use hot, soapy water to wash the cast if it becomes very soiled. |
Question 13 |
A college student visits a campus health service reporting knee pain, clicking when walking, “locking,” and “giving way” of the affected knee. The injury occurred when twisting the knee wrong during a tennis match. The nurse should further assess for which problem?
A | Injury of the meniscus cartilage |
B | Fracture of the lateral tibial condyle |
C | Injury and possible fractured patella |
D | Lateral collateral ligament injury |
Question 14 |
The nurse assesses that the client has some finger swelling of a newly casted right arm fracture with no other abnormal findings. Which is the nurse’s priority action?
A | Notify the HCP immediately. |
B | Split the cast to prevent constriction. |
C | Elevate the casted arm on pillows. |
D | Document the degree of finger swelling. |
Question 15 |
The client with a pelvic fracture developed a fat embolism. The nurse should assess the client for which specific sign?
A | Dyspnea |
B | Chest pain |
C | Delirium |
D | Petechiae |
Question 16 |
The clinic nurse completed teaching the client with a rotator cuff tear who is being treated conservatively. Which client statement indicates that fiirther teaching is needed?
A | “I received a corticosteroid injection in my shoulder to reduce the inflammation and pain.” |
B | “Now that the pain is controlled, I can do progressive stretching and strengthening exercises.” |
C | “I will continue to take ibuprofen for pain control, but I should take it with food.” |
D | “I will need an open acromioplasty to repair the torn cuff after the swelling is reduced.” |
Question 17 |
The nurse is caring for the client involved in an MVA who sustained an unstable pelvic fracture. Which HCP order should be the nurse’s priority?
A | Urinalysis and culture and sensitivity |
B | Blood alcohol level and toxicology screen |
C | Computed tomography (CT) scan of the pelvis |
D | Give two units of cross-matched whole blood |
Question 18 |
The nurse is assessing the client who is to have a closed reduction for a right elbow dislocation. Which should be the nurse’s priority?
A | Presence of bruising to the right elbow |
B | Pain level rating on a 0—10 scale |
C | Sensation and pulse of the right forearm |
D | Left—handed or right-handed |
Question 19 |
The nursing student is caring for the client who had a right TKR 1 day ago. Which action by the student requires the nurse to intervene?
A | Hands the client the control for the continuous passive motion (CPM) machine |
B | Offers the client an analgesic when pain is rated at 3 on a O to 10 scale |
C | Repositions the leg to insert an abductor pillow between the client’s legs |
D | Places an ice pack wrapped within a towel on the client’s operative knee |
Question 20 |
The nurse is caring for the client after a right TKR. To prevent circulatory complications, the nurse should ensure that the client is performing which action?
A | Flexing both feet and exercising uninvolved joints every hour while awake |
B | Using the continuous passive motion device (CPM) every 2 hours for 30 minutes |
C | Being assisted up to a chair as soon as the effects of anesthesia have worn off |
D | Using the trapeze to lift off the bed and then rotating each leg intermittently |
Question 21 |
The nurse is caring for the client 2 days post-right 'I‘HR in which the traditional posterior approach was used. Which interventions should the nurse implement?
A | Checks that an elevated toilet seat is in place and assists the client to the bathroom using a walker |
B | Removes the wedge pillow at the client’s request and places pillows to maintain right leg adduction |
C | Reinfuses the 400-mL wound autotransfusion drainage system returns that collected in the past 24 hours |
D | Assists the client to get out of bed on the left side so the client can stand to place and use the urinal |
Question 22 |
The LPN is reporting observations and cares to the RN. Based on the LPN’s report, which client should the RN assess immediately?
A | The client, 2 hours post-total knee replacement, has 100 mL bloody drainage in the autotransfusion drainage system container. |
B | The client with a crush injury to the arm was given another analgesic and a skeletal muscle relaxant for throbbing, unrelenting pain. |
C | The client in a new body cast was turned every 2 hours and is being supported with waterproof pillows. |
D | The client with a left leg external fixator has serous drainage from the pin sites, and pulses are present by Doppler. |
Question 23 |
The client has been in a body cast for the past 2 days to treat numerous broken vertebrae from a fall. Tire client is reporting dyspnea, vomiting, epigastric pain, and abdominal distention. Which action demonstrates the nurse’s best clinical judgment?
A | Immediately notify the health care provider. |
B | Initiate oxygen at 2 liters per nasal cannula. |
C | Place ice packs around the outside of the east. |
D | Administer ondansetron prescribed q6h pm. |
Question 24 |
The nurse, caring for the client who had bilateral THRs 2 days ago, determines that the client will need a referral to manage exercises and stairs when at home. The nurse should plan to initiate a referral with which interdisciplinary team member?
A | Occupational therapist |
B | Social worker |
C | Physical therapist |
D | Health care provider |
Question 25 |
The nurse is assessing the client immediately following a C5—C6 anterior cervical discectomy. Which potential problem should be the nurse’s priority?
A | Altered breathing pattern |
B | Impaired tissue perfusion |
C | Altered mobility |
D | Impaired skin integrity |
Question 26 |
The nurse assesses the client 6 hours following a lumbar spinal fusion. The client has a throbbing headache, but VS and CMS of the lower extremities are WNL. The lungs have fine basilar crackles. The back dressing has a dime-sized bloody spot surrounded by clear yellow drainage. Which nursing action demonstrates the nurse’s best clinical judgment?
A | Give prescribed morphine sulfate IV |
B | Have the client cough and deep breathe |
C | Reinforce the incisional dressing |
D | Notify the health care provider |
Question 27 |
The experienced nurse observes the new nurse caring for the client who is in skeletal traction to stabilize a proximal femur fracture prior to surgery. Which observation by the experienced nurse indicates the new nurse needs additional orientation?
A | Positions the client so the client’s feet stay clear of the bottom of the bed |
B | Checks ropes so that they are positioned in the wheel groves of the pulleys |
C | Removes weights from ropes until the weights hang free ofthe bed frame |
D | Performs pin site care with chlorhexidine solution once during the 8-hour shift |
Question 28 |
The client with Alzheimer’s dementia is being admitted to the nursing unit following a hip hemiarthroplasty to treat a hip fracture. Which initial intervention should the nurse plan for the client’s pain control?
A | Apply a fentanyl transdermal patch and replace after 24 hours. |
B | Start morphine sulfate per patient-controlled analgesia (PCA) with a basal rate. |
C | Administer intravenous morphine sulfate based on the client’s report of pain. |
D | Administer scheduled doses of morphine sulfate intravenously around the clock |
Question 29 |
When reviewing the chart of a 25 -year-old male, the nurse reads that the client was diagnosed with an osteosarcoma of the distal femur. Which statement indicates the nurse’s correct interpretation of the client’s diagnosis?
A | The tumor originated elsewhere in the client’s body and metastasized to the bone. |
B | Osteosarcoma is the most common and most often fatal primary malignant bone tumor. |
C | The only treatment for osteosarcoma is a leg amputation well above the tumor growth. |
D | The tumor is nonmalignant; it can be excised and the bone replaced with a bone graft. |
Question 30 |
The HCP prescribes cyclobenzaprine 30 mg orally tid for the client hospitalized with acute cervical neck pain. The pharmacy supplied 10-mg tablets. Which action by the nurse is best?
A | Administer three 10-mg tablets with food |
B | Call the HCP to question the dose prescribed |
C | Observe for drowsiness after administration |
D | Also give prn prescribed morphine sulfate IV |
Question 31 |
The nurse completes teaching the client who has a plaster cast following a right wrist fracture. Which statement, if made by the client, indicates the need for additional teaching?
A | “I should keep my cast uncovered while drying so that moisture can evaporate.” |
B | “My cast initially may smell musty. When dry, it should be odorless and shiny white.” |
C | “My cast may feel sticky and very warm initially, but it will dry in about 30 minutes." |
D | “I should avoid sharp or hard surfaces while drying because it causes dents in the cast.” |
Question 32 |
The nurse notes during an annual health screening for the 78-year—old client that the client is 1.5 inches shorter than at last year’s visit. Which initial screening might the nurse best anticipate for this client?
A | Bone mineral density (BMD) test |
B | An x-ray of both hips and spine |
C | A bone scan of the hips and spine |
D | A physical check for scoliosis |
Question 33 |
The client with DM is admitted with possible osteomyelitis secondary to an ankle wetmd. The client’s ankle is painful, red, swollen, and warm, and the wound is persistently draining. The client’s temperature is 102.2°F (39°C). Based on the client’s status, which HCP order should the nurse plan to defer until later?
A | Obtain a culture of the ankle wound. |
B | Administer ceftriaxone 1 g IV q12h. |
C | Apply splint to immobilize the ankle. |
D | Teach on IV antibiotic self-administration. |
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