Nclex-Rn Practice Questions-Care Of The Adult - Musculoskeletal Disorders Part 2
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Question 1 |
A client is receiving discharge teaching on early signs and symptoms of compartment syndrome to report to the health care provider. The nurse recognizes that teaching has been effective when the client makes which statement?
A | “I will contact my health care provider when I notice redness.” |
B | “I will contact my health care provider when I notice swelling.” |
C | “I will contact my health care provider when I have numbness and tingling.” |
D | “I will contact my health care provider when I notice a change in my skin color.” |
Question 2 |
A nurse is performing a neurovascular assessment. It is most important for the nurse to include which of the following in the assessment?
A | Orientation, movement, pulses, and warmth |
B | Capillary refills, movement, pulses, and warmth |
C | Orientation, pupillary response, temperature, and pulses |
D | Respiratory pattern, orientation, pulses, and temperature |
Question 3 |
A nurse has instructed a client to accurately measure the circumference of both calves each morning and to report any increase in size. The nurse determines that teaching has been effective when the client makes which statement?
A | “I’ll use a measuring tape to check circumference.” |
B | “I’ll use the standardized chart for limb circumference.” |
C | “I only have to call if one leg is significantly larger than the other.” |
D | “I can measure my calves either near the knee or closer to the ankle.” |
Question 4 |
A client with a left arm cast complains of a foul odor. What is the appropriate action by the nurse?
A | Assess further because this may be a sign of an infection. |
B | Teach the client proper cast care, including hygiene measures. |
C | This is normal, especially when a cast is in place for a few weeks. |
D | Assess further because this may be a sign of neurovascular compromise. |
Question 5 |
The nurse is collaborating with the orthopaedic technician regarding interventions to reduce the roughness of a cast. What is the best intervention?
A | Petal the edges. |
B | Elevate the limb. |
C | Break off the rough area. |
D | Distribute pressure evenly. |
Question 6 |
The nurse is aware that elevating a limb with a cast will prevent swelling. Which of the following actions best describes how this should be done?
A | Place the limb with the cast close to the body. |
B | Place the limb with the cast at the level of the heart. |
C | Place the limb with the cast below the level of the heart. |
D | Place the limb with the cast above the level of the heart. |
Question 7 |
A client asks the nurse to explain the reason why a plaster cast cannot get wet. What would be the nurse’s best response?
A | A wet cast can cause a foul odor. |
B | A wet cast will weaken or be destroyed. |
C | A wet cast is heavy and difficult to maneuver. |
D | It is okay to get the cast wet, just use a hair dryer to dry it off. |
Question 8 |
A client comes to the emergency department complaining of dull, deep bone pain unrelated to movement. The client asks the nurse if this could be a fracture. The best response by the nurse is:
A | “These are classic symptoms of a fracture.” |
B | “Fracture pain is sharp and related to movement.” |
C | “Fracture pain is sharp and unrelated to movement.” |
D | “Fracture pain is dull and deep and related to movement.” |
Question 9 |
The nurse is caring for a client with skeletal traction to the right leg. The client complains of severe right leg pain. Which action should the nurse perform first?
A | Perform pin care. |
B | Notify the health care provider. |
C | Check the client’s alignment in bed. |
D | Remove the weights from the traction. |
Question 10 |
Which of the following symptoms are considered signs of a fracture?
A | Tingling, coolness, and loss of pulses |
B | Loss of sensation, redness, and coolness |
C | Coolness, redness, and new site of pain |
D | Redness, warmth, and pain at the site of injury |
Question 11 |
A client has been treated for compartment syndrome by undergoing a fasciotomy. Which nursing diagnosis has the highest priority for this client?
A | Chronic pain |
B | Risk for infection |
C | Impaired gas exchange |
D | Decreased cardiac output |
Question 12 |
A client complains of low back pain that radiates down the right leg, with numbness and weakness of the right leg. Based on the subjective data, the nurse recognizes these complaints as related to which disorder?
A | Herniated nucleus pulposus |
B | Muscular dystrophy |
C | Parkinson’s disease |
D | Osteoarthritis |
Question 13 |
A client has decided on conservative treatment for a herniated nucleus pulposus. The nurse anticipates that the treatment will include which of the following?
A | Surgery |
B | Bone fusion |
C | Bed rest, pain medication, physiotherapy |
D | Strenuous exercise, pain medication, physiotherapy |
Question 14 |
Which of the following instructions should the nurse include in the preoperative teaching for a client scheduled for closed spine surgery?
A | An endoscope is used to perform the surgery. |
B | Intense physical therapy is needed after the procedure. |
C | There is a greater associated risk with closed spine surgery. |
D | Recovery time is twice as long as with open spine surgery. |
Question 15 |
The nurse provided teaching to the client with a herniated lumbar disk. The nurse determines further teaching is necessary when the client makes which statement?
A | “I can strengthen my back muscles by doing pelvic tilt exercises.” |
B | “I need to maintain a healthy weight to limit back strain.” |
C | “I should bend at the waist when picking up objects.” |
D | “I should increase my fiber and fluid intake.” |
Question 16 |
The nurse is caring for a client with low back pain. Which action may the nurse delegate to the nursing assistant?
A | Assess pain level. |
B | Palpate the abdomen for distension. |
C | Reposition the client from side-lying to back. |
D | Assess the client’s skin for skin breakdown. |
Question 17 |
A client asks the nurse what is the purpose of applying a cold pack to a sprained ankle. What is the best response by the nurse?
A | “It decreases pain and increases circulation.” |
B | “It numbs the nerves and dilates the blood vessels.” |
C | “It promotes circulation and reduces muscle spasm.” |
D | “It constricts local blood vessels and decreases swelling.” |
Question 18 |
The community health nurse found an elderly female client lying in the snow. The client was unable to move the right leg because of a fracture. What action should the nurse take first?
A | Immobilize the fracture in its present position. |
B | Elevate the leg on whatever is available. |
C | Realign the fracture ends. |
D | Reduce the fracture. |
Question 19 |
The nurse is preparing a client for discharge. Which one of the following discharge instructions should be included when teaching the client how to prevent back injury?
A | Sleep on your side and carry objects at arm’s length. |
B | Sleep on your back and carry objects at arm’s length. |
C | Sleep on your side and carry objects close to your body. |
D | Sleep on your back and carry objects close to your body. |
Question 20 |
The nurse suspects that a client with a recent fracture has developed compartment syndrome. The assessment of the client may find which symptom?
A | Body-wide decrease in bone mass |
B | A growth in and around the bone tissue |
C | Inability to perform active movement; pain with passive movement |
D | Inability to perform passive movement; pain with active movement |
Question 21 |
The nurse is caring for a client who has returned to the unit following the application of a cast for a fracture of the right ulna. The client is now complaining of severe pain, numbness, and tingling of the right arm. What is the most important action of the nurse?
A | Administer acetaminophen (Tylenol) as prescribed. |
B | Lower the arm below the level of the heart. |
C | Immediately report the client’s symptoms. |
D | Apply a heating pad. |
Question 22 |
The nurse is caring for a client with compartment syndrome. The nurse anticipates that the client may require which measure?
A | Casting |
B | Amputation |
C | Fasciotomy |
D | Observation; no treatment necessary |
Question 23 |
A client is admitted to the emergency department with a foot fracture, and a brace is applied. The nurse determines that teaching about the brace has been effective when the client makes which statement?
A | “The brace will act as a splint.” |
B | “The brace will allow for movement.” |
C | “The brace will help to prevent infection.” |
D | “The brace will encourage direct contact.” |
Question 24 |
A nurse is assessing a client who is experiencing new-onset signs and symptoms of paresthesia. What is the most appropriate question for the nurse to ask the client?
A | “Have you had any changes in range of motion (ROM)?” |
B | “Do you have any numbness and tingling?” |
C | “Do you have any pain and blanching?” |
D | “How long have you had fever and chills?” |
Question 25 |
A client is being discharged home with a prescription for skeletal muscle relaxants. What is the most important information for the nurse to tell the client?
A | Change your position quickly to avoid dizziness. |
B | Double a missed dose to ensure proper muscle relaxation. |
C | Cough and cold medications are appropriate to take, if needed. |
D | Avoid activities that require alertness; muscle relaxants can cause drowsiness. |
Question 26 |
The nurse is teaching a community class about back injuries. Which of the following statements by the nurse would be the most accurate concerning the area that is common for vertebral herniation?
A | It is the L1–L2, L4–L5 vertebra. |
B | It is the L1–L2, L5–S1 vertebra. |
C | It is the L4–L5, L5–S1 vertebra. |
D | It is the L5–S1, S2–S3 vertebra. |
Question 27 |
The nurse is performing a neurovascular assessment on a client who was admitted with a right fractured femur. The nurse noticed that the pulses are not palpable. What is the most important action of the nurse?
A | Alert the charge nurse immediately. |
B | Reassesses the pulses again in 1 hour. |
C | Notify the health care provider immediately. |
D | Verify the clinical findings with a Doppler ultrasonography. |
Question 28 |
A client has developed compartment syndrome following application of a cast from a fractured tibia. The nurse is aware that the priority goal of intervention is to:
A | prevent tissue death, which can occur within 2 to 4 hours. |
B | decrease the swelling in the extremity. |
C | prevent further complications. |
D | decrease the level of pain. |
Question 29 |
The nurse is caring for a client who is admitted for a herniated nucleus pulposus. The client’s pain level is a 10 out of 10. The health care provider ordered a morphine sulfate (Duramorph) patient-controlled analgesic (PCA), which is implemented for the client. What is the priority nursing assessment for this client?
A | Neurological system |
B | Respiratory system |
C | Gastrointestinal system |
D | Cardiovascular system |
Question 30 |
A 50-year-old client is admitted to the emergency department with severe lower back pain, weakness, and atrophy of the leg muscles. Based on the clinical manifestations, which diagnostic tests would the nurse expect the physician to order?
A | Chest X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) scan |
B | Lumbar puncture, chest X-ray, MRI, and CT scan |
C | Lumbar puncture, chest X-ray, and myelography |
D | Myelography, MRI, and CT scan |
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