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Musculoskeletal NCLEX Questions

NCLEX musculoskeletal practice questions on herniated discs, hip fractures, Buck’s traction, post-op care, and compartment syndrome with rationales to support nursing knowledge.

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    Musculoskeletal NCLEX Questions 1. While playing tennis, a patient suffers an injury to the knee. Which diagnostic test would the nurse anticipate the health care provider ordering to identify a soft tissue injury? a. X-ray b. MRI c. Arthroscopy and thermography of joint d. Duplex venous Doppler 2. A patient is scheduled for an open MRI to evaluate for left tibia osteomyelitis. Which information obtained by the nurse indicates that the nurse should consult with the healthcare provider before scheduling an open MRI? Select all that apply. a. Patient is pregnant. b. Patient is claustrophobic c. Patient is allergic to shellfish. d. Patient had a mitral valve replacement. e. Patient wears a hearing aid and contact lenses f. Patient has in implanted insulin pump. 3. Following a lumbar laminectomy, the postoperative patient continues to complain of the same low back pain that he had before surgery. The nurse knows that this finding is caused by what problem? a. Failure of the surgeon to remove the patient s herniated disk. b. Swelling in the operative area, which compresses adjacent structures. c. Twisting of the patient's spine when he turns side to side. d. Limitation of movement resulting of spinal fusion. 4. The nurse is caring for a patient with a herniated disc. What intervention is considered a part of conservative treatment of a herniated disk? a. Left lateral Sim s position with bathroom privileges. b. Bed rest and methocarbamol (Robaxin) to decrease muscle spasms. c. Small incision in the spinal column to remove the disk d. Daily physical therapy and ambulation with crutches. 5. What evaluation is important in the preoperative nursing assessment of a patient with a severely herniated lumbar disk? a. Movement and sensation in the lower extremities. b. Leg pain that radiates to both lower extremities. c . Reflexes in up per extremities. d. Pupillary reaction to light 6. In the immediate postoperative period after a lumbar laminectomy, what is a priority nursing action? a. Checking for bladder distention. b. Ambulating the patient. c. Changing the surgical dressing.

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    d. Determining the presence Df postural hypotension. 7. A patient has a fractured hip and is currently in Buck's traction before surgery. How is the counteraction in Buck's traction achieved? a. Applying a 10 lb counter weight at the knee. b. Placing shock blocks under the head of die bead. c. Elevating the knee gatch and elevating the head of die bed about 30 degrees. d. Elevating die foot of die bed frame and allowing the weights to hang freely. 8. What is important assessment information to obtain from a padent who is being admitted with a tentative diagnosis of a hip fractures? a. Circulation and sensation distal to the fracture. b. Amount of swelling around the fracture site. c. Status of range of motion in the extremity. d. Amount of pain the fracture is causing. 9. A patient is temporarily in Buck's traction for a fractured femur. What would be import to include in nursing care for this patient? a. Maintaining patient semi-Fowler's position to promote deep breathing. b. Checking the distal circulation of the affected leg. c. Turning the patient every two hours to the unaffected side. d. Allowing the patient to sit in a chair at bedside. 10. Which of the following statements by the patient who has recently had a total hip replacement indicates that he dees not understand mobility limitations? a. "I should not bend down to put on shoes and socks." b.__"It is okay to cross my legs if I am sitting in a chair." c. "I should put a pillow between my legs when lying on my side." d. "I should not sit in low chairs or on toilet seats that are low." 11. The nurse is assessing a patient who has a fractured fibula repaired with the use of an external fixator device. Which assessment findings would cause the nurse concern regardirg the development of compartmental syndrome? Select all that apply. a. Decrease in the pulse rate on the effected leg. b. Paresthesia distal to the area of injury. c. Toes on the effected leg cool to touch and edematous d. Complains the pins are hurting. e. Complaints of leg pain unrelieved by analgesics or repositioning f. Patient angry and calling loudly to nurse every 10 minutes.

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    12. A patient is admitted for an open fracture of die right femur. The nurse understands that an initial danger to the patient because of this type of fracture is: FES ia moat eprtrmjrrfy aaiac-jlea bnj-bone and t>ei>vlc a. Fat embolus (ratlin, w h n u K>U*a cximparimoi"' syncromo H p*lan AsinrialfKl b. Neurogenic shock W'-it .» ■ ti -..i. r < ■ ■□ r >- c. Osteomyelitis d. Compartmental syndrome 13. Twelve hours after hip surgery, a patient complains of sudden chest pain. What is the first nursing action? a. Reposition and elevate the head of the bed. b. Medicate with an analgesic. c. _Administer oxygen 2 L/min via nasal cannula. d. Notify the physician regarding the patient's pain status. 14. The nurse is preparing health teaching for adult women regarding prevention of osteoporosis What should be important to include in the teaching plan? Select all that apply. a. Walking 15-3C minutes each day. b. Supplemental calcium intake c. Resuction of caffeine intake. d. Increased intake of water. e. Avoiding sunlight due to photosen sitivity. f. Increased intake of fresh fruits and vegetables. 15. Which of the following put a woman at increased risk for development of osteoporosis? Select all that apply. a. Use of hormonal replacement therapy b. Having reached menopause c" Prolonged sterokTintake d. Fractured hip e. Hyperthyroid disease f. Compromised pulmonary function 16. A patient with diabetes has had a right belcw-the-knee amputation. He tells nurse that he feels pain in the amputated leg. even though the leg is gone. The best nurses response is based on what information? a. Phantom pain is experienced by most amputees; since the leg is no longer there, the pain will resolve without medication. b. The patient thinks he feels pain, but is actually a response to his denial about the amputation. c. The nurse cannot adequately assess the pain: therefore medication cannot be given d. Phantom pain occurs when the nerve endings have not adjusted to the loss of the extremity; pain medication should be offered. 17. A patient has diabetic peripheral vascular disease that requires amputation of his right leg below the knee. In the immediate postoperative period, what is the priority nursing action? a. Checking for bleeding from the incisional area. b. Keeping the residual limb adducted from the hip. c. Notifying the prosthetist to prepare the artificial limb.

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    d. Having the physical therapist begin partial weight-bearing exercise. 18. A patient with an amputation is fitted with prosthesis In preparing for the patient's discharge, what is important for the nurse to teach regarding residual limb care? a. Put lotion on the residual limb to keep the skin from getting dry and cracking. b. Visually inspect the residual limb every day for areas of pressure or skin breaks. c. Circulation in the residual limb will be increased by applications of warm, moist packs every morning. d. The residual limb should be elevated for at least 3 hours after removal of the prosthesis. 19. In taking the health history of a patient with severe painful osteoarthritis, the nurse will expect the patient to report which of the following? a. A gradual onset of the disease, with involvement of weigh bearing joints. b. A sudden onset of the disease, with involvement of all joints. c. No complaints of morning stiffness. d. Joint pain that is not affected by exercise. 20. A patient with osteoarthritis in his left knee has had a total knee replacement. What is important to include in the postoperative nursing care plan? a. Using constant passive motion (CPM) to promote joint flexibility. b. Wrapping the knee in a loose fitting absorbent bandage to promote flexibility. c. Keeping patient on bed rest for 2 days to maintain extension and immobilization of leg. d. Inserting a urinary retention catheter since the patient is on total bed rest for 2 days. 21. Which of the following dietary recommendations would the nurse encourage for a patient who has just been diagnosed with gout? a. Increased protein intake b. —Increased intake of fluids to 3000 mL daily c. No foods containing chocolate d. No cranberries or prunes 22. An older patient had bilateral osteoarthritis in his hips. Which statement by the nurse reflects important teaching principles for this patient regarding protection of his joints? a. "U s e a can or walker for ambulatic n.’ b. "Sit in straight-baked chairs that you can get out of easily." c. ‘Use a wheelchair when you are tired." d. "Get regular exercise and control your weight." 23. A patient begins receiving the medication methotrexate (Rheumatrex) for severe symptoms of rheumatoid arthritis. What is the most important information for the nurse to teach this patient regarding the medication? a. Take extra fiber and fluids to counteract the constipating effect. b. It is very important to have periodic lab work done. [. ■ < m . • i ii- ih.. r an-Ji c. Take the drug on an empty stomach ■■■■ , ■ ,. s i" ■■ ■■ ■ ■ , ■ d. Hirsutism and menstrual changes sometimes develop as side effects.

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