NCLEX Review - Week 11_Musculoskeletal

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See how much you know about the Musculoskeletal System

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Mrs. Ramos

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NCLEX Review - Week 11_Musculoskeletal


NCLEX Review - Week 11_MusculoskeletalOnline version See how much you know about the Musculoskeletal System by Mrs. Ramos 1 A client with osteoporosis is prescribed alendronate. Which instruction should the nurse give? a Take the medication with food b Lie down for 30 minutes after taking it c Take with a full glass of water on an empty stomach. d Take at bedtime 2 Which laboratory value should the nurse monitor in a client with a fractured femur at risk for fat embolism? a Serum lipase b Arterial blood gases (ABGs) c Troponin I d Platelet count 3 A nurse is caring for a client in Buck’s traction. Which is a priority intervention? a Remove the traction boot every 8 hours b Elevate the foot of the bed for comfort c Ensure weights hang freely d Massage the calf muscles to promote circulation 4 A client with rheumatoid arthritis reports morning stiffness. What is the best nurse teaching? a Apply cold packs to joints in the morning b Engage in high-impact exercise c Take NSAIDs before bed d Take a warm shower to relieve stiffness 5 Which finding requires immediate nursing intervention in a client with a long leg cast? a Slight edema of toes b Warm toes with brisk capillary refill c Reports of tingling and numbness d Slight discomfort when elevating the leg 6 Which dietary instruction is appropriate for a client with osteoporosis? a Increase intake of phosphorus-rich foods b Avoid dairy products c Increase intake of green leafy vegetables and dairy d Follow a low-calcium diet 7 What assessment finding supports a diagnosis of compartment syndrome? a Bounding pedal pulse b Pain that is unrelieved by opioids c Red, warm skin over the cast d Increased urine output 8 Which sign indicates correct understanding of crutch use with a three-point gait? a The injured leg and both crutches move forward together b The client advances both crutches, then both legs c Weight is borne equally on both legs d Crutches are held close together 9 A nurse assesses a client post-hip replacement. Which finding requires immediate action? a Hip flexion at 60 degrees b External rotation of the affected leg c Slight edema around the incision site d Reports of incisional pain 10 What is the primary purpose of incentive spirometry in a client post orthopedic surgery? a Prevent deep vein thrombosis b Prevent atelectasis c Improve appetite d Reduce surgical site infection risk 11 A client with a new cast reports itching inside the cast. What should the nurse instruct? a Insert a pen to scratch the area b Tap on the cast to relieve itching c Use a blow dryer on a cool setting d Sprinkle talcum powder into the cast 12 The nurse is assessing a client with scoliosis. Which is the most common finding? a Uneven waist or shoulders b Numbness in both feet c Bilateral lower limb edema d Pain on deep palpation of ribs 13 Which medication is most commonly used in gout treatment? a Alendronate b Methotrexate c Allopurinol d Prednisone 14 What is a priority postoperative intervention after spinal surgery? a Monitor for increased intracranial pressure b Keep the client flat for 48 hours c Logroll the patient during position changes d Encourage early ambulation 15 Which client is most at risk for developing osteoporosis? a A 45-year-old African American male b A 30-year-old lactating female c A 65-year-old postmenopausal Caucasian woman d A 25-year-old woman on oral contraceptives 16 What is the purpose of carisoprodol (Soma) in a client with a back injury? a Reduce inflammation b Promote bone healing c Relieve muscle spasms d Increase calcium absorption 17 Which assessment indicates normal healing of a fracture? a Nonunion 6 weeks post-injury b Presence of callus formation c Warmth and drainage from the site d Persistent severe pain 18 What is the most important safety teaching for a client prescribed methotrexate for rheumatoid arthritis? a Avoid potassium-rich foods b Take folic acid to reduce side effects c Drink grapefruit juice daily d Use a tanning bed to reduce rash 19 Which of the following is the earliest sign of osteomyelitis? a Low-grade fever b Cool skin over the affected area c Bradycardia d Constipation 20 A nurse is caring for a client in skeletal traction. What action is appropriate? a Remove weights every 2 hours b Monitor pin sites for infection c Elevate the leg with pillows under the knee d Loosen traction rope to reduce discomfort Feedback 1 Alendronate should be taken on an empty stomach with a full glass of water, and the patient must remain upright for 30 minutes to prevent esophageal irritation. 2 Fat embolism can cause hypoxia and respiratory distress. Monitoring ABGs helps assess for decreased oxygenation and respiratory compromise. 3 In Buck’s traction, weights must hang freely to maintain proper traction force and alignment. 4 Warmth improves joint flexibility and reduces morning stiffness in clients with rheumatoid arthritis. 5 Numbness and tingling may indicate neurovascular compromise (e.g., compartment syndrome), which is a medical emergency. 6 Green leafy vegetables and dairy are high in calcium and vitamin D, which help strengthen bones. 7 Severe pain unrelieved by analgesia is a hallmark of compartment syndrome. 8 In three-point gait, the patient moves both crutches and the affected leg forward, then shifts weight to the unaffected leg. 9 This may indicate dislocation of the prosthesis and requires immediate provider notification. 10 Deep breathing and incentive spirometry expand the lungs and prevent postoperative complications like atelectasis which can lead to pneumonia. 11 A cool air source can reduce itching without compromising skin integrity. 12 Asymmetry in the shoulders or hips is a hallmark sign of scoliosis. 13 Allopurinol is a xanthine oxidase inhibitor that decreases uric acid production in clients with gout. 14 Logrolling maintains spinal alignment and prevents injury post spinal surgery. 15 Age, ethnicity, and postmenopausal status increase risk for osteoporosis. 16 Carisoprodol is a centrally acting skeletal muscle relaxant. 17 Callus formation indicates new bone growth during the healing process. 18 Folic acid supplementation reduces adverse effects of methotrexate such as mouth sores and GI upset because Methotrexate's MOA is to interfere with folic acid metabolism 19 Fever, especially with localized bone pain, is an early sign of osteomyelitis. 20 Skeletal traction uses pins and wires; monitoring for signs of infection at pin sites is critical.

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NCLEX Review - Week 11_Musculoskeletal

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NCLEX Review - Week 11_MusculoskeletalOnline version

by Mrs. Ramos

A client with osteoporosis is prescribed alendronate. Which instruction should the nurse give?

Which laboratory value should the nurse monitor in a client with a fractured femur at risk for fat embolism?

A nurse is caring for a client in Buck’s traction. Which is a priority intervention?

A client with rheumatoid arthritis reports morning stiffness. What is the best nurse teaching?

Which finding requires immediate nursing intervention in a client with a long leg cast?

Which dietary instruction is appropriate for a client with osteoporosis?

What assessment finding supports a diagnosis of compartment syndrome?

Which sign indicates correct understanding of crutch use with a three-point gait?

A nurse assesses a client post-hip replacement. Which finding requires immediate action?

What is the primary purpose of incentive spirometry in a client post orthopedic surgery?

A client with a new cast reports itching inside the cast. What should the nurse instruct?

The nurse is assessing a client with scoliosis. Which is the most common finding?

Which medication is most commonly used in gout treatment?

What is a priority postoperative intervention after spinal surgery?

Which client is most at risk for developing osteoporosis?

What is the purpose of carisoprodol (Soma) in a client with a back injury?

Which assessment indicates normal healing of a fracture?

What is the most important safety teaching for a client prescribed methotrexate for rheumatoid arthritis?

Which of the following is the earliest sign of osteomyelitis?

A nurse is caring for a client in skeletal traction. What action is appropriate?

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