NCLEX Musculoskeletal Questions
To prepare for your NCLEX exam, you will need to review the high yield topics. Get started with this article on NCLEX musculoskeletal disorders and the NCLEX Musculoskeletal Questions. Can you answer the following questions:
What is compartment syndrome?
Describe the symptoms of compartment syndrome?
Explain the difference between DVT and pulmonary embolism.
Can you describe the signs and symptoms of deep vein thrombosis (DVT)?
What is D-dimer used to test for?
How do you define an open fracture?
What is the difference between an open fracture and a closed fracture?
Question A nurse is assessing a patient who reports severe pain and deformity of the right leg following a fall. The nurse suspects a fracture. Which of the following assessment findings would MOST likely confirm this suspicion?
A) Increased range of motion in the right leg
B) Warmth and redness over the site of injury
C) Crepitus and abnormal mobility at the site of injury
D) Diminished pain when the leg is elevated
E) Pulsating sensation in the affected limb
Correct Answer: C) Crepitus and abnormal mobility at the site of injury
Rationale: Crepitus, or a crackling sensation felt under the skin and joints, is a key indicator of bone fractures, as it suggests the rubbing of bone fragments. Abnormal mobility, particularly in areas that should not have a joint, signifies a break in the continuity of the bone. Increased range of motion, warmth, redness, diminished pain upon elevation, and pulsating sensations are not specific signs of fractures and may indicate other conditions or normal physiological responses to injury.
Question A patient diagnosed with osteoporosis is being educated on lifestyle modifications to manage their condition. Which of the following recommendations is MOST effective in slowing the progression of osteoporosis?
A) Restricting fluid intake to decrease bone mineral loss
B) Engaging in high-impact sports to strengthen bone
C) Increasing calcium and vitamin D intake
D) Limiting exposure to sunlight to reduce skin cancer risk
E) Adopting a sedentary lifestyle to prevent bone fractures
Correct Answer: C) Increasing calcium and vitamin D intake
Rationale: Calcium and vitamin D are crucial for bone health, with calcium supporting bone structure and strength, and vitamin D improving calcium absorption. Restricting fluid intake, engaging in high-impact sports, limiting sunlight exposure excessively, and adopting a sedentary lifestyle can actually have negative impacts on bone health and overall physical condition. Adequate intake of calcium and vitamin D, on the other hand, is a foundational step in managing and slowing the progression of osteoporosis.
Question A patient with a history of rheumatoid arthritis (RA) complains of joint stiffness in the morning that lasts for more than an hour. Which of the following interventions should the nurse recommend to help manage this symptom?
A) Increasing caffeine intake to improve alertness
B) Applying cold compresses to the joints in the morning
C) Starting a high-intensity interval training (HIIT) program
D) Performing gentle stretching exercises in the morning
E) Taking aspirin only when joint stiffness is severe
Correct Answer: D) Performing gentle stretching exercises in the morning
Rationale: Morning stiffness is a common symptom of rheumatoid arthritis, and gentle stretching exercises can help improve joint mobility and decrease stiffness. Cold compresses are more beneficial for acute injuries or inflammation to reduce swelling, not for chronic stiffness. High-intensity interval training may be too strenuous for individuals with RA and could exacerbate symptoms. Caffeine intake and sporadic use of aspirin do not address the underlying stiffness and may not provide the consistent relief that a regular stretching routine offers.
Question Which of the following symptoms would MOST likely indicate a patient is experiencing a flare-up of gout?
A) Chronic fatigue and generalized weakness
B) Sudden, severe pain in the big toe joint
C) Long-lasting, dull ache in the lower back
D) Continuous muscle twitching in the legs
E) Gradual increase in flexibility of the joints
Correct Answer: B) Sudden, severe pain in the big toe joint
Rationale: Gout is characterized by sudden, severe attacks of pain, redness, and tenderness in joints, often the joint at the base of the big toe. This symptom distinguishes gout from other musculoskeletal disorders, which might present with fatigue, backaches, muscle twitching, or changes in joint flexibility. Gout flare-ups are caused by elevated levels of uric acid in the blood, leading to the formation of urate crystals in the joints, which causes the intense pain associated with the condition.
Question A nurse is planning care for a patient who has just undergone a total hip replacement. Which of the following activities should the nurse include in the patient’s post-operative care plan to prevent dislocation of the new hip joint?
A) Encouraging the patient to cross their legs while sitting
B) Instructing the patient to sleep on the operated side
C) Advising the patient to use a raised toilet seat
D) Recommending deep squat exercises during physical therapy
E) Allowing the patient to sit in low chairs that flex the hip beyond 90 degrees
Correct Answer: C) Advising the patient to use a raised toilet seat
Rationale: After a total hip replacement, it’s crucial to avoid positions that can lead to dislocation of the new joint. Using a raised toilet seat minimizes the hip flexion angle, reducing the risk of dislocation. Crossing legs, sleeping on the operated side immediately post-surgery, performing deep squats, and sitting in low chairs can all increase the risk of dislocation by placing the hip in positions that stress the new joint beyond its stable range of motion immediately following surgery.
Musculoskeletal Disorders
NCLEX Musculoskeletal Questions, below
More NCLEX Style Questions
NCLEX Musculoskeletal Questions
1. The UAP is taking care of an 82-year-old female patient recently admitted with a hip fracture. The UAP asks the nurse about risk factors for osteoporosis. The nurse correctly answers, (select all that apply)
A. diabetes
B. prolonged steroid usee
C. old age
D. kidney failure
compartment syndrome
2. The nurse is caring for a 33-year-old male with a large circumferential burn of his left lower extremity. The nurse suspects compartment syndrome at physical examination. What is the best next step?
A. Lower the extremity
B. Administer the pain medication ordered
C. Encourage ambulation
D. Call the health care provider
nursing fracture care
3. The nurse is taking care of a 14-year-old male admitted after falling from a tree. Which of the following are true about fractured leg care prior to cast application? (select all that apply)
A. Ambulate with partial weight-bearing
B. Buck’s traction lengthens the injured leg and provides alignment
C. Assess distal pulses
D. Traction provides immobilization and reduces muscle spasm
Bucks traction nursing care
4. The nurse is taking care of a 41-year-old male patient recently admitted with a femur fracture. Which of the following are important in traction pin site care? (select all that apply)
A. It is part of Buck’s traction
B. The nurse should be concerned thick white or yellow drainage at the pin site
C. The pin site can not get wet
D. The nurse should be concerned a marked increase in the white blood count
Bucks traction nursing care
5. The nurse is taking care of a 71-year-old male patient recently admitted with a hip fracture of the left lower extremity. What is Buck’s traction?
A. Requires a metal pin inserted through the skin
B. Results from compression of the sciatic nerve
C. Consist of a pulley, weight and cord (rope)
D. A system used on a lower extremity to exert pull, align and stabilize the fracture
Fat embolism treatment
6. The nurse is caring for a 66-year-old male with a femur fracture of his right lower extremity and sudden shortness of breath. Which of the following are nursing priorities in a patient with fat embolism? (select all that apply)
A. Administering pain medicine
B. Administering heparin
C. Administer oxygen
D. Contact the health care provider
Signs Of Compartment Syndrome
7. A new mother calls the nurse about her son’s complaints after getting a new cast. How would the nurse recognize signs of compartment syndrome in a patient with a new cast? (select all that apply)
A. Increased pulses in the extremity
B. Swelling and tightness in the extremity
C. Severe pain reported by the patient
D. Pain with passive movement
Nursing Care after Arthroscopy
8. The nurse assesses a post-operative patient after arthroscopy. Which of the following are important nursing interventions after arthroscopy? (select all that apply)
A. Immobilize the leg for the first 72 hours post-operative
B. Keep the patient NPO for the first 24 hours post-operative
C. Resume ambulation when sensation returns as prescribed by the surgeon
D. Provide pain medication as prescribed by the surgeon
Crutch Walking Instructions
9. The nurse is assisting a patient with a new cast who is being discharged home with crutches. What are important nursing principles for fitting the crutches properly? (select all that apply)
A. Avoid brachial plexus injury
B. Make sure the crutches rest against the axilla
C. Ensure the crutches rest approximately 3-4 centimeters below the axilla
D. When using the crutches, the elbows should be straight (unbent) for support
plaster cast for fracture
10. The nurse is taking care of a 27-year-old female admitted after falling off her bicycle. Which of the following are true about plaster casts? (select all that apply)
A. Plaster casts take longer than synthetic casts to dry
B. Plaster casts pose no risk of compartment syndrome
C. Plaster cast are waterproof
D. The patient should monitor the extremity for circulation problems
Answers to NCLEX-style Questions
NCLEX Musculoskeletal Questions
1. B, C and D
Osteoporosis commonly affects the aging population and results in increased risk of bone fractures. Bone fractures may occur from minimal trauma such as fall while ambulating due to low bone mass and decreased bone strength. Bone mineral testing, DXA (dual-energy x-ray absorptiometry) may be recommended in women 65 years of age and older.
2. D
Compartment syndrome of the extremities occurs when pressure increases within a compartment and compromises the circulation (blood flow) to the tissues within the space. Acute compartment syndrome is a surgical emergency. Failure to recognize the condition may result in limb loss.
3. B, C and D
Fractures of the extremities require urgent evaluation. During the assessment, the nurse should complete a neurovascular examination including distal pulses, capillary refill, motor function and assessing sensation, as well as two-point discrimination.
4. B and D
Pin site care includes a careful inspection of the pin site for infection, using appropriate technique to cleanse the site, remove any crust and if necessary, reapply an appropriate dressing.
5. C and D
Buck’s traction is a type of skin traction that can be used to align and stabilize the fracture. It does not require placement of a pin through the skin. A foam boot may be placed on the extremity, and this will be attached to the pulley.
6. C and D
Fat embolism most commonly occurs in patients with pelvic or long bone fractures. The fat from the bone marrow enters the bloodstream and travels to the pulmonary circulation. Severe cases may result in respiratory failure and death.
7. B, C and D
Compartment syndrome of the extremity occurs when pressure increases within a compartment and compromises the circulation (blood flow) to the tissues within the space. Acute compartment syndrome is a surgical emergency. Failure to recognize the condition may result in limb loss. In addition to B, C, and D, patients may experience pins and needles type of pain, numbness and difficulty moving the extremity.
8. C and D
Arthroscopy is an orthopedic surgical procedure that allows the surgeon to see inside of the joint and perform reparative procedures without making a large incision. Recovery time is faster than the traditional open procedure utilizing the larger incision.
9. A and C
Crutches support a percent of a person’s body weight. Crutches must be positioned correctly. When standing, the underarm pad should not touch the axilla. Care must be taken to avoid brachial plexus injury.
10. A and D
Cast may be made of fiberglass or plaster and are used to immobilize bone fractures. If the nurse determines impaired circulation the health care provider must be notified. Parents and patients should be instructed about how to recognize signs of neurovascular compromise.