Musculoskeletal Disorders NCLEX Questions

Question A patient reports pain, swelling, and decreased range of motion in the left knee. The nurse observes warmth and redness over the area. Which initial nursing intervention is MOST appropriate for this patient?

A) Advise complete immobilization of the left knee
B) Apply a warm compress to the knee to reduce stiffness
C) Initiate passive range of motion exercises immediately
D) Elevate the left leg and apply a cold compress
E) Recommend immediate weight-bearing exercises to strengthen the knee

Correct Answer: D) Elevate the left leg and apply a cold compress

Rationale: The symptoms described are indicative of inflammation, possibly due to injury or an inflammatory condition such as arthritis. Elevating the leg and applying a cold compress can help reduce swelling and pain, which are immediate concerns. Warm compresses might increase swelling in the acute phase, and passive range of motion exercises should be initiated carefully, following evaluation by a healthcare provider. Complete immobilization and immediate weight-bearing exercises could exacerbate the condition and are not recommended without further assessment.

Question A nurse is educating a group of older adults on the prevention of osteoporosis. Which of the following dietary recommendations is MOST essential for bone health?

A) High-protein diet
B) Low-fat diet
C) Increased intake of phosphorus
D) Increased intake of green, leafy vegetables
E) Restriction of carbohydrate intake

Correct Answer: D) Increased intake of green, leafy vegetables

Rationale: Green, leafy vegetables are rich in calcium, which is essential for bone health, especially in preventing or slowing the progression of osteoporosis. While protein is important for overall health, a balance is necessary as excessive protein can lead to calcium loss. Low-fat diets do not directly affect bone density, phosphorus is important but not as critical as calcium, and restricting carbohydrate intake does not directly impact bone health. Therefore, increasing the intake of green, leafy vegetables is a key dietary recommendation for maintaining bone health.

Question A patient with a suspected ligament tear in the ankle is scheduled for an MRI. The patient asks why an MRI is necessary instead of an X-ray. Which explanation should the nurse provide?

A) “MRI is quicker and more comfortable than an X-ray.”
B) “MRI can better differentiate between bone and soft tissue injuries.”
C) “MRI uses ionizing radiation, which is more effective in showing ligament injuries.”
D) “MRI is less expensive than an X-ray and is therefore preferred.”
E) “MRI can only be used for lower body injuries, making it suitable for your ankle.”

Correct Answer: B) MRI can better differentiate between bone and soft tissue injuries.

Rationale: MRI (Magnetic Resonance Imaging) is particularly useful for diagnosing soft tissue injuries, such as ligament tears, because it provides detailed images of both bones and soft tissues. This contrasts with X-rays, which are excellent for visualizing bone fractures but not as effective for soft tissue injuries. MRIs do not use ionizing radiation, making them a safer option for detailed imaging of soft tissues without the risks associated with radiation exposure. The choice of MRI over X-ray is not based on speed, comfort, or cost, but on the diagnostic needs for specific types of injuries.

Question Question A patient is recovering from a rotator cuff repair. Which of the following exercises should the nurse FIRST recommend to enhance recovery?

A) Weight lifting using the affected arm
B) Swimming laps in a pool
C) Passive range of motion exercises
D) Tennis or other racquet sports
E) Yoga involving advanced arm positions

Correct Answer: C) Passive range of motion exercises

Rationale: Following a rotator cuff repair, it is crucial to begin with gentle exercises that do not strain the repaired tissues. Passive range of motion exercises, where the shoulder is moved without the patient’s muscle engagement, help maintain joint mobility and prevent stiffness without risking further injury. Weight lifting, swimming, playing racquet sports, and performing advanced yoga poses involve active motion and could place too much stress on the healing tissues in the early stages of recovery.

Question A nurse is caring for a patient who recently underwent spinal fusion surgery. Which of the following activities should the nurse discourage to prevent injury to the surgical site?

A) Walking short distances with assistance
B) Sitting upright in a chair for 30 minutes
C) Twisting at the waist to reach for objects
D) Using a log roll technique when getting out of bed
E) Performing deep breathing and coughing exercises

Correct Answer: C) Twisting at the waist to reach for objects

Rationale: After spinal fusion surgery, it’s important to avoid activities that place excessive stress on the spine, particularly twisting motions, which can disrupt the healing process and cause injury to the surgical site. Walking, sitting upright for short periods, using a log roll technique for bed mobility, and performing respiratory exercises are all part of a healthy recovery process, promoting circulation, preventing complications, and enhancing healing without jeopardizing the integrity of the spinal fusion.

More Musculoskeletal Disorder Questions

1. A 55-year-old patient presents to the emergency department with sudden onset severe back pain after lifting a heavy object. The pain is sharp, localized to the lower back, and worsens with movement. The patient denies any history of trauma or previous back pain. Which of the following conditions is most likely responsible for the patient’s symptoms?

A) Herniated disc
B) Spinal fracture
C) Sciatica
D) Degenerative disc disease

Correct Answer and Explanation

2 A 75-year-old patient is admitted to the emergency department with a suspected hip fracture after a fall. The nurse performs an assessment and notes the patient’s leg appears shortened and externally rotated. What type of fracture is most likely present?

A) Greenstick fracture
B) Comminuted fracture
C) Spiral fracture
D) Hip fracture

Correct Answer and Explanation

3 A 30-year-old male presents to the emergency department with a fractured arm after a fall. The nurse assesses the patient’s arm and notes crepitus, swelling, and tenderness over the fractured area. The nurse suspects a closed fracture. Which of the following interventions should the nurse prioritize?

A) Applying a cold pack to the fracture site
B) Immobilizing the fractured arm with a splint
C) Administering analgesics for pain relief
D) Assessing the neurovascular status of the affected arm

Correct Answer and Explanation

4 A 16-year-old athlete is brought to the emergency department with a suspected stress fracture in the foot. The nurse is providing education to the patient about managing the condition. Which of the following statements by the patient indicates an understanding of the nurse’s teaching?

A) “I will continue my regular training routine to strengthen my foot.”
B) “I will take ibuprofen regularly to reduce the pain and swelling.”
C) “I will use crutches and avoid putting weight on my foot.”
D) “I will apply heat packs to the affected area to promote healing.”

Correct Answer and Explanation

5 A 45-year-old patient is admitted to the hospital with multiple rib fractures following a motor vehicle accident. The nurse is assessing the patient and notices paradoxical chest wall movement during respiration. Which of the following complications should the nurse suspect based on this finding?

A) Pneumothorax
B) Pulmonary embolism
C) Hemothorax
D) Flail chest

Correct Answer and Explanation

6 A 65-year-old patient presents to the primary care clinic with complaints of joint pain, stiffness, and swelling in the hands and wrists. The patient reports experiencing these symptoms for several months and mentions difficulty performing daily activities. Upon examination, the nurse notes the presence of bony nodules on the distal interphalangeal joint (Heberden’s nodes). Which type of arthritis is most likely present?

A) Rheumatoid arthritis
B) Osteoarthritis
C) Gouty arthritis
D) Psoriatic arthritis

Correct Answer and Explanation

7 A 50-year-old female patient presents with recurrent episodes of joint inflammation, particularly affecting the right knee. The patient reports severe pain, redness, warmth, and limited range of motion during these episodes. Laboratory tests reveal elevated serum uric acid levels. Which type of arthritis is most likely responsible for the patient’s symptoms?

A) Rheumatoid arthritis
B) Osteoarthritis
C) Gouty arthritis
D) Ankylosing spondylitis

Correct Answer and Explanation

8 A 42-year-old patient sustains a fracture of the tibia and fibula in a motor vehicle accident. The healthcare provider determines that the fracture is an “open fracture”. Which of the following interventions should the nurse prioritize during the initial management of an open fracture? Select all that apply.

A) Immobilizing the fracture site with a splint
B) Administering prophylactic antibiotics
C) Covering the wound with a sterile dressing
D) Assessing the neurovascular status of the affected limb

Correct Answer and Explanation

9 A 35-year-old office worker complains of chronic low back pain that worsens with prolonged sitting and improves with walking or lying down. The pain is described as dull and achy, and there are no signs of radiculopathy or neurological deficits. Which of the following conditions is most likely causing the patient’s symptoms?
 
A) Herniated disc
B) Spinal stenosis
C) Musculoskeletal strain
D) Ankylosing spondylitis

Correct Answer and Explanation

10 A 55-year-old patient undergoes surgical repair of a fractured hip. On the second postoperative day, the nurse observes the patient attempting to move the affected leg independently without following the prescribed weight-bearing restrictions. What action should the nurse take? Select all that apply.

A) Reinforce the importance of adhering to weight-bearing restrictions
B) Inform the healthcare provider about the patient’s actions
C) Apply a restraint to the affected leg
D) Encourage the patient to continue exercising the affected leg.

Correct Answer and Explanation

1. The correct answer is A) Herniated disc

2 The correct answer is D) Hip fracture

3 The correct answer is D) Assessing the neurovascular status of the affected arm

4 The correct answer is C) “I will use crutches and avoid putting weight on my foot.”

5 The correct answer is D) Flail chest

6 The correct answer is B) Osteoarthritis 

7 The correct answer is C) Gouty arthritis 

8 The correct answer is B) Administering prophylactic antibiotics and C) Covering the wound with a sterile dressing 

9 The correct answer is C) Musculoskeletal strain

10 The correct answer is A) Reinforce the importance of adhering to weight-bearing restrictions and B) Inform the healthcare provider about the patient’s actions

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