NCLEX-RN
RN Musculoskeletal NCLEX Questions Questions
Question 1 of 5
The nurse provides discharge instructions to a client with a newly applied fiberglass cast for a fractured radius. Which of the following statements by the client would indicate a correct understanding of the teaching?
Correct Answer: D
Rationale: Drying a slightly wet fiberglass cast with a towel and a cool hair dryer is appropriate to prevent skin breakdown. A dependent position increases swelling, cutting the cast is unsafe, and warm compresses can worsen swelling and are not recommended.
Extract:
The following scenario applies to the next 6 items
The nurse in the medical-surgical unit is caring for a newly admitted client.
Item 1 of 6
History and Physical
1930: Client is a 45-year-old male who has a one-and-a-half-week history of pain, redness, and swelling in his right foot. He reported that the symptoms began after he accidentally cut his foot while walking barefoot in his backyard. Over the next few days, he developed pain and swelling around the cut, accompanied by redness and warmth. He went to urgent care two days later and was diagnosed with cellulitis in his right foot. He was prescribed antibiotics but could not afford the treatment. Three days ago, the pain escalated and was described as throbbing and constant, with a severity rating of 7/10 on the Numerical Pain Rating Scale. He states, "the pain is now in the bone of my foot; I don't know how else to describe it." He also noted occasional fever 101°F (38.3°C), chills, and general malaise. On physical examination, his right foot was erythematous, swollen, and warm to the touch. A 3 cm ulcer was noted on the plantar aspect of the right foot, with moderate purulent discharge present. The ulcer appeared deep, and palpation of the surrounding tissue elicited tenderness. There was limited range of motion in the right ankle due to pain. The distal pulses were palpable 2+, and there were signs of neuropathy in the feet (decreased sensation to light touch and pinprick). He has a medical history of uncontrolled diabetes mellitus (type two), obesity, peripheral neuropathy in all extremities, hypertension, hyperlipidemia, and epilepsy.
Question 2 of 5
Which of the following findings in the history and physical requires follow-up?
Correct Answer: A, B, D, E
Rationale: Decreased sensation (neuropathy) risks further injury, purulent drainage suggests infection, pain characteristics indicate severity and progression, and uncontrolled diabetes and other conditions increase complication risk. Peripheral pulses are normal at 2+.
Extract:
Question 3 of 5
The nurse is caring for assigned clients. The nurse should recognize that the client at greatest risk for compartment syndrome is the client who has which of the following?
Correct Answer: A
Rationale: A recent tibial fracture in a cast increases compartment syndrome risk due to swelling and pressure within a confined space. Ankle swelling, chronic osteomyelitis, and skin traction pose lower or different risks.
Question 4 of 5
A nurse is taking care of a client that is status-post hand arthroplasty. When creating the care plan, which of the following nursing interventions should be avoided to prevent complications?
Correct Answer: A
Rationale: Excessive full range of motion exercises shortly after hand arthroplasty can strain the surgical site, risking damage or delayed healing. Elevation, using the non-operative arm, and placing items within reach are appropriate.
Extract:
The following scenario applies to the next 1 items
The nurse in the outpatient clinic cares for a 31-year-old female client
Item 1 of 1
Nurses' Notes
0919: Client arrives for an appointment, reporting intermittent joint pain and stiffness in her wrists, fingers, and ankles. She says her symptoms started three months ago and are worse in the morning. In the past month, the pain and stiffness have become unbearable. She states that later in the afternoon, the pain lessens, but she describes the pain at its highest intensity in the morning. She states that she is handling the pain by warm compresses on her hands and ankles combined with over-the-counter naproxen. She recently purchased a splint which has helped some. Additionally, the client reports feeling 'run down' but attributes that to her new job, which she believes has caused her to lose 9 pounds (4.1 kg) in the past three months. On assessment, the client is alert and oriented to person, place, and time. She appears slightly restless, reporting wrist and finger pain rated 8 on a scale of 0 (no pain) to 10 (severe pain). Stating, "it hurts so bad." All ten fingers appear swollen and errythemic, with a limited range of motion. Capillary refill is less than 3 seconds. Radial pulses are 2+ and regular. Her breathing is unlabored, and clear lung sounds are noted in both lung fields. Abdomen is taut and symmetric with hypoactive bowel sounds. Denies any nausea, vomiting, or dysuria. Both ankles were slightly swollen and warm to touch. Vital signs: T 99.7° F (37.6° C), P 88, RR 18, BP 132/81, pulse oximetry reading 95%. She has a medical history of generalized anxiety disorder and is taking sertraline for treatment.
Question 5 of 5
For each assessment finding below, click to specify if the finding is consistent with the disease process of rheumatoid arthritis, osteoarthritis, or carpal tunnel syndrome. Each finding may support more than one (1) disease process. Note: Each column must have at least one (1) response option selected. Fatigue
| Client Finding | Rheumatoid Arthritis (RA) | Osteoarthritis | Carpal Tunnel Syndrome (CTS) |
|---|---|---|---|
| Fatigue | |||
| No Heberden's nodes | |||
| Low-grade fever | |||
| Pain relieved with nonsteroidal anti-inflammatory drugs | |||
| Pain relieved with splinting | |||
| Morning stiffness |
Correct Answer: A
Rationale: Fatigue is common in rheumatoid arthritis due to systemic inflammation. It is less typical in osteoarthritis or carpal tunnel syndrome, which are more localized conditions.