NCLEX-RN
RN NCLEX Questions for Musculoskeletal Disorders Questions
Question 1 of 5
The nurse in the emergency department is presented with two severed fingers from a client who experienced a traumatic amputation. What should the nurse do to properly preserve the severed fingers for possible reattachment?
Correct Answer: D
Rationale:
To preserve severed fingers for potential reattachment, wrap them in sterile gauze, place them in a sealed plastic bag, and then place the bag in ice water. Direct pressure is for bleeding control, not preservation. Irrigation is appropriate but incomplete. Direct ice contact can cause tissue damage from freezing.
Question 2 of 5
The nurse is developing a care plan for a client following a lumbar laminectomy. The nurse should plan to
Correct Answer: A
Rationale: Log rolling maintains spinal alignment and prevents strain after a lumbar laminectomy. A cervical collar is for neck injuries, a trapeze aids mobility but isn't primary, and high-Fowler's position may stress the surgical site.
Extract:
The nurse in the medical-surgical unit is caring for a newly admitted client.
Item 6 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.
Orders
2100:
Magnetic resonance imaging of the right foot without contrast
Insert peripheral vascular access device
Laboratory tests: blood culture and sensitivity (C & S), complete blood count (CBC), complete metabolic panel (CMP), lactic acid
vancomycin 1 g, IV, every 12 hours
Wound culture
fentanyl 50 mcg IV, every 5 hours PRN pain
Consultation
Infectious Disease Consultation
2050: Client was evaluated and I strongly suspect osteomyelitis in his right foot. Labs are pending. Agree with admission and will follow closely.
Nurses' Notes
2110: Orders received and reviewed. Vital signs: T 103° F (39.4° C), P 92, RR 18, BP 141/87, pulse oximetry reading 98% on room air. Client reports pain '8' on the Numerical Pain Scale.
Question 3 of 5
For each of the statements made by the client, click to specify whether the statement indicates an understanding or requires follow-up of the discharge teaching provided.
| Client Statements | Understanding | Requires Follow-up |
|---|---|---|
| I should wash my feet daily with warm water and mild soap, then dry thoroughly, especially between the toes.' | ||
| I should inspect my feet bi-weekly for any injuries.' | ||
| I should use a corn/callus remover on my feet.' | ||
| I should wear compression socks with well-fitting shoes.' | ||
| Controlling my blood sugar levels can help reduce my risk of developing foot complications.' |
Correct Answer: A: Indicated, B: Follow-up, C: Follow-up, D: Indicated, E: Indicated
Rationale: A: Proper foot hygiene prevents infection. B: Daily, not bi-weekly, inspection is needed with diabetes. C: Corn/callous removers risk skin breakdown. D: Compression socks and good shoes aid circulation. E: Blood sugar control reduces complication risk.
Extract:
Question 4 of 5
The nurse is caring for a client diagnosed with osteomalacia. The nurse is correct in characterizing osteomalacia as
Correct Answer: A
Rationale: Osteomalacia is bone softening due to inadequate vitamin D, impairing calcium absorption and mineralization. Bacterial invasion is osteomyelitis, decreased bone mass is osteoporosis, and minimal trauma fractures are not osteomalacia.
Extract:
The following scenario applies to the next 1 items
The nurse in the emergency department (ED) is caring for a 17-year-old male client.
Item 1 of 1
History and Physical
1722: The client has had an external fixation on the left wrist for the past two weeks. Today, he noticed swelling, increased pain, fever, and reports purulent drainage from the pin sites. The client reports poor adherence to performing pin care at home. On exam, the client is febrile and has an oral temperature of 103.4° F (39.7° C). The left wrist is erythemic, swollen, and tender to the touch.
Question 5 of 5
The nurse has reviewed the history and physical. For each potential intervention, click to specify whether the intervention is indicated or not indicated for the client.
| Potential Interventions | Indicated | Not Indicated |
|---|---|---|
| Obtain a prescription for an antibiotic | ||
| Culture the pin sites | ||
| Apply a pressure dressing over the pins | ||
| Obtain a prescription for analgesia | ||
| Position the client's wrist so it is extended |
Correct Answer: A: Indicated, B: Indicated, C: Not Indicated, D: Indicated, E: Not Indicated
Rationale: A: Antibiotics treat infection suggested by fever and drainage. B: Cultures identify the organism. C: Pressure dressings may damage pins or tissue. D: Analgesia addresses pain. E: Extension may worsen swelling and pain.