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WorksheetsNCLEX - Musculoskelatal Day1
Total questions: 18
Worksheet time: 18mins
Name
Class
Date
1.
The parent of a newborn is concerned about the possibility of the child developing hip dysplasia. Which intervention should the nurse encourage to help reduce the risk in this newborn?
a)
Choose an infant carrier with a narrow seat (9%)
b)
Place 2 diapers on the infant at all times (4%)
c)
Swaddle the infant with hips flexed and abducted (65%)
d)
Use an infant swing that keeps both legs straight (21%)
e)
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2.
A nurse on an orthopedic unit is caring for four clients with a casted extremity. Which client does the nurse prioritize to see first?
a)
Client reporting a tingling sensation (80%)
b)
Client reporting itching under the cast (0%)
c)
Client reporting pain of 5/10 on movement (1%)
d)
Client reporting throbbing on dependent positioning (16%)
e)
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3.
A nurse is caring for a client diagnosed with rheumatoid arthritis (RA). Which assessment finding does the nurse expect to assess?
a)
Asymmetrical pain in the large weight bearing joints (11%)
b)
Low back pain and stiffness that is worse in the morning (18%)
c)
Pain, swelling, and redness of the great toe (3%)
d)
Symmetrical pain and swelling in the small joints of the hands (67%)
e)
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4.
The nurse is educating a client newly diagnosed with rheumatoid arthritis about the disease process and home management. Which statement by the client indicates comprehension of teaching?
a)
"Even with appropriate treatment joint damage and disability are inevitable." (16%)
b)
"My arthritis can be resolved if I can improve my diet and lose weight." (8%)
c)
"My methotrexate should be taken even when my joints aren't hurting." (61%)
d)
"When my joints hurt, I should rest frequently and try not to move them." (13%)
e)
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5.
The health care provider suspects fat embolism syndrome in a client who has a long bone fracture in the right lower extremity. Which of the following assessment findings does the nurse expect to support this diagnosis? Select all that apply.
a)
Confusion and restlessness
b)
Hypoxemia detected by pulse oximetry
c)
Increasing pressure in the affected extremity
d)
Paresthesia of the affected extremity
e)
Petechiae over the neck and chest
6.
The nurse plans care for a client with surgically wired jaw fixation after a mandibular fracture. Which intervention should the nurse prioritize?
a)
Establishing a method of nonverbal communication (24%)
b)
Obtaining wire cutters to remain at the head of the bed (51%)
c)
Providing frequent oral hygiene with 0.9% sodium chloride (14%)
d)
Using pain-management techniques as needed (9%)
e)
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7.
The emergency department nurse is caring for a client who has recently been prescribed methadone for chronic severe back pain. The client ingested extra tablets tonight because the pain returned. Which assessment findings during discharge require the client to be monitored longer in the hospital setting? Select all that apply.
a)
Client falls asleep while the nurse is talking
b)
Client frequently scratches due to pruritus
c)
Client has third emesis since taking medication
d)
Monitor reveals one premature ventricular contraction
e)
Pulse oximeter shows oxygen saturation is 90%
8.
An elderly client with osteoporosis falls onto an out-stretched hand and injures the wrist. The client has severe wrist edema, deformity, and pain rated a 10 on a pain scale of 0-10. What should be the nurse's first action?
a)
Administer analgesia (12%)
b)
Apply an ice pack to the wrist (9%)
c)
Assess capillary refill and sensation (65%)
d)
Elevate the wrist above heart level (12%)
e)
-
9.
The nurse is planning care for a client who had a total hip replacement via the posterior approach 2 hours ago. Which of the following interventions should the nurse include in the client's plan of care? Select all that apply.
a)
Apply sequential compression devices bilaterally.
b)
Maintain the head of the bed at 90 degrees.
c)
Assess the client's pain level at regular intervals.
d)
Monitor the surgical dressing for drainage.
e)
Place an abductor pillow between the client's legs.
10.
The nurse is caring for a client with osteoporosis. The nurse should recognize that the client is at risk for developing
a)
joint enlargement (8%)
b)
a resting tremor (2%)
c)
kyphosis (61%)
d)
crepitus (26%)
e)
-
11.
The nurse in the operating room is caring for a client who received IV succinylcholine 15 minutes ago. The nurse notes the client is now flushed, profusely sweating, and has rigidity of the jaw muscle. Which of the following medications should the nurse prepare to administer to the client? Click the exhibit button for additional client information.
a)
IM epinephrine (27%)
b)
IV dantrolene (45%)
c)
IM glucagon (12%)
d)
IV lorazepam (14%)
e)
-
12.
The office nurse for an orthopedic health care provider receives 4 telephone messages. Which client does the nurse call back first?
a)
Client who had a left total knee replacement 7 days ago and reports cramping pain in the left calf (58%)
b)
Client with a fractured wrist who reports severe itching under a cast that was applied 3 days ago (4%)
c)
Client with an ankle sprain who is using crutches and reports tingling in the forearm and fingers (25%)
d)
Client with an intact anterior cruciate ligament injury who reports tightness in the knee unrelieved with ice (12%)
e)
-
13.
The nurse on the orthopedic unit is observing staff members caring for assigned clients. The nurse should intervene if a staff member is observed
a)
exposing a client's plaster leg cast to circulating air while the cast dries (17%)
b)
assisting a client who has a halo fixation device to ambulate in the hallway (28%)
c)
placing an abductor pillow between the legs of a client who had a total hip replacement 24 hours ago (13%)
d)
using pillows to elevate the residual limb of a client who had an above-the-knee amputation 72 hours ago (40%)
e)
-
14.
The nurse is caring for a client who has a hip fracture and is placed in Buck traction. Which of the following actions should the nurse take? Select all that apply.
a)
Place the client on the affected side.
b)
Monitor the client for skin breakdown.
c)
Perform frequent neurovascular checks.
d)
Keep the affected extremity in a neutral position.
e)
Ensure that the client receives adequate pain relief.
15.
The nurse has taught a client with newly diagnosed rheumatoid arthritis. Which of the following statements by the client would require follow-up?
a)
I can use a moist heat pack to alleviate joint stiffness. (19%)
b)
I should elevate my knees with pillows when I am sleeping. (60%)
c)
I will make sure to rest in between activities throughout the day. (14%)
d)
I will perform range-of-motion exercises daily to keep my joints flexible. (6%)
e)
-
16.
The nurse plans teaching for an adolescent client being discharged home with a Boston brace for treatment of scoliosis. Which instruction will the nurse include in the discharge teaching plan?
a)
Apply body lotion or powder under the brace to prevent skin irritation (6%)
b)
Avoid any exercises that require the use of spinal muscles (14%)
c)
Keep the brace on for all activities, including showering (12%)
d)
Wear a cotton t-shirt under the brace at all times (66%)
e)
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17.
The nurse is caring for a woman with obesity who is 3 days postoperative total hip joint replacement. Which laboratory value is of greatest concern and should be reported to the health care provider (HCP) immediately?
a)
Blood urea nitrogen (BUN) 22 mg/dL (7.9 mmol/L) (10%)
b)
Glucose 158 mg/dL (8.7 mmol/L) (7%)
c)
Hematocrit 33% (0.33) and hemoglobin 11 g/dL (110 g/L) (10%)
d)
White blood cell count (WBC) 16,000/mm3 (16.0 x10 /L) (71%)
e)
-
18.
The nurse is caring for a client who sustained a fracture of the femur 24 hours ago. Which of the following actions would be a priority for the nurse to take to reduce the client's risk for fat emboli?
a)
Minimize movement of the affected extremity. (38%)
b)
Apply a sequential compression device bilaterally. (31%)
c)
Encourage frequent use of an incentive spirometer. (20%)
d)
Administer IV morphine at regularly scheduled intervals. (9%)
e)
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