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WorksheetsNCLEX - Musculoskelatal Day2 (Part 1)
Total questions: 15
Worksheet time: 8mins
Name
Class
Date
1.
The nurse is teaching a client with newly diagnosed osteomalacia. Which of the following statements by the client would require follow-up? Select all that apply.
a)
"I will avoid eating foods high in calcium and phosphorus."
b)
"I will avoid spending time outside on sunny days."
c)
"I will decrease my activity level to prevent injury."
d)
"I will eat foods that are fortified with vitamin D."
e)
"I will use a cane to help me get around better."
2.
The nurse working on an orthopedic unit is receiving report on 4 clients with recent fractures. Which client should the nurse assess first?
a)
Client who has a femur fracture with a rash of pin-sized red spots on the chest and increased restlessness (71%)
b)
Client who has purulent drainage oozing from a skeletal traction pin insertion site and a temperature of 100.8 F (38.2 C) (5%)
c)
Client with a hip fracture receiving continuous IV saline with bilateral 2+ pitting leg edema and a blood pressure of (8%) 176/89 mm Hg
d)
Client with a rib fracture who is breathing at a rate of 23/min and is reporting 8/10 pain that is worse with inspiration (14%)
3.
The nurse is caring for a client with a mandibular fracture whose jaw is wired together. While the nurse is in the room, the client begins to choke on oral secretions. Which of the following actions would be a priority for the nurse to take?
a)
Cut the wires holding the jaw in place (31%)
b)
Notify the health care provider (6%)
c)
Obtain a tracheostomy tray (3%)
d)
Suction the mouth along the gum line (58%)
4.
The nurse is caring for a client who is 12 hours postoperative total hip replacement. Which nursing intervention is appropriate to help prevent dislocation of the hip prosthesis?
a)
Instructing the client to cross the legs only at the ankles (1%)
b)
Maintaining the head of the bed at 260-90 degrees (2%)
c)
Placing an abductor pillow between the legs when turning the client (93%)
d)
Turning the client to the affected side to alleviate lateral muscle pulling (1%)
5.
A 25-year-old marathon runner is admitted for suspected rhabdomyolysis. The client has oliguria, dark amber urine, and muscle pain. The nurse should implement which prescription first?
a)
ECG (22%)
b)
IV morphine 2 mg (5%)
c)
Normal saline bolus (52%)
d)
Urine sample (20%)
6.
The nurse receives laboratory reports on 4 clients. Which report is most concerning and should be reported to the health care provider?
a)
The client admitted with asthma exacerbation who has a PaCO2 of 32 mm Hg (4.26 kPa) (19%)
b)
The client diagnosed with chronic obstructive pulmonary disease whose latest arterial blood gas shows a PaO2 of (11%) 85 mm Hg (11.33 kPa)
c)
The client receiving warfarin for atrial fibrillation whose morning laboratory report includes an INR of 2.5 (7%)
d)
The client who had a total knee replacement 2 hours ago and whose hemoglobin is 7 g/dL (70 g/L) (61%)
7.
The nurse is planning care for a client with newly diagnosed Guillain-Barré syndrome. Which of the following interventions should the nurse include in the client's plan of care? Select all that apply.
a)
Initiate continuous cardiac monitoring for the client.
b)
Assess the client's respiratory status every hour.
c)
Assist the client with range-of-motion exercises.
d)
Assist the client with toileting using a bedpan.
e)
Provide a clear liquid diet for the client.
8.
The nurse completes the preoperative assessment for a client scheduled for a total knee replacement today. Which information should the nurse report to the health care provider (HCP) as soon as possible before the surgery?
a)
Has allergy to strawberries (18%)
b)
Is experiencing burning on urination starting yesterday (62%)
c)
Rates knee pain as a 9 on a 0-10 scale (3%)
d)
Stopped taking celecoxib 7 days ago (15%)
9.
A nurse cares for a frail, elderly client with osteoporosis in a nursing home. Which interventions are appropriate to include in the client's care plan to help prevent a hip fracture? Select all that apply.
a)
Calcium supplements
b)
Encourage bed rest
c)
Use of full bed rails during the night
d)
Vitamin D supplements
e)
Weight-bearing exercises
10.
A client in the postoperative period after an open reduction and internal fixation of a left wrist fracture reports constant, severe arm pain that is unrelieved by prescribed morphine administered 30 minutes ago. The client's nail beds appear dusky. What are the nurse's appropriate actions? Select all that apply.
a)
Apply a heating pad and encourage range-of-motion exercises
b)
Assess the temperature and movement of the fingers
c)
Elevate the arm on pillows above the level of the heart
d)
Notify the health care provider
e)
Reassure the client, document findings, and reassess in 1 hour
11.
A client involved in a motor vehicle collision reports severe pelvic and right heel pain. While waiting for imaging, the nurse assesses the client. Which finding should the nurse report to the health care provider immediately?
a)
Distended abdomen and absent bowel sounds (72%)
b)
Ecchymosis over the pelvic bones (20%)
c)
Hemoglobin of 11.5 g/dL (115 g/L) and hematocrit of 34% (0.34) (4%)
d)
Tenderness over the right heel (2%)
12.
The nurse is assessing a client with diabetes mellitus who had a right total knee replacement 8 hours ago. The client reports numbness and tingling in the lower extremities bilaterally. The client's pedal pulses are strong, and capillary refill is <3 seconds bilaterally. Which of the following actions should the nurse take?
a)
Offer the client PRN pain medication. (1%)
b)
Ask the client if the symptoms were present before surgery. (46%)
c)
Notify the client's health care provider. (24%)
d)
Continue the assessment by checking the client's surgical dressing. (27%)
13.
The nurse assesses a client who is receiving methotrexate for rheumatoid arthritis. Which statement by the client is most concerning?
a)
I am nauseated and vomited three times today. (8%)
b)
I drink four large cups of coffee every day. (8%)
c)
I have small, purple spots all over my skin. (54%)
d)
I plan to stop taking birth control today. (28%)
14.
The nurse provides discharge teaching to a client who had total hip replacement 4 days ago. Which client statement indicates that additional teaching is necessary?
a)
I will concentrate on leaning forward as I carefully sit down in a chair. (54%)
b)
I will do my leg raises and quadriceps and buttock isometric exercises 2-3 times a day. (23%)
c)
I will use the sock puller that the therapist gave me when I get dressed. (2%)
d)
My child got me a riser for the toilet seat at home. I hope my feet reach the floor! (19%)
15.
A 3-month-old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction?
a)
I should leave the harness on during diaper changes. (18%)
b)
I will adjust the harness straps every 3-5 days. (64%)
c)
I will inspect the skin under the straps 2-3 times daily. (5%)
d)
The harness should keep my baby's legs bent and spread apart. (11%)
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