Musculoskeletal Disorders RN NCLEX Questions
Question 1 of 5.
The nurse is caring for a client who has a fiberglass cast that has just been applied to their left arm due to a humerus fracture. Three hours later, the client complains of numbness in his fingers, and says his fingers 'have become pale.' What is the nurse's most appropriate action?
A. Reassure the client that this is just a normal occurrence after having a cast.
B. Ask the client to clench his fist frequently.
C. Remove the cast immediately.
D. Notify the primary healthcare provider (PHCP).
Explanation: Numbness and pallor in the fingers are signs of potential compartment syndrome or impaired circulation, which are serious complications. The most appropriate action is to notify the primary healthcare provider immediately for further evaluation and intervention. Reassuring the client or asking them to clench their fist does not address the urgency, and removing the cast is not within the nurse's scope without a provider's order.
Question 2 of 5.
The nurse is caring for a client six hours postoperative following a below-knee amputation (BKA). Which of the following assessment findings requires follow-up?
A. Restlessness
B. Blood pressure of 140/78 mmHg
C. Pulse rate of 89 bpm
D. Hypoactive bowel sounds in all four quadrants
Explanation: Restlessness can be a sign of pain, anxiety, or hypoxia, all of which require follow-up in a postoperative client. The blood pressure and pulse rate are within normal limits, and hypoactive bowel sounds are expected shortly after surgery due to anesthesia and reduced gastrointestinal motility.
Question 3 of 5.
For each assessment finding below, click to specify if the finding is consistent with the disease process of osteoarthritis, acute gout flare, or rheumatoid arthritis. Each finding may support more than 1 disease process.
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Explanation: Seen in inflammatory conditions; not typical in osteoarthritis. Chronic systemic inflammation may lead to unintentional weight loss. Indicates joint inflammation; osteoarthritis does not usually present with warmth or redness. Stiffness >1 hour, especially in small joints, is classic for RA. Movement worsens pain in all these conditions, though the cause differs. All limit ROM due to stiffness, inflammation, or damage. Pain is a shared feature, though severity and timing vary.
Question 4 of 5.
The nurse performs a home safety assessment for an older adult with rheumatoid arthritis. The nurse should make which recommendation to promote safety in the bathroom?
A. Recommend using a handheld (adjustable) shower head
B. Advise the client to lower the toilet seat to its lowest level
C. Instruct the client to reduce bathroom lighting
D. Recommend the use of towel racks for grab bars
Explanation: A handheld shower head allows the client with rheumatoid arthritis to bathe more easily, accommodating limited mobility and joint stiffness. Lowering the toilet seat may make standing difficult, reduced lighting increases fall risk, and towel racks are not sturdy enough for support.
Question 5 of 5.
The nurse is discharging a client following knee arthroplasty. Which of the following information should the nurse include in discharge teaching?
A. After this procedure, you will use a wheelchair to get around.'
B. You will need to resume your prescribed anticoagulants.'
C. Placing a pillow under your knee will help with the pain.'
D. You may ice the site for one hour at a time.'
Explanation: Resuming prescribed anticoagulants is crucial to prevent deep vein thrombosis after knee arthroplasty. A wheelchair may not be necessary, pillows under the knee can cause flexion contractures, and icing for one hour at a time risks skin damage; 15-20 minutes is safer.