Musculoskeletal Disorders RN NCLEX Questions
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Question 1 of 5.
The nurse is assessing a client who reports left knee pain after playing baseball. The nurse should initially
A. Feel the knee for warmth.
B. Inspect the knee for any swelling.
C. Palpate for crepitus in the knee.
D. Have the client perform active range of motion in the knee.
Explanation: Initial assessment starts with inspection for swelling, a visible sign of injury or inflammation post-activity. Warmth, crepitus, and range of motion are assessed next but are not the first step.
Question 2 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 3 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 4 of 5.
Extract:The following scenario applies to the next 1 items The nurse in the emergency department (ED) is caring for a 62-year-old female client. Item 1 of 1 Triage Note 1211: The client was brought to the ED by her neighbor, who was concerned about her increasing pain and immobility. The client's neighbor reported that the client called her a few hours ago, asking her to go to the ED because of increasing pain and the inability to perform her activities of daily living. History of osteoporosis, hypertension, and gout. She reports that she recently started seeing a rheumatologist because of persistent fatigue, low-grade fevers, and lack of appetite. Vital signs: T 99.7° F (37.6° C), P 82, RR 16, BP 134/76, pulse oximetry reading 98% on room air. Pain rated 7/10 on the Numerical Rating Scale, which is described as throbbing of both feet, especially in her toes. She also reports having stiffness in her wrists and fingers that starts in the morning and persists throughout the day. Triage assessment: the client is alert and fully oriented to person, place, and situation. Peripheral pulses 2+. Clear lung sounds bilaterally. Swollen, errythemic toes that are warm and tender to touch. She does not recall her weight but reports significant weight loss over the past three months.
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 5 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.
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