Musculoskeletal RN NCLEX Questions
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Question 1 of 5.
The nurse is teaching a client with low back pain. Which of the following statements, if made by the client, would require follow-up?
A. I am planning to stop smoking cigarettes.'
B. I should sleep on my stomach.'
C. I have decided to purchase a firm mattress.'
D. I will bend my knees when lifting objects.'
Explanation: Sleeping on the stomach can strain the lower back, requiring follow-up teaching. Quitting smoking, a firm mattress, and bending knees when lifting are all beneficial for back health.
Question 2 of 5.
Which of the following best describes an appropriate outcome for a 75-yr-old patient with a history of Huntington's disease, which has developed contractures?
A. The patient will monitor for signs of skin breakdown as a result of the contractures.
B. The patient will learn to reposition himself in bed and in his chair without assistance.
C. The patient will participate in range of motion exercises to reduce the effects of contractures.
D. The patient will verbalize the effects of contractures on activities of daily living.
Explanation: For a patient with Huntington's disease and contractures, participating in range of motion exercises is an appropriate outcome to help maintain joint mobility and reduce the severity of contractures. Monitoring for skin breakdown is important but not the primary outcome. Independent repositioning may not be feasible due to the progressive nature of Huntington's, and verbalizing effects is less actionable than active intervention.
Question 3 of 5.
Extract:The following scenario applies to the next 1 items The nurse cares for a client who sustained a femur fracture twelve hours ago Item 1 of 1 Nurses' Notes Client reports shortness of breath and stated, ‘something is not right.' The client was assessed to have a respiratory rate of 25/min and oxygen saturation of 90% while on room air. Lung sounds had bilateral crackles throughout, and respirations were labored. Chest pain was reported that worsened with breathing. An emergent 12-lead electrocardiogram was obtained, and it was observed that the client had reddish-purple spots on their torso. A rapid response was called.
The client is demonstrating signs and symptoms of
A. Pulmonary embolism
B. Myocardial infarction
C. Fat embolism syndrome
D. Compartment syndrome
Explanation: Fat embolism syndrome is likely after a femur fracture, with symptoms like shortness of breath, bilateral crackles, chest pain, and petechiae on the torso. Pulmonary embolism and myocardial infarction are less directly tied to fractures, and compartment syndrome affects the limb.
Question 4 of 5.
Extract:The nurse in the medical-surgical unit is caring for a newly admitted client. Item 4 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. 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.
The nurse plans care for this client. For each potential intervention, click to specify whether the intervention is indicated or not indicated for the client.
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Explanation: A: Warm compresses may worsen inflammation and infection. B: CBC monitors infection and inflammation. C: Blood cultures identify systemic infection. D: Pain medication addresses severe pain. E: MRI confirms osteomyelitis. F: IV fluids support hydration and antibiotic delivery.
Question 5 of 5.
The nurse is planning care for a client with a newly diagnosed fractured pelvis. Which action would lessen the risk of fat embolism syndrome (FES)?
A. Request a prescription for enoxaparin.
B. Alternate with the application of ice and heat.
C. Educate the client on pelvic immobilization.
D. Encourage passive range of motion of the lower legs.
Explanation: Pelvic immobilization reduces movement and the risk of fat globules entering the bloodstream, a key factor in fat embolism syndrome. Enoxaparin prevents clots, ice/heat manages swelling, and range of motion is beneficial but not primary for FES prevention.