Musculoskeletal Questions NCLEX
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Question 1 of 5.
The nurse notes during an annual health screening for the 78-year-old client that the client is 1.5 inches shorter than at last year's visit. Which initial screening might the nurse best anticipate for this client?
A. Bone mineral density (BMD) test
B. An x-ray of both hips and spine
C. A bone scan of the hips and spine
D. A physical check for scoliosis
Explanation: A. BMD testing will best determine if the loss of height is due to osteoporosis, a common finding with aging.
Question 2 of 5.
The occupational health nurse is planning health promotion activities for a group of factory workers. Which activity is an example of primary prevention for clients at risk for low back pain?
A. Teach back exercises to workers after returning from an injury.
B. Place signs in the work area about how to perform first aid.
C. Start a weight-reduction group to meet at lunchtime.
D. Administer a nonnarcotic analgesic to a client complaining of back pain.
Explanation: Weight reduction reduces spinal stress, a primary prevention strategy for low back pain. Post-injury exercises are secondary, first aid signs are tertiary, and analgesics treat symptoms, not prevent.
Question 3 of 5.
The nurse working on a medical-surgical floor feels a pulling in the back when lifting a client up in the bed. Which should be the first action taken by the nurse?
A. Continue working until the shift is over and then try to sleep on a heating pad.
B. Go immediately to the emergency department for treatment and muscle relaxants.
C. Inform the charge nurse and nurse manager on duty and document the occurrence.
D. See a private health-care provider on the nurse's off time but charge the hospital.
Explanation: Reporting and documenting the injury ensures workplace safety protocols and workers' compensation processes are followed. Continuing work risks further injury, ED is premature, and private care is secondary.
Question 4 of 5.
The nurse is discussing the importance of an exercise program for pain control to a client diagnosed with OA. Which intervention should the nurse include in the teaching?
A. Wear supportive tennis shoes with white socks when walking.
B. Carry a complex carbohydrate while exercising.
C. Alternate walking briskly and jogging when exercising.
D. Walk at least 30 minutes three (3) times a week.
Explanation: Walking 30 minutes thrice weekly reduces OA pain and stiffness through low-impact exercise. Supportive shoes are helpful but secondary, carbohydrates are irrelevant, and jogging may worsen OA.
Question 5 of 5.
The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis?
A. X-ray of the femur.
B. Serum alkaline phosphatase.
C. Dual-energy x-ray absorptiometry (DEXA).
D. Serum bone Gla-protein test.
Explanation: DEXA is the gold standard for osteoporosis diagnosis, measuring bone mineral density. X-rays detect fractures, alkaline phosphatase is nonspecific, and bone Gla-protein is not diagnostic.