While training a new RN in the emergency department, the nurse attends

RN Musculoskeletal NCLEX Questions

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Question 1 of 5.

While training a new RN in the emergency department, the nurse attends to a client with Guillain-Barre Syndrome. The new RN asks what may have caused this condition. Which of the following occurrences in the patient's history is most likely a contributing factor?

A. A spinal cord injury at age 12

B. An upper respiratory infection about a month ago

C. Hydrocephaly as an infant

D. A joint injury as a teenager

Explanation: Guillain-Barre Syndrome is often triggered by a recent infection, commonly an upper respiratory infection, leading to an autoimmune response against peripheral nerves. Spinal cord injury, hydrocephaly, and joint injury are unrelated.

Question 2 of 5.

The nurse provides discharge instructions to a client with a newly applied fiberglass cast for a fractured radius. Which of the following statements by the client would indicate a correct understanding of the teaching?

A. The swelling can be reduced by keeping my extremity in a dependent position.'

B. The edges of the cast can be cut with scissors until I feel comfortable.'

C. To reduce pain and swelling, I should apply a warm compress.'

D. If my cast gets slightly wet, pat it dry with a towel and try drying it with a hair dryer set on the cool setting.'

Explanation: Drying a slightly wet fiberglass cast with a towel and a cool hair dryer is appropriate to prevent skin breakdown. A dependent position increases swelling, cutting the cast is unsafe, and warm compresses can worsen swelling and are not recommended.

Question 3 of 5.

Extract:The following scenario applies to the next 6 items The nurse in the medical-surgical unit is caring for a newly admitted client. Item 1 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 101Â°F (38.3Â°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.

Which of the following findings in the history and physical requires follow-up?

A. Sensation in the feet

B. Drainage from wound

C. Peripheral pulses

D. Pain characteristics

E. Medical history

Explanation: Decreased sensation (neuropathy) risks further injury, purulent drainage suggests infection, pain characteristics indicate severity and progression, and uncontrolled diabetes and other conditions increase complication risk. Peripheral pulses are normal at 2+.

Question 4 of 5.

The nurse is caring for assigned clients. The nurse should recognize that the client at greatest risk for compartment syndrome is the client who has which of the following?

A. A left tibial fracture that was recently placed in a cast

B. Swelling in the ankles and is wearing compression stockings

C. Chronic osteomyelitis of the right femur

D. Skin traction following a left hip fracture

Explanation: A recent tibial fracture in a cast increases compartment syndrome risk due to swelling and pressure within a confined space. Ankle swelling, chronic osteomyelitis, and skin traction pose lower or different risks.

Question 5 of 5.

A nurse is taking care of a client that is status-post hand arthroplasty. When creating the care plan, which of the following nursing interventions should be avoided to prevent complications?

A. Encourage the client to perform finger and wrist exercises ten times per hour, using a full range of flexion and extension.

B. Place the client's personal items within reach of the client's non-operative arm.

C. Place the client's operative arm on a pillow to rest and keep it elevated.

D. Encourage the client to use the non-operative arm as much as possible.

Explanation: Excessive full range of motion exercises shortly after hand arthroplasty can strain the surgical site, risking damage or delayed healing. Elevation, using the non-operative arm, and placing items within reach are appropriate.