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NCLEX QUESTIONS MUSCULOSKELETAL WITH COMPLETE ANSWERS
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NCLEX QUESTIONS MUSCULOSKELETAL WITH COMPLETE ANSWERS
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NCLEX QUESTIONSMUSCULOSKELETAL WITH COMPLETE
ANSWERS
Which fffinding ffwill ffthe ffnurse ffexpect ffwhen ffassessing ffa ff60-year-old ffpatient ffwho
ffhas ffosteoarthritis ff(OA) ffof ffthe ffleft ffknee?
a. ffHeberden's ffnodules
b. ffPain ffupon ffjoint ffmovement
c. ffRedness ffand ffswelling ffof ffthe ffknee ffjoint
d. ffStiffness ffthat ffincreases ffwith ffmovement ff- ffAnswer ffANS: ffB
Initial ffsymptoms ffof ffOA ffinclude ffpain ffwith ffjoint ffmovement. ffHeberden's ffnodules
ffoccur ffon ffthe fffingers. ffRedness ffof ffthe ffjoint ffis ffmore ffstrongly ffassociated ffwith
ffrheumatoid ffarthritis ff(RA), ffand ffstiffness ffin ffOA ffis ffworse ffright ffafter ffthe ffpatient
ffrests ffand ffdecreases ffwith ffjoint ffmovement.
Which ffassessment fffinding ffabout ffa ffpatient ffwho ffhas ffbeen ffusing ffnaproxen
ff(Naprosyn) fffor ff3 ffweeks ffto fftreat ffosteoarthritis ffis ffmost ffimportant fffor ffthe ffnurse ffto
ffreport ffto ffthe ffhealth ffcare ffprovider?
a. ffThe ffpatient ffhas ffdark ffcolored ffstools.
b. ffThe ffpatient's ffpain ffhas ffnot ffimproved.
c. ffThe ffpatient ffis ffusing ffcapsaicin ffcream ff(Zostrix).
d. ffThe ffpatient ffhas ffgained ff3 ffpounds ffover ff3 ffweeks. ff- ffAnswer ffANS: ffA
Dark ffcolored ffstools ffmay ffindicate ffthat ffthe ffpatient ffis ffexperiencing ffgastrointestinal
ffbleeding ffcaused ffby ffthe ffnaproxen. ffThe ffinformation ffabout ffthe ffpatient's ffongoing
ffpain ffand ffweight ffgain ffalso ffwill ffbe ffreported ffand ffmay ffindicate ffa ffneed fffor ffa
ffdifferent fftreatment ffand/or ffcounseling ffabout ffavoiding ffweight ffgain, ffbut ffthese ffare
ffnot ffas fflarge ffa ffconcern ffas ffthe ffpossibility ffof ffgastrointestinal ffbleeding. ffUse ffof
ffcapsaicin ffcream ffwith fforal ffmedications ffis ffappropriate.
After ffthe ffnurse ffhas fffinished ffteaching ffa ffpatient ffwith ffosteoarthritis ff(OA) ffof ffthe ffleft
ffhip ffand ffknee ffabout ffhow ffto ffmanage ffthe ffOA, ffwhich ffpatient ffstatement ffindicates
ffa ffneed fffor ffmore ffeducation?
a. ff"I ffcan fftake ffglucosamine ffto ffhelp ffdecrease ffmy ffknee ffpain."
b. ff"I ffwill fftake ff1 ffg ffof ffacetaminophen ff(Tylenol) ffevery ff4 ffhours."
c. ff"I ffwill fftake ffa ffshower ffin ffthe ffmorning ffto ffhelp ffrelieve ffstiffness."
d. ff"I ffcan ffuse ffa ffcane ffto ffdecrease ffthe ffpressure ffand ffpain ffin ffmy ffhip." ff- ffAnswer
ffANS: ffB
,No ffmore ffthan ff4 ffg ffof ffacetaminophen ffshould ffbe fftaken ffdaily ffto ffavoid ffliver
ffdamage. ffThe ffother ffpatient ffstatements ffare ffcorrect ffand ffindicate ffgood
ffunderstanding ffof ffOA ffmanagement.
When ffcaring fffor ffa ffpatient ffwho ffhas ffosteoarthritis, ffthe ffnurse ffwill ffanticipate ffthe
ffneed ffto ffteach ffthe ffpatient ffabout ffwhich ffof ffthese ffmedications?
a. ffAdalimumab ff(Humira)
b. ffPrednisone ff(Deltasone)
c. ffCapsaicin ffcream ff(Zostrix)
d. ffSulfasalazine ff(Azulfidine) ff- ffAnswer ffANS: ffC
Capsaicin ffcream ffblocks ffthe fftransmission ffof ffpain ffimpulses ffand ffis ffhelpful fffor
ffsome ffpatients ffin fftreating ffOA. ffThe ffother ffmedications ffwould ffbe ffused fffor ffpatients
ffwith ffRA.
A ffpatient ffwho ffhas ffrheumatoid ffarthritis ffis ffseen ffin ffthe ffoutpatient ffclinic ffand ffthe
ffnurse ffnotes ffthat ffrheumatoid ffnodules ffare ffpresent ffon ffthe ffpatient's ffelbows. ffWhich
ffaction ffwill ffthe ffnurse fftake?
a. ffDraw ffblood fffor ffrheumatoid fffactor ffanalysis.
b. ffTeach ffthe ffpatient ffabout ffinjection ffof ffthe ffnodule.
c. ffAssess ffthe ffnodules fffor ffskin ffbreakdown ffor ffinfection.
d. ffDiscuss ffthe ffneed fffor ffsurgical ffremoval ffof ffthe ffnodule. ff- ffAnswer ffANS: ffC
Rheumatoid ffnodules ffcan ffbreak ffdown ffor ffbecome ffinfected. ffThey ffare ffnot
ffassociated ffwith ffchanges ffin ffrheumatoid fffactor ffand ffinjection ffis ffnot ffneeded.
ffRheumatoid ffnodules ffare ffusually ffnot ffremoved ffsurgically ffbecause ffof ffa ffhigh
ffprobability ffof ffrecurrence
When ffcaring fffor ffa ffpatient ffwith ffa ffnew ffdiagnosis ffof ffrheumatoid ffarthritis, ffwhich
ffaction ffwill ffthe ffnurse ffinclude ffin ffthe ffplan ffof ffcare?
a. ffInstruct ffthe ffpatient ffto ffpurchase ffa ffsoft ffmattress.
b. ffTeach ffpatient ffto ffuse fflukewarm ffwater ffwhen ffbathing.
c. ffSuggest ffthat ffthe ffpatient fftake ffa ffnap ffin ffthe ffafternoon.
d. ffSuggest ffexercise ffwith fflight ffweights ffseveral fftimes ffdaily. ff- ffAnswer ffANS: ffC
Adequate ffrest ffhelps ffdecrease ffthe fffatigue ffand ffpain ffthat ffare ffassociated ffwith
ffrheumatoid ffarthritis. ffPatients ffare fftaught ffto ffavoid ffstressing ffjoints, ffto ffuse ffwarm
ffbaths ffto ffrelieve ffstiffness, ffand ffto ffuse ffa fffirm ffmattress.
A ffhome ffhealth ffpatient ffwith ffrheumatoid ffarthritis ff(RA) ffcomplains ffto ffthe ffnurse
ffabout ffhaving ffchronically ffdry ffeyes. ffWhich ffaction ffby ffthe ffnurse ffis ffmost
ffappropriate?
a. ffReassure ffthe ffpatient ffthat ffdry ffeyes ffare ffa ffcommon ffproblem ffwith ffRA.
b. ffTeach ffthe ffpatient ffmore ffabout ffadverse ffaffects ffof ffthe ffRA ffmedications.
c. ffSuggest ffthat ffthe ffpatient ffstart ffusing ffover-the-counter ff(OTC) ffartificial fftears.
d. ffAsk ffthe ffhealth ffcare ffprovider ffabout fflowering ffthe ffmethotrexate ff(Rheumatrex)
ffdose. ff- ffAnswer ffANS: ffC
The ffpatient's ffdry ffeyes ffare ffconsistent ffwith ffSjögren's ffsyndrome, ffa ffcommon
ffextraarticular ffmanifestation ffof ffRA. ffSymptomatic fftherapy ffsuch ffas ffOTC ffeye ffdrops
, ffis ffrecommended. ffDry ffeyes ffare ffnot ffa ffside ffeffect ffof ffmethotrexate. ffAlthough ffdry
ffeyes ffare ffcommon ffin ffRA, ffit ffis ffmore ffhelpful ffto ffoffer ffa ffsuggestion ffto ffrelieve
ffthese ffsymptoms ffthan ffto ffoffer ffreassurance. ffThe ffdry ffeyes ffare ffnot ffcaused ffby ffRA
fftreatment, ffbut ffby ffthe ffdisease ffitself.
Which ffinformation ffwill ffthe ffnurse ffinclude ffwhen ffteaching ffrange-of-motion ffexercises
ffto ffa ffpatient ffwith ffan ffexacerbation ffof ffrheumatoid ffarthritis?
a. ffAffected ffjoints ffshould ffnot ffbe ffexercised ffwhen ffpain ffis ffpresent.
b. ffApplication ffof ffcold ffpacks ffbefore ffexercise ffmay ffdecrease ffjoint ffpain.
c. ffExercises ffshould ffbe ffperformed ffpassively ffby ffsomeone ffother ffthan ffthe ffpatient.
d. ffWalking ffmay ffsubstitute fffor ffrange-of-motion ff(ROM) ffexercises ffon ffsome ffdays. ff-
ffAnswer ffANS: ffB
Cold ffapplication ffis ffhelpful ffin ffreducing ffpain ffduring ffperiods ffof ffexacerbation ffof ffRA.
ffBecause ffthe ffjoint ffpain ffis ffchronic, ffpatients ffare ffinstructed ffto ffexercise ffeven ffwhen
ffjoints ffare ffpainful. ffROM ffexercises ffare ffintended ffto ffstrengthen ffjoints ffas ffwell ffas
ffimprove ffflexibility, ffso ffpassive ffROM ffalone ffis ffnot ffsufficient. ffRecreational ffexercise
ffis ffencouraged ffbut ffis ffnot ffa ffreplacement fffor ffROM ffexercises.
Prednisone ff(Deltasone) ffis ffprescribed fffor ffa ffpatient ffwith ffan ffacute ffexacerbation ffof
ffrheumatoid ffarthritis. ffWhich fflaboratory ffresult ffwill ffthe ffnurse ffmonitor ffto ffdetermine
ffwhether ffthe ffmedication ffhas ffbeen ffeffective?
a. ffBlood ffglucose fftest
b. ffLiver fffunction fftests
c. ffC-reactive ffprotein fflevel
d. ffSerum ffelectrolyte fflevels ff- ffAnswer ffANS: ffC
C-reactive ffprotein ffis ffa ffmarker fffor ffinflammation, ffand ffa ffdecrease ffwould ffindicate
ffthat ffthe ffcorticosteroid fftherapy ffwas ffeffective. ffBlood ffglucose ffand ffserum
ffelectrolyte fflevels ffalso ffwill ffbe ffmonitored ffto ffcheck fffor ffside ffeffects ffof ffprednisone.
ffLiver fffunction ffis ffnot ffroutinely ffmonitored fffor ffpatients ffreceiving ffsteroids.
When ffteaching ffa ffpatient ffwho ffhas ffrheumatoid ffarthritis ff(RA) ffabout ffhow ffto
ffmanage ffactivities ffof ffdaily ffliving, ffthe ffnurse ffinstructs ffthe ffpatient ffto
a. ffstand ffrather ffthan ffsit ffwhen ffperforming ffhousehold ffchores.
b. ffavoid ffactivities ffthat ffrequire ffcontinuous ffuse ffof ffthe ffsame ffmuscles.
c. ffstrengthen ffsmall ffhand ffmuscles ffby ffwringing ffsponges ffor ffwashcloths.
d. ffprotect ffthe ffknee ffjoints ffby ffsleeping ffwith ffa ffsmall ffpillow ffunder ffthe ffknees. ff-
ffAnswer ffANS: ffB
Patients ffare ffadvised ffto ffavoid ffrepetitious ffmovements. ffSitting ffduring ffhousehold
ffchores ffis ffrecommended ffto ffdecrease ffstress ffon ffjoints. ffWringing ffwater ffout ffof
ffsponges ffwould ffincrease ffthe ffjoint ffstress. ffPatients ffare ffencouraged ffto ffposition
ffjoints ffin ffthe ffextended ffposition, ffand ffsleeping ffwith ffa ffpillow ffbehind ffthe ffknees
ffwould ffdecrease ffthe ffability ffof ffthe ffknee ffto ffextend ffand ffalso ffdecrease ffknee ffrange
ffof ffmotion ff(ROM).
When ffhelping ffa ffpatient ffwith ffrheumatoid ffarthritis ff(RA) ffplan ffa ffdaily ffroutine, ffthe
ffnurse ffinforms ffthe ffpatient ffthat ffit ffis ffmost ffhelpful ffto ffstart ffthe ffday ffwith
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