NCLEX Questions: Musculoskeletal
Trama and Orthopedic Surgery Exam
When teaching seniors at a community recreation center, which information will the nurse
include about ways to prevent fractures?
a. Tack down scatter rugs in the home.
b. Most falls happen outside the home.
c. Buy shoes that provide good support and are comfortable to wear.
d. Range-of-motion exercises should be taught by a physical therapist. - ANS ANS: C
Comfortable shoes with good support will help decrease the risk for falls. Scatter rugs should be
eliminated, not just tacked down. Activities of daily living provide range of motion exercise; these
do not need to be taught by a physical therapist. Falls inside the home are responsible for many
injuries
A factory line worker has repetitive strain syndrome in the left elbow. The nurse will plan to
teach the patient about
a. surgical options.
b. elbow injections.
c. wearing a left wrist splint.
d. modifying arm movements. - ANS ANS: D
Treatment for repetitive strain syndrome includes changing the ergonomics of the activity. Elbow
injections and surgery are not initial options for this type of injury. A wrist splint might be used for
hand or wrist pain.
The occupational health nurse will teach the patient whose job involves many hours of typing
about the need to
a. obtain a keyboard pad to support the wrist.
b. do stretching exercises before starting work.
c. wrap the wrists with compression bandages every morning.
d. avoid using nonsteroidal antiinflammatory drugs (NSAIDs) for pain. - ANS ANS: A
Repetitive strain injuries caused by prolonged times working at a keyboard can be prevented by
the use of a pad that will keep the wrists in a straight position. Stretching exercises during the
day may be helpful, but these would not be needed before starting. Use of a compression
bandage is not needed, although a splint may be used for carpal tunnel syndrome. NSAIDs are
appropriate to use to decrease swelling.
Which discharge instruction will the emergency department nurse include for a patient with a
sprained ankle?
, a. Keep the ankle loosely wrapped with gauze.
b. Apply a heating pad to reduce muscle spasms.
c. Use pillows to elevate the ankle above the heart.
d. Gently move the ankle through the range of motion. - ANS ANS: C
Elevation of the leg will reduce the amount of swelling and pain. Compression bandages are
used to decrease swelling. For the first 24 to 48 hours, cold packs are used to reduce swelling.
The ankle should be rested and kept immobile to prevent further swelling or injury.
A 22-year-old tennis player has an arthroscopic repair of a rotator cuff injury performed in
same-day surgery. When the nurse plans postoperative teaching for the patient, which
information will be included?
a. "You will not be able to serve a tennis ball again."
b. "You will work with a physical therapist tomorrow."
c. "The doctor will use the drop-arm test to determine the success of surgery."
d. "Leave the shoulder immobilizer on for the first 4 days to minimize pain." - ANS ANS: B
Physical therapy after a rotator cuff repair begins on the first postoperative day to prevent
"frozen shoulder." A shoulder immobilizer is used immediately after the surgery, but leaving the
arm immobilized for several days would lead to loss of range of motion (ROM). The drop-arm
test is used to test for rotator cuff injury, but not after surgery. The patient may be able to return
to pitching after rehabilitation.
The nurse will instruct the patient with a fractured left radius that the cast will need to remain in
place
a. for several months.
b. for at least 3 weeks.
c. until swelling of the wrist has resolved.
d. until x-rays show complete bony union. - ANS ANS: B
Bone healing starts immediately after the injury, but since ossification does not begin until 3
weeks postinjury, the cast will need to be worn for at least 3 weeks. Complete union may take
up to a year. Resolution of swelling does not indicate bone healing.
A 48-year-old patient with a comminuted fracture of the left femur has Buck's traction in place
while waiting for surgery. To assess for pressure areas on the patient's back and sacral area
and to provide skin care, the nurse should
a. loosen the traction and help the patient turn onto the unaffected side.
b. place a pillow between the patient's legs and turn gently to each side.
c. turn the patient partially to each side with the assistance of another nurse.
d. have the patient lift the buttocks by bending and pushing with the right leg. - ANS ANS:
D
The patient can lift the buttocks off the bed by using the left leg without changing the right-leg
alignment. Turning the patient will tend to move the leg out of alignment. Disconnecting the
traction will interrupt the weight needed to immobilize and align the fracture.
Trama and Orthopedic Surgery Exam
When teaching seniors at a community recreation center, which information will the nurse
include about ways to prevent fractures?
a. Tack down scatter rugs in the home.
b. Most falls happen outside the home.
c. Buy shoes that provide good support and are comfortable to wear.
d. Range-of-motion exercises should be taught by a physical therapist. - ANS ANS: C
Comfortable shoes with good support will help decrease the risk for falls. Scatter rugs should be
eliminated, not just tacked down. Activities of daily living provide range of motion exercise; these
do not need to be taught by a physical therapist. Falls inside the home are responsible for many
injuries
A factory line worker has repetitive strain syndrome in the left elbow. The nurse will plan to
teach the patient about
a. surgical options.
b. elbow injections.
c. wearing a left wrist splint.
d. modifying arm movements. - ANS ANS: D
Treatment for repetitive strain syndrome includes changing the ergonomics of the activity. Elbow
injections and surgery are not initial options for this type of injury. A wrist splint might be used for
hand or wrist pain.
The occupational health nurse will teach the patient whose job involves many hours of typing
about the need to
a. obtain a keyboard pad to support the wrist.
b. do stretching exercises before starting work.
c. wrap the wrists with compression bandages every morning.
d. avoid using nonsteroidal antiinflammatory drugs (NSAIDs) for pain. - ANS ANS: A
Repetitive strain injuries caused by prolonged times working at a keyboard can be prevented by
the use of a pad that will keep the wrists in a straight position. Stretching exercises during the
day may be helpful, but these would not be needed before starting. Use of a compression
bandage is not needed, although a splint may be used for carpal tunnel syndrome. NSAIDs are
appropriate to use to decrease swelling.
Which discharge instruction will the emergency department nurse include for a patient with a
sprained ankle?
, a. Keep the ankle loosely wrapped with gauze.
b. Apply a heating pad to reduce muscle spasms.
c. Use pillows to elevate the ankle above the heart.
d. Gently move the ankle through the range of motion. - ANS ANS: C
Elevation of the leg will reduce the amount of swelling and pain. Compression bandages are
used to decrease swelling. For the first 24 to 48 hours, cold packs are used to reduce swelling.
The ankle should be rested and kept immobile to prevent further swelling or injury.
A 22-year-old tennis player has an arthroscopic repair of a rotator cuff injury performed in
same-day surgery. When the nurse plans postoperative teaching for the patient, which
information will be included?
a. "You will not be able to serve a tennis ball again."
b. "You will work with a physical therapist tomorrow."
c. "The doctor will use the drop-arm test to determine the success of surgery."
d. "Leave the shoulder immobilizer on for the first 4 days to minimize pain." - ANS ANS: B
Physical therapy after a rotator cuff repair begins on the first postoperative day to prevent
"frozen shoulder." A shoulder immobilizer is used immediately after the surgery, but leaving the
arm immobilized for several days would lead to loss of range of motion (ROM). The drop-arm
test is used to test for rotator cuff injury, but not after surgery. The patient may be able to return
to pitching after rehabilitation.
The nurse will instruct the patient with a fractured left radius that the cast will need to remain in
place
a. for several months.
b. for at least 3 weeks.
c. until swelling of the wrist has resolved.
d. until x-rays show complete bony union. - ANS ANS: B
Bone healing starts immediately after the injury, but since ossification does not begin until 3
weeks postinjury, the cast will need to be worn for at least 3 weeks. Complete union may take
up to a year. Resolution of swelling does not indicate bone healing.
A 48-year-old patient with a comminuted fracture of the left femur has Buck's traction in place
while waiting for surgery. To assess for pressure areas on the patient's back and sacral area
and to provide skin care, the nurse should
a. loosen the traction and help the patient turn onto the unaffected side.
b. place a pillow between the patient's legs and turn gently to each side.
c. turn the patient partially to each side with the assistance of another nurse.
d. have the patient lift the buttocks by bending and pushing with the right leg. - ANS ANS:
D
The patient can lift the buttocks off the bed by using the left leg without changing the right-leg
alignment. Turning the patient will tend to move the leg out of alignment. Disconnecting the
traction will interrupt the weight needed to immobilize and align the fracture.
