Musculoskeletal NCLEX Questions 79
Verified Questions with Correct
Solutions (2025 Updated Edition)
SECTION 1: FRACTURES AND TRAUMA
Question 1
A client with a fractured femur is in Buck's traction. Which assessment
finding requires immediate intervention?
A) Complaints of mild pain at the fracture site
B) Capillary refill of 2 seconds in the toes
C) Severe pain with passive dorsiflexion of the foot
D) Slight swelling around the fracture site
Correct Answer: C) Severe pain with passive dorsiflexion of the foot
Rationale: Severe pain with passive dorsiflexion of the foot is a sign of
compartment syndrome, a medical emergency. Compartment
syndrome occurs when pressure within a muscle compartment
increases, compromising tissue perfusion. Other signs include pain
out of proportion to the injury, pallor, paresthesia, and pulselessness.
Mild pain (A) and slight swelling (D) are expected findings. Capillary
refill of 2 seconds (B) is normal.
,Question 2
A client has a cast on the lower leg. Which finding indicates the cast is
too tight?
A) Capillary refill of 3 seconds
B) Pain that is relieved by elevation
C) Numbness and tingling in the toes
D) Slight swelling of the toes
Correct Answer: C) Numbness and tingling in the toes
Rationale: Numbness and tingling (paresthesia) are signs of nerve
compression and indicate the cast may be too tight. Capillary refill of
3 seconds (A) may be normal or slightly delayed. Pain relieved by
elevation (B) is not a sign of a tight cast. Slight swelling (D) is
expected initially. Other signs of a tight cast include pallor, delayed
capillary refill, and severe pain.
Question 3
A client is being discharged with a new cast on the left arm. Which
instruction should the nurse include?
A) Use a coat hanger to scratch under the cast
B) Keep the cast dry
C) Place a pillow under the casted arm to keep it elevated
D) Both B and C
Correct Answer: D) Both B and C
,Rationale: The client should keep the cast dry (B) and elevate the
casted arm on a pillow (C) to reduce swelling. Using a coat hanger (A)
to scratch under the cast can damage the skin and should be avoided.
The client should also be instructed to report any signs of
neurovascular compromise (numbness, tingling, color changes).
Question 4
A client with a fractured hip is placed in Buck's traction. The primary
purpose of this traction is to:
A) Reduce the fracture
B) Immobilize the hip
C) Alleviate muscle spasms and pain
D) Prepare the client for surgery
Correct Answer: C) Alleviate muscle spasms and pain
Rationale: Buck's traction is a type of skin traction used to alleviate
muscle spasms and pain, not to reduce the fracture (A). It provides
temporary immobilization (B) and may be used before surgery (D), but
its primary purpose is to reduce muscle spasms and pain. The traction
is applied to the leg using adhesive or foam tape and weights.
Question 5
A client with a fractured femur is in skeletal traction. Which finding
indicates that the traction is effective?
A) The client is able to move freely in bed
B) The client's pain is relieved
, C) The fracture is aligned
D) The client is comfortable
Correct Answer: C) The fracture is aligned
Rationale: The purpose of skeletal traction is to align the fractured
bone ends. Skeletal traction uses pins or wires inserted into the bone
to apply continuous traction. The fracture is aligned when the bone
ends are in proper position for healing. Pain relief (B) and comfort (D)
are secondary benefits. The client should not move freely in bed (A) as
this would disrupt the traction.
Question 6
A client with a fractured tibia is in a long leg cast. The nurse notes that
the client's toes are pale and cold. Which action should the nurse take
first?
A) Apply a heating pad to the foot
B) Elevate the leg
C) Notify the provider
D) Assess the capillary refill
Correct Answer: D) Assess the capillary refill
Rationale: The nurse should first assess the capillary refill to
determine the severity of the circulatory compromise. Pale and cold
toes indicate possible vascular compromise. The nurse should
perform a comprehensive neurovascular assessment (pulses,
sensation, movement, capillary refill, color, temperature). Notifying the
Verified Questions with Correct
Solutions (2025 Updated Edition)
SECTION 1: FRACTURES AND TRAUMA
Question 1
A client with a fractured femur is in Buck's traction. Which assessment
finding requires immediate intervention?
A) Complaints of mild pain at the fracture site
B) Capillary refill of 2 seconds in the toes
C) Severe pain with passive dorsiflexion of the foot
D) Slight swelling around the fracture site
Correct Answer: C) Severe pain with passive dorsiflexion of the foot
Rationale: Severe pain with passive dorsiflexion of the foot is a sign of
compartment syndrome, a medical emergency. Compartment
syndrome occurs when pressure within a muscle compartment
increases, compromising tissue perfusion. Other signs include pain
out of proportion to the injury, pallor, paresthesia, and pulselessness.
Mild pain (A) and slight swelling (D) are expected findings. Capillary
refill of 2 seconds (B) is normal.
,Question 2
A client has a cast on the lower leg. Which finding indicates the cast is
too tight?
A) Capillary refill of 3 seconds
B) Pain that is relieved by elevation
C) Numbness and tingling in the toes
D) Slight swelling of the toes
Correct Answer: C) Numbness and tingling in the toes
Rationale: Numbness and tingling (paresthesia) are signs of nerve
compression and indicate the cast may be too tight. Capillary refill of
3 seconds (A) may be normal or slightly delayed. Pain relieved by
elevation (B) is not a sign of a tight cast. Slight swelling (D) is
expected initially. Other signs of a tight cast include pallor, delayed
capillary refill, and severe pain.
Question 3
A client is being discharged with a new cast on the left arm. Which
instruction should the nurse include?
A) Use a coat hanger to scratch under the cast
B) Keep the cast dry
C) Place a pillow under the casted arm to keep it elevated
D) Both B and C
Correct Answer: D) Both B and C
,Rationale: The client should keep the cast dry (B) and elevate the
casted arm on a pillow (C) to reduce swelling. Using a coat hanger (A)
to scratch under the cast can damage the skin and should be avoided.
The client should also be instructed to report any signs of
neurovascular compromise (numbness, tingling, color changes).
Question 4
A client with a fractured hip is placed in Buck's traction. The primary
purpose of this traction is to:
A) Reduce the fracture
B) Immobilize the hip
C) Alleviate muscle spasms and pain
D) Prepare the client for surgery
Correct Answer: C) Alleviate muscle spasms and pain
Rationale: Buck's traction is a type of skin traction used to alleviate
muscle spasms and pain, not to reduce the fracture (A). It provides
temporary immobilization (B) and may be used before surgery (D), but
its primary purpose is to reduce muscle spasms and pain. The traction
is applied to the leg using adhesive or foam tape and weights.
Question 5
A client with a fractured femur is in skeletal traction. Which finding
indicates that the traction is effective?
A) The client is able to move freely in bed
B) The client's pain is relieved
, C) The fracture is aligned
D) The client is comfortable
Correct Answer: C) The fracture is aligned
Rationale: The purpose of skeletal traction is to align the fractured
bone ends. Skeletal traction uses pins or wires inserted into the bone
to apply continuous traction. The fracture is aligned when the bone
ends are in proper position for healing. Pain relief (B) and comfort (D)
are secondary benefits. The client should not move freely in bed (A) as
this would disrupt the traction.
Question 6
A client with a fractured tibia is in a long leg cast. The nurse notes that
the client's toes are pale and cold. Which action should the nurse take
first?
A) Apply a heating pad to the foot
B) Elevate the leg
C) Notify the provider
D) Assess the capillary refill
Correct Answer: D) Assess the capillary refill
Rationale: The nurse should first assess the capillary refill to
determine the severity of the circulatory compromise. Pale and cold
toes indicate possible vascular compromise. The nurse should
perform a comprehensive neurovascular assessment (pulses,
sensation, movement, capillary refill, color, temperature). Notifying the
