ATI Medical-Surgical Musculoskeletal Exam
Questions with Correct Answers (Verified
Answers) plus Rationales 2026 Q&A Instant
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1. A nurse is assessing a client who has a suspected fracture of
the lower leg. Which finding requires the nurse's immediate
attention?
A. Localized swelling
B. Pain rated 7/10
C. Bruising around the injury
D. Absent pedal pulse distal to the injury
Rationale: An absent distal pulse can indicate compromised
arterial circulation and possible neurovascular impairment. The
nurse should immediately assess circulation, sensation,
movement, and other neurovascular findings and notify the
provider promptly. Pain, swelling, and bruising are common
manifestations of fractures but are generally less immediately
threatening than loss of distal circulation.
2. A nurse is caring for a client with a newly applied cast.
Which assessment finding should the nurse report
immediately?
,A. Mild itching beneath the cast
B. Warm skin around the cast edges
C. Increasing pain unrelieved by prescribed analgesics
D. Mild swelling during the first several hours
Rationale: Increasing, severe, or unrelieved pain beneath a cast
can indicate compartment syndrome or impaired circulation.
Compartment syndrome is a limb-threatening emergency
because increasing tissue pressure can compromise blood flow
and nerve function. Mild itching, warmth, and some initial
swelling can occur after cast application.
3. A client with a cast reports severe pain and numbness in the
affected extremity. Which complication should the nurse
suspect?
A. Osteoporosis
B. Osteoarthritis
C. Compartment syndrome
D. Rheumatoid arthritis
Rationale: Severe pain that is disproportionate to the injury,
especially when accompanied by paresthesia or numbness, is
concerning for compartment syndrome. Increasing pressure
within a closed fascial compartment can impair nerves and
blood vessels. Prompt recognition and intervention are essential
to prevent permanent tissue damage.
,4. Which intervention is appropriate for a client who has a
new plaster cast?
A. Apply a heating pad over the cast.
B. Cover the cast with plastic until completely dry.
C. Handle the cast with the palms of the hands while it dries.
D. Place the casted extremity below heart level.
Rationale: A wet plaster cast should be handled with the palms
rather than the fingertips because fingertips can create
indentations that may cause pressure points against the skin.
The extremity should generally be elevated as prescribed to
reduce swelling. Direct heat can cause uneven drying and may
burn the client's skin.
5. A nurse is teaching a client how to use crutches. Which
instruction should the nurse include?
A. Place body weight on the axillae when walking.
B. Keep the elbows completely straight while using crutches.
C. Support body weight with the hands and arms rather than
the axillae.
D. Position the crutch tips directly against the feet.
Rationale: Weight should be supported through the hands and
arms rather than the axillae. Excessive pressure on the axillae
can compress nerves and blood vessels and may result in
brachial plexus injury. Properly fitted crutches should allow
space between the axillae and the top of the crutch.
, 6. A client is prescribed alendronate for osteoporosis. Which
statement indicates correct understanding of the medication?
A. “I will take it immediately before going to bed.”
B. “I will take it with a glass of milk.”
C. “I will take it with plain water and remain upright
afterward.”
D. “I will crush the tablet and mix it with food.”
Rationale: Alendronate can irritate the esophagus, so it should
be taken with a full glass of plain water according to the
prescribed administration schedule, and the client should
remain upright afterward. Taking it with milk, food, or other
beverages can decrease absorption. The medication should not
be taken immediately before lying down.
7. Which client is at greatest risk for osteoporosis?
A. A 25-year-old who exercises regularly
B. A 35-year-old who consumes adequate calcium
C. A 45-year-old with no significant medical history
D. A postmenopausal older adult with low calcium intake and
limited physical activity
Rationale: Advanced age, postmenopausal estrogen reduction,
inadequate calcium intake, and physical inactivity are important
risk factors for osteoporosis. Weight-bearing exercise and
adequate calcium and vitamin D intake help support bone
Questions with Correct Answers (Verified
Answers) plus Rationales 2026 Q&A Instant
Download PDF
1. A nurse is assessing a client who has a suspected fracture of
the lower leg. Which finding requires the nurse's immediate
attention?
A. Localized swelling
B. Pain rated 7/10
C. Bruising around the injury
D. Absent pedal pulse distal to the injury
Rationale: An absent distal pulse can indicate compromised
arterial circulation and possible neurovascular impairment. The
nurse should immediately assess circulation, sensation,
movement, and other neurovascular findings and notify the
provider promptly. Pain, swelling, and bruising are common
manifestations of fractures but are generally less immediately
threatening than loss of distal circulation.
2. A nurse is caring for a client with a newly applied cast.
Which assessment finding should the nurse report
immediately?
,A. Mild itching beneath the cast
B. Warm skin around the cast edges
C. Increasing pain unrelieved by prescribed analgesics
D. Mild swelling during the first several hours
Rationale: Increasing, severe, or unrelieved pain beneath a cast
can indicate compartment syndrome or impaired circulation.
Compartment syndrome is a limb-threatening emergency
because increasing tissue pressure can compromise blood flow
and nerve function. Mild itching, warmth, and some initial
swelling can occur after cast application.
3. A client with a cast reports severe pain and numbness in the
affected extremity. Which complication should the nurse
suspect?
A. Osteoporosis
B. Osteoarthritis
C. Compartment syndrome
D. Rheumatoid arthritis
Rationale: Severe pain that is disproportionate to the injury,
especially when accompanied by paresthesia or numbness, is
concerning for compartment syndrome. Increasing pressure
within a closed fascial compartment can impair nerves and
blood vessels. Prompt recognition and intervention are essential
to prevent permanent tissue damage.
,4. Which intervention is appropriate for a client who has a
new plaster cast?
A. Apply a heating pad over the cast.
B. Cover the cast with plastic until completely dry.
C. Handle the cast with the palms of the hands while it dries.
D. Place the casted extremity below heart level.
Rationale: A wet plaster cast should be handled with the palms
rather than the fingertips because fingertips can create
indentations that may cause pressure points against the skin.
The extremity should generally be elevated as prescribed to
reduce swelling. Direct heat can cause uneven drying and may
burn the client's skin.
5. A nurse is teaching a client how to use crutches. Which
instruction should the nurse include?
A. Place body weight on the axillae when walking.
B. Keep the elbows completely straight while using crutches.
C. Support body weight with the hands and arms rather than
the axillae.
D. Position the crutch tips directly against the feet.
Rationale: Weight should be supported through the hands and
arms rather than the axillae. Excessive pressure on the axillae
can compress nerves and blood vessels and may result in
brachial plexus injury. Properly fitted crutches should allow
space between the axillae and the top of the crutch.
, 6. A client is prescribed alendronate for osteoporosis. Which
statement indicates correct understanding of the medication?
A. “I will take it immediately before going to bed.”
B. “I will take it with a glass of milk.”
C. “I will take it with plain water and remain upright
afterward.”
D. “I will crush the tablet and mix it with food.”
Rationale: Alendronate can irritate the esophagus, so it should
be taken with a full glass of plain water according to the
prescribed administration schedule, and the client should
remain upright afterward. Taking it with milk, food, or other
beverages can decrease absorption. The medication should not
be taken immediately before lying down.
7. Which client is at greatest risk for osteoporosis?
A. A 25-year-old who exercises regularly
B. A 35-year-old who consumes adequate calcium
C. A 45-year-old with no significant medical history
D. A postmenopausal older adult with low calcium intake and
limited physical activity
Rationale: Advanced age, postmenopausal estrogen reduction,
inadequate calcium intake, and physical inactivity are important
risk factors for osteoporosis. Weight-bearing exercise and
adequate calcium and vitamin D intake help support bone
