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Nursing 354 Musculoskeletal Nursing
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Pdf
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1. A nurse is assessing a client with a suspected fracture of the femur. Which
finding requires the nurse's immediate attention?
A. Localized swelling
B. Bruising around the injury
C. Severe pain with movement
D. Absent distal pulse
Answer: D. Absent distal pulse
Rationale: An absent distal pulse suggests impaired arterial circulation and
possible vascular compromise. This is an emergency requiring immediate
assessment and intervention to prevent tissue ischemia.
2. Which assessment finding is most characteristic of compartment
syndrome?
A. Mild swelling relieved by elevation
B. Pain disproportionate to the injury
C. Warm skin with bounding pulses
D. Decreased temperature without pain
,Answer: B. Pain disproportionate to the injury
Rationale: Severe pain that is disproportionate to the injury, especially pain with
passive stretching, is an early and important sign of compartment syndrome.
Prompt treatment is necessary to prevent permanent neurovascular damage.
3. A client has a newly applied plaster cast. Which nursing intervention is
appropriate?
A. Cover the cast with plastic while it dries
B. Use a hair dryer on the hottest setting
C. Handle the cast with the palms of the hands
D. Rest the cast directly on a hard surface
Answer: C. Handle the cast with the palms of the hands
Rationale: A wet plaster cast should be handled with the palms rather than
fingertips because fingertips can create indentations that may cause pressure
injuries.
4. Which finding should a nurse report immediately in a client with a cast?
A. Mild itching beneath the cast
B. Warm toes with normal sensation
C. Slight swelling during the first day
D. Numbness and tingling in the extremity
Answer: D. Numbness and tingling in the extremity
Rationale: Numbness and tingling can indicate neurovascular compromise from
swelling or an overly tight cast and require prompt assessment.
5. Which intervention is most appropriate for reducing edema during the first
24 hours after an orthopedic injury?
A. Apply heat continuously
B. Elevate the affected extremity
C. Massage the injured area vigorously
D. Encourage dependent positioning
,Answer: B. Elevate the affected extremity
Rationale: Elevation above heart level helps reduce edema and promotes venous
return. Cold therapy may also be used when appropriate during the acute phase.
6. A client with a fractured hip is at greatest risk for which complication
related to immobility?
A. Cataracts
B. Deep vein thrombosis
C. Hearing loss
D. Hyperthyroidism
Answer: B. Deep vein thrombosis
Rationale: Hip fractures and prolonged immobility increase venous stasis and
significantly increase the risk for deep vein thrombosis and pulmonary
embolism.
7. Which finding is most concerning in a client with a suspected fat embolism
after a long-bone fracture?
A. Mild localized pain
B. Increased appetite
C. Sudden respiratory distress
D. Increased urine output
Answer: C. Sudden respiratory distress
Rationale: Fat embolism syndrome commonly presents with respiratory distress,
neurologic changes, and a petechial rash. Sudden respiratory deterioration
requires immediate intervention.
8. Which client is at greatest risk for osteoporosis?
A. A young adult who exercises regularly
B. An older adult with prolonged corticosteroid use
C. A middle-aged adult with adequate calcium intake
D. An adolescent with normal growth
, Answer: B. An older adult with prolonged corticosteroid use
Rationale: Advanced age and long-term corticosteroid therapy are major risk
factors for osteoporosis because corticosteroids decrease bone formation and
increase bone resorption.
9. Which nutrient is especially important for maintaining bone health?
A. Calcium
B. Sodium
C. Chloride
D. Fluoride
Answer: A. Calcium
Rationale: Calcium is essential for bone mineralization and skeletal strength.
Adequate calcium intake throughout life helps support bone health.
10.Which activity is most beneficial for maintaining bone density?
A. Prolonged bed rest
B. Weight-bearing exercise
C. Complete avoidance of activity
D. Passive range-of-motion exercises only
Answer: B. Weight-bearing exercise
Rationale: Weight-bearing activities stimulate bone remodeling and help
maintain bone density. Examples include walking and appropriately prescribed
resistance exercises.
11.A client with rheumatoid arthritis asks why morning stiffness occurs. Which
response by the nurse is most accurate?
A. "It results from prolonged muscle contraction during sleep."
B. "Inflammation in the joints tends to be more pronounced after periods of rest."
C. "It is caused by increased calcium deposits in the joints."
D. "It occurs because the joints completely lose their synovial fluid overnight."
Nursing 354 Musculoskeletal Nursing
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
___________________________________________________________________
1. A nurse is assessing a client with a suspected fracture of the femur. Which
finding requires the nurse's immediate attention?
A. Localized swelling
B. Bruising around the injury
C. Severe pain with movement
D. Absent distal pulse
Answer: D. Absent distal pulse
Rationale: An absent distal pulse suggests impaired arterial circulation and
possible vascular compromise. This is an emergency requiring immediate
assessment and intervention to prevent tissue ischemia.
2. Which assessment finding is most characteristic of compartment
syndrome?
A. Mild swelling relieved by elevation
B. Pain disproportionate to the injury
C. Warm skin with bounding pulses
D. Decreased temperature without pain
,Answer: B. Pain disproportionate to the injury
Rationale: Severe pain that is disproportionate to the injury, especially pain with
passive stretching, is an early and important sign of compartment syndrome.
Prompt treatment is necessary to prevent permanent neurovascular damage.
3. A client has a newly applied plaster cast. Which nursing intervention is
appropriate?
A. Cover the cast with plastic while it dries
B. Use a hair dryer on the hottest setting
C. Handle the cast with the palms of the hands
D. Rest the cast directly on a hard surface
Answer: C. Handle the cast with the palms of the hands
Rationale: A wet plaster cast should be handled with the palms rather than
fingertips because fingertips can create indentations that may cause pressure
injuries.
4. Which finding should a nurse report immediately in a client with a cast?
A. Mild itching beneath the cast
B. Warm toes with normal sensation
C. Slight swelling during the first day
D. Numbness and tingling in the extremity
Answer: D. Numbness and tingling in the extremity
Rationale: Numbness and tingling can indicate neurovascular compromise from
swelling or an overly tight cast and require prompt assessment.
5. Which intervention is most appropriate for reducing edema during the first
24 hours after an orthopedic injury?
A. Apply heat continuously
B. Elevate the affected extremity
C. Massage the injured area vigorously
D. Encourage dependent positioning
,Answer: B. Elevate the affected extremity
Rationale: Elevation above heart level helps reduce edema and promotes venous
return. Cold therapy may also be used when appropriate during the acute phase.
6. A client with a fractured hip is at greatest risk for which complication
related to immobility?
A. Cataracts
B. Deep vein thrombosis
C. Hearing loss
D. Hyperthyroidism
Answer: B. Deep vein thrombosis
Rationale: Hip fractures and prolonged immobility increase venous stasis and
significantly increase the risk for deep vein thrombosis and pulmonary
embolism.
7. Which finding is most concerning in a client with a suspected fat embolism
after a long-bone fracture?
A. Mild localized pain
B. Increased appetite
C. Sudden respiratory distress
D. Increased urine output
Answer: C. Sudden respiratory distress
Rationale: Fat embolism syndrome commonly presents with respiratory distress,
neurologic changes, and a petechial rash. Sudden respiratory deterioration
requires immediate intervention.
8. Which client is at greatest risk for osteoporosis?
A. A young adult who exercises regularly
B. An older adult with prolonged corticosteroid use
C. A middle-aged adult with adequate calcium intake
D. An adolescent with normal growth
, Answer: B. An older adult with prolonged corticosteroid use
Rationale: Advanced age and long-term corticosteroid therapy are major risk
factors for osteoporosis because corticosteroids decrease bone formation and
increase bone resorption.
9. Which nutrient is especially important for maintaining bone health?
A. Calcium
B. Sodium
C. Chloride
D. Fluoride
Answer: A. Calcium
Rationale: Calcium is essential for bone mineralization and skeletal strength.
Adequate calcium intake throughout life helps support bone health.
10.Which activity is most beneficial for maintaining bone density?
A. Prolonged bed rest
B. Weight-bearing exercise
C. Complete avoidance of activity
D. Passive range-of-motion exercises only
Answer: B. Weight-bearing exercise
Rationale: Weight-bearing activities stimulate bone remodeling and help
maintain bone density. Examples include walking and appropriately prescribed
resistance exercises.
11.A client with rheumatoid arthritis asks why morning stiffness occurs. Which
response by the nurse is most accurate?
A. "It results from prolonged muscle contraction during sleep."
B. "Inflammation in the joints tends to be more pronounced after periods of rest."
C. "It is caused by increased calcium deposits in the joints."
D. "It occurs because the joints completely lose their synovial fluid overnight."
