Musculoskeletal System Final Exam
MedSurg Exam I Questions with
Rationales 2026-2027 Updated.
1. A client is having a myelography. What action by the nurse is most important?
a. Assess serum aspartate aminotransferase (AST) levels.
b. Ensure that informed consent is on the chart.
c. Position the client flat after the procedure.
d. Reinforce the dressing if it becomes saturated - Answer ANS: B This diagnostic procedure is
invasive and requires informed consent. The AST does not need to be assessed prior to the
procedure. The client is positioned with the head of the bed elevated after the test to keep the
contrast material out of the brain. The dressing should not become saturated; if it does, the
nurse calls the provider.
2. A client is undergoing computed tomography (CT) of a joint. What action by the nurse is most
important before the test?
a. Administer sedation as prescribed.
b. Assess for seafood or iodine allergy.
c. Ensure that the client has no metal on the body.
d. Provide preprocedure pain medication - Answer ANS: B Because CT uses iodine-based
contrast material, the nurse assesses the client for allergies to iodine or seafood (which often
contains iodine). The other actions are not needed
3. A client had an arthroscopy 1 hour ago on the left knee. The nurse finds the left lower leg to
be pale and cool, with 1+/4+ pedal pulses. What action by the nurse is best?
a. Assess the neurovascular status of the right leg.
b. Document the findings in the clients chart.
c. Elevate the left leg on at least two pillows.
d. Notify the provider of the findings immediately - Answer ANS: A The nurse should compare
findings of the two legs as these findings may be normal for the client. If a difference is
observed, the nurse notifies the provider. Documentation should occur after the nurse has all
the data. Elevating the left leg will not improve perfusion if there is a problem.
4. A hospitalized clients strength of the upper extremities is rated at 3. What does the nurse
understand about this clients ability to perform activities of daily living (ADLs)?
a. The client is able to perform ADLs but not lift some items.
b. No difficulties are expected with ADLs.
c. The client is unable to perform ADLs alone.
,d. The client would need near-total assistance with ADLs - Answer ANS: A This rating indicates
fair muscle strength with full range of motion against gravity but not resistance. The client could
complete ADLs independently unless they required lifting objects.
5. A client is distressed at body changes related to kyphosis. What response by the nurse is
best?
a. Ask the client to explain more about these feelings.
b. Explain that these changes are irreversible.
c. Offer to help select clothes to hide the deformity.
d. Tell the client safety is more important than looks. - Answer ANS: A Assessment is the first
step of the nursing process, and the nurse should begin by getting as much information about
the clients feelings as possible. Explaining that the changes are irreversible discounts the clients
feelings. Depending on the extent of the deformity, clothing will not hide it. While safety is more
objectively important than looks, the client is worried about looks and the nurse needs to
address this issue.
6. The nurse knows that hematopoiesis occurs in what part of the musculoskeletal system? a.
Cancellous tissue b. Collagen matrix c. Red marrow d. Yellow marrow - Answer ANS: C
Hematopoiesis occurs in the red marrow, which is part of the cancellous tissues containing both
types of bone marrow
7. A nurse is providing community education about preventing traumatic musculoskeletal
injuries related to car crashes. Which group does the nurse target as the priority for this
education? a. High school football team b. High school homeroom class c. Middle-aged men d.
Older adult women - Answer ANS: A Young men are at highest risk for musculoskeletal injury
due to trauma, especially due to motor vehicle crashes. The high school football team, with its
roster of young males, is the priority group.
8. A school nurse is conducting scoliosis screening. In screening the client, what technique is
most appropriate? a. Bending forward from the hips b. Sitting upright with arms outstretched c.
Walking across the room and back d. Walking with both eyes closed - Answer ANS: A To assess
for scoliosis, a spinal deformity, the student should bend forward at the hips. Standing behind
the student, the nurse looks for a lateral curve in the spine. The other actions are not correct
9. The clients chart indicates genu varum. What does the nurse understand this to mean? a.
Bow-legged b. Fluid accumulation c. Knock-kneed d. Spinal curvature - Answer ANS: A Genu
varum is a bow-legged deformity. A fluid accumulation is an effusion. Genu valgum is knock-
kneed. A spinal curvature could be kyphosis or lordosis.
10. The nurse is assessing four clients with musculoskeletal disorders. The nurse should assess
the client with which laboratory result first? a. Serum alkaline phosphatase (ALP): 108 units/L b.
Serum aspartate aminotransferase (AST): 26 units/L c. Serum calcium: 10.2 mg/dL d. Serum
phosphorus: 2 mg/dL - Answer ANS: D A normal serum phosphorus level is 3 to 4.5 mg/dL; a
, level of 2 mg/dL is low, and this client should be assessed first. The values for serum ALP, AST,
and calcium are all within normal ranges.
1. A nursing student studying the musculoskeletal system learns about important related
hormones. What information does the student learn? (Select all that apply.) a. A lack of vitamin
D can lead to rickets. b. Calcitonin increases serum calcium levels. c. Estrogens stimulate
osteoblastic activity. d. Parathyroid hormone stimulates osteoclastic activity. e. Thyroxine
stimulates estrogen release. - Answer ANS: A, C, D Vitamin D is needed to absorb calcium and
phosphorus. A deficiency of vitamin D can lead to rickets. Estrogen stimulates osteoblastic
activity. Parathyroid hormone stimulates osteoclastic activity. Calcitonin decreases serum
calcium levels when they get too high. Thyroxine increases the rate of protein synthesis in all
tissue types.
2. A student nurse learns about changes that occur to the musculoskeletal system due to aging.
Which changes does this include? (Select all that apply.) a. Bone changes lead to potential safety
risks. b. Increased bone density leads to stiffness. c. Osteoarthritis occurs due to cartilage
degeneration. d. Osteoporosis is a universal occurrence. e. Some muscle tissue atrophy occurs
with aging - Answer ANS: A, C, E Many age-related changes occur in the musculoskeletal
system, including decreased bone density, degeneration of cartilage, and some degree of
muscle tissue atrophy. Osteoporosis, while common, is not universal. Bone density decreases
with age, not increases
3. An older clients serum calcium level is 8.7 mg/dL. What possible etiologies does the nurse
consider for this result? (Select all that apply.) a. Good dietary intake of calcium and vitamin D b.
Normal age-related decrease in serum calcium c. Possible occurrence of osteoporosis or
osteomalacia d. Potential for metastatic cancer or Pagets disease e. Recent bone fracture in a
healing stage - Answer ANS: B, C This slightly low calcium level could be an age-related
decrease in serum calcium or could indicate a metabolic bone disease such as osteoporosis or
osteomalacia. A good dietary intake would be expected to produce normal values. Metastatic
cancer, Pagets disease, or healing bone fractures will elevate calcium
4. When assessing gait, what features does the nurse inspect? (Select all that apply.) a. Balance
b. Ease of stride c. Goniometer readings d. Length of stride e. Steadiness - Answer ANS: A, B,
D, E To assess gait, look at balance, ease and length of stride, and steadiness. Goniometer
readings assess flexion and extension or joint range of motion.
1. A client has a bone density score of 2.8. What action by the nurse is best? a. Asking the client
to complete a food diary b. Planning to teach about bisphosphonates c. Scheduling another
scan in 2 years d. Scheduling another scan in 6 months - Answer ANS: B A T-score from a bone
density scan at or lower than 2.5 indicates osteoporosis. The nurse should plan to teach about
medications used to treat this disease. One class of such medications is bisphosphonates. A
food diary is helpful to determine if the client gets adequate calcium and vitamin D, but at this
point, dietary changes will not prevent the disease. Simply scheduling another scan will not help
treat the disease either.
MedSurg Exam I Questions with
Rationales 2026-2027 Updated.
1. A client is having a myelography. What action by the nurse is most important?
a. Assess serum aspartate aminotransferase (AST) levels.
b. Ensure that informed consent is on the chart.
c. Position the client flat after the procedure.
d. Reinforce the dressing if it becomes saturated - Answer ANS: B This diagnostic procedure is
invasive and requires informed consent. The AST does not need to be assessed prior to the
procedure. The client is positioned with the head of the bed elevated after the test to keep the
contrast material out of the brain. The dressing should not become saturated; if it does, the
nurse calls the provider.
2. A client is undergoing computed tomography (CT) of a joint. What action by the nurse is most
important before the test?
a. Administer sedation as prescribed.
b. Assess for seafood or iodine allergy.
c. Ensure that the client has no metal on the body.
d. Provide preprocedure pain medication - Answer ANS: B Because CT uses iodine-based
contrast material, the nurse assesses the client for allergies to iodine or seafood (which often
contains iodine). The other actions are not needed
3. A client had an arthroscopy 1 hour ago on the left knee. The nurse finds the left lower leg to
be pale and cool, with 1+/4+ pedal pulses. What action by the nurse is best?
a. Assess the neurovascular status of the right leg.
b. Document the findings in the clients chart.
c. Elevate the left leg on at least two pillows.
d. Notify the provider of the findings immediately - Answer ANS: A The nurse should compare
findings of the two legs as these findings may be normal for the client. If a difference is
observed, the nurse notifies the provider. Documentation should occur after the nurse has all
the data. Elevating the left leg will not improve perfusion if there is a problem.
4. A hospitalized clients strength of the upper extremities is rated at 3. What does the nurse
understand about this clients ability to perform activities of daily living (ADLs)?
a. The client is able to perform ADLs but not lift some items.
b. No difficulties are expected with ADLs.
c. The client is unable to perform ADLs alone.
,d. The client would need near-total assistance with ADLs - Answer ANS: A This rating indicates
fair muscle strength with full range of motion against gravity but not resistance. The client could
complete ADLs independently unless they required lifting objects.
5. A client is distressed at body changes related to kyphosis. What response by the nurse is
best?
a. Ask the client to explain more about these feelings.
b. Explain that these changes are irreversible.
c. Offer to help select clothes to hide the deformity.
d. Tell the client safety is more important than looks. - Answer ANS: A Assessment is the first
step of the nursing process, and the nurse should begin by getting as much information about
the clients feelings as possible. Explaining that the changes are irreversible discounts the clients
feelings. Depending on the extent of the deformity, clothing will not hide it. While safety is more
objectively important than looks, the client is worried about looks and the nurse needs to
address this issue.
6. The nurse knows that hematopoiesis occurs in what part of the musculoskeletal system? a.
Cancellous tissue b. Collagen matrix c. Red marrow d. Yellow marrow - Answer ANS: C
Hematopoiesis occurs in the red marrow, which is part of the cancellous tissues containing both
types of bone marrow
7. A nurse is providing community education about preventing traumatic musculoskeletal
injuries related to car crashes. Which group does the nurse target as the priority for this
education? a. High school football team b. High school homeroom class c. Middle-aged men d.
Older adult women - Answer ANS: A Young men are at highest risk for musculoskeletal injury
due to trauma, especially due to motor vehicle crashes. The high school football team, with its
roster of young males, is the priority group.
8. A school nurse is conducting scoliosis screening. In screening the client, what technique is
most appropriate? a. Bending forward from the hips b. Sitting upright with arms outstretched c.
Walking across the room and back d. Walking with both eyes closed - Answer ANS: A To assess
for scoliosis, a spinal deformity, the student should bend forward at the hips. Standing behind
the student, the nurse looks for a lateral curve in the spine. The other actions are not correct
9. The clients chart indicates genu varum. What does the nurse understand this to mean? a.
Bow-legged b. Fluid accumulation c. Knock-kneed d. Spinal curvature - Answer ANS: A Genu
varum is a bow-legged deformity. A fluid accumulation is an effusion. Genu valgum is knock-
kneed. A spinal curvature could be kyphosis or lordosis.
10. The nurse is assessing four clients with musculoskeletal disorders. The nurse should assess
the client with which laboratory result first? a. Serum alkaline phosphatase (ALP): 108 units/L b.
Serum aspartate aminotransferase (AST): 26 units/L c. Serum calcium: 10.2 mg/dL d. Serum
phosphorus: 2 mg/dL - Answer ANS: D A normal serum phosphorus level is 3 to 4.5 mg/dL; a
, level of 2 mg/dL is low, and this client should be assessed first. The values for serum ALP, AST,
and calcium are all within normal ranges.
1. A nursing student studying the musculoskeletal system learns about important related
hormones. What information does the student learn? (Select all that apply.) a. A lack of vitamin
D can lead to rickets. b. Calcitonin increases serum calcium levels. c. Estrogens stimulate
osteoblastic activity. d. Parathyroid hormone stimulates osteoclastic activity. e. Thyroxine
stimulates estrogen release. - Answer ANS: A, C, D Vitamin D is needed to absorb calcium and
phosphorus. A deficiency of vitamin D can lead to rickets. Estrogen stimulates osteoblastic
activity. Parathyroid hormone stimulates osteoclastic activity. Calcitonin decreases serum
calcium levels when they get too high. Thyroxine increases the rate of protein synthesis in all
tissue types.
2. A student nurse learns about changes that occur to the musculoskeletal system due to aging.
Which changes does this include? (Select all that apply.) a. Bone changes lead to potential safety
risks. b. Increased bone density leads to stiffness. c. Osteoarthritis occurs due to cartilage
degeneration. d. Osteoporosis is a universal occurrence. e. Some muscle tissue atrophy occurs
with aging - Answer ANS: A, C, E Many age-related changes occur in the musculoskeletal
system, including decreased bone density, degeneration of cartilage, and some degree of
muscle tissue atrophy. Osteoporosis, while common, is not universal. Bone density decreases
with age, not increases
3. An older clients serum calcium level is 8.7 mg/dL. What possible etiologies does the nurse
consider for this result? (Select all that apply.) a. Good dietary intake of calcium and vitamin D b.
Normal age-related decrease in serum calcium c. Possible occurrence of osteoporosis or
osteomalacia d. Potential for metastatic cancer or Pagets disease e. Recent bone fracture in a
healing stage - Answer ANS: B, C This slightly low calcium level could be an age-related
decrease in serum calcium or could indicate a metabolic bone disease such as osteoporosis or
osteomalacia. A good dietary intake would be expected to produce normal values. Metastatic
cancer, Pagets disease, or healing bone fractures will elevate calcium
4. When assessing gait, what features does the nurse inspect? (Select all that apply.) a. Balance
b. Ease of stride c. Goniometer readings d. Length of stride e. Steadiness - Answer ANS: A, B,
D, E To assess gait, look at balance, ease and length of stride, and steadiness. Goniometer
readings assess flexion and extension or joint range of motion.
1. A client has a bone density score of 2.8. What action by the nurse is best? a. Asking the client
to complete a food diary b. Planning to teach about bisphosphonates c. Scheduling another
scan in 2 years d. Scheduling another scan in 6 months - Answer ANS: B A T-score from a bone
density scan at or lower than 2.5 indicates osteoporosis. The nurse should plan to teach about
medications used to treat this disease. One class of such medications is bisphosphonates. A
food diary is helpful to determine if the client gets adequate calcium and vitamin D, but at this
point, dietary changes will not prevent the disease. Simply scheduling another scan will not help
treat the disease either.
