NCLEX Nursing Exam Review – Practice Questions and Study Guide

NCLEX-RN: Musculoskeletal N




Practice Questions N N




A nurse is working with a community group promoting healthy aging. What recommendation is
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best to help prevent osteoarthritis (OA)?
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a. Avoid contact sports.
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b. Get plenty of calcium.
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c. Lose weight if needed.
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d. Engage in weight-bearing exercise. - CORRECT ANSWER-c. Lose weight if needed.
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Obesity can lead to OA, and if the client is overweight, losing weight can help prevent OA or
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reduce symptoms once it occurs. Arthritis can be caused by contact sports, but this is less
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common than obesity. Calcium and weight-bearing exercise are both important for
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osteoporosis.
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A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about
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drugs used to treat the disease. For which medication does the nurse plan primary teaching?
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a. Acetaminophen (Tylenol)
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b. Cyclobenzaprine hydrochloride (Flexeril)
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c. Hyaluronate (Hyalgan)
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d. Ibuprofen (Motrin) - CORRECT ANSWER-a. Acetaminophen (Tylenol)
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,All of the drugs are appropriate to treat OA. However, the first-line drug is acetaminophen.
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Cyclobenzaprine is a muscle relaxant given to treat muscle spasms. Hyaluronate is a synthetic
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joint fluid implant. Ibuprofen is a nonsteroidal anti-inflammatory drug.
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The clinic nurse assesses a client with diabetes during a checkup. The client also has
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osteoarthritis (OA). The nurse notes the clients blood glucose readings have been elevated.
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What question by the nurse is most appropriate?
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a. Are you compliant with following the diabetic diet?
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b. Have you been taking glucosamine supplements?
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c. How much exercise do you really get each week?
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d. You're still taking your diabetic medication, right? - CORRECT ANSWER-b. Have you been
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taking glucosamine supplements?
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All of the topics are appropriate for a client whose blood glucose readings have been higher
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than usual. However, since this client also has OA, and glucosamine can increase blood glucose
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levels, the nurse should ask about its use. The other questions all have an element of
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nontherapeutic communication in them. Compliant is a word associated with negative images,
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and the client may deny being noncompliant. Asking how much exercise the client really gets is
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accusatory. Asking if the client takes his or her medications right? is patronizing.
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The nurse working in the orthopedic clinic knows that a client with which factor has an absolute
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contraindication for having a total joint replacement?
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a. Needs multiple dental fillings
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b. Over age 85
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c. Severe osteoporosis
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d. Urinary tract infection - CORRECT ANSWER-c. Severe osteoporosis
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Osteoporosis is a contraindication to joint replacement because the bones have a high risk of
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shattering as the new prosthesis is implanted. The client who needs fillings should have them
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,done prior to the surgery. Age greater than 85 is not an absolute contraindication. A urinary
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tract infection can be treated prior to surgery.
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An older client has returned to the surgical unit after a total hip replacement. The client is
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confused and restless. What intervention by the nurse is most important to prevent injury?
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a. Administer mild sedation.
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b. Keep all four side rails up.
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c. Restrain the clients hands.
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d. Use an abduction pillow. - CORRECT ANSWER-d. Use an abduction pillow.
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Older clients often have trouble metabolizing anesthetics and pain medication, leading to
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confusion or restlessness postoperatively. To prevent the hip from dislocating, the nurse should
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use an abduction pillow since the client cannot follow directions at this time. Sedation may
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worsen the clients mental status and should be avoided. Using all four siderails may be
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considered a restraint. Hand restraints are not necessary in this situation.
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What action by the perioperative nursing staff is most important to prevent surgical wound
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infection in a client having a total joint replacement?
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a. Administer preoperative antibiotic as ordered.
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b. Assess the clients white blood cell count.
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c. Instruct the client to shower the night before.
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d. Monitor the clients temperature postoperatively. - CORRECT ANSWER-a. Administer
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preoperative antibiotic as ordered.
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To prevent surgical wound infection, antibiotics are given preoperatively within an hour of
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surgery. Simply taking a shower will not help prevent infection unless the client is told to use
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, special antimicrobial soap. The other options are processes to monitor for infection, not
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prevent it.
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The nurse on the postoperative inpatient unit assesses a client after a total hip replacement. The
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clients surgical leg is visibly shorter than the other one and the client reports extreme pain.
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While a co-worker calls the surgeon, what action by the nurse is best?
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a. Assess neurovascular status in both legs.
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b. Elevate the affected leg and apply ice.
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c. Prepare to administer pain medication.
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d. Try to place the affected leg in abduction. - CORRECT ANSWER-a. Assess neurovascular status
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in both legs.
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This client has manifestations of hip dislocation, a critical complication of this surgery. Hip
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dislocation can cause neurovascular compromise. The nurse should assess neurovascular status,
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comparing both legs. The nurse should not try to move the extremity to elevate or abduct it.
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Pain medication may be administered if possible, but first the nurse should thoroughly assess
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the client.
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A client has a continuous passive motion (CPM) device after a total knee replacement. What
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action does the nurse delegate to the unlicensed assistive personnel (UAP) after the affected leg
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is placed in the machine while the client is in bed?
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a. Assess the distal circulation in 30 minutes.
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b. Change the settings based on range of motion.
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c. Raise the lower siderail on the affected side.
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d. Remind the client to do quad-setting exercises. - CORRECT ANSWER-c. Raise the lower
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siderail on the affected side.
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