Medical-Surgical Nursing: Musculoskeletal
System
Comprehensive Review with Practice Exams and Verified
Answers
Course Code: NURS 3260 | Latest Edition - 2025
SECTION 1: MUSCULOSKELETAL ANATOMY AND
PHYSIOLOGY
Question 1: What type of bone tissue forms the outer layer of bones and provides strength?
A) Cancellous bone
B) Cortical (compact) bone
C) Trabecular bone
D) Spongy bone
Answer: B) Cortical (compact) bone
Rationale: Cortical bone is dense, hard outer layer providing structural support and strength.
Cancellous (trabecular/spongy) bone is the inner porous structure containing bone marrow.
Together they maintain skeletal integrity.
Question 2: Which cells are responsible for bone formation?
A) Osteoclasts
B) Osteoblasts
C) Osteocytes
D) Chondrocytes
Answer: B) Osteoblasts
Rationale: Osteoblasts build bone by synthesizing and depositing new bone matrix.
Osteoclasts resorb (break down) bone. Osteocytes are mature bone cells that maintain bone
tissue. Chondrocytes form cartilage.
Question 3: What is the primary function of synovial fluid?
,A) Transmit nerve impulses
B) Lubricate joints and reduce friction
C) Store calcium
D) Produce blood cells
Answer: B) Lubricate joints and reduce friction
Rationale: Synovial fluid is a viscous fluid in joint cavities that lubricates joints, reduces
friction during movement, provides nutrients to cartilage, and removes waste products.
Produced by the synovial membrane.
Question 4: Which mineral is most abundant in bone tissue?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: C) Calcium
Rationale: Approximately 99% of the body's calcium is stored in bones, providing strength
and rigidity. Bones serve as a calcium reservoir, releasing calcium into blood when needed
for muscle contraction, nerve function, and blood clotting.
Question 5: What type of joint allows the greatest range of motion?
A) Fibrous joint
B) Cartilaginous joint
C) Synovial joint
D) Suture joint
Answer: C) Synovial joint
Rationale: Synovial joints (knee, hip, shoulder, elbow) are freely movable joints containing
synovial fluid. They allow the greatest range of motion. Fibrous joints (skull sutures) are
immovable; cartilaginous joints (vertebrae) allow limited movement.
Question 6: Which muscle type is under voluntary control?
A) Cardiac muscle
B) Smooth muscle
C) Skeletal muscle
D) Visceral muscle
,Answer: C) Skeletal muscle
Rationale: Skeletal muscle is voluntary, striated muscle attached to bones that produces
movement. Cardiac muscle (heart) and smooth muscle (organs, blood vessels) are involuntary
and function automatically.
Question 7: What is the primary function of ligaments?
A) Connect muscle to bone
B) Connect bone to bone
C) Produce synovial fluid
D) Store minerals
Answer: B) Connect bone to bone
Rationale: Ligaments are strong, fibrous connective tissue bands that connect bone to bone,
providing joint stability. Tendons connect muscle to bone, transmitting muscle force to create
movement.
Question 8: Bone remodeling is influenced by which hormone that increases calcium
resorption from bone?
A) Calcitonin
B) Parathyroid hormone (PTH)
C) Growth hormone
D) Thyroxine
Answer: B) Parathyroid hormone (PTH)
Rationale: PTH increases blood calcium by stimulating osteoclasts to resorb bone, releasing
calcium. Calcitonin (from thyroid) decreases blood calcium by inhibiting osteoclasts and
promoting calcium deposition in bone.
Question 9: What is the epiphyseal plate?
A) The bone marrow cavity
B) The growth plate in long bones
C) The outer bone covering
D) The joint surface
Answer: B) The growth plate in long bones
, Rationale: The epiphyseal plate (growth plate) is cartilage near the ends of long bones where
longitudinal growth occurs in children. It ossifies (closes) after puberty, ending bone
lengthening.
Question 10: Which blood test best indicates bone turnover and formation?
A) Complete blood count
B) Serum albumin
C) Alkaline phosphatase (ALP)
D) Blood urea nitrogen
Answer: C) Alkaline phosphatase (ALP)
Rationale: Alkaline phosphatase is an enzyme produced by osteoblasts during bone
formation. Elevated ALP indicates increased bone activity (fracture healing, bone disease,
Paget's disease). Also monitor serum calcium, phosphorus, and vitamin D levels.
SECTION 2: MUSCULOSKELETAL ASSESSMENT
Question 11: When assessing muscle strength, what does a grade of 3/5 indicate?
A) No muscle contraction
B) Muscle can move against gravity but not against resistance
C) Full strength
D) Muscle contraction without joint movement
Answer: B) Muscle can move against gravity but not against resistance
Rationale: Muscle strength grading: 0/5 = no contraction, 1/5 = slight contraction without
movement, 2/5 = movement with gravity eliminated, 3/5 = movement against gravity only,
4/5 = movement against some resistance, 5/5 = full strength against resistance.
Question 12: What assessment finding indicates a positive Tinel's sign?
A) Numbness when neck is flexed
B) Tingling sensation when nerve is tapped
C) Pain with straight leg raise
D) Joint clicking with movement
Answer: B) Tingling sensation when nerve is tapped
System
Comprehensive Review with Practice Exams and Verified
Answers
Course Code: NURS 3260 | Latest Edition - 2025
SECTION 1: MUSCULOSKELETAL ANATOMY AND
PHYSIOLOGY
Question 1: What type of bone tissue forms the outer layer of bones and provides strength?
A) Cancellous bone
B) Cortical (compact) bone
C) Trabecular bone
D) Spongy bone
Answer: B) Cortical (compact) bone
Rationale: Cortical bone is dense, hard outer layer providing structural support and strength.
Cancellous (trabecular/spongy) bone is the inner porous structure containing bone marrow.
Together they maintain skeletal integrity.
Question 2: Which cells are responsible for bone formation?
A) Osteoclasts
B) Osteoblasts
C) Osteocytes
D) Chondrocytes
Answer: B) Osteoblasts
Rationale: Osteoblasts build bone by synthesizing and depositing new bone matrix.
Osteoclasts resorb (break down) bone. Osteocytes are mature bone cells that maintain bone
tissue. Chondrocytes form cartilage.
Question 3: What is the primary function of synovial fluid?
,A) Transmit nerve impulses
B) Lubricate joints and reduce friction
C) Store calcium
D) Produce blood cells
Answer: B) Lubricate joints and reduce friction
Rationale: Synovial fluid is a viscous fluid in joint cavities that lubricates joints, reduces
friction during movement, provides nutrients to cartilage, and removes waste products.
Produced by the synovial membrane.
Question 4: Which mineral is most abundant in bone tissue?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: C) Calcium
Rationale: Approximately 99% of the body's calcium is stored in bones, providing strength
and rigidity. Bones serve as a calcium reservoir, releasing calcium into blood when needed
for muscle contraction, nerve function, and blood clotting.
Question 5: What type of joint allows the greatest range of motion?
A) Fibrous joint
B) Cartilaginous joint
C) Synovial joint
D) Suture joint
Answer: C) Synovial joint
Rationale: Synovial joints (knee, hip, shoulder, elbow) are freely movable joints containing
synovial fluid. They allow the greatest range of motion. Fibrous joints (skull sutures) are
immovable; cartilaginous joints (vertebrae) allow limited movement.
Question 6: Which muscle type is under voluntary control?
A) Cardiac muscle
B) Smooth muscle
C) Skeletal muscle
D) Visceral muscle
,Answer: C) Skeletal muscle
Rationale: Skeletal muscle is voluntary, striated muscle attached to bones that produces
movement. Cardiac muscle (heart) and smooth muscle (organs, blood vessels) are involuntary
and function automatically.
Question 7: What is the primary function of ligaments?
A) Connect muscle to bone
B) Connect bone to bone
C) Produce synovial fluid
D) Store minerals
Answer: B) Connect bone to bone
Rationale: Ligaments are strong, fibrous connective tissue bands that connect bone to bone,
providing joint stability. Tendons connect muscle to bone, transmitting muscle force to create
movement.
Question 8: Bone remodeling is influenced by which hormone that increases calcium
resorption from bone?
A) Calcitonin
B) Parathyroid hormone (PTH)
C) Growth hormone
D) Thyroxine
Answer: B) Parathyroid hormone (PTH)
Rationale: PTH increases blood calcium by stimulating osteoclasts to resorb bone, releasing
calcium. Calcitonin (from thyroid) decreases blood calcium by inhibiting osteoclasts and
promoting calcium deposition in bone.
Question 9: What is the epiphyseal plate?
A) The bone marrow cavity
B) The growth plate in long bones
C) The outer bone covering
D) The joint surface
Answer: B) The growth plate in long bones
, Rationale: The epiphyseal plate (growth plate) is cartilage near the ends of long bones where
longitudinal growth occurs in children. It ossifies (closes) after puberty, ending bone
lengthening.
Question 10: Which blood test best indicates bone turnover and formation?
A) Complete blood count
B) Serum albumin
C) Alkaline phosphatase (ALP)
D) Blood urea nitrogen
Answer: C) Alkaline phosphatase (ALP)
Rationale: Alkaline phosphatase is an enzyme produced by osteoblasts during bone
formation. Elevated ALP indicates increased bone activity (fracture healing, bone disease,
Paget's disease). Also monitor serum calcium, phosphorus, and vitamin D levels.
SECTION 2: MUSCULOSKELETAL ASSESSMENT
Question 11: When assessing muscle strength, what does a grade of 3/5 indicate?
A) No muscle contraction
B) Muscle can move against gravity but not against resistance
C) Full strength
D) Muscle contraction without joint movement
Answer: B) Muscle can move against gravity but not against resistance
Rationale: Muscle strength grading: 0/5 = no contraction, 1/5 = slight contraction without
movement, 2/5 = movement with gravity eliminated, 3/5 = movement against gravity only,
4/5 = movement against some resistance, 5/5 = full strength against resistance.
Question 12: What assessment finding indicates a positive Tinel's sign?
A) Numbness when neck is flexed
B) Tingling sensation when nerve is tapped
C) Pain with straight leg raise
D) Joint clicking with movement
Answer: B) Tingling sensation when nerve is tapped
