ATI Medical-Surgical Musculoskeletal Exam
Questions with Correct Answers
(VerifiedAnswers) plus Rationales 2026 Q&A
Instant Download PDF
1. A nurse is assessing a client who sustained a tibial fracture 4
hours ago. Which finding requires immediate intervention?
A. Mild swelling around the fracture
B. Bruising at the injury site
C. Increasing pain that is unrelieved by prescribed analgesics
D. Limited movement of the affected extremity
Rationale: Severe, escalating pain that is disproportionate to the
injury and not relieved by analgesics is an early and important
warning sign of acute compartment syndrome. Increasing tissue
pressure compromises capillary perfusion and can rapidly cause
ischemia, nerve injury, and muscle necrosis. The nurse should
immediately notify the provider and continue frequent
neurovascular assessments.
2. A client with a newly applied fiberglass cast reports severe
itching underneath the cast. Which action should the nurse
recommend?
A. Insert a ruler underneath the cast to scratch the skin
B. Apply powder underneath the cast
,C. Use a cool hair dryer to blow air under the cast
D. Remove the cast temporarily
Rationale: A cool hair dryer can provide relief from itching
without damaging the skin or cast. Objects should never be
inserted beneath a cast because they can cause skin injury,
infection, and pressure-related complications. Heat from a hair
dryer should also be avoided because it can cause burns.
3. A nurse is caring for a client with a lower-leg fracture.
Which assessment finding is most concerning for
compartment syndrome?
A. Mild edema
B. Bruising around the fracture
C. Paresthesia distal to the injury
D. Pain that decreases with elevation
Rationale: Paresthesia indicates impaired nerve function and
can occur as pressure within a compartment compromises
neural and vascular structures. It is a significant neurovascular
warning sign. The nurse should immediately report suspected
compartment syndrome because delayed treatment can result
in permanent tissue damage.
4. Which assessment finding is generally considered an early
manifestation of compartment syndrome?
,A. Pulselessness
B. Paralysis
C. Severe pain with passive movement
D. Complete loss of sensation
Rationale: Severe pain, particularly pain that increases with
passive stretching of the affected muscles, is an early and highly
concerning finding. Pulselessness and paralysis are generally
later manifestations that indicate advanced neurovascular
compromise. Waiting for loss of a pulse can delay treatment
and increase the risk of permanent injury.
5. A client with a femur fracture suddenly develops dyspnea,
confusion, and petechiae on the chest. Which complication
should the nurse suspect?
A. Pulmonary edema
B. Deep-vein thrombosis
C. Fat embolism syndrome
D. Tension pneumothorax
Rationale: Fat embolism syndrome can occur after major long-
bone fractures, particularly femur fractures. Classic
manifestations include respiratory distress, neurologic changes
such as confusion, and a petechial rash. The condition is
potentially life-threatening and requires immediate assessment
and supportive management.
6. Which finding is most characteristic of a fat embolism?
, A. Bradycardia and hypertension
B. Hypoxemia with respiratory distress
C. Unilateral absent breath sounds
D. Severe abdominal tenderness
Rationale: Fat droplets released from injured marrow can enter
the circulation and impair pulmonary function. Hypoxemia,
tachypnea, respiratory distress, neurologic changes, and
petechiae are characteristic findings. Prompt recognition is
important because respiratory compromise can progress
rapidly.
7. A nurse is caring for a client with skeletal traction. Which
action is appropriate?
A. Allow the weights to rest on the floor
B. Remove the weights during repositioning
C. Ensure the weights hang freely
D. Place additional weights on the system when pain increases
Rationale: Traction must provide continuous, prescribed force.
The weights should hang freely and should not rest on the floor
or bed. Nurses should not independently alter the prescribed
amount of traction because doing so can disrupt alignment and
cause additional injury.
8. Which action is appropriate when caring for a client
receiving skeletal traction?
Questions with Correct Answers
(VerifiedAnswers) plus Rationales 2026 Q&A
Instant Download PDF
1. A nurse is assessing a client who sustained a tibial fracture 4
hours ago. Which finding requires immediate intervention?
A. Mild swelling around the fracture
B. Bruising at the injury site
C. Increasing pain that is unrelieved by prescribed analgesics
D. Limited movement of the affected extremity
Rationale: Severe, escalating pain that is disproportionate to the
injury and not relieved by analgesics is an early and important
warning sign of acute compartment syndrome. Increasing tissue
pressure compromises capillary perfusion and can rapidly cause
ischemia, nerve injury, and muscle necrosis. The nurse should
immediately notify the provider and continue frequent
neurovascular assessments.
2. A client with a newly applied fiberglass cast reports severe
itching underneath the cast. Which action should the nurse
recommend?
A. Insert a ruler underneath the cast to scratch the skin
B. Apply powder underneath the cast
,C. Use a cool hair dryer to blow air under the cast
D. Remove the cast temporarily
Rationale: A cool hair dryer can provide relief from itching
without damaging the skin or cast. Objects should never be
inserted beneath a cast because they can cause skin injury,
infection, and pressure-related complications. Heat from a hair
dryer should also be avoided because it can cause burns.
3. A nurse is caring for a client with a lower-leg fracture.
Which assessment finding is most concerning for
compartment syndrome?
A. Mild edema
B. Bruising around the fracture
C. Paresthesia distal to the injury
D. Pain that decreases with elevation
Rationale: Paresthesia indicates impaired nerve function and
can occur as pressure within a compartment compromises
neural and vascular structures. It is a significant neurovascular
warning sign. The nurse should immediately report suspected
compartment syndrome because delayed treatment can result
in permanent tissue damage.
4. Which assessment finding is generally considered an early
manifestation of compartment syndrome?
,A. Pulselessness
B. Paralysis
C. Severe pain with passive movement
D. Complete loss of sensation
Rationale: Severe pain, particularly pain that increases with
passive stretching of the affected muscles, is an early and highly
concerning finding. Pulselessness and paralysis are generally
later manifestations that indicate advanced neurovascular
compromise. Waiting for loss of a pulse can delay treatment
and increase the risk of permanent injury.
5. A client with a femur fracture suddenly develops dyspnea,
confusion, and petechiae on the chest. Which complication
should the nurse suspect?
A. Pulmonary edema
B. Deep-vein thrombosis
C. Fat embolism syndrome
D. Tension pneumothorax
Rationale: Fat embolism syndrome can occur after major long-
bone fractures, particularly femur fractures. Classic
manifestations include respiratory distress, neurologic changes
such as confusion, and a petechial rash. The condition is
potentially life-threatening and requires immediate assessment
and supportive management.
6. Which finding is most characteristic of a fat embolism?
, A. Bradycardia and hypertension
B. Hypoxemia with respiratory distress
C. Unilateral absent breath sounds
D. Severe abdominal tenderness
Rationale: Fat droplets released from injured marrow can enter
the circulation and impair pulmonary function. Hypoxemia,
tachypnea, respiratory distress, neurologic changes, and
petechiae are characteristic findings. Prompt recognition is
important because respiratory compromise can progress
rapidly.
7. A nurse is caring for a client with skeletal traction. Which
action is appropriate?
A. Allow the weights to rest on the floor
B. Remove the weights during repositioning
C. Ensure the weights hang freely
D. Place additional weights on the system when pain increases
Rationale: Traction must provide continuous, prescribed force.
The weights should hang freely and should not rest on the floor
or bed. Nurses should not independently alter the prescribed
amount of traction because doing so can disrupt alignment and
cause additional injury.
8. Which action is appropriate when caring for a client
receiving skeletal traction?
