NCLEX RN Musculoskeletal Disorders
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with a fractured femur suddenly develops dyspnea, chest pain, and
confusion. Which complication should the nurse suspect?
A. Pneumonia
B. Fat embolism syndrome
C. Pulmonary edema
D. Tension pneumothorax
Answer: Fat embolism syndrome
Rationale: Fat embolism syndrome can occur after long-bone fractures.
Classic manifestations include respiratory distress, neurologic changes, and a
petechial rash.
2. Which assessment finding is most concerning in a client with a newly
applied cast?
A. Mild itching under the cast
B. Warm toes with brisk capillary refill
C. Severe pain unrelieved by prescribed analgesics
D. Mild swelling during the first 24 hours
Answer: Severe pain unrelieved by prescribed analgesics
Rationale: Severe, escalating pain that is disproportionate to the injury and
unrelieved by analgesics may indicate compartment syndrome, a limb-
threatening emergency.
3. A nurse is assessing a client for compartment syndrome. Which finding is
an early indicator?
A. Paralysis
B. Pulselessness
C. Severe pain with passive movement
D. Complete loss of sensation
Answer: Severe pain with passive movement
,Rationale: Pain out of proportion to the injury and pain with passive
stretching are early signs of compartment syndrome. Pulselessness and
paralysis are late findings.
4. Which intervention is appropriate for a client with a plaster cast?
A. Cover the cast with plastic during drying
B. Use a hair dryer on the hot setting
C. Handle the cast with the palms of the hands
D. Insert objects under the cast to relieve itching
Answer: Handle the cast with the palms of the hands
Rationale: Plaster casts should be handled with the palms rather than
fingertips to prevent indentations that can create pressure areas.
5. A client with a cast reports numbness and tingling in the affected
extremity. What should the nurse do first?
A. Elevate the extremity above the heart
B. Document the finding as expected
C. Notify the healthcare provider immediately
D. Apply ice directly over the cast
Answer: Notify the healthcare provider immediately
Rationale: New numbness and tingling may indicate impaired circulation or
nerve compression and requires prompt evaluation.
6. Which finding indicates adequate neurovascular status after orthopedic
surgery?
A. Absent pulse
B. Cool, pale extremity
C. Capillary refill of 2 seconds
D. Increasing numbness
Answer: Capillary refill of 2 seconds
Rationale: Capillary refill of approximately 2 seconds, warmth, normal color,
palpable pulses, and intact sensation indicate adequate peripheral perfusion.
7. A client has skeletal traction applied for a femoral fracture. Which nursing
intervention 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 the weights on the bed
Answer: Ensure the weights hang freely
, Rationale: Traction must remain continuous and the weights should hang
freely to maintain the prescribed force and alignment.
8. Which action should the nurse take when caring for a client in skeletal
traction?
A. Remove the traction weights every 4 hours
B. Assess the pin sites regularly
C. Place lotion around the pin sites
D. Cover the weights with blankets
Answer: Assess the pin sites regularly
Rationale: Skeletal traction uses pins inserted into bone, creating a risk for
infection. Pin sites require regular assessment according to facility protocol.
9. Which finding suggests a pin-site infection in a client receiving skeletal
traction?
A. Clear, minimal drainage
B. Mild tenderness immediately after insertion
C. Purulent drainage and increasing redness
D. Intact skin without drainage
Answer: Purulent drainage and increasing redness
Rationale: Purulent drainage, erythema, warmth, swelling, and increasing
pain are signs of possible pin-site infection.
10. A client has a hip replacement. Which movement should the nurse
instruct the client to avoid?
A. Keeping the legs slightly abducted
B. Using an elevated toilet seat
C. Crossing the legs
D. Sitting in a firm chair
Answer: Crossing the legs
Rationale: After total hip replacement, crossing the legs can cause hip
adduction and increase the risk of prosthetic dislocation.
11. Which position is generally appropriate after total hip arthroplasty?
A. Hip flexed greater than 90 degrees
B. Legs crossed at the knees
C. Operative leg maintained in abduction
D. Operative leg internally rotated
Answer: Operative leg maintained in abduction
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with a fractured femur suddenly develops dyspnea, chest pain, and
confusion. Which complication should the nurse suspect?
A. Pneumonia
B. Fat embolism syndrome
C. Pulmonary edema
D. Tension pneumothorax
Answer: Fat embolism syndrome
Rationale: Fat embolism syndrome can occur after long-bone fractures.
Classic manifestations include respiratory distress, neurologic changes, and a
petechial rash.
2. Which assessment finding is most concerning in a client with a newly
applied cast?
A. Mild itching under the cast
B. Warm toes with brisk capillary refill
C. Severe pain unrelieved by prescribed analgesics
D. Mild swelling during the first 24 hours
Answer: Severe pain unrelieved by prescribed analgesics
Rationale: Severe, escalating pain that is disproportionate to the injury and
unrelieved by analgesics may indicate compartment syndrome, a limb-
threatening emergency.
3. A nurse is assessing a client for compartment syndrome. Which finding is
an early indicator?
A. Paralysis
B. Pulselessness
C. Severe pain with passive movement
D. Complete loss of sensation
Answer: Severe pain with passive movement
,Rationale: Pain out of proportion to the injury and pain with passive
stretching are early signs of compartment syndrome. Pulselessness and
paralysis are late findings.
4. Which intervention is appropriate for a client with a plaster cast?
A. Cover the cast with plastic during drying
B. Use a hair dryer on the hot setting
C. Handle the cast with the palms of the hands
D. Insert objects under the cast to relieve itching
Answer: Handle the cast with the palms of the hands
Rationale: Plaster casts should be handled with the palms rather than
fingertips to prevent indentations that can create pressure areas.
5. A client with a cast reports numbness and tingling in the affected
extremity. What should the nurse do first?
A. Elevate the extremity above the heart
B. Document the finding as expected
C. Notify the healthcare provider immediately
D. Apply ice directly over the cast
Answer: Notify the healthcare provider immediately
Rationale: New numbness and tingling may indicate impaired circulation or
nerve compression and requires prompt evaluation.
6. Which finding indicates adequate neurovascular status after orthopedic
surgery?
A. Absent pulse
B. Cool, pale extremity
C. Capillary refill of 2 seconds
D. Increasing numbness
Answer: Capillary refill of 2 seconds
Rationale: Capillary refill of approximately 2 seconds, warmth, normal color,
palpable pulses, and intact sensation indicate adequate peripheral perfusion.
7. A client has skeletal traction applied for a femoral fracture. Which nursing
intervention 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 the weights on the bed
Answer: Ensure the weights hang freely
, Rationale: Traction must remain continuous and the weights should hang
freely to maintain the prescribed force and alignment.
8. Which action should the nurse take when caring for a client in skeletal
traction?
A. Remove the traction weights every 4 hours
B. Assess the pin sites regularly
C. Place lotion around the pin sites
D. Cover the weights with blankets
Answer: Assess the pin sites regularly
Rationale: Skeletal traction uses pins inserted into bone, creating a risk for
infection. Pin sites require regular assessment according to facility protocol.
9. Which finding suggests a pin-site infection in a client receiving skeletal
traction?
A. Clear, minimal drainage
B. Mild tenderness immediately after insertion
C. Purulent drainage and increasing redness
D. Intact skin without drainage
Answer: Purulent drainage and increasing redness
Rationale: Purulent drainage, erythema, warmth, swelling, and increasing
pain are signs of possible pin-site infection.
10. A client has a hip replacement. Which movement should the nurse
instruct the client to avoid?
A. Keeping the legs slightly abducted
B. Using an elevated toilet seat
C. Crossing the legs
D. Sitting in a firm chair
Answer: Crossing the legs
Rationale: After total hip replacement, crossing the legs can cause hip
adduction and increase the risk of prosthetic dislocation.
11. Which position is generally appropriate after total hip arthroplasty?
A. Hip flexed greater than 90 degrees
B. Legs crossed at the knees
C. Operative leg maintained in abduction
D. Operative leg internally rotated
Answer: Operative leg maintained in abduction
