NCLEX PRACTICE FOR MUSCULOSKELETAL
QUESTIONS AND ANSWERS LATEST 2024 VERSION
VERIFIED RATIONALE GRADED A+
10. A pa�ent with a comminuted fracture of the right femur has Buck's trac�on in place while wai�ng for
surgery. To assess for pressure areas on the pa�ent's back and sacral area and to provide skin care, the
nurse should
a.
have the pa�ent li� the butocks by bending and pushing with the le� leg.
b.
turn the pa�ent par�ally to each side with the assistance of another nurse.
c.
place a pillow between the pa�ent's legs and turn gently to each side.
d.
loosen the trac�on and have the pa�ent turn onto the unaffected side. - ansCorrect Answer: A
Ra�onale: The pa�ent can li� the butocks off the bed by using the le� leg without changing the right-leg
alignment. Turning the pa�ent will tend to move the leg out of alignment. Disconnec�ng the trac�on will
interrupt the weight needed to immobilize and align the fracture.
11. A pa�ent in the emergency department is diagnosed with a patellar disloca�on. The ini�al pa�ent
teaching by the nurse will focus on the need for
a.
conscious seda�on.
b.
a knee immobilizer.
c.
gentle knee flexion.
d.
cast applica�on. - ansCorrect Answer: A
Ra�onale: The first goal of collabora�ve management is realignment of the knee to its original anatomic
posi�on, which will require anesthesia or conscious seda�on. Immobiliza�on of the joint will be done
a�er realignment. Later, gentle ROM exercises may be started if the joint is stable. Cas�ng is not usually
required for disloca�ons.
,NCLEX PRACTICE FOR MUSCULOSKELETAL
QUESTIONS AND ANSWERS LATEST 2024 VERSION
VERIFIED RATIONALE GRADED A+
Cogni�ve Level: Applica�on Text Reference: p. 1632
Nursing Process: Implementa�on NCLEX: Physiological Integrity
12. Following a motor-vehicle accident, a pa�ent arrives in the emergency department with massive
right lower-leg swelling. Which ac�on will the nurse take first?
a.
Elevate the leg on pillows.
b.
Apply a compression bandage.
c.
Place ice packs on the lower leg.
d.
Check leg pulses and sensa�on. - ansCorrect Answer: D
Ra�onale: The ini�al ac�on by the nurse will be to assess the circula�on to the leg and to observe for any
evidence of injury such as fractures or disloca�ons. A�er the ini�al assessment, the other ac�ons may be
appropriate based on what is observed during the assessment.
13. Following the applica�on of a hip spica cast for a pa�ent with a fracture of the proximal third of the
le� femur, an appropriate nursing interven�on is to
a.
use the cast support bar to reposi�on the pa�ent every 2 to 3 hours.
b.
ask the pa�ent about any abdominal discomfort or nausea.
c.
discuss the reasons for remaining on bed rest for several weeks.
d.
, NCLEX PRACTICE FOR MUSCULOSKELETAL
QUESTIONS AND ANSWERS LATEST 2024 VERSION
VERIFIED RATIONALE GRADED A+
promote drying of the cast by placing the pa�ent in a prone posi�on every 4 hours. - ansCorrect Answer:
B
Ra�onale: Assessment of bowel tones, abdominal pain, and nausea and vomi�ng will detect the
development of cast syndrome. To avoid breakage, the support bar should not be used for reposi�oning.
A�er the cast dries, the pa�ent can begin ambula�ng with the assistance of physical therapy personnel.
The pa�ent should not be placed in the prone posi�on un�l the cast has dried to avoid breaking the cast.
Cogni�ve Level: Applica�on Text Reference: p. 1640
Nursing Process: Implementa�on NCLEX: Physiological Integrity
22. A�er falling at home, a pa�ent is admited to the emergency department, where x-rays confirm the
presence of an extracapsular fracture of the femur. When assessing the pa�ent, the nurse would expect
to find
a.
bruising of the le� hip and thigh.
b.
numbness in the le� leg and hip.
c.
outward poin�ng toes on the le� leg.
d.
weak or nonpalpable le� leg pulses. - ansCorrect Answer: C
Ra�onale: External rota�on of the leg is a classic sign associated with a hip fracture. Bruising does not
always appear rapidly, and bruising extending to the thigh might indicate hemorrhage. Numbness and
decreased pulses are not typical of a hip fracture unless there is associated �ssue swelling and trauma to
blood vessels.
3. A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing
pain and weakness in the le� hand and elbow. The nurse iden�fies these symptoms as related to
a.
muscle spasms.
QUESTIONS AND ANSWERS LATEST 2024 VERSION
VERIFIED RATIONALE GRADED A+
10. A pa�ent with a comminuted fracture of the right femur has Buck's trac�on in place while wai�ng for
surgery. To assess for pressure areas on the pa�ent's back and sacral area and to provide skin care, the
nurse should
a.
have the pa�ent li� the butocks by bending and pushing with the le� leg.
b.
turn the pa�ent par�ally to each side with the assistance of another nurse.
c.
place a pillow between the pa�ent's legs and turn gently to each side.
d.
loosen the trac�on and have the pa�ent turn onto the unaffected side. - ansCorrect Answer: A
Ra�onale: The pa�ent can li� the butocks off the bed by using the le� leg without changing the right-leg
alignment. Turning the pa�ent will tend to move the leg out of alignment. Disconnec�ng the trac�on will
interrupt the weight needed to immobilize and align the fracture.
11. A pa�ent in the emergency department is diagnosed with a patellar disloca�on. The ini�al pa�ent
teaching by the nurse will focus on the need for
a.
conscious seda�on.
b.
a knee immobilizer.
c.
gentle knee flexion.
d.
cast applica�on. - ansCorrect Answer: A
Ra�onale: The first goal of collabora�ve management is realignment of the knee to its original anatomic
posi�on, which will require anesthesia or conscious seda�on. Immobiliza�on of the joint will be done
a�er realignment. Later, gentle ROM exercises may be started if the joint is stable. Cas�ng is not usually
required for disloca�ons.
,NCLEX PRACTICE FOR MUSCULOSKELETAL
QUESTIONS AND ANSWERS LATEST 2024 VERSION
VERIFIED RATIONALE GRADED A+
Cogni�ve Level: Applica�on Text Reference: p. 1632
Nursing Process: Implementa�on NCLEX: Physiological Integrity
12. Following a motor-vehicle accident, a pa�ent arrives in the emergency department with massive
right lower-leg swelling. Which ac�on will the nurse take first?
a.
Elevate the leg on pillows.
b.
Apply a compression bandage.
c.
Place ice packs on the lower leg.
d.
Check leg pulses and sensa�on. - ansCorrect Answer: D
Ra�onale: The ini�al ac�on by the nurse will be to assess the circula�on to the leg and to observe for any
evidence of injury such as fractures or disloca�ons. A�er the ini�al assessment, the other ac�ons may be
appropriate based on what is observed during the assessment.
13. Following the applica�on of a hip spica cast for a pa�ent with a fracture of the proximal third of the
le� femur, an appropriate nursing interven�on is to
a.
use the cast support bar to reposi�on the pa�ent every 2 to 3 hours.
b.
ask the pa�ent about any abdominal discomfort or nausea.
c.
discuss the reasons for remaining on bed rest for several weeks.
d.
, NCLEX PRACTICE FOR MUSCULOSKELETAL
QUESTIONS AND ANSWERS LATEST 2024 VERSION
VERIFIED RATIONALE GRADED A+
promote drying of the cast by placing the pa�ent in a prone posi�on every 4 hours. - ansCorrect Answer:
B
Ra�onale: Assessment of bowel tones, abdominal pain, and nausea and vomi�ng will detect the
development of cast syndrome. To avoid breakage, the support bar should not be used for reposi�oning.
A�er the cast dries, the pa�ent can begin ambula�ng with the assistance of physical therapy personnel.
The pa�ent should not be placed in the prone posi�on un�l the cast has dried to avoid breaking the cast.
Cogni�ve Level: Applica�on Text Reference: p. 1640
Nursing Process: Implementa�on NCLEX: Physiological Integrity
22. A�er falling at home, a pa�ent is admited to the emergency department, where x-rays confirm the
presence of an extracapsular fracture of the femur. When assessing the pa�ent, the nurse would expect
to find
a.
bruising of the le� hip and thigh.
b.
numbness in the le� leg and hip.
c.
outward poin�ng toes on the le� leg.
d.
weak or nonpalpable le� leg pulses. - ansCorrect Answer: C
Ra�onale: External rota�on of the leg is a classic sign associated with a hip fracture. Bruising does not
always appear rapidly, and bruising extending to the thigh might indicate hemorrhage. Numbness and
decreased pulses are not typical of a hip fracture unless there is associated �ssue swelling and trauma to
blood vessels.
3. A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing
pain and weakness in the le� hand and elbow. The nurse iden�fies these symptoms as related to
a.
muscle spasms.
