1
HESI Exit Exam Musculoskeletal Question
Bank: Fractures, Arthritis & Post-Op Care
Table of Contents
Subtopic 1: Fracture Management and Postoperative Nursing Care................2
Subtopic 2: Arthritis – Types, Assessment, and Pharmacologic Management11
Subtopic 3: Postoperative Complications and Nursing Interventions in
Musculoskeletal Surgery................................................................................20
Subtopic 4: Pediatric and Geriatric Considerations in Fracture and Arthritis
Care...............................................................................................................29
Subtopic 5: Diagnostic Imaging, Labs, and Interpretation in Musculoskeletal
Disorders........................................................................................................39
Subtopic 6: Rehabilitation and Mobility Aids in Fracture & Arthritis Care.......48
Subtopic 7: Pharmacologic and Non-Pharmacologic Pain Management in
Musculoskeletal Disorders..............................................................................57
Subtopic 8: Postoperative Nursing Care in Fracture and Joint Surgery..........67
Subtopic 9: Pediatric and Geriatric Considerations in Fracture & Arthritis Care
.......................................................................................................................76
Subtopic 10: Complications and Emergency Situations in Fracture & Arthritis
Care...............................................................................................................85
, 2
Subtopic 1: Fracture Management and
Postoperative Nursing Care
Question 1
A nurse is caring for a patient who just returned from surgery following an
open reduction and internal fixation (ORIF) of a femoral fracture. Which
assessment requires immediate nursing intervention?
A. Capillary refill less than 2 seconds in toes
B. Absent dorsalis pedis pulse in the affected leg
C. Pain rated at 6/10
D. Mild swelling at the surgical site
Correct Answer: B
Rationale: An absent dorsalis pedis pulse indicates impaired circulation and
may signify compartment syndrome or arterial occlusion, which requires
immediate intervention.
Question 2
Which of the following is the priority nursing action when a patient with a
cast reports increasing pain unrelieved by analgesics?
A. Elevate the extremity
B. Administer additional pain medication
C. Assess for compartment syndrome
D. Reassure the patient that discomfort is expected
Correct Answer: C
, 3
Rationale: Increasing pain unrelieved by medication may indicate
compartment syndrome, a limb-threatening emergency. Prompt assessment
is crucial.
Question 3
A patient with a tibial fracture is placed in Buck’s traction. Which of the
following should the nurse do?
A. Remove the traction weights every 2 hours
B. Place pillows under the leg
C. Ensure weights hang freely and are not on the floor
D. Turn the patient every 30 minutes
Correct Answer: C
Rationale: In Buck's traction, weights must hang freely to maintain proper
alignment and traction force.
Question 4
Which complication is most critical to monitor in a patient with a long bone
fracture?
A. Fatigue
B. Constipation
C. Fat embolism
D. Urinary retention
Correct Answer: C
Rationale: Fat embolism is a serious complication of long bone fractures,
typically occurring within 48 hours post-injury.
, 4
Question 5
A nurse is educating a client with a new plaster cast. Which statement
indicates a need for further teaching?
A. "I will avoid getting the cast wet."
B. "I can use a metal hanger to scratch inside the cast if it itches."
C. "I should report any numbness or tingling in the limb."
D. "I need to keep the cast elevated for the first 48 hours."
Correct Answer: B
Rationale: Inserting objects into a cast can lead to skin injury or infection.
The patient should be educated on safer ways to relieve itching.
Question 6
Which of the following lab results should the nurse expect in a client with a
fractured femur?
A. Decreased serum calcium
B. Increased serum creatine kinase (CK)
C. Elevated white blood cell count
D. Decreased hematocrit
Correct Answer: B
Rationale: CK is often elevated due to muscle injury or breakdown associated
with fractures.
Question 7
HESI Exit Exam Musculoskeletal Question
Bank: Fractures, Arthritis & Post-Op Care
Table of Contents
Subtopic 1: Fracture Management and Postoperative Nursing Care................2
Subtopic 2: Arthritis – Types, Assessment, and Pharmacologic Management11
Subtopic 3: Postoperative Complications and Nursing Interventions in
Musculoskeletal Surgery................................................................................20
Subtopic 4: Pediatric and Geriatric Considerations in Fracture and Arthritis
Care...............................................................................................................29
Subtopic 5: Diagnostic Imaging, Labs, and Interpretation in Musculoskeletal
Disorders........................................................................................................39
Subtopic 6: Rehabilitation and Mobility Aids in Fracture & Arthritis Care.......48
Subtopic 7: Pharmacologic and Non-Pharmacologic Pain Management in
Musculoskeletal Disorders..............................................................................57
Subtopic 8: Postoperative Nursing Care in Fracture and Joint Surgery..........67
Subtopic 9: Pediatric and Geriatric Considerations in Fracture & Arthritis Care
.......................................................................................................................76
Subtopic 10: Complications and Emergency Situations in Fracture & Arthritis
Care...............................................................................................................85
, 2
Subtopic 1: Fracture Management and
Postoperative Nursing Care
Question 1
A nurse is caring for a patient who just returned from surgery following an
open reduction and internal fixation (ORIF) of a femoral fracture. Which
assessment requires immediate nursing intervention?
A. Capillary refill less than 2 seconds in toes
B. Absent dorsalis pedis pulse in the affected leg
C. Pain rated at 6/10
D. Mild swelling at the surgical site
Correct Answer: B
Rationale: An absent dorsalis pedis pulse indicates impaired circulation and
may signify compartment syndrome or arterial occlusion, which requires
immediate intervention.
Question 2
Which of the following is the priority nursing action when a patient with a
cast reports increasing pain unrelieved by analgesics?
A. Elevate the extremity
B. Administer additional pain medication
C. Assess for compartment syndrome
D. Reassure the patient that discomfort is expected
Correct Answer: C
, 3
Rationale: Increasing pain unrelieved by medication may indicate
compartment syndrome, a limb-threatening emergency. Prompt assessment
is crucial.
Question 3
A patient with a tibial fracture is placed in Buck’s traction. Which of the
following should the nurse do?
A. Remove the traction weights every 2 hours
B. Place pillows under the leg
C. Ensure weights hang freely and are not on the floor
D. Turn the patient every 30 minutes
Correct Answer: C
Rationale: In Buck's traction, weights must hang freely to maintain proper
alignment and traction force.
Question 4
Which complication is most critical to monitor in a patient with a long bone
fracture?
A. Fatigue
B. Constipation
C. Fat embolism
D. Urinary retention
Correct Answer: C
Rationale: Fat embolism is a serious complication of long bone fractures,
typically occurring within 48 hours post-injury.
, 4
Question 5
A nurse is educating a client with a new plaster cast. Which statement
indicates a need for further teaching?
A. "I will avoid getting the cast wet."
B. "I can use a metal hanger to scratch inside the cast if it itches."
C. "I should report any numbness or tingling in the limb."
D. "I need to keep the cast elevated for the first 48 hours."
Correct Answer: B
Rationale: Inserting objects into a cast can lead to skin injury or infection.
The patient should be educated on safer ways to relieve itching.
Question 6
Which of the following lab results should the nurse expect in a client with a
fractured femur?
A. Decreased serum calcium
B. Increased serum creatine kinase (CK)
C. Elevated white blood cell count
D. Decreased hematocrit
Correct Answer: B
Rationale: CK is often elevated due to muscle injury or breakdown associated
with fractures.
Question 7
