Musculoskeletal NCLEX Questions (76-80)

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76. The nurse is assessing the client who has just been measured and fitted for crutches. The nurse determines that the client's crutches are fitted correctly if:

a) the top of the crutch is even with the axilla
b) the elbow is straight when the hands is on the handgrip
c) the client's axilla is resting on the crutch pad during ambulation
d) the elbow is at a 30-degree angle when the hand is on the handgrip

77. The nurse is assigned to care for a client who is in traction. The nurse ensures a safe environment for the client by:

a) making sure that the knots are at the pulleys
b) checking the weights to be sure that they are off the floor
c) making sure that the head of the bed is kept at a 90-degree angle
d) monitor the weights to be sure that they are resting on a firm surface

78. Musculoskeletal NCLEX Questions  about a client with a possible rib fracture who has never had a chest x-ray. The nurse plans to tell the client which of the following about the procedure?

a) the x-ray stimulates a small amount of pain
b) the client will be asked to breathe in and out continuously during the x-ray
c) the x-ray technologist will stand next to the client during the x-ray
d) it is necessary to remove jewelry and any other metal objects from the chest area

79. The nurse has an order to get the client out of bed to a chair on the first postoperative day following total knee replacement. The nurse plans to do which of the following to protect the knee joint?

a) apply a compression dressing and put ice on the knee while sitting
b) obtain a walker to minimize weigh-bearing by the client on the affected leg
c) lift the client to the bedside chair, leaving the continuous passive motion (CPM) machine
d) apply a knee immobilizer before getting the client up and elevate the client's surgical leg while sitting

80. The nurse is conducting a health screening clinic for osteoporosis. The nurse determines that which client seen in the clinic is at the greatest risk of developing this disorder?

a) a 25-year old female who jogs
b) a 36-year old male who has asthma
c) a 70-year old male who consumes excess alcohol
d) a sedentary 65-year old female who smokes cigarettes





Musculoskeletal NCLEX Questions
Answers and Rationale

76) D

- For optimal upper extremity leverage, the elbow should be at approximately 30 degrees of flexion when the hand is resting on the handgrip. The top of the crutch needs to be two to three finger widths lower than the axilla. When crutch walking, all weight needs to be on the hands to prevent nerve palsy from pressure on the axilla.

77) B

- To achieve proper traction, weights need to be free-hanging, with knots kept away from the pulleys. Weights are not to be kept resting on a firm surface. The head of the bed is usually kept low to provide countertraction.

78) D

- Musculoskeletal NCLEX Questions Rationale - An x-ray is a photographic image of a part of the body on a special film, which is used to diagnose a wide variety of conditions. Any radiopaque objects such as jewelry or other metal must be removed from the chest area because they will interfere with the interpretation of the results. The x-ray is painless, and any discomfort would arise from repositioning a painful part for filming. The nurse may premedicate a client, if prescribed, who is at risk for pain. The client is asked to breathe in deeply and then hold the breath while the chest x-ray is taken. To minimize the risk of radiation exposure, the x-ray technologist stands in a separate area protected by a lead wall. The client also wears a lead shield over the reproductive organs.

79) D

- The nurse assists the client to get out of bed on the first postoperative day after putting a knee immobilizer on the affected joint to provide stability. The surgeon orders the weight-bearing limits on the affected leg. The leg is elevated while the client is sitting in the chair to minimize edema. Ice is not used unless prescribed. A compression dressing should already be in place on the wound. A CPM machine is used only while the client is in bed.

80) D

- Risk factors for osteoporosis include being female, postmenopausal status, advanced age, low-calcium diet, excessive alcohol intake, sedentary lifestyle, and cigarette smoking. The long-term use of corticosteroids, anticonvulsants, and furosemide (Lasix) also increase the risk.


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Musculoskeletal NCLEX Questions (1-8)