Let’s continue this NCLEX Questions series with MusculoSkeletal system NCLEX Reviewdisorders. Get a paper and try answering now!

NCLEX Questions:MusculoSkeletal

1. An elderly woman enters the hospital by ambulance complaining of pain in her right hip. She fell at home about three hours before admission to the hospital. Which observation of her right leg would suggest that she has a fractured hip?
1. Shortened, with external rotation.
2. Shortened, with internal rotation.
3. Equal in length to the nonaffected limb.
4. Abducted, with internal rotation.

2. A hip prosthesis is inserted in an elderly woman following a hip fracture. The nurse should design strategies to prevent the most dreaded complication of implant surgery, which is
1. infection.
2. phlebitis.
3. urinary retention.
4. narcotic addiction.

3. An elderly client returns from the operating room following a total hip replacement. Her IV is running at 150 ml per hour. Her pulse is 100 and full. Her respirations are moist and wheezy. What is the best initial nursing action?
1. Increase the drip rate of the IV.
2. Check electrolytes.
3. Report to the physician.
4. Slow down the IV.

4. The evening of the first postoperative day following a hip replacement the client’s temperature rises. What should the nurse do to confirm the nursing diagnosis of “risk for infection?”
1. Perform a lung assessment.
2. Send a urine sample for culture.
3. Remove the operative dressing.
4. Rotate the affected hip.

5. The nurse instructs a client who has had a hip replacement about proper transfer technique and body positioning. Which action by the client demonstrates understanding?
1. She puts a pillow between her legs.
2. She puts first one leg and then the other on the floor when arising.
3. She keeps her legs in a dependent position.
4. She sits straight up in a low chair.

6. A client who has had a hip replacement is receiving discharge instructions regarding home activities. Which statement by the client indicates a need for more teaching?
1. “I will not sit for more than an hour.”
2. “I will stand, walk and stretch frequently.”
3. “I will not cross my legs.”
4. “It is all right for me to tie my own shoes.”

7. A 48-year-old woman is admitted for a right total hip replacement. She has had rheumatoid arthritis for twenty years. What should be included in the preoperative teaching for this client?
1. Isometric exercises of the quadriceps and gluteal muscles.
2. Instructions on the necessity for keeping the right hip adducted after surgery.
3. The need to flex the involved hip postoperatively to maintain mobility.
4. Taking aspirin every 4 hours for 5 days before the surgery.

8. Three days after a total hip replacement the nurse is assessing the client. Which observation is most significant?
1. Pain in the operative site.
2. Swelling in the operative site.
3. Pain and tenderness in the calf.
4. Orthostatic hypotension.

9. Which of the following nursing measures would it be essential for the nurse to perform within the first eight hours after a plaster cast is applied to the right foot?
1. Elevate the right foot on pillows.
2. Pull the stockinet over the edge of the cast and tape it down.
3. Use a hair dryer to assist with the drying process.
4. Move the client in bed by placing hands securely around the cast.

10. Which observation by the nurse indicates a plaster cast is dry?
The cast
1. has a dull cast to it.
2. appears shiny.
3. is cool to the touch.
4. has small hairline breaks in it.

11. A young man was injured in a motorcycle accident yesterday. As a treatment for his fractured right femur, Kirschner wires were inserted and he was placed in balanced skeletal traction. In identifying the major reason that skeletal traction was applied to his fracture rather than skin traction the nurse understands that
1. skeletal traction does not allow for rotation of bone.
2. skin traction has more force for reducing the fracture, but it is harder to maintain the leg in alignment.
3. skin traction does not allow for flexion contractures to be pulled out.
4. skeletal traction can be maintained for longer periods of time enabling the fracture to heal.

12. Which nursing actions should be carried out for a client with a fractured right femur who is in balanced skeletal traction?
1. Place him on flat bedrest to keep the traction in place.
2. Keep the right leg flat on the bed so the traction can be more effective.
3. Hold the weights up when he is moved up in bed to prevent additional pull on the fracture site.
4. Maintain the weights so they hang freely and do not touch the bed.

13. The nurse is caring for a client in balanced skeletal traction following a right femur fracture. Which of the following clinical manifestations indicates that a complication has occurred and the physician should be notified?
1. The toes blanch when pinched.
2. The client is able to dorsiflex his right foot.
3. The client feels tingling in his right foot.
4. The toes on the right foot are warm to the touch.

14. The nurse is teaching an adolescent crutch walking. He has just had a fractured right ankle casted. The nurse knows the patient understands teaching about crutch walking when the patient is observed doing which of the following?
1. He moves the right crutch forward, then the left foot, then the left crutch followed by the right foot.
2. He stands with full weight on the left foot and moves the crutches forward. Then he puts weight on the crutches and hops forward.
3. He moves the left crutch and the right foot at the same time followed by the right crutch and the left foot.
4. He moves the right crutch and the right foot at the same time followed by moving the left crutch and the left foot simultaneously.

15. The nurse is instructing a parent how to reduce the likelihood her child will develop Lyme disease. What should be included in the discussion?
1. Remove standing water in places such as flowerpots and old tires.
2. Dress your child in long sleeves and long pants when she is outside in tall grass or wooded areas.
3. Have your child wear dark colored clothing when playing outside on the grass.
4. Keep your children indoors during July and August.

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