NCLEX Review Questions Musculoskeletal System (6-10)

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6. The nurse is teaching a  client who is preparing for discharge from the hospital after a total hip replacement. Which statement by the client would indicate the need for further instructions?

a) I cannot drive a car for probably 6 weeks
b) I should not sit in one position for more than 4 hours
c) I need to wear a support stocking on an unaffected leg
d) I need to place a pillow between my knees when I lie down

7. The nurse has given the client with a nonplaster (fiberglass) leg cast instructions regarding cast care at home. The nurse determines that the client needs further instructions if the client makes which statement?

a) I should avoid walking on wet, slippery floors
b) I'm not supposed to scratch the skin underneath the cast
c) It's all right to wipe dirt off of the top of the cast with a  damp cloth
d) if the cast gets wet, I can dry it with a dryer turned to the hot setting

8. The nurse is planning to teach a client with a below-the-knee amputation about skin care to prevent breakdown. Which of the following points should the nurse include in the teaching plan?

a)  a stump sock must be worn at all times and changed twice a week
b) the socket of the prosthesis must be dried carefully before it is used
c) the residual limb (stump) is washed gently and dried every other day
d) the socket of the prosthesis needs to be washed with a strong bactericidal agent daily

9. The nurse is teaching a client how to stand on crutches. The nurse tells the client to place the crutches:

a)  3 inches to the front and side of the toes
b) 8 inches to the front and side of the toes
c) 15 inches to the front and side of the toes
d) 20 inches to the front and side of the toes

10. A client with a compound (open)  fracture of the radius has a plaster cast applied in the emergency department. The nurse provides home-care instructions and tells the client to seek medical attention if which of the following occurs?

a) numbness and tingling are felt in the fingers
b) the cast feels heavy and damp after 24 hours of application
c) the entire cast feels warm during the first 24 hours after application
d) bloody drainage is noted in the cast during the first 6 hours after application





NCLEX Review Questions Musculoskeletal System
Answers and Rationale

6) B
- The client needs to be instructed to not sit continuously for more than 1 hour. The client should be instructed to stand, stretch, and take a few steps periodically. The client cannot drive a car for 6 weeks after surgery unless allowed to do so by a physician. A support stocking should be worn on the unaffected leg, and an Ace bandage usually is prescribed to be placed on the affected leg until there is no swelling in the legs and feet and until full activities are resumed. The legs are abducted by placing a pillow between them when the client lies down.

7) D
- If the cast gets wet, it can be dried with a hair dryer set to a cool setting. The client is instructed to avoid walking on wet, slippery floors to prevent falls. If the skin under the cast itches, cool air from a hair dryer may be used to relieve it. The client should never scratch under the cast because of the risk of skin breakdown and infection. Surface soil on a cast may be removed with a damp cloth.

8) B
- The socket of the prosthesis is cleansed with a mild detergent, rinsed, and dried carefully each day. A strong bactericidal agent would not be used. A stump sock must be worn at all times to absorb perspiration, and it is changed daily. The residual limb (stump) is washed, dried, and inspected for breakdown twice each day.

9) B
- The classic tripod position is taught to the client before instructions regarding gait are given. The crutches are placed anywhere from 6 to 10 inches in front of and to the side of the client's toes, depending on the client's body size. This provides a wide enough base of support for the client and improves balance.

10) A
- A limb encased in a cast is at risk for nerve damage and diminished circulation from increased pressure caused by edema. Signs of increased pressure from the cast include numbness, tingling, and increased pain. A cast can take up to 48 hours to dry and generates heat while drying. Some drainage may occur initially with a compound (open) fracture.


After you reviewed your answers through its rationale, you can go to the next page to continue your review: 

NCLEX Review Questions Musculoskeletal System (11-15)


Or go back to the first page:

NCLEX Review Questions Musculoskeletal System (1-5)

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