UPGRADED MUSKULOSKELETAL DISORDERS 

PREPARED AND SCREENED BY: PROF.GREYLANDO HISU RN,BSEd,MANc 

A. CARE FOR THE PATIENT WITH MASKULOSKELETAL DISORDERS: 

1. When teaching crutch walking to a client following an internal fixation of a hip fracture, the nurse should 
instruct the client to place weight on: 
A. The axillary region 
B. The upper arms 
C. Palms of the hands 
D. Both lower extremities.  

2. Post- amputation, to control edema of the stump the nurse should: 

A. Keep the stump elevated with one pillow for 1 day. . 
B. Rewrap the elastic bandage as necessary. 
C. Administer the prescribed diuretics. 
D. Restrict the clients oral fluid intake. 

3. Elderly people have high incidence of hip fractures because of: 

 A. Carelessness  
 B. Fragility of bone 
 C. Rheumatoid diseases  
 D. Sedentary existence 

4. Osteoporosis may be caused by: 

 A. Estrogen therapy  
 B. Excess calcium intake 
 C. Hypoparathyroidism  
 D. Prolonged immobility 

5. The nurse should explain to Mrs. Ray that chief reason for applying skin traction such as Buck’s extension is to:
A. Help reduce the fracture and to relieve muscle spasm and pain. 
B. Keep him from turning and moving in bed. 
C. Prevents contractures from developing. 
D. Maintain the limb in a position of external rotation. 

6. Part of the nursing assessment of Mr. ray is assessment of peripheral pulses. The important characteristics when 
assessing the peripheral pulses are: 
A. Contractility and rate. 
B. Color of skin and rhymn 
C. Amplitude and symmetry 
D. Local temperature and visible pulsations. 

7. Which of the following conditions is the primary complication of osteoporosis? 

 A. Pain  
 B. Fractures 
 C. Hardening of the bones  
 D. Increased in bone matrix 

8. A 42 year old woman just had a total hysterectomy. Is she at risk for osteoporosis? 
A. No, because she still has her thyroid gland. 
B. No, because she’s not at risk until she’s older. 
C. Yes, because she’s still producing hormones. 
 D. Yes, because she’s just has surgically induced menopause.
9. A client has been prescribed a diet that limits purine-rich foods. Which of the following foods would the nurse 
teach to avoid eating? 
A. Bananas and dried 
B. Milk, ice cream, and yogurt. 
C. Wine, cheese, and preserved fruits, meats, and vegetables. 
D. Anchovies, sardines, kidneys, sweetbreads and lentils.  

10. A client with gout is encouraged to increase fluid intake. Which of the following statements best explains why 
increased oral fluid intake are encouraged for gout? 
A. Fluid increase calcium absorption. 
B. Fluid decrease inflammation. 
C. Fluids promote the excretion of uric acid. 
D. Fluids provide a cushion for weakened bones. 

11. Which of the following conditions or actions can cause primary osteoarthritis? 
A. Overuse of joints, aging and obesity. 
B. Obesity, diabetes mellitus, aging. 
C. Congenital abnormality, aging, overuse of joints. 
D. Diabetes mellitus, congenital anomaly, aging 

12. Heberden’s nodes are a common sign of osteoarthritis. Which of the following  
 statement is correct about this deformity? 
A. It appears only in men. 
B. It appears on the distal interphalangeal joints. 
C. It appears on the proximal interphalageal joints. 
D. It appears on the dorsolateral aspect of the interphalageal joints.  

13. During the assessment of a client, signs of osteoarthritis are noted. Which of the following assessment findings 
would indicate osteoarthritis? 
A. Elevated sedimentation rate. 
B. Multiple subcutaneous nodules. 
C. Asymmetrical joint involvement. 
D. Signs of inflammation, such as heat, fever, and malaise. 

14. A client uses a cane for assistance in walking. Which of the following statements is true about a cane or other 
assistive devices? 
A. A walker is a better choice than a cane. 
B. The cane should be used on the affected side. 
C. The cane should be used on the unaffected side. 
D. A client with osteoarthritis should be encouraged to ambulate without a cane. 

15. Which of the following characteristics applies to a closed fracture? 

A. Extensive tissue damage. 
B. Increased risk of infection. 
C. Same as for a compound fracture. 
D. Intact skin over the fracture site. 

16. When the fracture line is straight across the bone, the fracture is known as which of the following types?  A.
Linear C. Longitudinal 
B. Oblique D. Transverse 

17. Which of the following type of traction is used for children who weight under 35
lb? A. Bryant’s traction C. Buck’s traction 
B. Pelvic belt D. Russell traction
18. The primary purpose of skeletal traction is to: 
 A. To immobilize the bone. 
B. To prevent muscle spasm. 
C. To relieve contractures. 
D. To prevent breakage of the bone. 

19. The nurse is caring for a client with skeletal traction. It is most important that the nurse monitors which of the 
following? 
A. The pin site for unusual redness, swelling, purulent drainage, and foul odor 
B. The distance between the client’s hip and the traction 
C. The number of times the client exercises the affected limb 
D. How the client is coping with immobilization 

20. Which type of exercise is indicated for clients with rheumatoid arthritis to strengthen the muscles while keeping  the
joints stationary? 
A. Isotonic 
B. Isometric 
C. Range of motion 
D. Flexion-extension 

21. Which of the following manifestations will differentiate osteoarthritis from rheumatoid arthritis?
A. Pain 
B. Limited joint mobility 
C. Joint stiffness 
D. Nodules in the finger joints 

22. One of the elderly residents is confined to bed due to traction for a fractured femur. Which of the following 
situations decreases the effectiveness of the traction? 

A. The ropes are in the wheel grooves of the pulley. 

B. The traction weights hang freely from the bed at all times. 
C. The weights allow movement of client. 
D. The traction weights are removed when repositioning the client. 

23. After the amputation, the client’s stump is snugly bandages throughout the post-operative period. What is the 
main purpose for this intervention? 
A. Facilitate shrinkage of the stump 
B. Prevent bleeding  
C. Enhance circulation in the stump 
D. Protect the stump from injury 

24. Which activity will enable the client to develop muscle strength necessary for the use of crutches?
A. Weight lifting 
B. Squeezing a rubber ball 
C. Flexing and extending the knees 
D. Rotating the arms 

25. A 69 year old client asks the nurse what is the difference Osteoarthritis(OA) and Rheumatoid arthritis (RA).  Which
response is correct ? 
A. OA in a noninflammatory joint disease, RA in characterized by inflamed, swollen joints. B. OA and RA are
very similar. OA affects the smaller joints, and RA affects the larger, weight-bearing joints.” C. OA affects
joints on both sides of the body. RA is usually unilateral. 
D. OA is more common in women. RA is more common in men.  

26. A man who had undergone bilateral above –knee amputation will be discharged home. Which of the following 
statements when made by the patient indicates the need for further teaching?
A. “ When I’m in bed, I will elevate my stump on a pillow.” 
 B. “ I will wear cotton stump socks.” 
C. “ I will wash the stump with warm water and mild soap.” 
D. “When I sit, I will see to it that the stump is extended.” 

27. A client has fiberglass cast on the right arm. Which action should the nurse include in the care plan?
A. Keeping the casted arm warm by covering it with a light blanket. 
B. Avoiding handling the cast for 24 hours or until it is dry. 
C. Evaluating pedal and posterior tibial pulses every 2 weeks. 
D. Assessing movement and sensation in the fingers of the right hand.  

28. The nurse is caring for a client with a newly applied leg cast, which of the following should not be included in  the
care of the cast? 
A. The nurse handles the cast with fingers to avoid denting or disruption of the cast. 
B. The nurse supports the leg cast with a pillow to control swelling. 
C. The nurse teaches the client to report absence of pulse. 
D. The nurse assesses the circulation of the distal part of casted leg. 

29. Which of this is a common example of skeletal traction. 

A. Bryant’s traction C. Buck’s traction 
B. Halo vest D. Russell traction 

30. The type of open fracture that is more than 1 cm is classified as: 
 A. Type 1 C. Type ll  
 B. Type lll D. Type 1V  

31. This type of crutches is use when weight bearing is allowed to both leg and is faster?  A.
2 point gait C. 4 point gait 

 B. 3 point gait D. Swing through  

32. What should be readily available at the bedside to prevent bleeding post-amputation? A.
Tourniquet C. Foot board 
B. Plaster D. Ruler 

33. When using crutches in climbing the stairs what leg is being step first? 
 A. Affected leg C. Both 
 B. Unaffected D. Use the hands  

34. Which of this type of cast dries faster? 

A. Fiberglass cast B. Glassfiber C. Not plaster of Paris D. Made of fiber  

35. When caring for traction which of this intervention needs further teaching? 
a. Maintain proper body alignment. 
b. Check of the circulation of the extremities. 
c. Remove the weight of the traction. 
d. Hang the weight freely.  

36. The nurse is caring for a client with skeletal traction. It is most important that the nurse monitors which of the 
following? 
A. The pin site for unusual redness, swelling, purulent drainage, and foul odor 
B. The distance between the client’s hip and the traction 
C. The number of times the client exercises the affected limb 
D. How the client is coping with immobilization 

37. Which of the following manifestations will differentiate osteoarthritis from rheumatoid arthritis?
A. Pain 
 B. Limited joint mobility 
C. Joint stiffness 
D. Nodules in the finger joints 

38. The nurse is assessing a client with possible osteoarthritis. The most significant risk factor for osteoarthritis
is:  A. Congenital deformity C. Age  
 B. Trauma D. Obesity  

39. The treatment for osteoarthritis commonly includes salicylates. Salicylates can be dangerous in older people 
because they can cause which of the following side effects? 
 A. Hearing loss  
 B. Increased pain in joints. 
 C. Decreased calcium absorption  
 D. Increased bone demineralization 

40. In compartment syndrome, how long would it take for death tissue to occur? 
 A. 2 to 4 hours C. 6 to 8 hours  
 B. 24 hours D. 72 hours 

41. The hemorrhage that occur in compartment syndrome causes which of the following symptoms? a.
Edema  
b. Decrease venous pressure 
c. Increased venous circulation  
d.Increased arterial circulation 

42. After treatment of compartment syndrome, a client reports experiencing parethesia. Which of the following 
symptoms would be seen with paresthesia? 
a. Fever and chills  
b.Change in range of motion 
c. Pain and blanching  
 D. Numbness and tingling 

43. Which of the following characteristics of the fascia can cause it to develop compartment syndrome? a. It’s
highly flexible. 
b. It’s unable to expand. 
c. It’s fragile and weak.  
d.It’s the only tissue within the compartment 

44. Which of the following symptoms is the early sign of compartment syndrome? 
 A. Heat B. Paresthesia C. Skin pallor D. Swelling 

45. A nurse has implemented a plan of care for a client with a C5 spinal cord injury. Which of the following client 
outcomes would indicate effectiveness of the interventions? 
a. Regains bladder and bowel control 
b. Performs activities of daily living independently 
c. Maintains intact skin 
d. Independently transfers self to and from the wheelchair 

46. When transporting a client on a stretcher, the nurse makes certain that the client’s arm do not hang down over  the
edge. By taking this precaution, the nurse prevents injury to the: 
a. Solar plexus B. Celiac plexus C. Basilar plexus D. Brachial plexus 

47. When reading the admission assessment for a patient, the nurse notes that the patient has an excoriated area on  the
skin of the right forearm. Which nursing action will be included in the plan of care? a. Apply moisturizing lotion
to the area
b. Assess the area daily for atrophy 
 c. Scrub the affected area vigorously 
d. Cover the area with a sterile dressing 

48. Which of the following descriptions of touchdown weight bearing is correct? 

a. Full weight bearing on the affected extremity. 
b. 30% to 50% weight bearing on the affected extremity. 
c. No weight on the extremity, but may touch on the floor with it. 
d. No weight on the extremity and keep it elevated at all times. 

49. A patient with a spinal cord injury at level C3-4 is being cared for in the ED. What is the priority assessment? a.
Determine the level at which the patient has intact sensation. 
b. Assess the level at which the patient has retained mobility. 
c. Check blood pressure and pulse for signs of spinal shock. 
d. Monitor respiratory effort and oxygen saturation level. 

50. Nursing management of a client with a pulmonary embolism focuses on which of the following actions?  A.
Assessing oxygen status 
 B. Monitoring the oxygen delivery device 
 C. Monitoring for other sources of clots 
 D. Determining whether the client is able to cough.