Musculoskeletal NCLEX questions

A client is being discharged after application of a plaster leg cast. The nurse determines that the client understands proper care of the cast of the client makes which statement?

" I need to avoid getting the cast wet"

The nurse is caring for the client who has had skele- stal traction applied to the left leg . The client is com- plaining of severe left leg pain . Which action would the nurse take first ?

Check the client's alignment in bed

The nurse is caring for a client with a fresh application of a plaster leg cast. The nurse would plan to prevent the development of compartment syndrome by which action?

Elevating the limb and applying ice to the affected leg

A client with acute muscle spasms has been taking baclofen. The client caused the clinic nurse because of a continuous feeling of weakness and fatigue, and ask the nurse about discontinuing the medication. The nurse would make which appropriate response to the client?

"Weakness and fatigue commonly occur will diminish with continued medication use."

The nurse is preparing a list of cast care instructions for a client who just had a plaster cast applied to his right forearm Which instructions would the nurse include on the list ? Select all that apply .

1. Keep the cast and extremity elevated 2. The cast needs to be kept clean and dry 3. Allow the wet cast 24 to 72 hours to dry

During the monitoring of a clients response to disease, modifying anti-rheumatic drugs, which findings with the nurse interpret as acceptable responses? Select all that apply.

1. Symptom control during periods of emotional stress. 2. Normal white blood cell, platelet, and neutrophil count counts. 3. Radiological findings that show non-progression of joint degeneration. 4. An increased range of motion in the affected joints three months into therapy.

The nurse is planning to reinforce instructions to the client about how to stand on crutches . In the instructions , the nurse would plan to tell the client to place the crutches in which position ?

8 inches to the front and side of the client's toes

Dantrolene sodium is prescribed for a client experiencing flexor spasms, and the client asked the nurse about the action of the medication. The nurse responds knowing that which is the therapeutic action of this medication?

Ask directly on the skeletal muscle to relieve spasticity

The nurse is reinforcing discharge instructions to a client receiving baclofen. Which were the nurse include in the instructions?

Avoid the use of alcohol.

The nurse is monitoring a client receiving baclofen for side effects related to the medication. Which would indicate that the client is experiencing a side effect?

Drowsiness

The nurse is assigned to care for a client with mul- tiple traumas who is admitted to the hospital . The client has a leg fracture , and a plaster cast has been applied . In positioning the casted leg , the nurse would perform which intervention ?

Elevate the leg on pillows continuously for 24 to 48 hours

Cyclobenzaprine is prescribed for a client to treat muscle spasms and the nurse is reviewing the clients records. Which disorder would indicate a need to contact the PCP regarding the administration of this medication?

Glaucoma

The nurse witnesses a client sustain a fall and suspects that the client's leg may be fractured . Which action is the priority ?

Immobilize the leg before moving the client

A client has sustained a closed fracture and has just had a cast applied to the affected arm . The client is complaining of intense pain . The nurse has elevat- ed the limb , applied an ice bag , and administered an analgesic , which was ineffective in relieving the pain . The nurse interprets that this pain may be caused by which condition ?

Impaired tissue perfusion

The nurse is reviewing the laboratory studies on a client receiving dantrolene sodium. Which laboratory test would identify an adverse effect associated with the administration of this medication?

Liver function test

The nurse is evaluating the clients use of a cane for left-sided weakness. The nurse would intervene and correct the client if the nurse observed that the client performed which action?

Moves the cane when the right leg is moved

The nurse has provided instructions regarding specific leg exercises for the client immobilized in right skeletal lower leg traction . The nurse determines that the client needs further teaching if the nurse observes the client doing which activity ?

Performing active ROM exercises to the right ankle and knee

A client is complaining of skin irritation from the edges of a cast applied the previous day . The nurse would plan for which intervention ?

Petaling the cast edges with adhesive tape

The nurse is checking the casted extremity of a client . The nurse needs to check for which sign indicative of infection ?

Presence of a " hot spot " on the cast

A client with a hip fracture asks the nurse why Buck's extension traction is being applied before surgery . The nurse's response is based on the under- standing that Buck's extension traction has which primary function ?

Provides comfort by reducing muscle spasms and provides fracture immobilization

The nurse is reviewing the record of a client who has been prescribed baclofen. Which disorder would alert the nurse to contact the PCP?

Seizure disorder

The nurse is evaluating the pin sites of a client in skeletal traction . The nurse would be least concerned with which finding ?

Serous drainage

The nurse is one of several people who witness a vehicle hit a pedestrian at a fairly low speed on a small street . The individual is dazed and tries to get up , and the leg appears fractured . The nurse would plan to perform which action ?

Stay with the person and encourage the person to remain still .

Alendronate is prescribed for a client with osteoporosis and the nurse is providing instructions for the administration of the medication. Which instruction would the nurse reinforce?

Take the medication with a full glass of water after rising in the morning

The client has been taking medication for rheumatoid arthritis for three weeks. During the administration of etanercept, it is most important for the nurse to collect which data?

The white blood cell and platelet counts