NCLEX - PN Ch.59 - Musculoskeletal System

The nurse is planning to reinforce instructions to the client about how to stand on crutches. In the instructions, the nurse should plan to tell the client to place the crutches in which position? 1. 3 inches to the front and side of the clients toes 2. 8 inches to the front and side of the clients toes 3. 15 inches to the front and side of the clients toes 4. 20 inches to the front and side of the clients toes

8 inches to the front and side of the clients toes

The nurse is caring for the client who has had skeletal traction applied to the left leg. The client is complaining of severe left leg pain. Which action should the nurse take first? 1. Provide pin care 2. Call the health care provider (HCP) 3. Check the clients alignment in bed 4. Medicate the client with an analgesic

Check the clients alignment in bed

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 should plan to perform which action? 1. Try to manually reduce the fracture 2. Assist the person to get up and walk to the sidewalk 3. Leave the person for a few moments to call an ambulance 4. Stay with the person and encourage the person to remain still

Stay with the person and encourage them to remain still

A client is being discharged home after application of a plaster leg cast. The nurse determines that the client understands proper care of the cast if the client makes which statement? 1. "i need to avoid getting the cast wet" 2. "I will use my fingertips to lift and move the leg" 3. "I need to cover the casted leg with warm blankets" 4. "I can use a padded coat hanger end to scratch under the cast"

"I need to avoid getting the cast wet"

The nurse is assigned to care for a client with multiple 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 should perform which intervention? 1. Keep the leg in a level position 2. Elevate the leg for 3 hours, and put it flat for 1 hour 3. Keep the leg level for 3 hours, and elevate for 1 hour 4. Elevate the leg on pillows continuously for 24 to 48 hours

Elevate the leg on pillows continuously for 24 to 48 hours

The nurse is caring for a client with fresh application of a plaster leg cast. The nurse should plan to prevent the development of compartment syndrome by which action? 1. Elevating the limb and applying ice to the affected leg 2. Elevating the limb and covering the limb with bath blankets 3. Keeping the leg horizontal and applying ice to the affected leg 4. Placing the leg in a slightly dependent position and applying ice

Elevating the limb and applying ice to the affected leg

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? 1. Pulling up on the trapeze 2. Flexing and extending the feet 3. Doing quadriceps-setting and gluteal-setting exercises 4. Performing active range of motion (ROM) to the right ankle and knee.

Performing active range of motion (ROM) 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 should plan for which intervention? 1. Massage the skin at the rim of the cast 2. Petaling the cast edges with adhesive tape 3. Using a rough file to smooth the cast edges 4. Applying lotion ot the skin at the rim of the cast

Petaling the cast edges with adhesive tape

The nurse is checking the casted extremity of a client. The nurse should check for which sign of indicative of infection? 1. Dependent edema 2. Diminished distal pulse 3. Presence of a "hot spot" on the cast 4. Coolness and pallor of the extremity

Presence of a "hot spot" on the cast

The nurse witnesses a client sustain a fall and suspects that the clients leg may be fractured. Which action is the priority? 1. Take a set of vital signs 2. Call the radiology department 3. Immobilize the leg before moving the client 4. Reassure the client that everything will be fine

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 elevated the limb, applied an ice bag, and administered an analgesic, which was ineffective in relieving the pain. The nurse interprets that his pain may be caused by which condition? 1. Infection under the cast 2. The anxiety of the client 3. Impaired tissue perfusion 4. The newness of the fracture

Impaired tissue perfusion

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 should 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 4. Expect tingling and numbness in the extremity 5. Use a hair dryer set on a warm to hot setting to dry the cast 6. Use a soft padded object that will fit under the cast to scratch the skin under the cast

Keep the cast and extremity elevated, the cast needs to be kept clean and dry, and allow the wet cast 24 to 48 hours to dry

The nurse is evaluating the clients use of a cane for left-sided weakness. The nurse should intervene and correct the client if the nurse observed that the client performed which action? 1. Holds the cane to the right side 2. Moves the cane when the right leg is moved 3. Leans on the cane when the right leg swings through 4. Keeps the cane 6 inches out to the side of the right foot

Moves the cane when the right leg is moved

A client with a hip fracture asks the nurse why Buck's extension traction is being applied before surgery. The nurses response is based on the understanding that Buck's extension traction has which primary function? 1. Allows bony healing to begin before surgery 2. Provides rigid immobilization of the fracture site 3. Lengthens the fractured leg to prevent severing of blood vessels 4. Provides comfort by reducing muscle spasms and provides fracture immobilization

Provides comfort by reducing muscle spasms and provides fracture immobilization

The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding? 1. Inflammation 2. Serous drainage 3. Pain at a pin site 4. Purulent drainage

Serous drainage