NCLEX : Musculoskeletal Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #1 : Symptoms And Test For Musculoskeletal Conditions

All of the following are common findings in osteoarthritis except __________.

Possible Answers:

stiffness and pain in affected joints 

bony protuberances of affected joints

symmetrical joint involvement

asymmetrical joint involvement

Correct answer:

symmetrical joint involvement

Explanation:

Osteoarthritis generally presents as asymmetrical joint stiffness and pain, often with bony protuberances (osteophytes) that are either palpable or visible on imaging. Symmetrical joint involvement is more typical in rheumatoid arthritis. Joints will present with signs of inflammation: redness, heat, pain, and swelling, due to the inflammatory nature of this condition.

Example Question #2 : Symptoms And Test For Musculoskeletal Conditions

A positive anterior drawer test of the knee would be indicative of injury to which of the following structures?

Possible Answers:

Medial collateral ligament

Posterior cruciate ligament

Lateral collateral ligament

Anterior cruciate ligament

Correct answer:

Anterior cruciate ligament

Explanation:

The anterior drawer test of the knee checks for injury to or instability of the anterior cruciate ligament. During this test the patient lies supine position with knees bent to 90 degrees. The practitioner sits on the both feet of the subject and places both hands around the upper tibia of the patient's symptomatic leg, then pulls anteriorly on the proximal tibia. A positive finding would be excessive anterior translocation or a soft end-feel, indicating a sprain or tear of the anterior cruciate ligament.

Example Question #1 : Musculoskeletal Condition Follow Up

Lambert-Eaton syndrome is associated with what malignancy?

Possible Answers:

Melanoma

Colon cancer

Gastric carcinoma

Small cell lung cancer

Correct answer:

Small cell lung cancer

Explanation:
Approximately 60% of individuals with Lambert- Eaton syndrome have small cell lung cancer. The onset of Lambert-Eaton symptoms often precedes the detection of the cancer and should be followed up with radiographic imaging of the chest.

Example Question #31 : Musculoskeletal Conditions

A post-menopausal female client presents to the client after being newly diagnosed with osteoporosis. The client is here to discuss with the nurse what type of lifestyle modifications she will need to treat the disease. 

Which of the following should the nurse include when educating the client?

Possible Answers:

Engage in low impact exercises

Lose 10 pounds

Start a low carbohydrate high protein diet

Drink one glass of wine with dinner 

Quit smoking

Correct answer:

Quit smoking

Explanation:

Smoking and alcohol ingestion are risk factors for developing osteopenia or osteoporosis. These activities should be discontinued to help prevent against bone loss. Diet and exercise are important factors, but losing 10 pounds or low impact exercise will not increase bone mass. 

Example Question #2 : Musculoskeletal Condition Follow Up

The nurse cares for a 16-year-old patient in the emergency department. He has returned to the hospital after having a fiberglass cast applied to his right ulna from a fracture the day before. Which of the following manifestations in the patient should most concern the nurse?

Possible Answers:

Severe pain in the right arm

Itching under the cast

Capillary refill of 3 seconds in the right fingertips

Pain in the right shoulder

Warm fingers and palm in the right hand

Correct answer:

Severe pain in the right arm

Explanation:

The nurse should be aware of potential complications of cast placement, such as compartment syndrome, which can cause nervous, vascular, and muscle damage. Signs and symptoms include tingling distal to the cast placement, severe pain in the casted region, swelling in the cast and distal to the casted region, pallor in the affected region, and muscle weakness. These signs and symptoms would indicate immediate cast removal to prevent further damage to the tissue. Itching under the cast is common and expected, and pain in supporting shoulder of the arm can occur due to the increased weight and positioning of the cast. 3 seconds for capillary refill is within normal limits; extended time for capillary refill in the distal region would be concerning. Warmth in the hand and fingers distal for the casted region would indicate normal circulation as well, but congestion and swelling in the extremity would be worrisome.

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