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muscoloskeletal disorders, Cheat Sheet of Nursing

University of Massachusetts - AmherstNursing

nursing med surg muscoloskeletal

Typology: Cheat Sheet

2024/2025

Uploaded on 05/09/2025

brianna-cuddy
brianna-cuddy 🇺🇸

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Extra credit for NUR1002 (Med Surg Prof D. Eccles
spring 2021, MDC)
150 Questions on The Musculoskeletal System
1. When counseling an older patient about ways to prevent fractures, which
information will the nurse include?
Ans: Buying shoes that provide good support and are comfortable to wear is
recommended.
2. A patient is seen at the urgent care center after falling on the right arm and
shoulder. It will be most important for the nurse to determine:
Ans: whether the right arm is shorter than the left.
3. A checkout clerk in a grocery store has muscle and tendon tears that have
become inflamed, causing pain and weakness in the left hand and elbow. The
nurse identifies these symptoms as related to:
Ans: repetitive strain injury.
4. When working with a patient whose job involves many hours of word
processing, the nurse will teach the patient about the need:
Ans: obtain a keyboard pad to support the wrist while word processing.
5. A patient arrives in the emergency department with ankle swelling and
severe pain after twisting the ankle playing soccer. All of the following
orders are written by the health care provider. Which one will the nurse act
on first?
Ans: Wrap the ankle and apply an ice pack.
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Partial preview of the text

Download muscoloskeletal disorders and more Cheat Sheet Nursing in PDF only on Docsity!

Extra credit for NUR1002 (Med Surg Prof D. Eccles

spring 2021, MDC)

150 Questions on The Musculoskeletal System

  1. When counseling an older patient about ways to prevent fractures, which information will the nurse include? Ans: Buying shoes that provide good support and are comfortable to wear is recommended.
  2. A patient is seen at the urgent care center after falling on the right arm and shoulder. It will be most important for the nurse to determine: Ans: whether the right arm is shorter than the left.
  3. A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing pain and weakness in the left hand and elbow. The nurse identifies these symptoms as related to: Ans: repetitive strain injury.
  4. When working with a patient whose job involves many hours of word processing, the nurse will teach the patient about the need: Ans: obtain a keyboard pad to support the wrist while word processing.
  5. A patient arrives in the emergency department with ankle swelling and severe pain after twisting the ankle playing soccer. All of the following orders are written by the health care provider. Which one will the nurse act on first? Ans: Wrap the ankle and apply an ice pack.
  1. Following x-rays of an injured wrist, the patient is informed that it is badly sprained. In teaching the patient to care for the injury, the nurse tells the patient to: Ans: use pillows to keep the arm elevated above the heart.
  2. A 22-year-old patient started an exercise regimen 2 months ago that includes running 3 to 4 miles a day. The patient tells the nurse, "I enjoy my daily runs, but now I have shin splints." Which response by the nurse is appropriate? Ans: You may be increasing your running time too quickly and need to cut back a little bit."
  3. A 20-year-old baseball pitcher has an arthroscopic repair of a rotator cuff injury performed in same-day surgery. When the nurse plans postoperative teaching for the patient, which information will be included? Ans: You have an appointment with a physical therapist for tomorrow.
  4. A patient with a fractured radius asks when the cast can be removed. The nurse will instruct the patient that the cast can be removed only after the bone: Ans: is strong enough to stand mild stress.
  5. A patient with a comminuted fracture of the right femur has Buck's traction in place while waiting for surgery. To assess for pressure areas on the patient's back and sacral area and to provide skin care, the nurse should: Ans: have the patient lift the buttocks by bending and pushing with the left leg.
  6. A patient in the emergency department is diagnosed with a patellar dislocation. The initial patient teaching by the nurse will focus on the need for: Ans: conscious sedation.

that the patient is prepared to ambulate independently with the crutches on observing that the patient: Ans: advances the right leg and both crutches together and then advance the left leg.

  1. A patient with comminuted fractures of the tibia and fibula is treated with open reduction and application of an external fixator. The next day, the patient complains of severe pain in the leg, which is unrelieved by ordered analgesics. The patient's toes are pink, but the patient complains of numbness and tingling. The most appropriate action by the nurse is to: Ans: notify the patient's health care provider.
  2. A patient with a fractured pelvis is initially treated with bed rest with no turning from side to side permitted. The second day after admission, the patient develops chest pain, tachypnea, and tachycardia. The nurse determines that the patient's symptoms are most likely related to fat embolism when assessment of the patient reveals: Ans: pinpoint red areas on the upper chest. 21.The health care provider initially orders bed rest for a patient with an open- book pelvic fracture. Which assessment data obtained by the nurse are most important to report to the health care provider? Ans: The bowel sounds are absent.
  3. After falling at home, a patient is admitted to the emergency department, where x-rays confirm the presence of an extracapsular fracture of the femur. When assessing the patient, the nurse would expect to find: Ans: outward pointing toes on the left leg.
  1. A patient with an intracapsular fracture of the left femur is placed in Buck's traction before surgery for a hip replacement. The patient asks why traction is necessary when surgery is planned. The nurse's response to the patient is based on the knowledge that traction: Ans: will decrease the incidence of painful muscle spasms
  2. A patient with lower-leg fractures has an external fixation device in place and is scheduled for discharge. Which information will the nurse include in the discharge teaching? Ans: You will need to assess and clean the pin insertion sites daily. 25.When getting a patient from the bed into the chair for the first time since having an ORIF of a hip fracture, the nurse should: Ans: assist the patient to use a walker with partial weight bearing to assist in transfer to the chair.
  3. A patient is admitted with facial injuries after a bicycle accident and has a repair of a fractured mandible. When doing postoperative teaching, the nurse will include information about: Ans: when the patient may need to cut the immobilizing wires.
  4. A patient who has severe peripheral arterial disease and ischemic foot ulcers is upset with the health care provider's recommendation to have an above- the-knee amputation. The patient tells the nurse, "If they want to cut off my leg, they should just shoot me instead." The most appropriate response to the patient's statement is: Ans: Let's talk about how you feel this surgery will affect you
  5. On the first postoperative day, a patient with a below-the-knee amputation complains of pain in the amputated limb. An appropriate action by the nurse is to: Ans: administer prescribed opioids to relieve the pain.

Ans: Call the health care provider for increased swelling or numbness.

  1. A patient who has a proximal humerus fracture that is immobilized with a left-sided long-arm cast, and a sling is admitted to the medical-surgical unit. Which nursing intervention will be included in the plan of care? Ans: Assess the left axilla and change absorbent dressings as needed.
  2. A patient who has been hospitalized for 3 days with a hip fracture and Buck's traction has sudden onset shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first? Ans: Administer oxygen at 4 L/min by a nasal cannula.
  3. All these medications are ordered at 9:00 AM for a patient who has had a right-hip replacement the previous day and is scheduled to ambulate with the physical therapist for the first time at 9:45. Which medication should be given first? Ans: Oxycodone (Roxicodone) 5 mg PO 39.The nurse observes a patient doing all these activities after having a hip- replacement surgery. Which patient action requires that the nurse intervene immediately? Ans: The patient leans over to pull shoes and socks on.
  4. Based on the nurse's understanding of the physiology of bone and cartilage, the injury that the nurse would expect to heal most rapidly is a: Ans: fracture of the mid humerus.
  5. The nurse is assessing the passive range of motion of a patient's shoulder. The patient complains of pain during circumduction when the nurse moves the arm behind the patient. Which question should the nurse ask?

Ans: Do you have difficulty in putting on a jacket?

  1. When the health care provider tells a patient that the pain in the patient's knee is caused by bursitis, the patient asks the nurse to explain just what bursitis is. The nurse's best response would be to tell the patient bursitis is an inflammation of: Ans: a small, fluid-filled sac found at many joints
  2. During assessment of the musculoskeletal system of a 74-year-old woman, the nurse notes that the patient has lost 1 inch in height since the previous visit two years ago. The nurse will plan to teach the patient about: Ans: dual-energy x-ray absorptiometry (DEXA).
  3. When taking a patient history during assessment of the musculoskeletal system, the nurse identifies an increased risk for the patient who reports: Ans: that a parent became much shorter with aging.
  4. Which information obtained during the nurse's assessment of the patient's nutritional-metabolic pattern may indicate the risk for musculoskeletal problems? Ans: The patient is 5 ft 2 in and weighs 180 lb.
  5. When the nurse is assessing a new patient in the clinic, which information about the patient's medications will be of most concern? Ans: The patient has severe asthma and requires frequent therapy with steroids.
  6. While testing the patient's muscle strength, the nurse finds that the patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light resistance. The nurse should document the patient's muscle strength as level:
  1. A 54-year-old patient is about to have a bone scan. In teaching the patient about this procedure, the nurse should include what information? Ans: The patient will be asked to drink increased fluids after the procedure
  2. Musculoskeletal assessment is an important component of care for patients on what type of long-term therapy? Ans: Corticosteroids
  3. A female patient with a long-standing history of rheumatoid arthritis has sought care because of increasing stiffness in her right knee that has culminated in complete fixation of the joint. The nurse would document the presence of which problem? Ans: Ankylosis
  4. The nurse is performing a musculoskeletal assessment of an 81-year-old female patient whose mobility has been progressively decreasing in recent months. How should the nurse best assess the patient's range of motion (ROM) in the affected leg? Ans: Observe the patient's unassisted ROM in the affected leg.
  5. In reviewing bone remodeling, what should the nurse know about the involvement of bone cells? Ans: Osteoblast deposit new bone.
  6. When working with patients, the nurse knows that patients have the most difficulties with diarthrodial joints. Which joints are included in this group of joints (select all that apply)? Ans: a) Hinge joint of the knee b) Ball and socket joint of the shoulder or hip 60.An 82-year-old patient is frustrated by her flabby belly and rigid hips. What should the nurse tell the patient about these frustrations? Ans: Decreased muscle mass and strength and increased hip rigidity are normal changes of aging
  1. The nurse is conducting health screening for osteoporosis. Which client is at greatest risk of developing this disorder? Ans: A sedentary 65-year-old woman who smokes cigarettes
  2. The nurse has given instructions to a client returning home after knee arthroscopy. Which statement by the client indicates that the instructions are understood? Ans: I need to report a fever or site inflammation to my health care provider
  3. The nurse is one of several persons who witnessed a vehicle hit a pedestrian at fairly low speed on a small street. The victim is dazed and tries to get up. The leg appears fractured. Which intervention should the nurse take? Ans: Stay with the victim and encourage the person to remain still. 64.Which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? Select all that apply. Ans: Keep the cast clean and dry.
  4. The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding? Ans: Serous drainage
  5. 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 elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing this pain? Ans: Impaired tissue perfusion
  6. The nurse is admitting a client with multiple traumas to the nursing unit. The client has a leg fracture and has a plaster cast applied. Which position would be best for the casted leg? Ans: Elevated on pillows continuously for 24 to 48 hours
  7. A client is being discharged to home after application of a plaster leg cast. Which statement indicates that the client understands proper care of the cast?

Ans: Temperature of 101.6 F orally

  1. A client with a hip fracture asks the nurse why Buck's (extension) traction is being applied before surgery. The nurse provides a response based on which purpose of Buck's (extension) traction? Ans: Provides comfort by reducing muscle spasms and provides fracture immobilization
  2. Proper care of a sprain is Ans: Rest, Ice, Compression and Elevation (RICE)
  3. Obesity places patients at an increased surgical risk because of which of the following factors? (Select all that apply.) Ans: a) Ventilatory capacity is reduced. b) Fatty tissue has a poor blood supply 78.You are caring for a patient after surgery who underwent a liver resection. His prothrombin time "PT" or an activated partial thromboplastin time "APTT" is greater than normal. He has low blood pressure; tachycardia; thready pulse; and cool, clammy, pale skin, and he is restless. You assess his surgical wound, and the dressing is saturated with blood. Which immediate interventions should you perform? (Select all that apply.) Ans: A) Notify the surgeon. B) Maintain intravenous (IV) fluid infusion and prepare to give volume replacement. C) Monitor the patient's vital signs every 15 minutes or more frequently until his condition stabilizes.
  4. After a surgical patient has been given preoperative sedatives, which safety precaution should a nurse take? Ans: Reinforce to the patient to remain in bed or on the stretcher
  5. The operating room (OR) and post anesthesia care unit (PACU) are high- risk environments for patients with a latex allergy. Which safety measures to prevent a latex reaction should the nurse implement? (Select all that apply.) Ans: A) Screening patients about food allergies known to have a cross- reactivity to latex such as kiwis and bananas. B) Having a latex allergy cart

available at all times. C) Communicating with the operating room (OR) team as soon as 24 to 48 hours in advance of the surgery when a latex-sensitive patient is identified

  1. A nurse is recovering a patient who received conscious sedation for cosmetic surgery. Which of the following is an advantage that conscious sedation has over general anesthesia? Ans: Amnesia and relief of pain 82.You have been given the following postoperative patients to care for on your shift. Based on the information provided, which patient should you see first? Ans: A 57-year-old following hip replacement 6 hours earlier who is receiving intravenous patient-controlled analgesia (PCA) with a history of OSA. The pulse oximeter has been alarming and reading 85%
  2. Hand-off communications that occur between the post anesthesia care unit (PACU) nurse and the nurse on the postoperative nursing unit should be done when a patient returns to the nursing unit. Select appropriate components of a safe and effective hand-off. (Select all that apply.) Ans: A) Vital signs, the type of anesthesia provided, blood loss, and level of consciousness. B) Uninterrupted time to review the recent pertinent events and ask questions
  3. A nurse is working in the preoperative holding area and is assigned to care for a patient who is having a prosthetic aortic valve placed. The nurse inserts an intravenous (IV) line and obtains vital signs. The patient has a temperature of 39°C (102°F), heart rate of 120, blood pressure (BP) of 84/50, and an elevated white blood cell (WBC) count. The nurse immediately notifies the surgeon of the patient's vital signs because: Ans: The surgery may need to be delayed to check the patient's WBC count and investigate the source of the fever before surgery.
  4. A nurse is working in an ambulatory care setting and is ready to discharge a patient who is wheelchair dependent. The patient underwent dilation of an esophageal stricture. Her post anesthesia recovery score for ambulatory

90.Which of the following is an adverse side effect of inhalation anesthetics? Ans: Malignant hyperthermia

  1. A 68-year-old client is undergoing an endoscopy, which will require moderate sedation. Which of the following findings in her history indicates the need for further assessment? Ans: COPD 92.Which of the following preoperative client findings should be reported to a client's provider? Ans: Creatinine level of 2.8. Prothrombin time of 23 seconds. Glucose level of 235. WBC count of 17, 850
  2. A nurse records a client's VS before transferring him to a paranesthesia unit for an exploratory laparotomy. The client's temperature is 39C (102.2F) orally. Which of the following actions should the nurse take? Ans: Contact and inform the provider about the temp
  3. Which of the following are a nurse's responsibilities regarding informed consent for a procedure? Ans: Ensure that the client signs the consent prior to administration of preoperative medications. Clarify any points given by the provider about the procedure after the provider's explanation. Document the client signing the consent form in the chart
  4. A nurse is caring for a client who had a hysterectomy and resumed a regular diet earlier in the day. The client is now reporting nausea and has vomited once. Which of the following actions should the nurse take first? Ans: Assess for bowel sounds
  5. A nurse is preparing to care for a client in the surgical unit who will be receiving diazepam (Valium) IV. For which of the following should the nurse monitor this client? Ans: Respiratory depression
  1. What should the nurse teach the patient recovering from an episode of acute low back pain? Ans: Perform daily exercise as a lifelong routine.
  2. A nurse is providing discharge teaching to a client who has a fracture of the right tibia and a fiberglass cast. Which of the following instructions should the nurse include in the teaching? Ans: Report any worsening or unrelieved pain.
  3. A nurse is assessing a client who is postoperative following a right below- the-knee amputation. Which of the following findings should the nurse identify as a possible complication? Ans: Presence edema above the stump dressing.
  4. A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first? Ans: Pallor of the toes.
  5. If a cast is too tight it will increase pressure on the blood vessels, impairing circulation. When this occurs, pallor of the toes is the initial finding. Ans: The nurse should immediately report this finding to the provider.
  6. A nurse is caring for an older adult client who has a fractured hip and will require rehabilitative care. The client's family asks the nurse for information about this type of care. Which of the following explanations should the nurse provide? Ans: This service began with the client's admission to the hospital.
  7. A nurse is assessing the elastic bandage on the stump of a client who had a right below-the-knee amputation. Which of the following findings should the nurse identify as a complication? Ans: Pitting edema around the stump dressing

extension traction. The nurse should include which of the following information in the teaching? Ans: Buck's extension traction will relieve muscle spasms.

  1. A nurse is caring for a client who has a hip fracture that requires surgical repair. Which of the following health care professionals is responsible for obtaining informed consent from the client for the procedure? Ans: Surgeon
  2. A client who has a femur fracture states, "I can't stay in this bed any longer. I need to get home so I can take care of my family." The nurse responds, "You have talked about your family several times. Can you tell me more about your specific concerns?" Which type of therapeutic communication response is the nurse using? Ans: Focusing
  3. A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the client's affected arm? Ans: Increasing edema
  4. A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status? Ans: Instruct the client to wiggle his toes.
  5. A nurse notes increasing edema in the calf of a client who has multiple fractures of the leg. The nurse should recognize that increasing edema is a manifestation of which of the following complications? Ans: Acute compartment syndrome
  6. A nurse is caring for an older adult client who had a femoral head fracture 24 hours ago and is in skin traction. The client reports shortness of

breath and dyspnea. The nurse should suspect that the client has developed which of the following complications? Ans: Fat embolism

  1. A nurse is caring for a client who is 2 days postoperative following an above-the-knee amputation. Which of the following is an appropriate nursing intervention for this client at this time? Ans: Have the client lie prone every 3 hours for 20 minutes at a time
  2. A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first? Ans: Checking capillary refill
  3. A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which of the following changes in assessment should indicate to the nurse that the client could be developing a serious complication? Ans: Increased respiratory rate from 18 to 44/min
  4. A nurse is caring for a client in the emergency department who had a traumatic amputation of his left arm in an industrial accident. The nurse should expect the client to be experiencing which of the following of Kubler-Ross's stages of grief? Ans: Denial
  5. A nurse is caring for a client who sustained a femur fracture in an automobile accident and is placed into skeletal traction. The nurse may remove the weights from the traction device if which of the following occurs? Ans: The client develops a life-threatening situation.