🦴 Musculoskeletal System MCQ Test
Questions 100 | Practice for Nursing & Medical Exams
Covers exams like NCLEX, AIIMS, NEET, USMLE, PLAB, DHA, HAAD, MOH, Prometric, ESIC, NHM
Practice Musculoskeletal System MCQs with clear explanations to strengthen your exam preparation.
🦴 📋 About This Musculoskeletal System Test
🔹 Number of Questions: 100 MCQs
🔹 Marks: 1 Point / Correct Answer
🔹 Negative Marking: No
🔹 Difficulty: Easy • Moderate • High
🔹 Explanations: Yes
🔹 Relevance: NCLEX, AIIMS, NEET, USMLE, PLAB, ESIC, NHM & Other Nursing/Medical Exams
🔹 Pass Marks: 75/100
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Question 1
Which bone classification includes the humerus and the femur?
A. Flat bones
B. Irregular bones
C. Long bones
D. Short bones
Explanation:
The humerus and femur are classified as long bones. Long bones are longer than they are wide and mainly support body weight and facilitate movement. Flat bones protect organs, while irregular bones have complex shapes.
The humerus and femur are classified as long bones. Long bones are longer than they are wide and mainly support body weight and facilitate movement. Flat bones protect organs, while irregular bones have complex shapes.
Question 2
How many bones make up the mature adult human skeleton?
A. 270
B. 206
C. 300
D. 208
Explanation:
The mature adult skeleton consists of 206 bones. Infants are born with approximately 270–300 bones, many of which fuse together during growth.
The mature adult skeleton consists of 206 bones. Infants are born with approximately 270–300 bones, many of which fuse together during growth.
Question 3
Prolonged bed rest can lead to a plantar flexion contracture, commonly known as:
A. Genu valgum
B. Hallux valgus
C. Foot drop
D. Torticollis
Explanation:
Foot drop develops when prolonged immobility causes the foot to remain in plantar flexion. Proper positioning and range-of-motion exercises help prevent this complication.
Foot drop develops when prolonged immobility causes the foot to remain in plantar flexion. Proper positioning and range-of-motion exercises help prevent this complication.
Question 4
When a patient is in traction, how should the weights be positioned to ensure the pulling force is effective?
A. Resting on the floor to prevent excessive pull
B. Hanging freely and not touching the floor or bed
C. Tied securely to the bed frame to prevent movement
D. Removed during the night to allow the patient to rest
Explanation:
Traction weights must hang freely at all times. If they touch the floor or bed, the prescribed pulling force is interrupted, making the traction ineffective.
Traction weights must hang freely at all times. If they touch the floor or bed, the prescribed pulling force is interrupted, making the traction ineffective.
Question 5
Which of the following bones is classified as a flat bone?
A. Vertebrae
B. Scapula
C. Patella
D. Malleolus
Explanation:
The scapula (shoulder blade) is a flat bone that protects structures and provides a broad surface for muscle attachment. Vertebrae are irregular bones, while the patella is a sesamoid bone.
The scapula (shoulder blade) is a flat bone that protects structures and provides a broad surface for muscle attachment. Vertebrae are irregular bones, while the patella is a sesamoid bone.
Question 6
A nurse performing a head-to-toe assessment on a post-operative patient with a history of gout knows that an acute attack most commonly begins in which site?
A. The elbow
B. The wrist
C. The big toe
D. The knee
Explanation:
An acute gout attack most commonly begins in the first metatarsophalangeal (MTP) joint, commonly known as the big toe. This painful condition is called podagra and is the classic initial presentation of gout.
An acute gout attack most commonly begins in the first metatarsophalangeal (MTP) joint, commonly known as the big toe. This painful condition is called podagra and is the classic initial presentation of gout.
Question 7
Which hand deformity is a hallmark sign of advanced Rheumatoid Arthritis (RA) but is NOT typically seen in Osteoarthritis (OA)?
A. Ulnar deviation
B. Heberden’s nodes
C. Bouchard’s nodes
D. Bony enlargements of the DIP joints
Explanation:
Ulnar deviation is a characteristic deformity of advanced Rheumatoid Arthritis. In contrast, Heberden’s nodes, Bouchard’s nodes, and bony enlargements of the distal interphalangeal (DIP) joints are classic findings of Osteoarthritis.
Ulnar deviation is a characteristic deformity of advanced Rheumatoid Arthritis. In contrast, Heberden’s nodes, Bouchard’s nodes, and bony enlargements of the distal interphalangeal (DIP) joints are classic findings of Osteoarthritis.
Question 8
When teaching a patient about taking oral alendronate (Fosamax) for osteoporosis, which instruction is critical to prevent esophageal irritation?
A. Take the medication with a full glass of milk
B. Sit upright for at least 30 minutes after taking the pill
C. Take the tablet right before going to bed at night
D. Consume the medication with your morning calcium supplement
Explanation:
Alendronate should be taken first thing in the morning with a full glass of plain water. The patient must remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation and ulcer formation.
Alendronate should be taken first thing in the morning with a full glass of plain water. The patient must remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation and ulcer formation.
Question 9
Following a total hip arthroplasty (THA), which action should the nurse instruct the patient to avoid to prevent prosthesis dislocation?
A. Using a high-seated chair with arms
B. Using an abduction wedge between the legs
C. Flexing the hips more than 90 degrees
D. Walking with a cane or walker
Explanation:
After total hip replacement, patients should avoid hip flexion greater than 90°, crossing the legs, and internal rotation of the hip because these movements can dislocate the prosthetic joint.
After total hip replacement, patients should avoid hip flexion greater than 90°, crossing the legs, and internal rotation of the hip because these movements can dislocate the prosthetic joint.
Question 10
Following a myelogram using water-soluble contrast media, how should the nurse position the patient to prevent meningeal irritation or seizures?
A. Completely flat in a supine position for 8 hours
B. With the head of the bed elevated 30 to 45 degrees
C. In a Trendelenburg (head-down) position
D. In a prone position with a pillow under the abdomen
Explanation:
After a myelogram using water-soluble contrast media, the head of the bed should be elevated 30–45°. This prevents the contrast from migrating toward the brain, reducing the risk of meningeal irritation and seizures.
After a myelogram using water-soluble contrast media, the head of the bed should be elevated 30–45°. This prevents the contrast from migrating toward the brain, reducing the risk of meningeal irritation and seizures.
Question 11
What is the primary purpose of applying Buck’s extension skin traction for a patient with a fractured hip prior to surgery?
A. To provide permanent fixation of the fracture
B. To immobilize the fracture and reduce painful muscle spasms
C. To allow the patient to perform active range-of-motion exercises
D. To achieve precise skeletal alignment using invasive pins
Explanation:
Buck’s extension skin traction is a temporary form of skin traction used before surgery. It helps immobilize the affected limb, maintain alignment, and reduce painful muscle spasms associated with hip fractures. It is not intended for permanent fracture fixation.
Buck’s extension skin traction is a temporary form of skin traction used before surgery. It helps immobilize the affected limb, maintain alignment, and reduce painful muscle spasms associated with hip fractures. It is not intended for permanent fracture fixation.
Question 12
A child is diagnosed with moderate scoliosis with the apex of the curve at the sixth thoracic vertebra (T6). Which brace is most likely to be prescribed?
A. Boston brace
B. TLSO brace
C. Milwaukee brace
D. Underarm orthosis
Explanation:
The Milwaukee brace is recommended for scoliosis when the apex of the spinal curve is at or above T6. Low-profile braces such as the Boston brace are generally used for lower thoracic or lumbar curves.
The Milwaukee brace is recommended for scoliosis when the apex of the spinal curve is at or above T6. Low-profile braces such as the Boston brace are generally used for lower thoracic or lumbar curves.
Question 13
A nurse suspects acute compartment syndrome in a patient with a lower leg fracture. How should the affected extremity be positioned while awaiting the surgeon?
A. Elevated high above the level of the heart
B. In a dependent position hanging off the bed
C. Level with the heart
D. Wrapped tightly with an elastic compression bandage
Explanation:
In acute compartment syndrome, the affected limb should be kept at the level of the heart. Elevating it above heart level can reduce arterial blood flow and worsen tissue ischemia, while a dependent position increases swelling.
In acute compartment syndrome, the affected limb should be kept at the level of the heart. Elevating it above heart level can reduce arterial blood flow and worsen tissue ischemia, while a dependent position increases swelling.
Question 14
When reviewing the laboratory results of a patient with suspected gout, which serum uric acid level would support the diagnosis?
A. 2.1 mg/dL
B. 5.5 mg/dL
C. 9.5 mg/dL
D. 4.2 mg/dL
Explanation:
A serum uric acid level of 9.5 mg/dL indicates hyperuricemia, which strongly supports the diagnosis of gout. Normal adult levels are generally between 3.5 and 7.2 mg/dL.
A serum uric acid level of 9.5 mg/dL indicates hyperuricemia, which strongly supports the diagnosis of gout. Normal adult levels are generally between 3.5 and 7.2 mg/dL.
Question 15
Which assessment finding is a classic, distinguishing sign of Fat Embolism Syndrome (FES) rather than a simple pulmonary embolism?
A. Sudden onset of dyspnea and tachypnea
B. Confusion and restlessness
C. A petechial rash on the chest, neck, and axillae
D. Localized pain in the calf muscle
Explanation:
The hallmark finding of Fat Embolism Syndrome (FES) is a petechial rash over the chest, neck, axillae, or conjunctiva, usually appearing 24–72 hours after a long-bone fracture. Although respiratory distress and neurological symptoms may occur, the petechial rash is the classic distinguishing feature.
The hallmark finding of Fat Embolism Syndrome (FES) is a petechial rash over the chest, neck, axillae, or conjunctiva, usually appearing 24–72 hours after a long-bone fracture. Although respiratory distress and neurological symptoms may occur, the petechial rash is the classic distinguishing feature.
Question 16
A patient taking Colchicine for gout reports muscle pain, tingling in the fingers, and has a grayish color to the lips. What is the priority nursing action?
A. Hold the medication and notify the physician immediately
B. Administer the next dose as scheduled to treat the pain
C. Encourage the patient to increase fluid intake to 3 liters daily
D. Apply warm compresses to the tingling extremities
Explanation:
Muscle pain, tingling, numbness, and grayish or bluish lips are warning signs of Colchicine toxicity. The medication should be withheld immediately, and the healthcare provider should be notified. Continuing the drug may lead to serious adverse effects.
Muscle pain, tingling, numbness, and grayish or bluish lips are warning signs of Colchicine toxicity. The medication should be withheld immediately, and the healthcare provider should be notified. Continuing the drug may lead to serious adverse effects.
Question 17
After receiving the shift report, which orthopedic patient should the nurse assess first?
A. A patient in Buck’s traction who reports a pain level of 4/10
B. A patient post-total knee replacement with a cold foot and pale nailbeds
C. A patient with osteoarthritis reporting morning joint stiffness
D. A patient scheduled for a DEXA scan who is asking for breakfast
Explanation:
A cold foot and pale nailbeds suggest impaired circulation and neurovascular compromise, which is a surgical emergency. The nurse should assess this patient first to prevent permanent tissue damage. The other situations are stable or expected findings.
A cold foot and pale nailbeds suggest impaired circulation and neurovascular compromise, which is a surgical emergency. The nurse should assess this patient first to prevent permanent tissue damage. The other situations are stable or expected findings.
Question 18
Regarding pediatric skeletal development, why is injury to the epiphyseal plate considered a serious medical concern?
A. It is the strongest part of the bone and indicates massive trauma
B. It is only found in flat bones like the skull
C. Damage to this area can cause permanent growth disturbances
D. It is the primary site of red blood cell production
Explanation:
The epiphyseal (growth) plate is responsible for the longitudinal growth of children’s bones. Injury to this area can interfere with normal bone development, resulting in limb-length discrepancies, deformities, or permanent growth disturbances.
The epiphyseal (growth) plate is responsible for the longitudinal growth of children’s bones. Injury to this area can interfere with normal bone development, resulting in limb-length discrepancies, deformities, or permanent growth disturbances.
Question 19
To prevent hip flexion contractures in a patient after a below-the-knee amputation (BKA), the nurse should instruct the patient to:
A. Keep the residual limb elevated on a pillow at all times
B. Lie in a prone position for 20 to 30 minutes several times a day
C. Sit in a soft armchair for at least 8 hours a day
D. Maintain the knee in a flexed position while resting
Explanation:
Patients with a below-the-knee amputation (BKA) should lie prone for 20–30 minutes several times daily to stretch the hip flexor muscles and prevent hip flexion contractures. Prolonged elevation of the residual limb or keeping the knee flexed promotes contracture formation.
Patients with a below-the-knee amputation (BKA) should lie prone for 20–30 minutes several times daily to stretch the hip flexor muscles and prevent hip flexion contractures. Prolonged elevation of the residual limb or keeping the knee flexed promotes contracture formation.
Question 20
Why is a Dual-energy X-ray absorptiometry (DEXA) scan preferred over plain X-rays for diagnosing early osteoporosis?
A. It involves the injection of radioactive isotopes into the bone
B. It can detect bone loss before it is visible on plain X-rays
C. It measures serum calcium and phosphorus levels simultaneously
D. It provides a three-dimensional view of soft tissue tumors
Explanation:
A DEXA (Dual-energy X-ray absorptiometry) scan is the gold standard for measuring bone mineral density and can detect early bone loss before changes become visible on plain X-rays. Conventional X-rays usually detect osteoporosis only after approximately 30–50% of bone mass has already been lost.
A DEXA (Dual-energy X-ray absorptiometry) scan is the gold standard for measuring bone mineral density and can detect early bone loss before changes become visible on plain X-rays. Conventional X-rays usually detect osteoporosis only after approximately 30–50% of bone mass has already been lost.
Question 21
Which type of joint allows movement in only one plane, such as flexion and extension?
A. Hinge joint
B. Ball-and-socket joint
C. Pivot joint
D. Saddle joint
Explanation:
A hinge joint permits movement in a single plane, mainly flexion and extension. Common examples include the elbow, knee, and interphalangeal joints. Ball-and-socket joints allow movement in multiple directions, while pivot joints permit rotation.
A hinge joint permits movement in a single plane, mainly flexion and extension. Common examples include the elbow, knee, and interphalangeal joints. Ball-and-socket joints allow movement in multiple directions, while pivot joints permit rotation.
Question 22
Which bone is commonly referred to as the “collarbone”?
A. Scapula
B. Sternum
C. Clavicle
D. Humerus
Explanation:
The clavicle, commonly called the collarbone, connects the sternum to the scapula and is one of the most frequently fractured bones.
The clavicle, commonly called the collarbone, connects the sternum to the scapula and is one of the most frequently fractured bones.
Question 23
Scoliosis is best defined as which type of spinal deformity?
A. An exaggerated outward curvature of the thoracic spine
B. An exaggerated inward curvature of the lumbar spine
C. A lateral sideways S- or C-shaped curvature of the spine
D. A rigid, stooped posture with the head leaning forward
Explanation:
Scoliosis is a lateral curvature of the spine measuring at least 10°. Kyphosis is an exaggerated outward thoracic curve, while lordosis is an exaggerated inward lumbar curve.
Scoliosis is a lateral curvature of the spine measuring at least 10°. Kyphosis is an exaggerated outward thoracic curve, while lordosis is an exaggerated inward lumbar curve.
Question 24
Which type of bone classification includes the humerus and the femur?
A. Long bones
B. Short bones
C. Flat bones
D. Irregular bones
Explanation:
The humerus and femur are classified as long bones. These bones support body weight and provide leverage for movement.
The humerus and femur are classified as long bones. These bones support body weight and provide leverage for movement.
Question 25
Which diagnostic test is the most accurate for measuring bone mineral density to diagnose osteoporosis?
A. Plain X-ray of the femur
B. Serum Alkaline Phosphatase (ALP) levels
C. Dual-energy X-ray absorptiometry (DEXA) scan
D. Serum calcium and phosphorus levels
Explanation:
A DEXA scan is the gold standard for measuring bone mineral density and diagnosing osteoporosis. It can detect early bone loss before it becomes visible on plain X-rays.
A DEXA scan is the gold standard for measuring bone mineral density and diagnosing osteoporosis. It can detect early bone loss before it becomes visible on plain X-rays.
Question 26
What is the primary function of the periosteum?
A. To provide a cushion between joints to prevent friction
B. To cover the bone and provide a route for blood vessels and nerves
C. To produce red blood cells within the bone marrow
D. To act as the growth plate for longitudinal bone growth
Explanation:
The periosteum is a tough outer membrane covering bones. It contains blood vessels, nerves, and lymphatic vessels that nourish bone tissue and support growth and repair.
The periosteum is a tough outer membrane covering bones. It contains blood vessels, nerves, and lymphatic vessels that nourish bone tissue and support growth and repair.
Question 27
A nurse is providing care for a child in Buck’s skin traction. Which intervention is essential to prevent external rotation of the affected leg?
A. Maintain the head of the bed at a 45-degree angle
B. Use an abduction wedge between the child’s legs
C. Place rolled towels on the external surface of the knee
D. Attach an extra 5-lb weight to the traction pulley
Explanation:
In Buck’s skin traction, rolled towels are placed along the outer side of the knee to prevent external rotation and maintain proper alignment of the affected leg.
In Buck’s skin traction, rolled towels are placed along the outer side of the knee to prevent external rotation and maintain proper alignment of the affected leg.
Question 28
When assessing a patient for Rheumatoid Arthritis (RA), which joint involvement pattern is most characteristic of this disease?
A. Symmetrical involvement of small joints
B. Asymmetrical involvement of weight-bearing joints
C. Unilateral involvement of the first metatarsophalangeal joint
D. Localized involvement of only the distal interphalangeal joints
Explanation:
Rheumatoid Arthritis usually affects small joints symmetrically, especially the hands and feet. Osteoarthritis more commonly affects weight-bearing joints and is often asymmetrical.
Rheumatoid Arthritis usually affects small joints symmetrically, especially the hands and feet. Osteoarthritis more commonly affects weight-bearing joints and is often asymmetrical.
Question 29
To prevent hip flexion contractures during the first 24 hours after a below-the-knee amputation (BKA), the nurse should:
A. Maintain the residual limb in a dependent position
B. Elevate the residual limb on a pillow
C. Instruct the patient to lie in a prone position immediately
D. Encourage the patient to sit in a chair for 2 hours at a time
Explanation:
During the first 24 hours after a below-the-knee amputation, the residual limb is elevated on a pillow to reduce edema. After 24 hours, prolonged elevation should be avoided to prevent hip flexion contractures.
During the first 24 hours after a below-the-knee amputation, the residual limb is elevated on a pillow to reduce edema. After 24 hours, prolonged elevation should be avoided to prevent hip flexion contractures.
Question 30
A patient is being discharged after a total hip arthroplasty (THA). Which statement by the patient indicates the need for further teaching?
A. “I will use a high-seated chair to keep my hip flexion less than 90 degrees.”
B. “I will cross my legs at the ankles when I am sitting in a chair.”
C. “I will use a walker until the doctor tells me I can stop.”
D. “I will call my doctor immediately if I have a sudden increase in pain.”
Explanation:
After a total hip arthroplasty, patients should never cross their legs because this can dislocate the prosthetic hip. Using a high chair, walking with a walker, and reporting sudden pain are appropriate postoperative measures.
After a total hip arthroplasty, patients should never cross their legs because this can dislocate the prosthetic hip. Using a high chair, walking with a walker, and reporting sudden pain are appropriate postoperative measures.
Question 31
When evaluating the laboratory results of a patient with suspected gout, which serum uric acid level would the nurse consider elevated?
A. 4.2 mg/dL
B. 6.0 mg/dL
C. 9.5 mg/dL
D. 2.1 mg/dL
Explanation:
Normal serum uric acid levels are generally 3.5–7.2 mg/dL. A value of 9.5 mg/dL indicates hyperuricemia, a common finding in patients with gout.
Normal serum uric acid levels are generally 3.5–7.2 mg/dL. A value of 9.5 mg/dL indicates hyperuricemia, a common finding in patients with gout.
Question 32
When performing the Adams forward-bending test for scoliosis, what specific finding is the nurse looking for?
A. The disappearance of the spinal curve
B. A “swayback” appearance in the lumbar region
C. Asymmetric rib elevation or a prominent rib hump
D. The inability of the patient to touch their toes
Explanation:
The Adams forward-bending test is positive when there is a rib hump or asymmetric rib elevation, indicating structural scoliosis caused by vertebral rotation.
The Adams forward-bending test is positive when there is a rib hump or asymmetric rib elevation, indicating structural scoliosis caused by vertebral rotation.
Question 33
For a patient in skeletal traction, what is the primary nursing responsibility regarding the traction weights?
A. Ensure the weights hang freely and do not touch the floor
B. Lift the weights once per shift to check the skin under the straps
C. Position the weights on the bed frame while the patient is eating
D. Increase the weight by 2 lbs if the patient reports muscle spasms
Explanation:
Traction weights must hang freely at all times. If they touch the bed or floor, the prescribed traction force is lost, making the treatment ineffective.
Traction weights must hang freely at all times. If they touch the bed or floor, the prescribed traction force is lost, making the treatment ineffective.
Question 34
Why is elevating the extremity above heart level contraindicated if acute compartment syndrome is suspected?
A. It causes significant increase in venous return, leading to right-sided heart failure
B. It reduces arterial perfusion pressure, which worsens tissue ischemia
C. It increases the risk of a fat embolism moving to the lungs
D. It prevents the formation of a necessary hematoma at the fracture site
Explanation:
In acute compartment syndrome, elevating the limb above heart level decreases arterial blood flow, worsening tissue ischemia. The affected limb should instead be maintained at heart level.
In acute compartment syndrome, elevating the limb above heart level decreases arterial blood flow, worsening tissue ischemia. The affected limb should instead be maintained at heart level.
Question 35
Which assessment finding is a classic, distinguishing sign of Fat Embolism Syndrome (FES) following a femur fracture?
A. Sudden onset of shortness of breath and chest pain
B. Severe pain in the calf during dorsiflexion (Homans’ sign)
C. A petechial rash on the chest, neck, and axillae
D. Localized swelling and redness at the fracture site
Explanation:
The hallmark sign of Fat Embolism Syndrome (FES) is a petechial rash on the chest, neck, axillae, or conjunctiva, usually appearing 24–72 hours after a long-bone fracture.
The hallmark sign of Fat Embolism Syndrome (FES) is a petechial rash on the chest, neck, axillae, or conjunctiva, usually appearing 24–72 hours after a long-bone fracture.
Question 36
A patient is prescribed oral alendronate (Fosamax) and a calcium supplement. What is the correct way to administer these?
A. Take both together with breakfast to improve absorption
B. Take alendronate first thing in the morning and the calcium at least 30 minutes later
C. Take the calcium with a full glass of water and the alendronate at bedtime
D. Take alendronate with orange juice and the calcium with milk
Explanation:
Alendronate should be taken on an empty stomach with plain water immediately after waking. Calcium supplements should be taken at least 30 minutes later because calcium reduces alendronate absorption.
Alendronate should be taken on an empty stomach with plain water immediately after waking. Calcium supplements should be taken at least 30 minutes later because calcium reduces alendronate absorption.
Question 37
When performing a neurologic assessment on a child in halo skeletal traction, why does the nurse ask the patient to follow a finger with their eyes (lateral gaze)?
A. To assess for cranial nerve involvement due to pin placement or traction force
B. To check for increased intracranial pressure (ICP) from the initial trauma
C. To determine the child’s level of consciousness and orientation
D. To screen for symptoms of a developing fat embolism
Explanation:
Halo traction uses pins attached to the skull. Assessing lateral eye movement helps evaluate cranial nerve function and detects possible nerve injury caused by the traction or pin placement.
Halo traction uses pins attached to the skull. Assessing lateral eye movement helps evaluate cranial nerve function and detects possible nerve injury caused by the traction or pin placement.
Question 38
Regarding the long-term management of gout, which safety instruction is critical for a patient taking Allopurinol?
A. Stop the medication immediately if you have a loose bowel movement
B. Increase your intake of vitamin C to acidify the urine
C. Report any new skin rash immediately to the healthcare provider
D. Take the medication only when you feel an acute attack coming on
Explanation:
Allopurinol may rarely cause Stevens-Johnson syndrome, a life-threatening hypersensitivity reaction. Any new skin rash should be reported immediately, and the medication should not be continued until evaluated.
Allopurinol may rarely cause Stevens-Johnson syndrome, a life-threatening hypersensitivity reaction. Any new skin rash should be reported immediately, and the medication should not be continued until evaluated.
Question 39
After a myelogram using water-soluble contrast media, how should the nurse position the patient to prevent seizures and headaches?
A. Completely flat in a supine position for 8 hours
B. In the Trendelenburg position
C. With the head of the bed elevated 30 to 45 degrees
D. Prone with a pillow under the abdomen
Explanation:
Following a myelogram with water-soluble contrast, the head of the bed should remain elevated 30–45° to prevent the contrast medium from reaching the brain and causing meningeal irritation or seizures.
Following a myelogram with water-soluble contrast, the head of the bed should remain elevated 30–45° to prevent the contrast medium from reaching the brain and causing meningeal irritation or seizures.
Question 40
After a change-of-shift report, which orthopedic patient should the nurse assess first?
A. A patient post-total knee replacement who reports a cold foot and pale nailbeds
B. A patient in Buck’s traction for a hip fracture who is complaining of a pain level of 4/10
C. A patient with osteoarthritis who reports significant joint stiffness this morning
D. A patient scheduled for a DEXA scan in two hours who is asking for breakfast
Explanation:
A cold foot with pale nailbeds suggests neurovascular compromise, which is an emergency requiring immediate assessment. The remaining patients are stable or experiencing expected findings.
A cold foot with pale nailbeds suggests neurovascular compromise, which is an emergency requiring immediate assessment. The remaining patients are stable or experiencing expected findings.
Question 41
What is the common medical term for the “kneecap”?
A. Malleolus
B. Patella
C. Scapula
D. Olecranon
Explanation:
The patella is the anatomical name for the kneecap. It is the largest sesamoid bone in the body and protects the knee joint while improving the leverage of the quadriceps muscle.
The patella is the anatomical name for the kneecap. It is the largest sesamoid bone in the body and protects the knee joint while improving the leverage of the quadriceps muscle.
Question 42
Which spinal deformity is commonly referred to as “swayback”?
A. Kyphosis
B. Scoliosis
C. Lordosis
D. Myosis
Explanation:
Lordosis is an exaggerated inward curvature of the lumbar spine, commonly called swayback. Kyphosis is an exaggerated thoracic curve, while scoliosis is a lateral curvature of the spine.
Lordosis is an exaggerated inward curvature of the lumbar spine, commonly called swayback. Kyphosis is an exaggerated thoracic curve, while scoliosis is a lateral curvature of the spine.
Question 43
When a patient is in traction, how should the weights be positioned?
A. Resting on the floor to prevent excessive pull
B. Tied securely to the bed frame
C. Hanging freely and not touching the floor
D. Covered with a cloth to maintain cleanliness
Explanation:
Traction weights must hang freely at all times. If they touch the bed or floor, the prescribed traction force is interrupted, making the treatment ineffective.
Traction weights must hang freely at all times. If they touch the bed or floor, the prescribed traction force is interrupted, making the treatment ineffective.
Question 44
Which complication of immobility is related to the loss of calcium from the bones?
A. Renal calculi
B. Hypostatic pneumonia
C. Deep vein thrombosis
D. Contractures
Explanation:
Prolonged immobility causes bone demineralization, releasing calcium into the bloodstream. Excess calcium is excreted by the kidneys, increasing the risk of renal calculi (kidney stones).
Prolonged immobility causes bone demineralization, releasing calcium into the bloodstream. Excess calcium is excreted by the kidneys, increasing the risk of renal calculi (kidney stones).
Question 45
Which of the following is a hallmark hand deformity specifically associated with Rheumatoid Arthritis (RA)?
A. Heberden’s nodes
B. Ulnar deviation
C. Bouchard’s nodes
D. Bony overgrowth of the DIP joints
Explanation:
Ulnar deviation is a classic deformity seen in advanced Rheumatoid Arthritis. Heberden’s and Bouchard’s nodes are characteristic findings of Osteoarthritis.
Ulnar deviation is a classic deformity seen in advanced Rheumatoid Arthritis. Heberden’s and Bouchard’s nodes are characteristic findings of Osteoarthritis.
Question 46
A “compound” fracture is best defined as a fracture where:
A. The bone is broken into many small fragments
B. The bone is partially broken on only one side
C. The skin surface is broken, exposing bone and tissue
D. The fracture occurs at an angle across the bone
Explanation:
A compound (open) fracture occurs when the broken bone communicates with the outside environment through a break in the skin, increasing the risk of infection.
A compound (open) fracture occurs when the broken bone communicates with the outside environment through a break in the skin, increasing the risk of infection.
Question 47
To control edema in a residual limb immediately following an amputation, the nurse should use which wrapping technique?
A. A figure-of-eight pattern
B. A tight circular pattern
C. A proximal-to-distal spiral
D. Loose gauze dressing only
Explanation:
A figure-of-eight elastic bandage provides even compression, reduces edema, shapes the residual limb, and avoids creating a tourniquet effect that could impair circulation.
A figure-of-eight elastic bandage provides even compression, reduces edema, shapes the residual limb, and avoids creating a tourniquet effect that could impair circulation.
Question 48
What is the priority nursing action for a client experiencing an acute gout attack?
A. Encourage active range-of-motion exercises
B. Apply warm compresses to the joint
C. Elevate the affected extremity
D. Massage the affected area to improve blood flow
Explanation:
During an acute gout attack, the affected extremity should be elevated to reduce swelling and pain. Heat, massage, and excessive joint movement can worsen inflammation.
During an acute gout attack, the affected extremity should be elevated to reduce swelling and pain. Heat, massage, and excessive joint movement can worsen inflammation.
Question 49
Following a total hip arthroplasty (THA), which type of chair should the nurse instruct the patient to avoid?
A. A low-seated sofa or soft armchair
B. A high-seated chair with arms
C. A firm, straight-backed chair
D. A reclining chair kept in the upright position
Explanation:
After a total hip arthroplasty, patients should avoid low or soft chairs because they cause excessive hip flexion (>90°), increasing the risk of hip dislocation.
After a total hip arthroplasty, patients should avoid low or soft chairs because they cause excessive hip flexion (>90°), increasing the risk of hip dislocation.
Question 50
To prevent hip flexion contractures in a patient after a below-the-knee amputation (BKA), the nurse should:
A. Keep the residual limb elevated on pillows for the first 72 hours
B. Instruct the patient to lie in a prone position several times a day
C. Maintain the patient in a sitting position for most of the day
D. Encourage the use of a knee-flexed position while resting
Explanation:
Patients should lie prone for 20–30 minutes several times daily to stretch the hip flexor muscles and prevent hip flexion contractures. Prolonged elevation on pillows should be avoided after the initial postoperative period.
Patients should lie prone for 20–30 minutes several times daily to stretch the hip flexor muscles and prevent hip flexion contractures. Prolonged elevation on pillows should be avoided after the initial postoperative period.
Question 51
Which of the following is identified as a non-modifiable risk factor for osteoporosis?
A. Tobacco use
B. Sedentary lifestyle
C. Female gender
D. Low dietary calcium intake
Explanation:
Female gender is a non-modifiable risk factor for osteoporosis. Smoking, physical inactivity, and poor calcium intake are modifiable lifestyle factors that can be changed to reduce risk.
Female gender is a non-modifiable risk factor for osteoporosis. Smoking, physical inactivity, and poor calcium intake are modifiable lifestyle factors that can be changed to reduce risk.
Question 52
When assessing the neurovascular status (the 5 Ps) of a limb in a cast, “paresthesia” refers to:
A. Pale or dusky skin color
B. Absence of a distal pulse
C. Numbness, tingling, or a “pins-and-needles” sensation
D. Inability to move the fingers or toes
Explanation:
Paresthesia refers to numbness, tingling, burning, or a “pins-and-needles” sensation. It is often an early sign of nerve compression or ischemia and requires prompt assessment.
Paresthesia refers to numbness, tingling, burning, or a “pins-and-needles” sensation. It is often an early sign of nerve compression or ischemia and requires prompt assessment.
Question 53
A patient taking colchicine for acute gout should be instructed to stop the medication and notify the provider if they experience:
A. Increased urinary output
B. Severe nausea, vomiting, or diarrhea
C. A mild headache
D. Increased appetite
Explanation:
Severe nausea, vomiting, and diarrhea are common early signs of colchicine toxicity. The medication should be discontinued immediately, and the healthcare provider should be notified.
Severe nausea, vomiting, and diarrhea are common early signs of colchicine toxicity. The medication should be discontinued immediately, and the healthcare provider should be notified.
Question 54
Which statement regarding pediatric skeletal development is true?
A. The epiphyseal plate is the weakest part of a growing bone.
B. Infant bones are as brittle as adult bones.
C. Fractures in children under 1 year of age are very common.
D. The periosteum in children is much thinner than in adults.
Explanation:
The epiphyseal (growth) plate is the weakest part of a child’s growing bone and is especially vulnerable to injury. Damage to this area may interfere with normal bone growth.
The epiphyseal (growth) plate is the weakest part of a child’s growing bone and is especially vulnerable to injury. Damage to this area may interfere with normal bone growth.
Question 55
A nurse suspects acute compartment syndrome in a patient with a leg fracture. Where should the limb be positioned?
A. Above the level of the heart to reduce swelling
B. Below the level of the heart to maximize blood flow
C. At the level of the heart
D. In a dependent position hanging off the bed
Explanation:
When acute compartment syndrome is suspected, the affected limb should be maintained at heart level. Elevating it above the heart decreases arterial blood flow and can worsen tissue ischemia.
When acute compartment syndrome is suspected, the affected limb should be maintained at heart level. Elevating it above the heart decreases arterial blood flow and can worsen tissue ischemia.
Question 56
Which clinical finding is a distinguishing sign of Fat Embolism Syndrome (FES) rather than a simple pulmonary embolism?
A. A petechial rash on the chest, neck, and axillae
B. Sudden onset of dyspnea and tachypnea
C. Localized pain in the calf muscle
D. Confusion and restlessness
Explanation:
A petechial rash is the classic distinguishing feature of Fat Embolism Syndrome, typically appearing within 24–72 hours after a long-bone fracture. Respiratory distress and confusion can occur in both FES and pulmonary embolism.
A petechial rash is the classic distinguishing feature of Fat Embolism Syndrome, typically appearing within 24–72 hours after a long-bone fracture. Respiratory distress and confusion can occur in both FES and pulmonary embolism.
Question 57
Following a myelogram using water-soluble contrast, how should the nurse position the patient?
A. Completely flat in a supine position for 8 hours
B. With the head of the bed elevated 30 to 45 degrees
C. In a Trendelenburg position
D. In a prone position with a pillow under the abdomen
Explanation:
After a myelogram using water-soluble contrast, the head of the bed should remain elevated 30–45 degrees to reduce the risk of seizures and meningeal irritation.
After a myelogram using water-soluble contrast, the head of the bed should remain elevated 30–45 degrees to reduce the risk of seizures and meningeal irritation.
Question 58
A child has a moderate scoliosis curve with the apex at the sixth thoracic vertebra (T6). Which brace is most likely to be prescribed?
A. Milwaukee brace
B. Boston brace
C. Miami brace
D. Underarm thoraco-lumbo-sacral orthosis
Explanation:
The Milwaukee brace is recommended for scoliosis when the curve apex is at or above T6. Boston and other low-profile braces are generally used for lower thoracic or lumbar curves.
The Milwaukee brace is recommended for scoliosis when the curve apex is at or above T6. Boston and other low-profile braces are generally used for lower thoracic or lumbar curves.
Question 59
Regarding gout prophylaxis, what is a critical instruction for a patient starting Allopurinol?
A. Take the medication only during an acute flare-up
B. Do not initiate the medication during an active gout attack
C. Limit fluid intake to 1 liter per day
D. Use aspirin as the primary pain reliever while on this drug
Explanation:
Allopurinol is used for the long-term prevention of gout and should not be started during an acute gout attack, as sudden changes in uric acid levels may prolong or worsen the attack.
Allopurinol is used for the long-term prevention of gout and should not be started during an acute gout attack, as sudden changes in uric acid levels may prolong or worsen the attack.
Question 60
To assess the motor function of the median nerve in a post-operative shoulder surgery patient, the nurse should ask the patient to:
A. Spread all fingers wide against resistance
B. Flex the wrist against resistance
C. Move the thumb toward the palm (opposition)
D. Shrug the shoulders against resistance
Explanation:
The median nerve supplies the thenar muscles responsible for thumb opposition. Asking the patient to touch the thumb to the little finger is a simple test of median nerve motor function.
The median nerve supplies the thenar muscles responsible for thumb opposition. Asking the patient to touch the thumb to the little finger is a simple test of median nerve motor function.
Question 61
When assessing for structural scoliosis using the Adams forward-bending test, which finding should the nurse document?
A. Disappearance of the spinal curve upon bending
B. Protruding abdomen and forward-tilted pelvis
C. Exaggerated thoracic curvature (humpback)
D. Posterior projection of the ribs on the convex side (rib hump)
Explanation:
A rib hump on the convex side of the spine during the Adams forward-bending test is the classic finding of structural scoliosis caused by vertebral rotation.
A rib hump on the convex side of the spine during the Adams forward-bending test is the classic finding of structural scoliosis caused by vertebral rotation.
Question 62
Which clinical manifestation is a hallmark systemic symptom of Rheumatoid Arthritis (RA) that is generally absent in Osteoarthritis (OA)?
A. Persistent fatigue and generalized weakness
B. Joint crepitus during active movement
C. Bony enlargements on distal interphalangeal joints
D. Pain that is strictly localized to the affected joints
Explanation:
Rheumatoid Arthritis is a systemic autoimmune disease that commonly causes fatigue, malaise, and generalized weakness. Osteoarthritis is primarily a localized degenerative joint disease.
Rheumatoid Arthritis is a systemic autoimmune disease that commonly causes fatigue, malaise, and generalized weakness. Osteoarthritis is primarily a localized degenerative joint disease.
Question 63
A nurse suspects acute compartment syndrome in a patient with a lower leg fracture. How should the nurse position the affected extremity while waiting for the surgeon?
A. Elevated on several pillows to reduce local edema
B. Above the level of the heart to maximize venous return
C. Level with the heart to maintain arterial perfusion
D. In a dependent position to increase blood flow
Explanation:
In acute compartment syndrome, the extremity should be maintained at heart level. Elevating it above the heart decreases arterial perfusion and worsens tissue ischemia.
In acute compartment syndrome, the extremity should be maintained at heart level. Elevating it above the heart decreases arterial perfusion and worsens tissue ischemia.
Question 64
In a patient with multiple long-bone fractures, when is the nurse most alert for the onset of Fat Embolism Syndrome (FES)?
A. Within the first 2 hours of the initial trauma
B. Within 24 to 72 hours following the injury
C. Between 5 and 7 days after surgical stabilization
D. Immediately after the application of a plaster cast
Explanation:
Fat Embolism Syndrome most commonly develops 24–72 hours after long-bone fractures. Early recognition is essential because it can rapidly become life-threatening.
Fat Embolism Syndrome most commonly develops 24–72 hours after long-bone fractures. Early recognition is essential because it can rapidly become life-threatening.
Question 65
Which instruction regarding oral alendronate (Fosamax) administration is correct to prevent esophageal irritation?
A. Take the medication with a small snack to reduce nausea
B. Lie down for 30 minutes after taking the tablet
C. Take the pill first thing in the morning with plain water only
D. Consume the medication with 8 ounces of orange juice
Explanation:
Alendronate should be taken first thing in the morning with plain water on an empty stomach. The patient should remain upright for at least 30 minutes after taking the medication.
Alendronate should be taken first thing in the morning with plain water on an empty stomach. The patient should remain upright for at least 30 minutes after taking the medication.
Question 66
A nurse is reviewing the lab results for a patient suspected of having gout. Which serum uric acid level would support this diagnosis?
A. 2.1 mg/dL
B. 9.2 mg/dL
C. 5.5 mg/dL
D. 7.0 mg/dL
Explanation:
Normal serum uric acid levels are generally 3.5–7.2 mg/dL. A value of 9.2 mg/dL indicates hyperuricemia and supports the diagnosis of gout.
Normal serum uric acid levels are generally 3.5–7.2 mg/dL. A value of 9.2 mg/dL indicates hyperuricemia and supports the diagnosis of gout.
Question 67
What is the primary purpose of applying Buck’s extension traction for a patient with a fractured hip prior to surgery?
A. To immobilize the fracture and reduce painful muscle spasms
B. To provide permanent fixation of the fracture site
C. To allow the patient to perform active range-of-motion
D. To achieve precise skeletal alignment using invasive pins
Explanation:
Buck’s extension traction is a temporary skin traction used before surgery to immobilize the fractured limb, maintain alignment, and reduce painful muscle spasms.
Buck’s extension traction is a temporary skin traction used before surgery to immobilize the fractured limb, maintain alignment, and reduce painful muscle spasms.
Question 68
To prevent hip dislocation following a total hip arthroplasty (THA) via a posterior approach, the nurse should instruct the patient to avoid:
A. Keeping the legs straight while sitting
B. Using an abduction wedge between the legs
C. Standing and walking within the first 24 hours
D. Flexing the hips more than 90 degrees
Explanation:
After a posterior total hip arthroplasty, patients must avoid hip flexion greater than 90°, crossing the legs, and internal rotation to reduce the risk of prosthesis dislocation.
After a posterior total hip arthroplasty, patients must avoid hip flexion greater than 90°, crossing the legs, and internal rotation to reduce the risk of prosthesis dislocation.
Question 69
Following a myelogram using water-soluble contrast media, which position is priority for the nurse to maintain?
A. Completely flat in a supine position
B. Semi-Fowler’s with knees slightly flexed
C. Head of the bed elevated 30 to 45 degrees
D. Prone with a pillow under the abdomen
Explanation:
After a myelogram with water-soluble contrast, the head of the bed should be elevated 30–45° to reduce the risk of seizures and meningeal irritation.
After a myelogram with water-soluble contrast, the head of the bed should be elevated 30–45° to reduce the risk of seizures and meningeal irritation.
Question 70
Which statement regarding pediatric skeletal development is accurate and guides nursing care?
A. Infant bones are fully ossified and brittle at birth
B. The periosteum in children is much thinner and weaker than in adults
C. Fractures in children under 1 year of age are common and rarely indicate abuse
D. Injury to the epiphyseal plate can cause permanent growth disturbances
Explanation:
The epiphyseal (growth) plate is responsible for longitudinal bone growth. Injury to this area may result in permanent growth disturbances, deformity, or limb-length discrepancies.
The epiphyseal (growth) plate is responsible for longitudinal bone growth. Injury to this area may result in permanent growth disturbances, deformity, or limb-length discrepancies.
Question 71
When handling a new plaster cast that is still wet, the nurse should use:
A. Palms of the hands to prevent indentations and pressure points
B. Fingertips to ensure a tight, secure fit
C. A hair dryer on a high-heat setting to speed up drying
D. A plastic covering to protect the cast from environmental moisture
Explanation:
A wet plaster cast should always be handled with the palms of the hands. Using fingertips can create indentations that may cause pressure points and skin breakdown.
A wet plaster cast should always be handled with the palms of the hands. Using fingertips can create indentations that may cause pressure points and skin breakdown.
Question 72
A patient with gout is discussing dietary modifications. The nurse should advise the patient to avoid which food high in purines?
A. Bananas and citrus fruits
B. Sardines and organ meats
C. Whole wheat bread and crackers
D. Low-fat dairy products
Explanation:
Sardines and organ meats are rich in purines, which increase uric acid production and may trigger gout attacks. Patients with gout should limit these foods.
Sardines and organ meats are rich in purines, which increase uric acid production and may trigger gout attacks. Patients with gout should limit these foods.
Question 73
Which hand deformity is considered a hallmark sign of advanced Rheumatoid Arthritis (RA)?
A. Ulnar deviation and swan-neck deformity
B. Heberden’s nodes on the distal joints
C. Bouchard’s nodes on the proximal joints
D. Bony overgrowth on the base of the thumb
Explanation:
Ulnar deviation and swan-neck deformities are classic features of advanced Rheumatoid Arthritis. Heberden’s and Bouchard’s nodes are characteristic findings of Osteoarthritis.
Ulnar deviation and swan-neck deformities are classic features of advanced Rheumatoid Arthritis. Heberden’s and Bouchard’s nodes are characteristic findings of Osteoarthritis.
Question 74
Which laboratory value serves as a biomarker for osteoblastic activity and is typically elevated during healing fractures or growth spurts?
A. Rheumatoid Factor (RF)
B. Creatine Phosphokinase (CPK)
C. Alkaline Phosphatase (ALP)
D. Erythrocyte Sedimentation Rate (ESR)
Explanation:
Alkaline Phosphatase (ALP) is produced by osteoblasts and increases during periods of active bone formation, such as fracture healing and childhood growth.
Alkaline Phosphatase (ALP) is produced by osteoblasts and increases during periods of active bone formation, such as fracture healing and childhood growth.
Question 75
When wrapping a residual limb after amputation to prepare for a prosthesis, which technique should the nurse use?
A. A circular wrapping pattern to ensure even compression
B. A distal-to-proximal wrap that is tight at the top
C. A figure-of-eight pattern to avoid a tourniquet effect
D. Leaving the end of the limb exposed to the air
Explanation:
A figure-of-eight elastic wrap provides proper compression, reduces edema, shapes the residual limb, and prevents a tourniquet effect that could impair circulation.
A figure-of-eight elastic wrap provides proper compression, reduces edema, shapes the residual limb, and prevents a tourniquet effect that could impair circulation.
Question 76
Regarding the pharmacological management of gout, the nurse understands that Allopurinol is used for:
A. Relieving immediate pain during an acute flare-up
B. Long-term prophylaxis to lower serum uric acid levels
C. Inhibiting neutrophil migration to the joint space
D. Rapidly dissolving existing tophi during an attack
Explanation:
Allopurinol decreases uric acid production and is prescribed for long-term prevention of gout attacks. It is not used for immediate treatment of an acute attack.
Allopurinol decreases uric acid production and is prescribed for long-term prevention of gout attacks. It is not used for immediate treatment of an acute attack.
Question 77
The spinal deformity characterized by an exaggerated inward curvature of the lumbar spine, often called “swayback,” is:
A. Kyphosis
B. Scoliosis
C. Lordosis
D. Torticollis
Explanation:
Lordosis is an exaggerated inward lumbar curvature commonly known as swayback. Kyphosis produces a humpback appearance, while scoliosis causes lateral spinal curvature.
Lordosis is an exaggerated inward lumbar curvature commonly known as swayback. Kyphosis produces a humpback appearance, while scoliosis causes lateral spinal curvature.
Question 78
Which diagnostic finding is most definitive for confirming a diagnosis of acute compartment syndrome?
A. An intracompartmental pressure reading greater than 30 mmHg
B. A serum creatine kinase (CK) level within normal limits
C. An X-ray showing a comminuted fracture
D. A weak but palpable distal pedal pulse
Explanation:
An intracompartmental pressure greater than 30 mmHg strongly supports the diagnosis of acute compartment syndrome and requires urgent surgical intervention.
An intracompartmental pressure greater than 30 mmHg strongly supports the diagnosis of acute compartment syndrome and requires urgent surgical intervention.
Question 79
Which of the following is an example of a non-modifiable risk factor for osteoporosis?
A. Low dietary calcium intake
B. Tobacco use and smoking
C. Female gender
D. Sedentary lifestyle
Explanation:
Female gender is a non-modifiable risk factor for osteoporosis. Lifestyle factors such as smoking, inactivity, and poor calcium intake can be modified to reduce risk.
Female gender is a non-modifiable risk factor for osteoporosis. Lifestyle factors such as smoking, inactivity, and poor calcium intake can be modified to reduce risk.
Question 80
When caring for a patient in halo skeletal traction, which piece of equipment must the nurse keep at the bedside at all times?
A. A set of wire cutters
B. A specialized torque wrench
C. A sterile pin site care kit
D. An extra set of weights
Explanation:
A specialized torque wrench must always be kept at the bedside of patients in halo traction so the halo vest can be safely loosened or removed in an emergency, such as during cardiopulmonary resuscitation.
A specialized torque wrench must always be kept at the bedside of patients in halo traction so the halo vest can be safely loosened or removed in an emergency, such as during cardiopulmonary resuscitation.
Question 81
A nurse is assessing a patient with a compound fracture of the tibia and notes unrelenting pain unrelieved by opioids, pallor, and a capillary refill of 4 seconds. What is the priority nursing action?
A. Elevate the affected extremity above the heart level
B. Administer an additional dose of the prescribed analgesic
C. Notify the physician immediately of suspected compartment syndrome
D. Apply ice packs to the area to reduce swelling
Explanation:
Severe pain unrelieved by analgesics, pallor, and delayed capillary refill are classic signs of acute compartment syndrome. This is a surgical emergency requiring immediate notification of the healthcare provider.
Severe pain unrelieved by analgesics, pallor, and delayed capillary refill are classic signs of acute compartment syndrome. This is a surgical emergency requiring immediate notification of the healthcare provider.
Question 82
Which non-pharmacological intervention is the priority for a client experiencing an acute gout attack in the great toe?
A. Elevate the affected extremity to promote venous return
B. Perform active range-of-motion exercises to prevent stiffness
C. Apply warm compresses to the joint to improve circulation
D. Massage the affected area to reduce crystal accumulation
Explanation:
During an acute gout attack, elevating the affected limb helps reduce edema and pain. Heat, massage, and vigorous movement can increase inflammation and should be avoided.
During an acute gout attack, elevating the affected limb helps reduce edema and pain. Heat, massage, and vigorous movement can increase inflammation and should be avoided.
Question 83
To prevent hip flexion contractures in a patient 48 hours after a below-the-knee amputation (BKA), the nurse should instruct the patient to:
A. Keep the residual limb elevated on a pillow at all times
B. Lie in a prone position for 20 to 30 minutes several times a day
C. Sit in a chair for at least 8 hours a day to promote core strength
D. Maintain the knee in a flexed position while resting
Explanation:
After the first 24 hours, patients should lie prone for 20–30 minutes several times daily to stretch the hip flexors and prevent hip flexion contractures.
After the first 24 hours, patients should lie prone for 20–30 minutes several times daily to stretch the hip flexors and prevent hip flexion contractures.
Question 84
Which of the following is considered a modifiable risk factor for the development of Osteoarthritis (OA)?
A. Being overweight or obese
B. Increasing age
C. Genetic susceptibility
D. Previous joint trauma or injury
Explanation:
Obesity is a major modifiable risk factor for osteoarthritis because excess body weight increases stress on weight-bearing joints such as the knees and hips.
Obesity is a major modifiable risk factor for osteoarthritis because excess body weight increases stress on weight-bearing joints such as the knees and hips.
Question 85
When screening a school-age child for scoliosis, the nurse should use the Adams forward-bending test to look for:
A. An exaggerated inward curvature of the lumbar spine
B. A humpback appearance in the thoracic region
C. Disappearance of the spinal curve upon bending
D. Asymmetric rib elevation or a prominent rib hump
Explanation:
The Adams forward-bending test is positive when a rib hump or asymmetric rib elevation is present, indicating possible structural scoliosis.
The Adams forward-bending test is positive when a rib hump or asymmetric rib elevation is present, indicating possible structural scoliosis.
Question 86
For a patient in Buck’s extension traction, what is the maximum weight typically applied to prevent skin shearing and breakdown?
A. 15 to 20 pounds (6.8 to 9.1 kg)
B. 5 to 10 pounds (2.3 to 4.5 kg)
C. 20 to 25 pounds (9.1 to 11.3 kg)
D. 1 to 4 pounds (0.45 to 1.8 kg)
Explanation:
Buck’s skin traction generally uses 5–10 pounds (2.3–4.5 kg) of weight. Higher weights may cause skin breakdown and reduce the effectiveness of skin traction.
Buck’s skin traction generally uses 5–10 pounds (2.3–4.5 kg) of weight. Higher weights may cause skin breakdown and reduce the effectiveness of skin traction.
Question 87
A patient presents with joint pain and stiffness. Which finding is most characteristic of Rheumatoid Arthritis (RA) rather than Osteoarthritis (OA)?
A. Morning stiffness lasting less than 30 minutes
B. Asymmetric joint involvement primarily in weight-bearing joints
C. Symmetrical joint swelling and morning stiffness lasting longer than 1 hour
D. Pain that follows activity and improves with rest
Explanation:
Rheumatoid Arthritis typically causes symmetrical joint involvement with prolonged morning stiffness lasting more than one hour, unlike Osteoarthritis.
Rheumatoid Arthritis typically causes symmetrical joint involvement with prolonged morning stiffness lasting more than one hour, unlike Osteoarthritis.
Question 88
When providing discharge teaching for a patient prescribed oral alendronate (Fosamax) for osteoporosis, the nurse should include which instruction?
A. Take the medication right before going to bed at night
B. Take the tablet with a full glass of orange juice to increase absorption
C. Sit upright for at least 30 minutes after taking the medication
D. Take the medication with your morning calcium supplement
Explanation:
Patients taking alendronate should remain upright for at least 30 minutes after administration to reduce the risk of esophageal irritation and ulceration.
Patients taking alendronate should remain upright for at least 30 minutes after administration to reduce the risk of esophageal irritation and ulceration.
Question 89
A nurse is caring for a patient with a fractured femur. Which assessment finding would most likely indicate the development of Fat Embolism Syndrome (FES)?
A. Localized paresthesia and cool skin in the affected limb
B. Severe pain on passive stretch of the affected extremity
C. A weak distal pulse and slowed capillary refill
D. Dyspnea, confusion, and a petechial rash on the chest and neck
Explanation:
The classic triad of Fat Embolism Syndrome includes respiratory distress (dyspnea), neurological changes (confusion), and a petechial rash, usually occurring 24–72 hours after a long-bone fracture.
The classic triad of Fat Embolism Syndrome includes respiratory distress (dyspnea), neurological changes (confusion), and a petechial rash, usually occurring 24–72 hours after a long-bone fracture.
Question 90
Which statement by a patient with a new fiberglass cast indicates a need for further teaching?
A. “I will wiggle my fingers every hour to check my circulation.”
B. “I can use a wire hanger to scratch the skin inside my cast if it itches.”
C. “I will call the doctor if my fingers feel numb or tingly.”
D. “I will keep my casted arm elevated to reduce swelling.”
Explanation:
Patients should never insert objects such as a wire hanger inside a cast because it can injure the skin and lead to infection. Persistent itching should be reported to the healthcare provider.
Patients should never insert objects such as a wire hanger inside a cast because it can injure the skin and lead to infection. Persistent itching should be reported to the healthcare provider.
Question 91
Regarding gout therapeutics, which statement is true regarding the administration of Allopurinol?
A. It should not be started during an acute gout flare-up.
B. It is used to treat the immediate pain and inflammation of an acute attack.
C. It works by inhibiting neutrophil migration to the joint.
D. The patient should limit fluid intake to 1 liter per day while taking it.
Explanation:
Allopurinol is used for the long-term prevention of gout and should not be initiated during an acute gout attack, as sudden changes in uric acid levels may worsen or prolong the flare.
Allopurinol is used for the long-term prevention of gout and should not be initiated during an acute gout attack, as sudden changes in uric acid levels may worsen or prolong the flare.
Question 92
To assess the motor function of the median nerve in a post-operative shoulder surgery patient, the nurse should ask the patient to:
A. Spread all fingers wide against resistance.
B. Touch the thumb to the palm (opposition).
C. Flex the wrist against resistance.
D. Shrug the shoulders against resistance.
Explanation:
The median nerve controls thumb opposition through the thenar muscles. Asking the patient to touch the thumb to the palm is the standard motor assessment.
The median nerve controls thumb opposition through the thenar muscles. Asking the patient to touch the thumb to the palm is the standard motor assessment.
Question 93
Which diagnostic test is the most accurate for diagnosing osteoporosis?
A. Plain X-ray of the long bones.
B. Serum alkaline phosphatase (ALP) levels.
C. Dual-energy X-ray absorptiometry (DEXA) scan.
D. Serum calcium and phosphorus levels.
Explanation:
A DEXA scan is the gold standard for measuring bone mineral density and diagnosing osteoporosis before significant bone loss becomes visible on plain X-rays.
A DEXA scan is the gold standard for measuring bone mineral density and diagnosing osteoporosis before significant bone loss becomes visible on plain X-rays.
Question 94
A “greenstick” fracture is best described as:
A. A fracture where the bone splinters into many small fragments.
B. A fracture that occurs at an angle across the bone.
C. A fracture that results from a twisting motion.
D. An incomplete fracture where only one side of the bone is broken.
Explanation:
A greenstick fracture is an incomplete fracture in which one side of the bone breaks while the opposite side bends. It is commonly seen in children because their bones are more flexible.
A greenstick fracture is an incomplete fracture in which one side of the bone breaks while the opposite side bends. It is commonly seen in children because their bones are more flexible.
Question 95
To toughen a residual limb in preparation for a prosthesis, the nurse should instruct the patient to:
A. Push the residual limb against a soft pillow, then gradually firmer surfaces.
B. Rub the end of the stump with a rough washcloth for 10 minutes daily.
C. Apply a thick layer of lotion to the stump twice a day.
D. Avoid any pressure on the end of the stump until the incision is fully healed.
Explanation:
Gradually applying pressure to the residual limb helps desensitize and toughen the tissues, preparing the limb for safe prosthetic fitting.
Gradually applying pressure to the residual limb helps desensitize and toughen the tissues, preparing the limb for safe prosthetic fitting.
Question 96
Prolonged bed rest can lead to a plantar flexion contracture, commonly known as:
A. Genu valgum.
B. Foot drop.
C. Torticollis.
D. Hallux valgus.
Explanation:
Foot drop develops when prolonged plantar flexion causes shortening of the calf muscles and Achilles tendon, preventing normal dorsiflexion.
Foot drop develops when prolonged plantar flexion causes shortening of the calf muscles and Achilles tendon, preventing normal dorsiflexion.
Question 97
When performing pin site care for a patient in skeletal traction, the nurse should:
A. Use the same sterile swab for all pin sites to save supplies.
B. Apply a thick layer of antibiotic ointment around the pins.
C. Cleanse each pin site with a separate sterile swab using an aseptic technique.
D. Remove any crusting around the pins using a vigorous scrubbing motion.
Explanation:
Each pin site should be cleaned using a separate sterile swab and strict aseptic technique to reduce the risk of pin-site infection.
Each pin site should be cleaned using a separate sterile swab and strict aseptic technique to reduce the risk of pin-site infection.
Question 98
Which joint-protection technique should the nurse teach a patient with Rheumatoid Arthritis (RA)?
A. Slide heavy items along a flat surface rather than lifting them.
B. Use small joints instead of large joints whenever possible.
C. Perform vigorous exercise during an acute inflammatory flare.
D. Carry heavy bags using the fingers and hands rather than the shoulder.
Explanation:
Patients with RA should slide heavy objects instead of lifting them to reduce stress on painful joints and help prevent joint damage.
Patients with RA should slide heavy objects instead of lifting them to reduce stress on painful joints and help prevent joint damage.
Question 99
Following a myelogram using water-soluble contrast, the nurse should maintain the patient in which position?
A. Completely flat in a supine position for 8 hours.
B. In a prone position with a pillow under the abdomen.
C. In a Trendelenburg position.
D. With the head of the bed elevated 30 to 45 degrees.
Explanation:
After a water-soluble contrast myelogram, the head of the bed should be elevated 30°–45° to reduce the risk of meningeal irritation and seizures.
After a water-soluble contrast myelogram, the head of the bed should be elevated 30°–45° to reduce the risk of meningeal irritation and seizures.
Question 100
Which of the following is considered the hallmark early sign of acute compartment syndrome?
A. Absence of a distal pulse (pulselessness).
B. Pain that is out of proportion to the injury and unrelieved by medication.
C. Paralysis or inability to move the extremity.
D. The affected limb matching the ambient room temperature (poikilothermia).
Explanation:
The earliest and most reliable sign of acute compartment syndrome is severe pain that is disproportionate to the injury and not relieved by analgesics. Prompt recognition and treatment are essential to prevent permanent tissue damage.
The earliest and most reliable sign of acute compartment syndrome is severe pain that is disproportionate to the injury and not relieved by analgesics. Prompt recognition and treatment are essential to prevent permanent tissue damage.
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🦴 Why This Musculoskeletal System Test Matters?
1. Why should I practice Musculoskeletal System MCQs?
They strengthen your understanding of bones, joints, muscles, fractures, arthritis, traction, and orthopedic nursing while improving exam confidence.
2. How are these MCQs useful?
These questions follow the latest nursing exam pattern, improve critical thinking, increase accuracy, and help with quick revision before exams.
3. Why is the musculoskeletal system important in nursing?
Nurses frequently care for patients with fractures, osteoporosis, arthritis, amputations, traction, joint replacements, and other orthopedic conditions, making this topic essential for safe patient care.
4. Why is this topic important for competitive exams?
Musculoskeletal disorders, fracture management, traction, casts, osteoporosis, gout, and rheumatoid arthritis are high-weightage topics in nursing and medical entrance and recruitment exams.
5. Who can use these questions?
These MCQs are ideal for Nursing Students, GNM, ANM, B.Sc. Nursing, Post Basic Nursing, Medical Students, and all healthcare competitive exam aspirants.
6. Which exams are covered?
NCLEX, AIIMS, NORCET, NEET, USMLE, PLAB, DHA, HAAD, MOH, Prometric, ESIC, NHM, RRB Staff Nurse, DSSSB, GMCH, PGIMER, CHO, and other Nursing & Medical Exams.
7. How often should I practice?
Practice a few MCQs every day and regularly review explanations to improve retention, speed, and exam performance.
8. Are explanations included?
Yes. Every question includes a clear, exam-focused explanation to help you understand the concept and avoid common mistakes.