Chapter 41: Musculoskeletal - NCLEX exam with 100% correct answers
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Chapter 41: Musculoskeletal - NCLEX
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Chapter 41: Musculoskeletal - NCLEX
Which of the following statements is accurate regarding care of a plaster cast?
a) The cast must be covered with a blanket to keep it moist during the first 24 hours.
b) The cast will dry in about 12 hours.
c) A dry plaster cast is dull and gray.
d) The cast can be dented while it is damp. co...
Which of the following statements is accurate regarding care of a plaster cast?
a) The cast must be covered with a blanket to keep it moist during the first 24 hours.
b) The cast will dry in about 12 hours.
c) A dry plaster cast is dull and gray.
d) The cast can be dented while it is damp. correct answersd) The cast can be dented while it is damp.
Explanation:
The cast can be dented while it is damp. A dry plaster case is white and shiny. The cast will dry in 24 to 72
hours. A freshly applied cast should be exposed to circulating air to dry and should not be covered with
clothing or bed linens or placed on plastic-coated mats or bedding. pg.1104
Upon reporting to work and receiving report, a nurse has been assigned to provide care for three clients.
Each of the clients has called out to the nurses' station requesting assistance. Which client should the
nurse see first?
a) A 60-year-old female, who is in traction to manage chronic muscle spasms, who is requesting
assistance to order her evening meal
b) A 32-year-old male, who had a plaster cast applied to his leg 2 hours ago, who complains that the cast
feels as if it's getting tighter
c) The order doesn't matter; all clients are of equal priority
d) A 56-year-old male, who had an arthroscopy of his left knee 3 hours ago, who is asking to be
discharged correct answersb) A 32-year-old male, who had a plaster cast applied to his leg 2 hours ago,
who complains that the cast feels as if it's getting tighter
Explanation:
The male who reports his cast feels tighter requires a complete assessment that focuses on his
neurovascular status. The nurse should respond to him first. The older male and female are stable and
aren't priorities at this time. pg.1105
,The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing
diagnosis for the client is:
a) Risk for ineffective therapeutic regimen management
The client without adequate support and resources is at risk for ineffective therapeutic regimen
management. A total knee replacement may be used to treat avascular necrosis. While an orthopedic
client is at risk for disturbed body image and situational low self-esteem, there is no evidence that these
exist for this client. pg.1128
Which of the following is an inaccurate principle of traction?
a) The weights are not removed unless intermittent treatment is prescribed.
b) The patient must be in good alignment in the center of the bed.
c) Skeletal traction is interrupted to turn and reposition the patient.
d) The weights must hang freely. correct answersc) Skeletal traction is interrupted to turn and reposition
the patient.
Explanation:
Skeletal traction is never interrupted. The weights are not removed unless intermittent treatment is
prescribed. The weights must hang freely with the patient in good alignment in the center of the bed.
pg.1114
A client's cast is removed. The client is worried because the skin appears mottled and is covered with a
yellowish crust. What advice should the nurse give the client to address the skin problem?
a) Apply lotions and take warm baths or soaks.
b) Scrub the area vigorously to remove the crust.
c) Consult a skin specialist.
d) Avoid exposure to direct sunlight. correct answersa) Apply lotions and take warm baths or soaks.
,Explanation:
The client should be advised to apply lotions and take warm baths or soaks. This will help in softening
the skin and removing debris. The client usually sheds this residue in a few days so the client need not
consult a skin specialist. It is not advisable to scrub the area vigorously. The client need not avoid
exposure to direct sunlight because the area is not photosensitive. pg.1108
A group of students is studying for a test on traction. The students demonstrate understanding of the
types of traction when they identify which of the following as an example of skin traction?
a) Thomas splint
b) Balanced suspension
c) Crutchfield tongs
d) Buck's correct answersd) Buck's
Explanation:
An example of skin traction is Buck's traction. Crutchfield tongs, a Thomas splint, or balanced suspension
traction are types of skeletal traction. pg.1113
A 12-year-old client fractured her right leg while skiing and is undergoing an open reduction of the femur
fracture. She returns to the orthopedic unit where you practice nursing with a cast in place. What is the
rationale for frequently assessing her pedal pulses?
a) Maintaining adequate circulation
b) Ensuring there wasn't nerve damage during surgery
Circulation, sensation, and mobility of exposed fingers or toes must be assessed every 1 to 2 hours to
ensure neurovascular status is not compromised. pg.1121
A client is seen in the emergency department for an injury acquired from falling off of a bicycle and
fracturing the arm. The client also has a long laceration that has been sutured in the same area. The
client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse?
, a) "We will need to monitor the status of the laceration to be sure it does not get infected."
b) "You will be able to wear the splint longer than you would a cast."
c) "The splint is less expensive than the cast."
d) "The arm does not require the same immobilization that a leg fracture would." correct answersa) "We
will need to monitor the status of the laceration to be sure it does not get infected."
Explanation:
A splint would be used when there is special skin treatment or observation that is required. The arm
fracture would require the same form of immobilization that a leg fracture does. The length of time the
splint can be worn is equal to that of a cast to immobilize the fracture. The cost of the splint and cast
would be similar. pg.1105
Mr. Williams returned to the nursing unit following orthopedic surgery and is complaining of pain. Which
of the following interventions will help relieve pain?
a) Encourage client to do ROM exercises as indicated.
b) Elevate the affected extremity and use cold applications.
c) Apply antiembolism stockings as indicated.
d) Instruct client to deep breathe and cough every 2 hours until he can ambulate. correct answersb)
Elevate the affected extremity and use cold applications.
Explanation:
Elevating the affected extremity and using cold applications reduce swelling. This intervention helps with
maintenance of effective respiratory rate and depth. This intervention helps maintain full ROM of
unaffected joints. They help prevent deep vein thrombosis (DVT). pg.1105
Which of the following would be inconsistent as a component of self-care activities for the patient with a
cast?
a) Cushioning rough edges of the cast with tape
b) Elevate the casted extremity to heart level frequently
c) Do not attempt to scratch the skin under a cast
d) Cover the cast with plastic to insulate it correct answersd) Cover the cast with plastic to insulate it
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