MUSCULO SKELETAL SYSTEM DPP

MUSCULO SKELETAL SYSTEM (b) Examining the bedding under the patient
(c) Observing for ecchymosis at the
CRUTCH WALKING & TOTAL HIP operative site
REPLACEMENT (d) Measuring the weight of patient
1. Which of the following principle should 6. Which of the following complication
the nurse Mira consider during assisting should the nurse conclude for a client
a patient with crutches to learn the four- who had a total hip replacement 24 hours
point gait? ago?
(a) Pressure on the Axilla may damage (a) Fat embolism
nerves in the area. (b) Urinary incontinence
(b) Elbows should be kept in rigid extension. (c) Hypovolemic shock
(c) The patient must be able to bear weight (d) Pulmonary embolism
on both legs. 7. Which of the following part of the body
(d) Option A and C should the nurse instruct the patient to
2. Which of the following instruction given place weight during crutch walking who
by the nurses to help a patient for had arthroscopic surgery of the knee?
walking with crutches? (a) The Axillary region
(a) Use of the trapeze to strengthen the (b) Palms of the hands
biceps muscles (c) Dorsal surface of palm
(b) Exercise the triceps muscles and wrist (d) Both lower extremities
extensors, 8. How should the nurse position the
(c) Exercises with or without weights to affected hip after the client undergoes a
strengthen the muscles of the upper total hip replacement?
extremities (a) Adduct the hip
(d) Both B and C (b) Flex the hip
3. Which of the following position should a (c) Abduct the hip
nurse avoid placing a patient who had (d) Extend the hip
surgery for a total hip replacement? 9. Which of the following device is most
(a) Supine helpful to have on hand postoperatively
(b) Semi-Fowler when providing nursing care for the
(c) Orthopneic patient who is recovering from a total hip
(d) Lateral replacement?
4. Which of the following nursing activity (a) A bed cradle
should be help to prevent thrombus (b) Lower side rails
formation in a patient who had a total hip (c) An overhead trapeze
replacement? (d) A bed board
(a) Pacing the patient in sitting position 10. What of the following comfort device is
(b) Encouraging the patient to perform best for preventing external rotation of
ankle exercises the operative leg when caring for a
(c) Turning the patient from side to side patient with a total hip replacement?
(d) Ambulating the patient just after surgery (a) A turning sheet
5. Which of the following priority for (b) A trochanter roll
observe the hemorrhage when a nurse is (c) A footboard
caring for a patient who had a total hip (d) A foam mattress
replacement? 11. Why the crutches cannot rest up
(a) Checking pulse of patient every hours underneath the arm for extra support?
(a) Patient cannot move with crutches
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MUSCULO SKELETAL SYSTEM DPP
(b) Injury to the brachial plexus nerves AMPUTATION
(c) Skin breakdown in the area of the Axilla 1. Which of the following least nursing
(d) A fall and further injury intervention initially should receive by a
1. [d] 2. [d] 3. [c] 4. [b] 5. [b] patient who experiences a traumatic
6. [a] 7. [b] 8. [c] 9. [c] 10. [b] amputation of a leg in a vehicle accident?
11. [b] (a) Educate about residual limb care
GOUT (b) Maintaining the compression dressing
1. Which of the following medication does (c) Monitoring Hematocrit value
the nurse anticipate to prescribe to (d) Using therapeutic communication
prevent and treat an acute attack of techniques
gout? 2. A patient has an amputation of a lower
(a) Probenecid limb. Which of the following instructions
(b) Colchicine’s should the nurse give the patient to
(c) Diclofenac sodium prevent a hip flexion contracture?
. (d) Hydrocortisone (a) Sit in a chair for 60 minutes twice times a
2. Which of the following foods avoid with day.
gout patient to limit painful attacks? (b) Turn from side to side every 1 to 2 hours.
(a) Cheese (c) Lie on the abdomen 30 minutes four to
(b) Banana six times daily.
(c) Egg (d) Perform muscle setting exercises thrice
(d) Shellfish daily.
3. Which of the following laboratory test 3. Which of the following nursing
typically validate a diagnosis of gout? measurement is needed to control edema
(a) Creatinine clearance of the residual limb to a patient after
(b) Blood urea nitrogen above the-knee amputation?
(c) Calcium (a) Restrict the sodium intake.
(d) Serum uric acid (b) Administer the osmotic diuretic
4. Which of the following body part is (c) Apply the elastic bandage as necessary.
usually affected by gout? (d) Residual limb should be elevated on a
(a) Wrist joints pillow.
(b) Index finger 4. Which of the following priority should the
(c) Sacrococygeal vertebrae nurse use to promote early and efficient
(d) Great toe ambulation after a patient has a mid-
5. Which of the following laboratory values thigh amputation?
assess by nurse in a patient who (a) Elevated the residual limb on a pillow.
diagnosed as gout? (b) Provide semi fowler position
(a) Phosphorus level of 3.2 Mg/dL (c) Turn the patient to the prone position
(b) Uric acid level of 8.6 Mg/dL routinely.
(c) Potassium level of 3.7 MEq/L (d) Encourage the patient to lying on the
(d) Calcium level of 9.2 Mg/dL unaffected side.
1. [b] 2. [d] 3. [d] 4. [d] 5. [b] 5. A patient has a hip replacement. Which of
the following clinical assessment indicate
of pulmonary embolism except?
(a) Elevation rate of respiration
(b) Unilateral chest pain
(c) Flushing of the face
(d) Sudden onset of shortness of breath
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MUSCULO SKELETAL SYSTEM DPP
6. Which of the following advice given by (b) Shortening of the affected extremity with
the nurse to a patient who is allowed out external rotation
of bed after an above-the-knee (c) Increase the size of affected extremity
amputation? (d) Abduction with external rotation
(a) Do not follow doctor's order 3. Which of the following type of
(b) Lift the patient hip to the affected side contracture expected by nurse with a
(c) Keep the hip raised with the residual limb patient who has hip fractured?
elevated, (a) Flexion of the hip
(d) Keep the hip in extension and alignment. (b) Externally rotation of the hip
7. Which of the following crutch gait should (c) Hyperextension of the hip
the nurse advice to the patient after a (d) Both Option A and B
single-leg amputation? 4. Where should the nurse begin applying
(a) Three-point the elastic bandage when a patient has
(b) Four-point severely sprain in ankle?
(c) Tripod (a) Above the ankle
(d) Swing-through (b) Below the knee
8. A patient with diabetes mellitus has had (c) Across the phalanges
a left below-knee amputation. Which of (d) At the metatarsals
the following specific signs observe by 5. Which is the best technique for applying
nurse because of the history of diabetes? the elastic bandage to the patient's lower
(a) Slight redness of the incision area extremity when a patient has sprain in
(b) Edema of the amputation site ankle?
(c) Hemorrhage (a) Figure-eight bandage
(d) Wound evisceration (b) Mitten bandage
1. [a] 2. [c] 3. [c] 4. [c] 5. [c] (c) Spiral-reverse bandage
6. [d] 7. [b] 8. [d] (d) Spica bandage
6. A patient has fracture of the tibia. To
FRACTURE, SPLINT & TRACTION immobilize the fractured part, how
1. A patient is admitted in patient unit with should the nurse apply a splint?
a fracture of the neck of the femur. Which (a) Above the knee to below the hip
of the following position should the nurse (b) Below the knee to above the hip
maintain the patient's affected (c) Above the ankle to below the knee
extremity? (d) Below the ankle to above the knee
(a) External rotation with flexion of the knee 7. Which of the following explanation
and hip correct by nurse about comminuted
(b) Internal rotation with flexion of the knee fracture of the distal tibia?
and hip (a) One bone end is driven into the other.
(c) Internal rotation with extension of the (b) There is no open break in the skin.
knee and hip (c) The bone is splintered into pieces.
(d) External rotation with extension of knee (d) A portion of the bone is split away.
and hip 8. Which of the following findings suggest
2. Which of the following clinical finding that the patient is developing fat
should the nurse expect when assessing a embolism syndrome except?
patient with a fracture of the neck of the (a) Bradycardia
femur? (b) Petechiae
(a) Adduction with internal rotation (c) Dyspnea
(d) Mental status changes
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MUSCULO SKELETAL SYSTEM
9. Which of the following emergency
measures, should the nurse perform first
in a road side accident patient care?
(a) Check the client breathing.
(b) Assess the client for injuries.
(c) Move the patient to the stretcher.
(d) Cover the injured site with a bandage.
10. Which of the following assessment
finding is the best indication that the
patient is experiencing secondary
complications from the fractured ribs?
(a) Coughing up pink, frothy sputum
(b) Asymmetrical chest expansion
(c) Expiratory wheezing on auscultation
(d) Arrhythmia
11. The nurse sees a bone fragment
protruding from the patient's thigh as
well as profuse bleeding from the wound.
Which technique is most appropriate to
control the bleeding?
(a) Elevate the injured extremity.
(b) Apply direct pressure on the wound.
(c) Compress the femoral artery.
(d) Place a tourniquet around the leg.
12. Which of the following is the most
preferred position when transporting a
victim with a possible back injury?
(a) Prone
(b) Side-lying
(c)Supine and rolling
(d) Semi-Fowler's
13. Which of the following risk factor most
significant for sustaining a hip fracture?
(a) The patient is postmenopausal.
(b) The patient has type B diabetes.
(c) The patient who is obese.
(d) The patient is bed ridden.
14. Which of the following diet would the
nurse encourage for the patient with
immobility due to the fractured hip?
(a) Potassium rich diet
(b) Carbohydrate diet
(c) Protein rich diet
(d) Fat rich diet
15. What is the purpose of antiembolism
stockings used for patient after surgery?
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DPP
(a) Antiembolism stockings prevent blood
from pooling in the legs.
(b) Antiembolism stockings keep the blood
vessels constricted
(c) Antiembolism stockings keep the blood
pressure lower in the legs.
(d) Antiembolism stockings reduce blood
flow to the extremities.
16. How should the nurse position the chair
to facilitate transferring the patient from
the bed?
(a) Perpendicular to the bed
(b) At the end of the bed
(c) Parallel with the bed
(d) Away from bed
17. When preparing the patient for cast
application, which of the following
statement by the nurse is most accurate?
(a) You may feel itchy while the cast is wet.
(b) You will feel warm as the wet plaster sets.
(c) You will feel a foul odour until the cast is
dry.
(d) You feel anxiety after plaster is dry.
18. How can the nurse best support the wet
cast while the physician wraps the arm
with rolls of wet plaster?
(a) By using the finger of hands
(b) By resting it on a firm mattress
(c) By using a restrain
(d) By using the palms of the hands
19. After the arm cast has been applied,
which nursing observation is the best
indication that the patient may be
developing compartment syndrome
except?
(a) The fingers develop muscle spasms.
(b) The patient's hand becomes appear pale.
(c) The patient experiences severe pain.
(d) The radial pulse feels weak or absent.
20. Which of the following is the highest
priority when planning care of a patient
with permanent paraplegia?
(a) Teaching the patient about prevention of
skin breakdown
(b) Avoided rehabilitation to the patient
(c) Strengthening the patient's upper body
muscles
MUSCULO SKELETAL SYSTEM
(d) Letting the patient verbalize about the
accident
21. Which of the following is the best method
to assess circulation in the casted
extremity?
(a) Ask the patient to wiggle the fingers.
(b) Depress the patient's nail beds, and
document the time it takes for the color to
return.
(c) Inserts a finger between the cast.
(d) Ask to patient about deep breathing
22. which of the following equipment should
the nurse anticipate needing to facilitate
the client's bowel elimination after apply
hip spica cast is used to immobilize and
promote healing of a hip joint or
fractured femur?
(a) Raised toilet seat
(b) Mechanical lift
(c) Fracture bedpan
(d) Bedside commode
23. Which of the following assessment
finding suggests that the patient in the
hip spica cast may be developing cast
syndrome?
(a) Abdominal distention and abdominal
pain
(b) The patient becomes Hypotensive.
(c) The patient becomes confused.
(d) The patient becomes dyspnoeic
24. Which nursing technique is best when
planning to change the patient's bed
linens when he placed in Buck's traction?
(a) Do not change the sheet
(b) Apply the linens from the foot to the top
of the bed.
(c) Roll the patient from one side of the bed
to the other.
(d) Raise the patient from the bed with a
mechanical lift.
25. Which of the following assessment
finding warrants immediate action by the
nurse when a patient has Buck's traction?
(a) The leg is in line with the pull of the
traction.
(b) The traction weights are hanging above
the Floor.
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DPP
(c) The rope is in the groove of the traction
pulley.
(d) The patient's foot is touching the end of
the bed.
26. Which of the following technique is the
best for assessing circulation in the leg
when a patient has Buck's traction?
(a) Check temperature of patient four hourly
(b) Palpate for pulsation of the Dorsalis
pedis artery.
(c) Take the patient's blood pressure with
popliteal artery
(d) Observe whether the patient can wiggle
or move the toes.
27. To prevent skin breakdown while the
patient is placed in Russell's traction, the
nurse must inspect the skin in which of
the following area?
(a) Near the iliac spine
(b) In the popliteal space
(c) Over the ischial spines
(d) At the metacarpal area
28. Which of the following necessary for the
effectiveness of Russell's traction except?
(a) Traction weights must hang freely above
the floor for effective use.
(b) The patient's foot should not touch the
end of the bed.
(c) The rope is knotted at the location of a
pulley.
(d) The weight is about 61 cm from the floor.
29. Which of the following observation
requires the nurse's immediate attention
when a cervical halter type of skin
traction is applied to a patient?
(a) The weight hangs between the
headboard and wall.
(b) The patient's ears are clear of the
traction ropes.
(c) The halter rests under the patient's chin
and Occiput.
(d) There is a soft pillow beneath the
patient's head
30. Which material added by the nurse is best
for covering the tips of the pin to prevent
injuries while the patient is in skeletal leg
traction?
MUSCULO SKELETAL SYSTEM DPP
(a) Gauze and Cotton balls (a) Elevate the leg for 2 hours and put it flat
(b) Sand bags for 12 hour.
(c) Cork blocks (b) Keep the leg in a level position.
(d) Rubber tubes (c) Keep the leg level for 2 hours and elevate
31. Which of the following finding is the best it for 30 minute.
indication that the patient has an (d) Elevate the leg on pillows continuously
infection at skeletal traction at the pin for 24 to 48 hours.
site? 36. Which of the following is an early
(a) Mucoid drainage at the pin site symptom of compartment syndrome
(b) Bloody drainage at the pin site when a patient has arm cast?
(c) Serous drainage at the pin site (a) Pain during coughing
(d) Purulent drainage at the pin site (b) Pain that increases when the arm is
32. Which of the following nursing dependent
observation provides the best indication (c) Numbness and tingling in the fingers
that the halo cervical traction device is (d) Cold, bluish-colored fingers
applied appropriately? 1. [c] 2. [b] 3. [d] 4. [d] 5. [a]
(a) The client has full range of motion in the 6. [d] 7. [c] 8. [a] 9. [a] 10. [b]
(b) The client's neck pain is within a tolerable 11. [c] 12. [c] 13. [a] 14. [c] 15. [a]
level. 16. [c] 17. [b] 18. [d] 19. [a] 20. [c]
(c) The client reports the ability to see 21. [b] 22. [c] 23. [a] 24. [b] 25. [d]
straight ahead 26. [b] 27. [b] 28. [c] 29. [d] 30. [c]
(d) The patient can feel comfort 31. [d] 32. [c] 33. [b] 34. [c] 35. [d]
33. A nurse is evaluating the pin sites of a 36. [c]
patient in skeletal traction. The nurse
would be least concerned with which of
RHEUMATOID ARTHRITIS
the following findings?
1. Which nursing action a nurse should
(a) Inflammation
avoid when caring for a patient with a
(b) Serous drainage
newly applied long leg cast?
(c) Purulent drainage
(a) Elevating the cast on a pillow
(d) Pain at a pin site
(b) Drying the cast exposed to natural air
34. What is the expectation by nurse when a
(c) Drying the cast by using a bed cradle
patient do not get relief in closed fracture
(d) Handling the cast with fingertips
pain by The nurse elevates the limb,
2. Which of the following is best initial
applies an ice bag, and administers an
response by nurse when a patient
analgesic ?
discomfort and asks the nurse to release
(a) Pain may be caused by the recent
the traction?
occurrence of the fracture
(a) I cannot remove because the weights are
(b) Pain may be caused the anxiety of the
needed to keep the bone aligned"
patient
(b) I will remove half of the weights and
(c) Pain may be caused impaired tissue
notify your health care provider.
perfusion
(c) I have to follow the physician directions,
(d) Pain may be caused Infection under the
and releasing weights is not ordered
cast
(d) Nurse give prescribed pain medication to
35. What is the nursing intervention when a
patient
patient has a leg fracture and had a
plaster cast applied?

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MUSCULO SKELETAL SYSTEM DPP
3. Which of the following assessment where 9. Which of the following laboratory test
nurse should contact to physician during help in diagnosis of rheumatoid arthritis?
care a patient with a long leg cast? (a) Alkaline Phosphatase
(a) Prolonged capillary refilling test (b) Bence Jones protein
(b) Swelling of the toes (c) Antinuclear antibody
(c) Drainage and Foul odour from the plaster (d) Amylase test
cast 10. Which of the following nursing
(d) Both Option A and B intervention should be preventing
4. Which of the following nursing deformities in a patient with rheumatoid
intervention prevent contractures of the arthritis?
joints of the lower extremities in a (a) Bracing of joints
patient with paraplegia except? (b) Massage the joints
(a) Using supportive devices to maintain (c) Active exercise
alignment (d) Isometric exercises
(b) Changing the patient's position every 11. Which of the following joints affect in
hour osteoarthritis?
(c) Providing the patient with active exercise (a) Knees joints
instructions (b) Hips joints
(d) Performing passive range-of-motion (c) Distal inter phalangeal joints
exercises several times daily (d) All of the above
5. What is the use of tilt table when a 12. What is the use of hydrocortisone
patient who has been immobilized? injected into the knee joint of a patient
(a) Prevent loss of calcium from long bones. who diagnosed as rheumatoid arthritis?
(b) Prevent orthostatic hypotension. (a) Reduce joint fever of patient
(c) Maintain circulation to the skin. (b) Reduce inflammation
(d) Both Option A and B (c) Provide Lubrication to the joint
6. What is the purpose of the traction? (d) Prevent risk of fracture
(a) Relieve muscle spasm and pain 13. A patient with rheumatoid arthritis, may
(b) Increase further complication after have following symptoms except?
fracture (a) Boutonniere deformity
(c) Prevent contractures from developing (b) Heber den nodes
(d) Maintain the limb in an external rotation (c) Swan neck deformity
7. What is the appropriate about increase (d) Ulnar drift
the counter traction in a patient who has 14. What is the commonest time where
hip fracture? patient experience maximum pain with
(a) Restraint the patient rheumatoid arthritis?
(b) Increase weight to the traction (a) In the morning on awakening
(c) Elevating the foot of the bed uses gravity (b) During passive exercise
and the patient's weight for counter (c) Cold applications on joint increase pain
traction. (d) When the latex fixation test is positive
(d) Elevate the waist of the patient 15. Which of the following nursing action to
8. Which of the following important prevent deformities of the knee in a
characteristics of the pedal pulses? patient with an exacerbation of arthritis?
(a) Local temperature and visible pulsations (a) Encourage Range of motion exercise of
(b) Color of skin and rhythm the joint
(c) Amplitude (quality) and symmetry (b) Maintain joints in functional alignment
(d) Body balance and vertigo during resting time.
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MUSCULO SKELETAL SYSTEM DPP
(c) Immobilize the joint.
(d) Both A and B
16. Which of the following laboratory test
value diagnostic indicator of rheumatoid
arthritis?
(a) Erythrocyte sedimentation rate
(b) Blood urea nitrogen
(c) Fasting blood sugar
(d) Partial thromboplastin time
17. Which of the following appropriate
nursing action for administer aspirin to a
patient?
(a) Give aspirin with hot coffee.
(b) Give aspirin Give aspirin with cold water.
(c) Give aspirin before meals only.
(d) Give aspirin with food or meals.
18. Which finger joints would the nurse
expect to be most affected by the
rheumatoid arthritis?
(a) Proximal finger joints
(b) Lateral finger joints
(c) Medial finger joints
(d) Distal finger joints
19. Which of the following assessment
finding would the nurse consider a likely
adverse effect of the patient's
Methotrexate therapy?
(a) Constipation
(b) Chest pain
(c) Mouth sores
(d) Polyuria
20. Which of the following assessment
finding is the best indication of aspirin
toxicity?
(a) Dizziness
(b) Ringing in the ears
(c) Orange red colour of urine
(d) Proteinuria
1. [d] 2. [a] 3. [d] 4. [c] 5. [d]
6. [a] 7. [c] 8. [c] 9. [c] 10. [c]
11. [d] 12. [b] 13. [b] 14. [a] 15. [d]
16. [a] 17. [d] 18. [a] 19. [c] 20. [b]

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