NCLEX Musculoskeletal Practice Questions and Answers (2023 – 2024) Graded A+
. A patient with an open fracture of the left tibia and soft tissue damage
... [Show More] underwent a surgical reduction and fixation of the tibia with debridement of nonviable tissue and drain placement. When assessing the patient during the postoperative period, the nurse will be most concerned about
a. fever with chills and night sweats.
b. light yellow drainage from the wound.
c. pain on movement of the affected limb.
d. muscle spasms around the affected bone. - Answer: A
Rationale: Fever, chills, and night sweats are suggestive of osteomyelitis. The other clinical manifestations are typical after a fracture repair.
Cognitive Level: Application Text Reference: p. 1669
Nursing Process: Assessment NCLEX: Physiological Integrity
2. A patient is hospitalized for initiation of regional antibiotic perfusion for acute osteomyelitis of the right femur. Which intervention will be included in the plan of care?
a. Frequent weight-bearing exercise
b. Immobilization of the right leg
c. Avoid administration of NSAIDs
d. Support right leg in a flexed position - Answer: B
Rationale: Immobilization of the affected leg helps to decrease pain and reduce the risk for pathologic fractures. Weight-bearing exercise increases the risk for pathologic fractures. NSAIDs are frequently prescribed to treat pain. Flexion of the affected limb is avoided to prevent contractures.
Cognitive Level: Application Text Reference: pp. 1670-1671
Nursing Process: Planning NCLEX: Physiological Integrity
3. A patient is being discharged after 2 weeks of IV antibiotic therapy for acute osteomyelitis in the left leg. Which information will be included in the discharge teaching?
a. The reason for taking oral antibiotics for 7 to 10 days after discharge
b. The need for daily aerobic exercise to help maintain muscle strength
c. How to monitor and care for the long-term IV catheter site
d. How to apply warm packs safely to the leg to reduce pain - Answer: C
Rationale: The patient will be on IV antibiotics for several months, and the patient will need to recognize signs of infection at the IV site and how to care for the catheter during daily activities such as bathing. IV antibiotics rather than oral antibiotics are used for acute osteomyelitis. Patients are instructed to avoid exercise and heat application because these will increase swelling and the risk for spreading infection.
Cognitive Level: Application Text Reference: p. 1670
Nursing Process: Implementation NCLEX: Physiological Integrity
4. A patient has chronic osteomyelitis of the left femur, which is being managed at home with self-administration of IV antibiotics. On a home visit, the nurse identifies the nursing diagnosis of ineffective therapeutic regimen management when the nurse finds that the patient
a. is unable to plantar-flex the foot on the affected side.
b. uses crutches to avoid weight bearing on the affected leg.
c. takes and records the oral temperature twice a day.
d. is irritable and frustrated with the length of treatment required. - Answer: A
Rationale: Footdrop is an indication that the foot is not being supported in a neutral position by a splint. Using crutches and monitoring the oral temperature are appropriate self-care activities. Frustration with the length of treatment is not an indicator of ineffective management of the osteomyelitis.
Cognitive Level: Application Text Reference: p. 1672
Nursing Process: Diagnosis
NCLEX: Health Promotion and Maintenance
5. Which statement by a patient who is scheduled for an above-the-knee amputation for treatment of an osteogenic sarcoma of the right tibia indicates that patient teaching is needed? [Show Less]