Musculoskeletal Nursing for the NCLEX-RN Exam

Common failure modes

These are the patterns that cause most candidates to lose marks on this topic. Recognising them in advance is half the work.

• !Releasing pressure dressings or splints without provider order in suspected compartment syndrome (correct: notify provider for emergent fasciotomy)
• !Forgetting that traction weights must hang freely and never touch the floor
• !Not anticipating fat embolism syndrome (petechiae, dyspnea, mental change) 24–72 hours after long-bone fracture
• !Mixing up DVT prevention measures by surgery type — total hip needs prolonged anticoagulation (35 days)

Study tips

• 1Drill the 6 P's of compartment syndrome (Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia) — pain out of proportion is the earliest sign.
• 2Memorize post-THA precautions: no hip flexion past 90°, no adduction past midline, no internal rotation, abductor pillow in place.
• 3For traction, never lift weights, never bump the bed; check skin integrity at pin sites every 4 hours.
• 4Osteoporosis: bisphosphonates require sitting upright 30 min after dose to prevent esophagitis; check vitamin D and calcium baseline.

Sample NCLEX-RN Musculoskeletal Nursing questions

These sample items mirror the format and difficulty of real NCLEX-RN questions. Practice with thousands more on the free Koydo question bank.

1. 1

   A client 4 hours post-tibial-fracture casting reports severe pain unrelieved by morphine. The nurse notes a tense calf and decreased capillary refill. The priority action is:

   • AElevate the leg above heart level
   • BApply ice to the calf
   • CNotify the provider immediately for suspected compartment syndromeCorrect
   • DReposition the cast for comfort
   Why this answer?

   Pain out of proportion to injury, tense compartment, and decreased capillary refill are classic signs of compartment syndrome — a surgical emergency requiring fasciotomy. Elevation may worsen perfusion; never elevate above heart level when compartment syndrome is suspected.