MSNCB Musculoskeletal Care 3

Question 1

When assessing capillary refill in a casted extremity, which finding requires the nurse to contact the provider?

Accepted Answer

Refill in 4 seconds with pallor

Answer

Capillary refill greater than 3 seconds with pallor indicates compromised arterial circulation and possible neurovascular compromise.

Question 2

A patient with osteoporosis is prescribed alendronate (Fosamax). Which teaching point is essential?

Accepted Answer

Remain upright for at least 30 minutes after taking the medication

Answer

Bisphosphonates must be taken with plain water on an empty stomach, and the patient must remain upright for 30 minutes to prevent esophageal erosion.

Question 3

Which clinical manifestation differentiates osteomyelitis from a simple soft tissue infection?

Accepted Answer

Persistent bone pain with point tenderness and elevated ESR/CRP

Answer

Osteomyelitis typically presents with bone point tenderness, marked elevation of inflammatory markers (ESR, CRP), and often a positive bone scan.

Question 4

A patient with rheumatoid arthritis (RA) is started on methotrexate. Which laboratory monitoring is required?

Accepted Answer

Liver function tests and complete blood count regularly

Answer

Methotrexate is hepatotoxic and myelosuppressive; LFTs and CBC must be monitored regularly to detect toxicity.

Question 5

A patient returns from the OR after open reduction internal fixation (ORIF) of the radius. What is the priority neurovascular assessment?

Accepted Answer

Check pulses, sensation, and movement of the fingers distal to the injury

Answer

Neurovascular assessment distal to a fracture or surgical site detects early compartment syndrome or vascular injury.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test