CMSRN Neurological and Musculoskeletal Care 2

Question 1

A patient with a hip fracture is being assessed for neurovascular status. Which assessment finding requires immediate reporting?

Accepted Answer

Absent distal pulse and pallor in the affected extremity

Answer

Absent pulse and pallor indicate arterial compromise to the limb, which is a vascular emergency requiring immediate intervention to prevent limb loss.

Question 2

Which precaution is essential for a patient who has undergone a posterior total hip replacement?

Accepted Answer

Do not flex the hip beyond 90 degrees

Answer

Posterior hip precautions prohibit hip flexion beyond 90 degrees, adduction past midline, and internal rotation to prevent dislocation of the prosthesis.

Question 3

A patient with a long-bone fracture of the femur suddenly develops petechiae on the chest and axillae, confusion, and dyspnea 24 hours post-injury. What complication does the nurse suspect?

Accepted Answer

Fat embolism syndrome

Answer

Fat embolism syndrome presents with the classic triad of petechiae (especially on upper body), respiratory distress, and neurological changes 24–72 hours after long-bone fracture.

Question 4

A patient post-total knee replacement complains of calf pain, warmth, and swelling. The priority nursing action is to:

Accepted Answer

Notify the provider and avoid massaging or manipulating the extremity

Answer

These symptoms suggest deep vein thrombosis; the extremity should not be massaged or manipulated, and the physician must be notified to arrange imaging and anticoagulation.

Question 5

When assessing a patient's cast for compartment syndrome, the nurse monitors for which primary symptom?

Accepted Answer

Pain unrelieved by opioids and out of proportion to the injury

Answer

Pain that is disproportionate to the injury and unrelieved by analgesics is the earliest and most significant symptom of compartment syndrome.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Neurological and Musculoskeletal Care 2