Musculoskeletal System Practice Test 8
Musculoskeletal System NCLEX Practice Test
Musculoskeletal System is a key topic within the NCLEX test plan, located under Nursing Science → Clinical Foundations → Musculoskeletal System. This section emphasizes mobility, rehabilitation, and nursing interventions for injury prevention. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 8th part of the Musculoskeletal System series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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In the Musculoskeletal System Study Cards section, shared by real NCLEX candidates, you’ll find concise summaries and high-yield insights related to the most tested concepts. It’s a perfect space to reinforce challenging topics and sharpen your recall through quick, focused repetitions. Short, powerful, and repeatable!
Musculoskeletal System Practice Test 8
Which structure connects muscles to bones?
- Ligaments
- Cartilage
- Tendons
- Fascia
Explanation: Answer reason: Tendons are dense connective tissues that attach skeletal muscle to bone, transmitting the force of muscle contraction to produce movement at joints. In contrast, ligaments connect bone to bone and stabilize joints. Cartilage cushions and supports joints, and fascia primarily surrounds and separates muscles rather than forming the primary attachment to bone. Category reason: This question tests foundational knowledge of connective tissue structures (tendon vs ligament) within the musculoskeletal system, which is a core anatomy/biomedical concept rather than a nursing intervention decision.
Knee joint is?
- Hinge
- Fibrous
- Pivot
- Ball and socket
Explanation: Answer reason: The knee is a synovial joint that primarily permits flexion and extension, making it classified as a (modified) hinge joint. Although it can allow a small amount of rotation when flexed, its dominant movement pattern is hinge-like. It is not fibrous (which are largely immovable), not a pivot joint (rotation around a single axis like the atlantoaxial joint), and not a ball-and-socket joint (multiaxial like the hip/shoulder). Category reason: This question tests classification of a joint type in the skeletal system, which is foundational anatomy/biomechanics content within the Musculoskeletal System.
Which bone of the wrist is most commonly fractured?
- Scaphoid
- Triquetrum
- Lunate
- Pisiform.
Explanation: Answer reason: The scaphoid is the most commonly fractured carpal bone, classically after a fall onto an outstretched hand with wrist extension. It is clinically important because its proximal pole has a relatively tenuous blood supply, increasing risk for nonunion and avascular necrosis if missed. Triquetrum fractures are less common and often occur as dorsal avulsion injuries, while lunate is more associated with dislocation than being the most frequently fractured. Pisiform fractures are rare. Category reason: The question tests foundational knowledge of carpal bone anatomy and common injury patterns, which is primarily a musculoskeletal system science topic rather than a nursing intervention or prioritization scenario.
The hardest connective tissue is?
- Cartilage
- Bone
- Ligament
- Tendon
Explanation: Answer reason: Bone is the hardest connective tissue because its extracellular matrix is mineralized, primarily with hydroxyapatite (calcium phosphate) crystals, which provides high compressive strength and rigidity. Cartilage is firm but not mineralized to the same extent, so it is less hard. Ligaments and tendons are dense regular connective tissue rich in collagen, optimized for tensile strength rather than hardness. Category reason: This question tests foundational knowledge of connective tissues and skeletal tissue properties, which is primarily covered under the Musculoskeletal System in nursing science.
What is the longest bone in the human body?
- Femur
- Tibia
- Humerus
- Radius
Explanation: Answer reason: The femur is the longest and strongest bone in the human body, extending from the hip to the knee. Its length and robust structure support body weight and enable major movements like walking and running. The tibia is also long but is shorter than the femur, while the humerus and radius are upper-limb bones and are not the longest overall. Category reason: This is a factual question about skeletal anatomy (identifying the longest bone), which falls under the Musculoskeletal System in Nursing Science rather than nursing care decision-making.
What makes Bones be too strong..?
- Zinc
- Calcium
- Sodium
- Potassium
Explanation: Answer reason: Calcium is the primary mineral responsible for bone hardness and strength through hydroxyapatite crystal formation in the bone matrix. Adequate calcium supports normal bone mineralization, whereas sodium and potassium mainly function as electrolytes for fluid balance and nerve/muscle function. Zinc is a trace element involved in enzymes and growth but is not the main determinant of bone strength compared with calcium. Category reason: The question tests which mineral is most directly responsible for bone strength and mineralization, a foundational concept in the musculoskeletal system.
Which joint in your arm is where the humerus, radius, and ulna bones meet?
- Thigh
- Hand
- Elbow
Explanation: Answer reason: The humerus articulates with the radius and ulna at the elbow joint. Specifically, the humeroulnar and humeroradial articulations (along with the proximal radioulnar joint) form the elbow complex. The thigh and hand do not contain the humerus, and they are not the anatomical site where these three bones meet. Category reason: This is a foundational anatomy question about where specific bones articulate, which falls under the Musculoskeletal System rather than nursing judgment or patient-care decision-making.
What type of joint is found in the shoulder?
- Gliding
- Hinge
- Fixed
- Ball and Socket
Explanation: Answer reason: The shoulder (glenohumeral) joint is a synovial ball-and-socket joint formed by the head of the humerus articulating with the glenoid fossa of the scapula. This joint type permits movement in multiple planes, including flexion/extension, abduction/adduction, and internal/external rotation. Gliding joints (e.g., intercarpal), hinge joints (e.g., elbow), and fixed joints (e.g., skull sutures) do not match the shoulder’s wide range of motion. Category reason: The question tests identification of a joint type based on anatomy of the shoulder, which is foundational musculoskeletal system knowledge rather than a nursing intervention or clinical judgment scenario.
What is the primary motion of the wrist joint?
- Flexion
- Extension
- Rotation
- Circumduction.
Explanation: Answer reason: The wrist (radiocarpal) joint is a condyloid (ellipsoid) synovial joint, whose characteristic/primary movements are flexion, extension, abduction, and adduction, which combine to produce circumduction. True axial rotation is not a primary motion at the wrist; pronation-supination occurs mainly at the radioulnar joints. Compared with single-plane motions like flexion or extension, circumduction best represents the wrist’s primary combined movement pattern enabled by its biaxial design. Category reason: This question tests foundational joint biomechanics and types of movement at the wrist, which is core anatomy/functional knowledge of the musculoskeletal system rather than a nursing care decision.
What type of joints are found in the shoulder?
- Ball and socket
- Hinge
- Suture
- Gliding
Explanation: Answer reason: Ball and socket The primary shoulder (glenohumeral) joint is a ball-and-socket synovial joint formed by the head of the humerus (ball) and the glenoid fossa of the scapula (socket). This structure permits movement in multiple planes, including flexion/extension, abduction/adduction, and rotation. Hinge joints allow mainly flexion/extension (e.g., elbow), sutures are immovable skull joints, and gliding joints occur between relatively flat surfaces (e.g., some carpal bones). Category reason: This is a foundational question about classification and function of a specific skeletal joint, which is primarily studied within the Musculoskeletal System rather than nursing care decision-making.
Which doctor is for bone and joint problems?
- Dermatologist
- Dentist
- Orthopedic
- ENT
Explanation: Answer reason: Orthopedic Orthopedic doctors specialize in the musculoskeletal system, including bones, joints, ligaments, tendons, and related injuries or degenerative conditions. Bone and joint problems such as fractures, arthritis, and joint pain are typically evaluated and treated by orthopedics. Dermatologists treat skin conditions, dentists treat teeth and oral structures, and ENT specialists treat ear, nose, and throat disorders. Category reason: This is a foundational question about which medical specialty manages bone and joint conditions, which primarily tests knowledge of the musculoskeletal system rather than nursing interventions.
Which type of muscle is voluntary?
- Cardiac
- Smooth
- Skeletal
- None of the above
Explanation: Answer reason: Skeletal Skeletal muscle is under voluntary control via the somatic nervous system, allowing conscious movement of bones and joints. Cardiac muscle contracts involuntarily through intrinsic pacemaker activity modulated by the autonomic nervous system. Smooth muscle is also involuntary and is controlled primarily by autonomic nerves, hormones, and local factors in organs and blood vessels. Category reason: This tests identification of voluntary vs involuntary muscle types, a core concept of the muscular/musculoskeletal system within anatomy and physiology rather than nursing interventions or clinical prioritization.
Which bone is the longest in the human body?
- Humerus
- Tibia
- Femur
- Radius
Explanation: Answer reason: Femur The femur (thigh bone) is the longest and strongest bone in the human body, extending from the hip to the knee. Its length and robust structure support body weight and enable major lower-limb movements. The humerus, tibia, and radius are long bones as well, but they are shorter than the femur. Category reason: This question tests factual identification of a major bone of the skeletal system, which is core musculoskeletal anatomy rather than nursing care decision-making.
The condition where the big toe deviates laterally is called?
- Flat foot
- Hallux valgus
- Gout
- Hammer toe
Explanation: Answer reason: Hallux valgus Hallux valgus is a deformity in which the great toe deviates laterally toward the other toes, often associated with a medial prominence at the first metatarsophalangeal joint (bunion). Flat foot refers to loss of the medial longitudinal arch, not toe deviation. Gout is an inflammatory arthritis (often at the first MTP) but does not specifically describe lateral deviation. Hammer toe is flexion deformity of the proximal interphalangeal joint, typically affecting lesser toes rather than the great toe. Category reason: This is a terminology/anatomy-based identification of a foot deformity (lateral deviation of the great toe), which falls under musculoskeletal system knowledge rather than nursing care decision-making.
Ligament injury resulting from over stress is known as?
- Abduction
- Strain
- Sprain
- Subluxation
Explanation: Answer reason: Sprain A sprain is an injury to a ligament caused by overstretching or tearing, commonly due to twisting forces at a joint. In contrast, a strain refers to injury of muscle or tendon. Abduction is a movement (away from midline), not an injury diagnosis, and subluxation is a partial dislocation of a joint. Category reason: This question tests foundational knowledge distinguishing types of musculoskeletal injuries (ligament vs muscle/tendon), which fits the Musculoskeletal System subject area.
Which bone is the longest in the human body?
- Tibia
- Humerus
- Femur
- Fibula
Explanation: Answer reason: Femur The femur (thigh bone) is the longest and strongest bone in the human body, extending from the hip to the knee. Its length and robust structure support body weight and facilitate locomotion. The tibia and fibula are bones of the lower leg and are shorter than the femur, while the humerus is the longest bone of the upper limb but not the entire body. Category reason: This question tests foundational knowledge of human skeletal anatomy—identifying the longest bone—within the musculoskeletal system rather than nursing care decision-making.
What is the main component of bones?
- Protein
- Calcium
- Potassium
Explanation: Answer reason: Calcium Bone’s hardness and strength largely come from mineralized matrix, primarily hydroxyapatite (a calcium phosphate crystal) deposited on a collagen framework. While collagen (protein) is an important organic component providing tensile strength, the predominant mineral component is calcium in the form of calcium phosphate salts. Potassium is not a principal structural component of bone. Category reason: This question tests basic composition of bone tissue (a core topic within the musculoskeletal system) rather than nursing interventions or patient-care decisions.
Scapula bone present in?
- Rib
- Humerus
- Radius
- Pelvis
Explanation: Answer reason: Humerus The scapula is the shoulder blade, part of the pectoral (shoulder) girdle. It articulates with the head of the humerus at the glenohumeral (shoulder) joint via the glenoid cavity. It does not form joints with the ribs, radius, or pelvis in standard human anatomy. Category reason: This tests identification and relationships of skeletal structures of the upper limb/shoulder girdle, which falls under the Musculoskeletal System.
WHICH OF THE FOLLOWING MUSCLES CAUSES LATERAL ROTATION OF THE HIP JOINT?
- GLUTEUS MAXIMUS
- GLUTEUS MINIMUS
- ADDUCTOR MAGNUS
- GLUTEUS MEDIUS
Explanation: Answer reason: GLUTEUS MAXIMUS Gluteus maximus is a prime mover for hip extension and also produces lateral (external) rotation at the hip due to its fiber orientation and insertion into the femur/iliotibial tract. Gluteus medius and minimus primarily abduct and medially rotate the hip (especially their anterior fibers). Adductor magnus primarily adducts the hip and does not serve as the main lateral rotator in standard anatomy teaching. Category reason: This is a foundational anatomy/biomechanics question about actions of specific hip muscles, which falls under the Musculoskeletal System.
Which bone has a longer half-life?
- Humerus
- Femur
- Radius
- Clavicle
Explanation: Answer reason: Femur Bone “half-life” refers to the time required for half of a bone’s mineral content to be renewed through remodeling. Dense cortical bone generally has a slower turnover (longer half-life) than bones with relatively more trabecular bone. The femur is a large weight-bearing long bone with substantial cortical thickness, so its remodeling is slower, giving it a longer half-life compared with the other listed bones. Category reason: This question tests foundational knowledge about skeletal bone composition and remodeling/turnover differences among bones, which is primarily Musculoskeletal System content rather than a nursing care decision.
All of the following are functions of the skeletal system EXCEPT?
- Protection of vital organs
- Production of hormones
- Support and structure
- Blood cell production
Explanation: Answer reason: Production of hormones The primary functions of the skeletal system include support/structure, protection of vital organs (e.g., skull, rib cage), and hematopoiesis (blood cell production) in red bone marrow. “Production of hormones” is not typically listed as a core skeletal function in standard nursing/anatomy frameworks; hormone production is classically an endocrine system role. Therefore, it is the best exception among the choices. Category reason: This question tests foundational knowledge of the musculoskeletal system’s normal functions (support, protection, and hematopoiesis), which is a basic biomedical science concept rather than a nursing intervention decision.
What's the strongest muscle (by weight) in the human body?
- Gluteus maximus
- Heart
- Masseter
- Biceps brachii
Explanation: Answer reason: Masseter The masseter (a jaw-closing muscle) can generate very high bite forces relative to its size, making it commonly cited as the strongest muscle by weight. The gluteus maximus is often considered the largest muscle by mass, not necessarily the strongest per unit weight. The heart is powerful and continuously active but is not typically labeled the “strongest by weight” in standard anatomy trivia. Biceps brachii does not produce forces comparable to the masseter relative to its cross-sectional area. Category reason: This is a foundational anatomy/musculoskeletal knowledge question about comparative muscle strength rather than a nursing care decision, so it fits NursingScience under the Musculoskeletal System.
Goniometer is used to assess?
- Auditory faculty
- Muscle strength
- Range of motion of joints
- Visual Activity
Explanation: Answer reason: range of motion of joints A goniometer is a measurement tool used to quantify joint angles, which directly reflects a joint’s range of motion (ROM). ROM assessment is used to evaluate musculoskeletal function and limitations due to injury, inflammation, contractures, or post-operative status. Auditory and visual functions are assessed with hearing/vision tests, and muscle strength is assessed with manual muscle testing scales rather than a goniometer. Category reason: This item tests knowledge of an instrument used to measure joint movement/angles, which is a foundational concept in evaluating the musculoskeletal system rather than a nursing management or prioritization decision.
A nurse is assessing a client with scoliosis. Which physical finding is expected?
- Even shoulder height
- Straight spine
- Lateral spinal curvature
- Exaggerated lumbar lordosis
Explanation: Answer reason: Scoliosis is defined by an abnormal lateral curvature of the spine, often accompanied by vertebral rotation. Common assessment findings include asymmetry such as uneven shoulders/hips and a rib hump on forward-bend testing, reflecting the lateral curve. The other options describe normal alignment or a different spinal curvature disorder (lordosis is an exaggerated inward lumbar curve). Category reason: This question tests recognition of a characteristic structural abnormality of the spine, which is primarily musculoskeletal anatomy/orthopedic science rather than a nursing intervention or prioritization scenario.
Which animal tissue connects bone to muscle?
- Ligament
- Nerve
- Tendon
- Epithelium
Explanation: Answer reason: Tendons are dense regular connective tissue structures that attach skeletal muscle to bone, allowing force generated by muscle contraction to be transmitted to the skeleton to produce movement. In contrast, ligaments connect bone to bone and primarily stabilize joints. Nerves conduct electrical signals, and epithelium covers and lines surfaces rather than providing musculoskeletal attachment. Category reason: This is a foundational anatomy question about connective tissues in the musculoskeletal system rather than a nursing care decision or safety/intervention scenario.
The strongest ligament in the human body is?
- Ligamentum teres
- Iliofemoral ligament.
- Anterior cruciate ligament
- Posterior cruciate ligament.
Explanation: Answer reason: It is a very thick, strong capsular ligament of the hip (Y-shaped) that resists hyperextension and helps maintain upright posture with minimal muscular effort. Compared with the cruciate ligaments, which are strong but specialized to stabilize the knee, this hip ligament is classically cited as the strongest ligament in the body. Ligamentum teres primarily contributes to hip stability and carries a small vascular supply but is not the strongest. Category reason: This question tests identification of a specific ligament and comparative strength within the hip/knee anatomy, which is core musculoskeletal anatomy knowledge rather than nursing care decision-making.
The functional unit of skeletal muscle is called?
- Sarcolemma
- Myofibril
- Synapse
- Sarcomere
Explanation: Answer reason: Skeletal muscle contraction occurs through the sliding-filament mechanism within repeating segments of myofibrils. The smallest repeating segment that contains the organized actin and myosin filaments and generates force is the sarcomere, making it the functional contractile unit. The sarcolemma is the muscle cell membrane, a myofibril is a bundle of sarcomeres, and a synapse refers to a junction between excitable cells rather than the contractile unit. Category reason: This tests foundational knowledge of skeletal muscle structure and the basic contractile unit, which is a core topic within the Musculoskeletal System rather than nursing care decision-making.
Which of the following is the most common cause of structural kyphosis in adolescents?
- Rickets
- Scheuermann’s disease
- Postural habits
- Osteoporosis
Explanation: Answer reason: Structural kyphosis in adolescents is most commonly due to Scheuermann kyphosis, a growth-related disorder causing anterior wedging of multiple thoracic vertebral bodies and a rigid spinal curve. This contrasts with postural kyphosis, which is typically flexible and correctable with positioning. Rickets can cause bone deformities but is a less common cause of adolescent structural kyphosis in typical settings. Osteoporosis is uncommon as a primary cause of kyphosis in adolescents and is more associated with older adults or specific secondary conditions. Category reason: This question tests etiologic knowledge of a spinal deformity (kyphosis) and the underlying musculoskeletal disorder most associated with rigid, structural curvature in adolescents, which is foundational Musculoskeletal System content rather than nursing interventions or prioritization.
Which muscle is called "workhorse of elbow flexion"?
- Biceps brachii
- Brachialis
Explanation: Answer reason: b) brachialis It is the primary elbow flexor in most forearm positions because it inserts on the ulna and therefore acts independently of forearm pronation/supination. This makes it a consistent, powerful contributor to elbow flexion across functional movements. In contrast, the biceps brachii is a strong supinator and its elbow-flexion contribution varies with forearm position (strongest with supination). Category reason: This is a foundational anatomy/biomechanics question about which muscle primarily produces elbow flexion, which fits the Musculoskeletal System within NursingScience rather than nursing judgment or interventions.
The Strongest bone in the Human body is?
- Femur
- Tibia
- Humerus
- Radius
Explanation: Answer reason: A) Femur It bears the greatest load during standing and ambulation and has a large diameter with thick cortical bone, giving it very high compressive and bending strength. As the primary weight-bearing long bone of the lower extremity, it is structurally adapted to resist the largest mechanical stresses. The tibia is also weight-bearing but is generally considered less strong than the femur overall, and the humerus/radius are upper-limb bones subjected to lower habitual loads. Category reason: This is a foundational question about which skeletal bone has the greatest strength, which falls under the Musculoskeletal System rather than nursing care decision-making.
“Haversian canals” are found in _?
- Brain
- Heart
- Bone
Explanation: Answer reason: They are central canals within osteons of compact bone that contain blood vessels and nerves to nourish and innervate bone tissue. These canals run longitudinally and are connected to each other by Volkmann’s canals, supporting nutrient and waste exchange. This is a hallmark microscopic feature of compact bone organization rather than nervous or cardiac tissue. Category reason: This tests a structural feature of compact bone (osteons and their central canals), which is core content of the Musculoskeletal System in nursing science.
---- is the science of treatment of musclar and skeletal system.?
- Odontology
- Ophthalmology
- Orthopaedics
- Paediatrics
Explanation: Answer reason: It is the medical specialty focused on diagnosing and treating disorders of bones, joints, muscles, ligaments, tendons, and related structures. This includes trauma care (e.g., fractures), degenerative disease (e.g., osteoarthritis), congenital problems, and rehabilitation of function. The other options refer to teeth, eyes, or child health rather than the musculoskeletal system. Category reason: This is a foundational question about which medical specialty treats the musculoskeletal system, so it best fits Musculoskeletal System under NursingScience rather than nursing care decision-making.
Shoulder joint is?
- Ball and socke
- Hinge
- Fibrous
- Pivot
Explanation: Answer reason: The glenohumeral (shoulder) joint is a synovial joint where the rounded head of the humerus articulates with the shallow glenoid fossa of the scapula, allowing movement in multiple planes. This configuration permits flexion/extension, abduction/adduction, and internal/external rotation with circumduction. Hinge joints primarily allow flexion/extension, pivot joints allow rotation around a single axis, and fibrous joints have minimal to no movement. Category reason: This tests identification of the type of the shoulder articulation, which is foundational anatomy and joint classification within the musculoskeletal system.
Connects muscle to the bones?
- Areolar
- Cartilage
- Tendons
- Ligaments
Explanation: Answer reason: Tendons are dense, collagen-rich connective tissues that attach skeletal muscle to bone, transmitting the force of muscle contraction to produce movement. Ligaments instead connect bone to bone and stabilize joints. Cartilage provides cushioning and structural support in joints, not muscle attachment. Areolar tissue is loose connective tissue used for packing and support, not for strong muscle-to-bone linkage. Category reason: This item tests foundational knowledge of connective tissues and how muscles attach to bones, which is core content within the Musculoskeletal System rather than a nursing intervention or clinical judgment scenario.
Osgood-Schlatter disease effects:
- Humerus
- Femur
- Tibia
- Fibula
Explanation: Answer reason: Osgood-Schlatter disease is traction apophysitis of the tibial tuberosity caused by repetitive pulling of the patellar tendon during growth spurts, commonly in adolescents who run/jump. The pathology localizes to the anterior proximal tibia just below the knee, producing pain and swelling over the tibial tubercle. The humerus, femur, and fibula are not the classic site of this overuse injury. Category reason: This tests recognition of the anatomic site affected by a named overuse condition (tibial tuberosity), which is primarily musculoskeletal anatomy/pathophysiology knowledge rather than a nursing care decision.
A 20-year-old man falls while playing football and lands on his right arm. He presents with pain, swelling, and an obvious deformity of the right upper arm. What is the most likely diagnosis?
- Clavicle fracture
- Rotator cuff tear
- Proximal humerus fracture
- Wrist dislocation
Explanation: Answer reason: A fall onto the arm with pain, swelling, and an obvious deformity localized to the upper arm most strongly indicates a fracture of the humerus rather than a shoulder soft-tissue injury. A rotator cuff tear typically causes shoulder pain and weakness (especially abduction) without a gross bony deformity. Clavicle fractures more often present with deformity over the clavicle/shoulder girdle, and a wrist dislocation would localize deformity and swelling to the wrist rather than the upper arm. Category reason: This question tests recognition of an acute traumatic injury of a specific bone region (upper arm/humerus), which is foundational musculoskeletal injury knowledge rather than a nursing intervention or prioritization scenario.
A 35 year old male manual labourer sustained a displaced subcapital hip fracture after falling at work. The fracture was reduced and fixed with 3 cannulated screws. Five months after the operation, he presents to your clinic with worsening hip pain. What is the most likely diagnosis?
- Nonunion
- Osteonecrosis
- Loosening of the cannulated screws
- Malunion
- Osteomyelitis
Explanation: Answer reason: Displaced subcapital (intracapsular) femoral neck fractures commonly disrupt the retinacular blood supply to the femoral head, predisposing to avascular necrosis even after apparently successful screw fixation. Progressive/worsening groin or hip pain months after surgery is a classic presentation of developing femoral head osteonecrosis. Nonunion more often presents with persistent pain and failure of radiographic healing, while infection would usually include systemic signs or elevated inflammatory markers. Category reason: This item tests complication mechanisms and diagnosis after an intracapsular femoral neck fracture fixation (vascular compromise leading to avascular necrosis), which is foundational musculoskeletal pathology rather than a nursing intervention or prioritization task.
A 75 year old lady slips on a throw rug in her living room and falls. An X-ray reveals a displaced subcapital hip fracture. Prior to her fall, the patient lived alone, performed all ADLs independently and enjoyed golfing. The most appropriate management of this fracture is?
- Moore’s unipolar hemiarthroplasty
- Bedrest for 6 weeks
- Reduction with internal fixation using 3 cannulated screws
- Bipolar hemiarthroplasty
- Total hip replacement
Explanation: Answer reason: In an active, cognitively intact older adult with a displaced subcapital (intracapsular) femoral neck fracture, arthroplasty is preferred because the femoral head blood supply is compromised, making nonunion and avascular necrosis more likely with internal fixation. Total hip replacement is favored over hemiarthroplasty in independently mobile patients with higher functional demands because it generally provides better functional outcomes and lower long-term pain. Bedrest is inappropriate due to high morbidity (DVT, pneumonia, deconditioning) and does not address the displaced fracture. Unipolar/bipolar hemiarthroplasty is more often chosen for lower-demand or frailer patients where maximizing function is less critical. Category reason: This item tests orthopedic management of a displaced intracapsular femoral neck fracture and selection among surgical procedures, which is foundational musculoskeletal knowledge rather than nursing judgment/interventions.
A 21 year old presents to your office after injuring her knee in a soccer game. She states that the knee clicks when she walks and has “locked” on several occasions. On exam there is an effusion and the knee is grossly stable. The most likely diagnosis is?
- Anterior cruciate ligament tear
- Meniscal tear
- Osteoarthritis
- Bursitis
- Medial collateral ligament tear
Explanation: Answer reason: Mechanical symptoms like clicking and intermittent locking strongly suggest a meniscal injury due to a torn fragment catching in the joint. A knee effusion can occur with internal derangement, and the report that the knee is grossly stable argues against major ligament instability as the primary problem. ACL tears typically present with acute instability and positive laxity tests, while MCL injury causes medial pain with valgus stress, and bursitis/osteoarthritis are less consistent with acute locking in a young athlete. Category reason: This is a diagnostic question about traumatic knee pathology and characteristic clinical features of joint internal derangements, which fits the Musculoskeletal System foundational science domain rather than nursing intervention decision-making.
Knee joint and elbow joint are examples of?
- Ball & Socket joint
- Saddle album
- Pivot joint
- Hinge joint
Explanation: Answer reason: These joints primarily allow flexion and extension in a single plane, which is characteristic of a hinge-type synovial joint. The elbow is a classic hinge joint permitting bending and straightening of the forearm. The knee is a modified hinge joint where flexion and extension predominate, with only limited rotation when flexed, so it is still best classified as a hinge joint among the given choices. Category reason: This question tests classification of joint types and movements, which is foundational musculoskeletal anatomy/biomechanics rather than nursing interventions.
The most common bone fracture in body is?
- Radius
- Clavicle
- Femur
- Vertebra
Explanation: Answer reason: Falls onto an outstretched hand commonly transmit force to the distal forearm, making distal radius fractures (e.g., Colles fracture) very frequent across age groups. By contrast, clavicle fractures are common but generally less frequent than distal radius fractures in overall population statistics. Femur fractures are less common and typically require higher-energy trauma (or severe osteoporosis). Vertebral fractures occur in osteoporosis but are not the most common overall fracture type across the general population. Category reason: This is a foundational anatomy/orthopedic fact about which bone is most frequently fractured, without requiring nursing prioritization or interventions, so it fits NursingScience under the Musculoskeletal System.
Which is the largest synovial joint of the human body?
- Knee Joint
- Shoulder Joint
- Wrist Joint
- Ankle Joint
Explanation: Answer reason: It is considered the largest synovial joint because it has the greatest articular surface area and the most extensive joint capsule among synovial joints. It is a complex, weight-bearing joint formed primarily by the femur, tibia, and patella and includes multiple compartments. Its large size and supporting ligaments/menisci reflect the high mechanical demands placed on it during standing and ambulation. Category reason: This question tests identification of a major joint based on structural anatomy, which falls under the Musculoskeletal System rather than nursing care decisions.
An abnormal lateral curvature of spine is known as ____.?
- Ankylosis
- Lordosis
- Scoliosis
- Kyphosis
Explanation: Answer reason: A lateral (side-to-side) deviation of the vertebral column is termed scoliosis and often presents with asymmetric shoulder/hip height or rib prominence on forward bending. Lordosis refers to an exaggerated inward (anterior) curvature, typically lumbar. Kyphosis refers to an exaggerated outward (posterior) thoracic curvature. Ankylosis describes abnormal stiffening/fusion of a joint rather than a curvature pattern. Category reason: This item tests identification of a spinal curvature deformity, a core concept in the musculoskeletal system rather than nursing care decision-making.
Which finding indicates successful healing of a fractured tibia?
- Absence of pain at the fracture site
- Increase in white blood cells
- Capillary refill <4 seconds
- Callus formation on X-ray
Explanation: Answer reason: Radiographic callus indicates the reparative phase of bone healing, showing new woven bone bridging the fracture and increasing stability. Absence of pain is subjective and can be influenced by analgesics or nerve injury, so it is not a reliable marker of union. Increased WBC suggests inflammation or infection rather than healing, and normal capillary refill reflects perfusion but not bone repair progression. Category reason: This question tests objective evidence of fracture union and bone repair physiology, which is primarily a Musculoskeletal System foundational science concept rather than a nursing intervention decision.
A complication of osteoporosis is?
- Rheumatoid arthritis
- Gouty arthritis
- Dorsal flexion
- Joint deformity
Explanation: Answer reason: Osteoporosis reduces bone mass and microarchitectural integrity, making bones fragile and prone to vertebral compression fractures. Recurrent vertebral collapse can alter spinal alignment (e.g., kyphosis), leading to visible skeletal shape changes that are often described clinically as deformity. Rheumatoid arthritis and gouty arthritis are inflammatory arthritides and are not complications caused by low bone density itself. “Dorsal flexion” is a movement term rather than a disease consequence.
Colle's fracture refers to the Injury of :-
- Shoulder Joint
- Wrist Joint
- Knee Joint
- Elbow Joint
Explanation: Answer reason: This injury occurs at the wrist region because the distal radius forms the primary bony support of the radiocarpal joint. Therefore the associated joint region tested is the wrist rather than proximal joints. Other listed joints are anatomically unrelated to the characteristic distal radius fracture mechanism and location.
Gallow's fraction is used for?
- Fracture shaft of femur
- Fracture neck of femur
- Fracture humerus
- Fracture tibia
Explanation: Answer reason: The technique relies on the child’s low body weight and intact skin for safe traction forces, which is why it is not a standard treatment for adult long-bone fractures. Fractures of the femoral neck typically require urgent surgical fixation due to risks like avascular necrosis rather than traction as definitive care. Humerus and tibia fractures have different preferred immobilization/traction approaches and are not the classic indication for this traction type.
Bone growth occurs at:
- Shaft
- Epiphysis
- Diaphysis
- Medulla
Explanation: Answer reason: Chondrocytes proliferate and hypertrophy here, and the cartilage is progressively replaced by bone through endochondral ossification, lengthening the bone until plate closure. The diaphysis/shaft is primarily the site of cortical bone and marrow cavity rather than the key location for length increase. The medulla refers to the marrow cavity contents and does not control bone length growth.
Which is the nurse's best explanation to the parent of a toddler who asks what a greenstick fracture is?
- “It is a fracture in the growth plate of the bone.”
- “It is a fracture that does not go all the way through the bone.”
- “Because children’s bones are not fully developed, any fracture in a young child is called a greenstick fracture.”
- “It is a fracture in which a complete break occurs in the bone and small pieces of bone are broken off.”
Explanation: Answer reason: ” A greenstick fracture is an incomplete fracture where the bone bends and cracks but the break does not extend through the entire cortex, which is common in young children due to their more flexible bones. This description directly explains the key defining feature in parent-friendly language. A growth-plate fracture is specifically a physeal (Salter-Harris) injury, which is a different entity. A complete break with fragments describes a comminuted fracture, not a greenstick injury.
The nurse admits a 7 year-old to the emergency room after a leg injury. The x-rays show a femur fracture near the epiphysis. The parents ask what will be the outcome of this injury. The appropriate response by the nurse should be which of these statements?
- "The injury is expected to heal quickly because of thin periosteum."
- "In some instances the result is a retarded bone growth."
- "Bone growth is stimulated in the affected leg."
- "This type of injury shows more rapid union than that of younger children."
Explanation: Answer reason: " Fractures near the epiphysis can involve the growth plate (physis), which is responsible for longitudinal bone growth in children. Damage to this cartilage can lead to premature closure or asymmetric growth, resulting in limb-length discrepancy or angular deformity. This is a recognized complication of physeal injuries even when alignment is restored. A common misconception is that pediatric fractures always heal faster without consequence; while healing is often quicker, growth-plate involvement specifically raises concern for growth disturbance.
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