Master Skeletal System Disorders: 10 Essential MCQs with Rationales for Nursing Exams

 Introduction:

Are you preparing for Nursing competitive exams (AIIMS, NORCET, ESIC) or Medical entrance tests? Here is a collection of important Multiple Choice Questions regarding Skeletal System Disorders with detailed rationales to boost your knowledge.

Q1. Which of the following is a chronic, progressive metabolic bone disease characterized by low bone mass and structural deterioration of bone tissue?

A) Osteoarthritis

B) Osteoporosis

C) Osteomyelitis

D) Rheumatoid Arthritis

Correct Answer: B) Osteoporosis

Rationale: Osteoporosis is known as the "silent thief" because it slowly robs the skeleton of its banked resources. It involves compromised bone strength predisposing a person to an increased risk of fracture. Osteoarthritis is joint degeneration, Osteomyelitis is bone infection, and RA is an autoimmune disease.

Q2. A patient is diagnosed with Gout. Which laboratory value should the nurse monitor most closely?

A) Calcium levels

B) Blood Urea Nitrogen (BUN)

C) Uric Acid levels

D) Creatinine levels

Correct Answer: C) Uric Acid levels

Rationale: Gout is a type of arthritis caused by the accumulation of uric acid crystals in the joints. High levels of uric acid (Hyperuricemia) indicate the severity of the condition.

Q3. Which clinical manifestation is considered a classic sign of Systemic Lupus Erythematosus (SLE)?

A) Swan-neck deformity

B) Butterfly rash over cheeks and bridge of nose

C) Heberden’s nodes

D) Boutonniere deformity

Correct Answer: B) Butterfly rash over cheeks and bridge of nose

Rationale: The "butterfly rash" (malar rash) is a hallmark symptom of SLE, an autoimmune disease that can affect the joints and skeleton. The other deformities listed are typically associated with Rheumatoid Arthritis or Osteoarthritis.

Q4. A patient with a fractured femur is at risk for Fat Embolism Syndrome (FES). Which of the following is the earliest sign of FES?

A) Petechiae on the chest

B) Confusion and altered mental status

C) Shortness of breath

D) High fever

Correct Answer: B) Confusion and altered mental status

Rationale: While respiratory distress and petechiae are classic signs, altered mental status (confusion, restlessness) due to hypoxemia is often the earliest sign of a fat embolism traveling to the brain or lungs.

Q5. Which type of fracture is most common in children due to the flexibility of their bones?

A) Comminuted fracture

B) Greenstick fracture

C) Compound fracture

D) Spiral fracture

Correct Answer: B) Greenstick fracture

Rationale: A Greenstick fracture is an incomplete fracture where one side of the bone breaks and the other side bends. It is most common in children because their bones are softer and more flexible than adults.

Q6. What is the priority nursing assessment for a patient with a fresh plaster cast on the leg to detect Compartment Syndrome?

A) Assessing for foul smell

B) Monitoring the 5 P's (Pain, Pulse, Pallor, Paresthesia, Paralysis)

C) Checking the temperature of the room

D) Elevating the limb above heart level

Correct Answer: B) Monitoring the 5 P's

Rationale: Compartment syndrome is a medical emergency caused by increased pressure within a muscle compartment. The 5 P's are the gold standard for early detection to prevent tissue necrosis.

Q7. Heberden’s nodes and Bouchard’s nodes are characteristic deformities found in which condition?

A) Rheumatoid Arthritis

B) Psoriatic Arthritis

C) Osteoarthritis

D) Gouty Arthritis

Correct Answer: C) Osteoarthritis

Rationale: Heberden’s nodes (distal interphalangeal joints) and Bouchard’s nodes (proximal interphalangeal joints) are bony overgrowths typically seen in patients with Osteoarthritis.

Q8. A client is diagnosed with Rheumatoid Arthritis (RA). Which statement best describes the pathophysiology of this disease?

A) It is a wear-and-tear disease of weight-bearing joints.

B) It is an autoimmune disease causing inflammation of the synovial membrane.

C) It is caused by a Vitamin D deficiency.

D) It is an infection of the bone marrow.

Correct Answer: B) It is an autoimmune disease causing inflammation of the synovial membrane.

Rationale: RA is a chronic, systemic autoimmune disorder where the immune system attacks the synovium (lining of the membranes that surround the joints), leading to inflammation and joint damage.

Q9. Which diagnostic test is considered the "Gold Standard" for measuring bone mineral density (BMD) to diagnose Osteoporosis?

A) X-Ray

B) MRI Scan

C) DEXA Scan (Dual-energy X-ray absorptiometry)

D) CT Scan

Correct Answer: C) DEXA Scan

Rationale: The DEXA scan is the most accurate test to measure bone mineral density and is the definitive method for diagnosing osteoporosis and osteopenia.

Q10. A nurse is caring for a patient after a total hip replacement. Which position should be avoided to prevent dislocation of the prosthesis?

A) Abduction of the legs

B) Internal rotation and adduction

C) Keeping legs straight

D) Slight elevation of the head

Correct Answer: B) Internal rotation and adduction

Rationale: Adduction (crossing legs) and internal rotation can force the head of the femur out of the acetabulum socket. Patients are usually advised to keep an abduction pillow between their legs.