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NR 511 Final questions to review with Complete Solutions
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NR 511 Final questions to reviewwith Complete Solutions
One of the initial steps in assessing patients with musculoskeletal complaints
is to determine whether the complain is articular or nonarticular in origin.
Which of the following in an example of an articular structure?
A. Bone
B. Synovium
C. Tendons
D. Fascia - -Synovium
-You have detected the presence of crepitus on examination of a patient
with a musculoskeletal complaint. Additionally, there is limited range of
motion (ROM) with both active and passive movement. These findings
suggest that the origin of the musculoskeletal complaint is:
A. Articular
B. Inflammatory
C. Nonarticular
D. A and B - -Articular
-Which of the following signs or symptoms indicate an inflammatory etiology
to musculoskeletal pain?
A. Decreased CRP
B.hyperalbuminemia
C. Morning stiffness
D. Weight gain - -Morning stiffness
-Which of the following statements concerning the musculoskeletal exam is
true?
A. The uninvolved side should be examined initially and then compared to
the involved side
B. The part of the body that is causing the patient pain should be examined
first
C. When possible, the patient should not be asked to perform active ROM
exercises to avoid causing pain
D. Radiographs should always be obtained prior to examination so as not to
cause further injury to the patient. - -When possible, the patient should not
be asked to perform active ROM exercises to avoid causing pain
-You are performing muscle strength testing on a patient presenting with
musculoskeletal pain and find that the patient has complete ROM with
gravity eliminated. Which numeric grade of muscle strength would you give
this patient?
A. 1
,B. 2
C. 3
D. 4
E. 5 - -B
-Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and
limited movement in her right shoulder. She denies any history of trauma.
Her exam reveals a 75% reduction in both active and passive range of
motion of the right shoulder. Mrs. Gray is also experiencing tenderness with
motion and pain at the deltoid insertion. Her medical history is significant for
type 1 diabetes mellitus and hypertension. Her social history reveals that she
is a secretary and that she is right-handed. Based on her exam and medical
history, you suspect adhesive capulitis or "frozen shoulder." Which clue in
Mrs. Gray's history supports this diagnosis?
A. HX HTN
B. Her affected shoulder is her dominant arm
C. Her HX of DM
D. Her work as a secretary predisposes her to repetitive motions - -HX of DM
-Jennifer is an 18-year-old girl who comes to the emergency room after a fall
during a soccer game. Jennifer explains that she fell on her left side and kept
her arm out straight to break her fall. She has been experiencing severe pain
and limited range of motion in her left shoulder. The clinician has diagnosed
Jennifer with a dislocated shoulder. Which of the following statements are
true concerning shoulder dislocation?
A. Posterior dislocations are more common than anterior dislocations
B. There is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses
C. Recurrent dislocations are uncommon and would require great force to
result in injury
D. Surgery is the most common treatment of choice - -There is a risk of
neurovascular and neurosensory trauma, so the clinician should check for
distal pulses
-Mrs. Anderson is a 35-year-old woman who has been recently diagnosed
with carpal tunnel syndrome. She has two young children and asks the
clinician what the chances are that they will also develop carpal tunnel
syndrome. Which of the following responses would be correct regarding the
risk of developing carpal tunnel syndrome?
- Carpal tunnel syndrome commonly occurs in families. Genetic factors are
thought to account for about half the risk of developing carpal tunnel.
- Only people with occupations that require repeated flexion extension of the
wrist, use of hand tools that require forceful gripping, or hand tools that
vibrate are at risk for developing carpal tunnel.
,- An underlying musculoskeletal disorder must be present for a person to
develop carpal tunnel.
- Carpal tunnel syndrome only occurs in the presence of a hormonal
imbalance. - -Carpal tunnel syndrome commonly occurs in families. Genetic
factors are thought to account for about half the risk of developing carpal
tunnel.
-Which of the following statements is true regarding the treatment of carpal
tunnel syndrome?
A. The goal of TX is to prevent flexion and extension movements of the wrist
B. Splints are used in carpal tunnel syndrome, because they allow for free
movement the fingers and thumb while maintaining the wrist in a neutral
position
C Corticosterioid injections are discouraged in the treatment of CTS because
of the risks for median nerve damage, scarring, and infection
D. All of the above - -All of the above
-Sam is a 25-year-old man who has been diagnosed with low back strain
based on his history of localized low back pain and muscle spasm along with
a normal neurological examination. As the clinician, you explain to Sam that
low back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus
pulposus or ruptured disc?
A. Morning stiffness and limited mobility of the L spine
B. Unilateral radicular pain symptoms that extend below the knee and are
equal to or greater than the back pain
C. Fever, chills, and elevated ESR
D. Pathologic fractures, severe night pain, weight loss, and fatigue - -
Unilateral radicular pain symptoms that extend below the knee and are equal
to or greater than the back pain
-The clinician has instructed Sam, a 25 year old patient with low back strain,
to use NSAIDs to manage his symptoms of pain and discomfort. Which of the
following statements would be most appropriate when teaching Sam about
NSAIDs?
A. You should start with the lowest dose that is effective in managing your
pain, because long-term use of NSAIDs can result in GI disorders such as
ulcers and hemorrhage.
B You should start with the lowest dose that is effective in managing your
pain to avoid developing tolerance to the medication
C. You should take the max recommended dose of NSAIDs so that you will
not need to take narcotics to control your pain
D. It is important to take NSAIDs on an empty stomach in order to increase
absorption - -You should start with the lowest dose that is effective in
managing your pain, because long-term use of NSAIDs can result in GI
disorders such as ulcers and hemorrhage.
, -Janet is 30y/o woman who has been diagnosed with a herniated disc at the
L5-S1. She is currently in the emergency room with suspicion of cauda
equina compression. Which of the following is a sign or symptom of cauda
equina compression?
A. Paresthesia of the perineum & buttock
B. A reduced or absent ankle reflex
C. Numbness in the lateral foot
D. Gastrocnemius weakness - -Paresthesia of the perineum & buttock
-Which of the following statements is true concerning the management of
the client with a herniated disc?
A. Muscle relaxants and narcotics can be used to control moderate pain but
should be d/c after 3 weeks of use
B. An epidural injection is helpful in reducing leg pain that has persisted for
at least 3 weeks after the herniation occurred
C. Intolerable pain for more than a 3 month period is an indication for
surgical intervention
D All of the above - -Intolerable pain for more than a 3 month period is an
indication for surgical intervention
-John is a 16 y/o boy presents to your office after hurting his knee in a
football game. He described twisting his knee & then being able to extend it
completely. John tells you he heard a pop when the injury occurred & has
been experiencing localized pain. You suspect a meniscal tear. Which test
would be most appropriate to assess for the presence of a meniscal tear?
A. Lachman test
B. Vulgus stress test
C. McMurray circumduction test
D. Varus stress test - -McMurray circumduction test
-The clinician suspects that a clients has patellar instability. In order to test
for this, the client is seated with the quadriceps relaxed, and the knee is
placed in extension. Next the patella is displaced laterally, and the knee is
flexed to 30 degrees. If instability is present, this maneuver displaces the
patella to an abnormal position on the lateral femoral condyle, and the client
with perceive pain. Testing for patellar instability in this way is known as:
A. Apprehesion sign
B. Bulge sign
C. Thumb sign
D. None of the above - -Apprehesion sign
-The clinician is caring for Diane, a 22 year old woman who presents with an
injured ankle. Diane asks the clinician if she will need an x ray. The clinician
explains to Diane that an x ray is not always necessary for an injured ankle
and that the decision to obtain radiographs is dependent on the examination
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