NUR 621 final exam Questions With Complete Solutions
"tennis elbow" is also called? Correct Answer lateral
epicondylitis
14 year old basketball player is complaining of pain in his knee
that is worsened while jumping, kneeling, and going up stairs.
There was no trauma. What is most likely diagnosis and tx?
Correct Answer osgood- schlatter's disease. RICE protocol
2 crucial aspects for patients and families to understand in
palliative care near the end of life Correct Answer 1. prognosis
2. nature of the illness
5 areas that lead to quality palliative care according to the IOM
Correct Answer 1. delivery of person-centered and family-
centered care
2.clinician-patient communication and advanced care planning
3. professional education and development
4. Policies and payment system to support palliative care in all
settings
5. Public education and engagement
5 challenges to palliative care provision in primary care settings
determined by the California Health Care Foundation Correct
Answer 1. lack of time for providers to work on goals of care
and advanced directives
2. added responsibility in a busy primary care setting
3. No viable payment mechanism for reimbursement
4. differing resources required by different patients
5. Lack of primary care understanding of palliative care
,50 year old patient with lower back pain that started one week
prior. Pain is worsened by bending or sitting at his desk. It is
improved by standing up. You perform the straight leg raise test
and the patient reports pain below the knee when the leg is
elevated to 45 degrees. What is most likely diagnosis? Correct
Answer Herniated nucleus pulposus. Straight leg test is positive
when patient has pain below the knee when the leg is raised
below 60 degrees. Pain with herniated disc is typically acute,
worsened with bending, and improved by standing
60 year old male with BMI of 41 presents with lower back pain
that occasionally causes pain in both of his legs after standing
for long periods of time. Your diagnosis is lumbar stenosis.
What is the goal of therapy? What should PT exercises focus
on? Correct Answer Goal is to prevent progression of disease.
PT should focus on spinal flexion. Weight loss will also improve
symptoms
A 16 year old soccer player presents with history of sore throat,
enlarged posterior cervical lymph nodes, fatigue, and stomach
pain. Positive Kernigs sign. What is something you would
include in teaching this patient? Correct Answer Avoid sports
and physical activity for 4 weeks, even if feeling better, to
prevent risk of splenic rupture
A 5 year old child has a high fever, bilateral non-exudative
conjunctivitis, erythematous mouth and pharynx, and
desquamating rash. They have not responded to antipyritics or
antibiotics. What should you be suspicious of? What is the
,treatment? Correct Answer Kawasaki syndrome/disease. Tx is
aspirin and IVIG
A 60 year old woman presents with right shoulder pain and
impaired ROM. Her PMHx includes hypertension, diabetes. She
has worked as a secretary for 30 years and is right hand
dominant. What aspect of her hx can be attributed to her
diagnosis of adhesive capsulitis? Correct Answer Hx of
diabetes increases risk for frozen shoulder/adhesive capsulitis.
A 69 year old male reports he has recently felt more fatigued,
achey in his shoulders and neck, stiffness in the AM, and weight
loss. Over the last two days, he has had a headache in his
temples and visual changes. What is your differential? Correct
Answer Polymyalgia Rheumatica that has progressed to giant
cell arteritis.
A child is brought in by her mother who has been holding her
arm and crying. The mother says it started after swinging her up
by her arms while playing. The child is guarding and screams in
pain when you palpate the epitrochlear area. What should you
do next? Correct Answer Do not attempt to reduce nurse maids
elbow, pain in epitrochlear area could indicate a fracture.
Referral to ortho.
A mother asks why her child with autism has sleep disordered
breathing while her other children do not. What would you
explain to her? Correct Answer decreased muscle tone or
hypotonia can contribute to sleep apnea in children with ASD.
, A parent is concerned about allowing their child to participate in
gym class due to their asthma condition. How should you advise
them? Correct Answer ASthma should not prevent children
from participating in sports or activity. Ensure an asthma plan is
in place
A parent of a child with frequent sleep walking and night terrors
asks about giving benadryl to help the child sleep. How would
you advise this parent? Correct Answer Benadryl and other
antihistamines are not recommended for children with
parasomnias.
A patient hurt their ankle playing basketball. They present with
pain in the malleolar zone and pain at the posterior edge of the
lateral malleolus. Are ankle radiographs indicated? Correct
Answer Yes!
Ottawa ankle: A series of ankle radiograph films is required only
if there is any pain in malleolar zone and any of these findings:
bone tenderness at A; bone tenderness at B; inability to bear
weight both immediately and in the emergency department.
A patient hurt their ankle playing basketball. They present with
pain in the malleolar zone. they are able to bear weight for 6
steps but are limping. Are ankle radiographs indicated? Correct
Answer No.
Ottawa ankle: A series of ankle radiograph films is required only
if there is any pain in malleolar zone and any of these findings:
bone tenderness at A; bone tenderness at B; inability to bear
weight both immediately and in the emergency department.
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