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Dunphy Musculoskeletal Exam Questions with Correct Answers
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Dunphy Musculoskeletal Exam Questions with Correct Answers
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Dunphy Musculoskeletal ExamQuestions with Correct Answers
9. Which of the following statements is true regarding the treatment of carpal tunnel
syndrome?
a. The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome, because they allow for free movement
of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel
syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above - Answer-d. All of the above
10. Sam is a 25-year-old 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 lumbar 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 erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue - Answer-b.
Unilateral radicular pain symptoms that extend below the knee and are equal to or
greater than the back pain
11. 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 the use of 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 gastrointestinal (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 maximum 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." - Answer-a. "You should start with the lowest dose that is effective in
managing your pain,
because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such
as ulcers and hemorrhage."
12. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the
level of 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. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks - Answer-d. Paresthesia of the perineum
and buttocks
13. 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
discontinued 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 - Answer-c. Intolerable pain for more than a 3-month period is an
indication for surgical
intervention.
14. John is a 16-year-old boy who presents to the emergency room after hurting his
knee in a football
game. He described twisting his knee and then being unable to extend it completely.
John tells the
clinician that he heard a pop when the injury occurred and has been experiencing
localized pain. The
clinician suspects a meniscal tear. Which test would be most appropriate to assess for
the presence of
a meniscal tear?
a. Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test - Answer-b. McMurray circumduction test
15. The clinician suspects that a client 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 flexed to 30°. If instability is present, this maneuver displaces the
patella to an
abnormal position on the lateral femoral condyle, and the client will perceive pain.
Testing for
patellar instability in this way is known as:
a. Apprehension sign
b. Bulge sign
c. Thumb sign
d. None of the above - Answer-a. Apprehension sign
16. 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 and Diane's description of her injury. Which of the following clues in
Diane's
examination or history would alert the clinician to the need for obtaining radiographs?
a. Inability to bear weight immediately after the injury
b. Development of marked ankle swelling and discoloration after the injury
c. Crepitation with palpation or movement of the ankle
d. All of the above - Answer-d. All of the above
17. Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The
clinician has explained
to Mr. Jackson that the goals for managing osteoarthritis include controlling pain,
maximizing
functional independence and mobility, minimizing disability, and preserving quality of
life. Mr.
Jackson explains to the clinician that his first choice would be to use complementary
therapies to
control his condition and asks what therapies are most effective in treating
osteoarthritis. What
would be the most appropriate response from the clinician?
a. "Complementary therapies should be considered only if surgical interventions are
not successful."
b. "I am unfamiliar with the available complementary therapies for osteoarthritis and
prefer to discuss more mainstream treatments, such as NSAIDs and physical
therapy, to manage your condition."
c. "I would be happy to discuss all the treatment options available to you.
Comp - Answer-c. "I would be happy to discuss all the treatment options available to
you.
Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being
, studied for use in the treatment of osteoarthritis and have shown promise when
used with standard medical therapy."
18. Normal estrogen function is important for preventing osteoporosis in both men and
women. Estrogen
works to prevent osteoporosis in which of the following ways?
a. By decreasing the erosive activity of osteoclasts
b. By promoting osteoclastogenesis
c. By inhibiting osteoclast apoptosis
d. All of the above - Answer-a. By decreasing the erosive activity of osteoclasts
19. Which of the following tests is considered the gold standard for definitively
diagnosing
osteoporosis?
a. Bone alkaline phosphatase levels
b. Urinary N-telopeptide assay
c. Bone mass density measurement by densitometry
d. Magnetic resonance imaging - Answer-c. Bone mass density measurement by
densitometry
20. What is the recommended daily calcium intake for adults over the age of 50 with low
bone mass?
a. 1,200 mg/day
b. 1,000 mg/day
c. 1,300 mg/day
d. 1,500 mg/day - Answer-d. 1,500 mg/day
21. Mrs. Allen is a 60-year-old woman who has been diagnosed with osteoporosis. She
is very
concerned about the risk of breast cancer associated with hormone replacement
therapy and is
wondering what other treatments are available to her. The clinician explains that
bisphosphonates are
another class of drugs used in the prevention and treatment of osteoporosis. What
teaching should
the clinician give Mrs. Allen in regard to taking bisphosphonates?
a. Taking bisphosphonates can result in hypercalcemia, so calcium intake should be
decreased while taking this class of drugs.
b. There is potential for upper GI irritation, so these medications are contraindicated
in people with abnormalities of the esophagus or delayed esophageal emptying.
c. This class of drugs can be taken at any time of the day without regard to meals.
d. None of the above - Answer-b. There is potential for upper GI irritation, so these
medications are contraindicated
in people with abnormalities of the esophagus or delayed esophageal emptying.
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