NUR 603 FINAL EXAM REVIEW EXAM
QUESTIONS & DETAILED ANSWERS
RATED 100% COMPLETE
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 - Correct Answer ✔✔ D. Paresthesia of
the perineum and buttocks
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. Compleme -
Correct 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."
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 - Correct Answer ✔✔ B. McMurray circumduction test
,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 - Correct Answer ✔✔ A. Apprehension sign
A clinician has performed a synovial fluid analysis and the results are as follows: visual
analysis: turbid and yellow, viscosity: decreased, 52,000 white blood cells (WBCs) per
mm3, polymorphonuclear leukocytes (PMNs): 75%, protein: 5 g/dL. Which of the
following conditions could this result be attributed to?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis - Correct Answer ✔✔ D. Septic arthritis
Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left
great toe. The clinician suspects acute gout. Which of the following should the clinician
expect in the initial test results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
C. Decreased urine pH
D. Decreased C-reactive protein - Correct Answer ✔✔ A. Elevated uric acid level
Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is
assessing for median nerve compression by having Debbie maintain forced flexion of
her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of
these tests did the clinician just perform?
A. Allen's test
B. Phalen's test
C. Tinel's sign
D. Finkelstein's test - Correct Answer ✔✔ B. Phalen's test
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 - Correct Answer
✔✔ B. Unilateral radicular pain symptoms that extend below the knee and are equal to
or greater than the back pain
Felice is a 66-year-old female who complains that walking and prolonged standing
causes pain and weakness in her legs and buttocks. She expresses that she has short-
term relief when she leans on the shopping cart. When she sleeps on her back, she
sometimes wakes up in the night in pain. Which of the following diagnoses is most
likely?
A. Multiple sclerosis
B. Herniated lumbar disc
C. Lumbar spinal stenosis
D. Cervical spondylosis - Correct Answer ✔✔ C. Lumbar spinal stenosis
To diagnose fibromyalgia, there must be tenderness on digital palpation in at least 11 of
18 (nine pairs) tender point sites, which would include the
A. occiput, low cervical, trapezius, and supraspinatus
B. proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints of the hands, and
the metatarsophalangeal (MTP) and PIP joints of the foot
C. facet joints of the cervical, thoracic, and lumbar spine
D. radial and ulnar styloids and the medial and lateral malleoli - Correct Answer ✔✔ A.
occiput, low cervical, trapezius, and supraspinatus
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 examination
reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs.
Gray also is 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
examination and medical history, you suspect adhesive capsulitis, or "frozen shoulder."
Which clue in Mrs. Gray's history supports this diagnosis?
A. History of hypertension
B. Her affected shoulder is also her dominant arm.
C. Her history of diabetes mellitus
D. Her work as a secretary predisposes her to repetitive motions. - Correct Answer ✔✔
C. Her history of diabetes mellitus
The clinician is assessing Sally's diffuse hip pain. How should the clinician begin the
examination?
A.Begin the range-of-motion examination with an assessment of the motion that causes
pain.
B.Physical examination of the hip must first assess its position at rest.
C.The patient should move the hip prior to radiographic studies to determine whether
they are necessary.
QUESTIONS & DETAILED ANSWERS
RATED 100% COMPLETE
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 - Correct Answer ✔✔ D. Paresthesia of
the perineum and buttocks
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. Compleme -
Correct 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."
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 - Correct Answer ✔✔ B. McMurray circumduction test
,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 - Correct Answer ✔✔ A. Apprehension sign
A clinician has performed a synovial fluid analysis and the results are as follows: visual
analysis: turbid and yellow, viscosity: decreased, 52,000 white blood cells (WBCs) per
mm3, polymorphonuclear leukocytes (PMNs): 75%, protein: 5 g/dL. Which of the
following conditions could this result be attributed to?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis - Correct Answer ✔✔ D. Septic arthritis
Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left
great toe. The clinician suspects acute gout. Which of the following should the clinician
expect in the initial test results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
C. Decreased urine pH
D. Decreased C-reactive protein - Correct Answer ✔✔ A. Elevated uric acid level
Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is
assessing for median nerve compression by having Debbie maintain forced flexion of
her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of
these tests did the clinician just perform?
A. Allen's test
B. Phalen's test
C. Tinel's sign
D. Finkelstein's test - Correct Answer ✔✔ B. Phalen's test
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 - Correct Answer
✔✔ B. Unilateral radicular pain symptoms that extend below the knee and are equal to
or greater than the back pain
Felice is a 66-year-old female who complains that walking and prolonged standing
causes pain and weakness in her legs and buttocks. She expresses that she has short-
term relief when she leans on the shopping cart. When she sleeps on her back, she
sometimes wakes up in the night in pain. Which of the following diagnoses is most
likely?
A. Multiple sclerosis
B. Herniated lumbar disc
C. Lumbar spinal stenosis
D. Cervical spondylosis - Correct Answer ✔✔ C. Lumbar spinal stenosis
To diagnose fibromyalgia, there must be tenderness on digital palpation in at least 11 of
18 (nine pairs) tender point sites, which would include the
A. occiput, low cervical, trapezius, and supraspinatus
B. proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints of the hands, and
the metatarsophalangeal (MTP) and PIP joints of the foot
C. facet joints of the cervical, thoracic, and lumbar spine
D. radial and ulnar styloids and the medial and lateral malleoli - Correct Answer ✔✔ A.
occiput, low cervical, trapezius, and supraspinatus
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 examination
reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs.
Gray also is 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
examination and medical history, you suspect adhesive capsulitis, or "frozen shoulder."
Which clue in Mrs. Gray's history supports this diagnosis?
A. History of hypertension
B. Her affected shoulder is also her dominant arm.
C. Her history of diabetes mellitus
D. Her work as a secretary predisposes her to repetitive motions. - Correct Answer ✔✔
C. Her history of diabetes mellitus
The clinician is assessing Sally's diffuse hip pain. How should the clinician begin the
examination?
A.Begin the range-of-motion examination with an assessment of the motion that causes
pain.
B.Physical examination of the hip must first assess its position at rest.
C.The patient should move the hip prior to radiographic studies to determine whether
they are necessary.
