NUR 603 FINAL EXAM STUDY GUIDE
QUESTIONS & A+ GRADED ANSWERS
ALL PASSED
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: - Correct Answer ✔✔ Articular
Which of the following signs or symptoms indicate an inflammatory etiology to
musculoskeletal pain? - Correct Answer ✔✔ Morning stiffness
Which of the following statements concerning the musculoskeletal examination is true? -
Correct Answer ✔✔ The uninvolved side should be examined initially and then
compared to the involved side.
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 history supports this diagnosis? - Correct Answer ✔✔ Her
history of diabetes mellitus
Jennifer is an 18-year-old woman 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 straight
to break her fall. She has been experiencing severe pain and limited ROM in her left
shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the
following statements are true concerning shoulder dislocation? - Correct Answer ✔✔
There is a risk of neurovascular and neurosensory trauma, so the clinician should check
for distal pulses.
Fred has been diagnosed with a trigger finger of the ring finger. Which of the following
management strategies is appropriate? - Correct Answer ✔✔ Local anesthetic injection
into the tendon sheath
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 also will develop carpal tunnel syndrome. Which of the following responses
would be correct regarding the risk of developing carpal tunnel syndrome? - Correct
,Answer ✔✔ People with occupations that require repeated flexion extension of the
wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate
are at risk for developing carpal tunnel.
Which of the following statements is true regarding the treatment of carpal tunnel
syndrome? - Correct Answer ✔✔ All of the above: goal of tx is to prevent flexion and
extension movements of wrist, splints are used because they allow for free movement
of the fingers and thumb while maintaining the wrist in neutral position, and
corticosteroid injections are discouraged in the treatment because the risks for median
nerve damage, scarring, and infection
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? - Correct Answer ✔✔
Unilateral radicular pain symptoms that extend below the knee and are equal to or
greater than the back pain
The clinician has instructed Sirius, a 23-year-old patient with low back strain, to us
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? -
Correct Answer ✔✔ "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.
Which of the following statements is true concerning the management of the client with
a herniated disc? - Correct Answer ✔✔ Intolerable pain for more than a 3mo period is
an indication for surgical intervention.
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? - Correct
Answer ✔✔ McMurray circumduction test
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? - Correct Answer ✔✔ All of the above: Inability to
bear weight immediately after the injury, development of marked ankle swelling and
discoloration after the injury, and crepitation with palpation or movement of the ankle
, 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 effecting in treating osteoarthritis. What would be the most
appropriate response from the clinician? - Correct Answer ✔✔ "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."
Chris is a 28-year-old male who complains of lower back pain that began 3 days ago.
The pain is worse when he stands or bends, and it is somewhat relieved when he sits.
The clinician performs the straight leg raise test and it is negative. Plain film x-ray is
positive. Which diagnosis is most likely? - Correct Answer ✔✔ Muscle strain
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: 5g/dL. Which of the
following conditions could this result be attributed to? - Correct Answer ✔✔ Septic
arthritis
What is the recommended daily calcium intake for men 70 years and younger? - Correct
Answer ✔✔ 1000 mg/day
Which of the following medications is appropriate to treat Paget's disease? - Correct
Answer ✔✔ Reclast
One of the most frequent presenting signs/symptoms of osteoporosis is: - Correct
Answer ✔✔ Bony fracture
Mrs. Tomas was seen in the office complaining of pain and point tenderness in the area
of her elbow. The pain has increased following a day of gardening 1 week ago. A
physical finding that differentiates the diagnosis and is most consistent with lateral
epicondylitis (tennis elbow) is: - Correct Answer ✔✔ Pain at the elbow with resisted
movements at the wrist and forearm
Which of the following would lead the clinician to suspect a tumor when paired with low
back pain? - Correct Answer ✔✔ Unintended weight loss >10% of body weight in 6
months
The clinician is assessing Sally's diffuse hip pain. How should the clinician begin the
examination? - Correct Answer ✔✔ Physical examination of the hip must first assess its
position at rest
QUESTIONS & A+ GRADED ANSWERS
ALL PASSED
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: - Correct Answer ✔✔ Articular
Which of the following signs or symptoms indicate an inflammatory etiology to
musculoskeletal pain? - Correct Answer ✔✔ Morning stiffness
Which of the following statements concerning the musculoskeletal examination is true? -
Correct Answer ✔✔ The uninvolved side should be examined initially and then
compared to the involved side.
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 history supports this diagnosis? - Correct Answer ✔✔ Her
history of diabetes mellitus
Jennifer is an 18-year-old woman 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 straight
to break her fall. She has been experiencing severe pain and limited ROM in her left
shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the
following statements are true concerning shoulder dislocation? - Correct Answer ✔✔
There is a risk of neurovascular and neurosensory trauma, so the clinician should check
for distal pulses.
Fred has been diagnosed with a trigger finger of the ring finger. Which of the following
management strategies is appropriate? - Correct Answer ✔✔ Local anesthetic injection
into the tendon sheath
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 also will develop carpal tunnel syndrome. Which of the following responses
would be correct regarding the risk of developing carpal tunnel syndrome? - Correct
,Answer ✔✔ People with occupations that require repeated flexion extension of the
wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate
are at risk for developing carpal tunnel.
Which of the following statements is true regarding the treatment of carpal tunnel
syndrome? - Correct Answer ✔✔ All of the above: goal of tx is to prevent flexion and
extension movements of wrist, splints are used because they allow for free movement
of the fingers and thumb while maintaining the wrist in neutral position, and
corticosteroid injections are discouraged in the treatment because the risks for median
nerve damage, scarring, and infection
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? - Correct Answer ✔✔
Unilateral radicular pain symptoms that extend below the knee and are equal to or
greater than the back pain
The clinician has instructed Sirius, a 23-year-old patient with low back strain, to us
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? -
Correct Answer ✔✔ "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.
Which of the following statements is true concerning the management of the client with
a herniated disc? - Correct Answer ✔✔ Intolerable pain for more than a 3mo period is
an indication for surgical intervention.
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? - Correct
Answer ✔✔ McMurray circumduction test
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? - Correct Answer ✔✔ All of the above: Inability to
bear weight immediately after the injury, development of marked ankle swelling and
discoloration after the injury, and crepitation with palpation or movement of the ankle
, 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 effecting in treating osteoarthritis. What would be the most
appropriate response from the clinician? - Correct Answer ✔✔ "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."
Chris is a 28-year-old male who complains of lower back pain that began 3 days ago.
The pain is worse when he stands or bends, and it is somewhat relieved when he sits.
The clinician performs the straight leg raise test and it is negative. Plain film x-ray is
positive. Which diagnosis is most likely? - Correct Answer ✔✔ Muscle strain
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: 5g/dL. Which of the
following conditions could this result be attributed to? - Correct Answer ✔✔ Septic
arthritis
What is the recommended daily calcium intake for men 70 years and younger? - Correct
Answer ✔✔ 1000 mg/day
Which of the following medications is appropriate to treat Paget's disease? - Correct
Answer ✔✔ Reclast
One of the most frequent presenting signs/symptoms of osteoporosis is: - Correct
Answer ✔✔ Bony fracture
Mrs. Tomas was seen in the office complaining of pain and point tenderness in the area
of her elbow. The pain has increased following a day of gardening 1 week ago. A
physical finding that differentiates the diagnosis and is most consistent with lateral
epicondylitis (tennis elbow) is: - Correct Answer ✔✔ Pain at the elbow with resisted
movements at the wrist and forearm
Which of the following would lead the clinician to suspect a tumor when paired with low
back pain? - Correct Answer ✔✔ Unintended weight loss >10% of body weight in 6
months
The clinician is assessing Sally's diffuse hip pain. How should the clinician begin the
examination? - Correct Answer ✔✔ Physical examination of the hip must first assess its
position at rest
