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NR511 Davis Edge- Musculoskeletal Disorders Week 5

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Davis Edge- Musculoskeletal Disorders Week 5 Mr. McKinsey, age 69, was recently given a diagnosis of degenerative joint disease. Which assessment should the nurse practitioner use to check for effusion of the patient’s knee? a. Thomas test b. Tinel Test c. Bulge test d. Phalen test A nurse practitioner is driving home from work and stops at the scene of a motorcycle accident that must have just occurred, as there are no rescue vehicles present. The driver is lying unconscious at the side of the road with an obvious open fracture of his femur. Which of the following actions should take priority? a. Stopping the bleeding from the wound. b. Determining if there has been a cervical fracture. c. Establishing an airway. d. Palpating the peripheral pulses. The valgus stress test, varus stress test, Lachman test, and thumb sign are all considered standard tests to check the integrity of the ligaments of the knee. Which test would the nurse practitioner choose to assess the anterior cruciate ligament (ACL), which is the most commonly involved structure in severe knee injury? a. Valgus stress test. b. Varus stress test. c. Lachman test. d. Thumb sign. You are assessing Jamal, age 16, after a football injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: a. Lateral meniscus. b. Cruciate ligament. c. Medial meniscus. d. Collateral ligament. Cass, age 67, tells the nurse practitioner (NP) that she has been diagnosed with a condition that causes sudden flares of pain, swelling, and redness of the joints in her toes. She cannot remember the name of the diagnosis, but she knows it is caused by urate crystals that “get stuck in the joint and cause pain.” She is on hydrochlorothiazide (HCTZ) for management of her hypertension. The NP should suspect a diagnosis of: A. Septic arthritis. B. Gout. C. Rheumatoid arthritis. D. Charcot neuro-osteoarthropathy. Ethan, age 10, jumped off a 2-foot wall, twisting his foot and ankle upon landing. His ankle x-ray demonstrates a fracture of the distal tibia, over the articular surface, through the epiphysis and physis. Based on the Salter-Harris classification of growth plate injuries, you know this is a: a. Salter-Harris II fracture. b. Salter-Harris III fracture. c. Salter-Harris IV fracture. d. Salter-Harris V fracture. Mrs. Kelly, age 80, has a curvature of the spine. This is likely to indicate which age-related change? a. Lordosis. b. Dorsal kyphosis. c. Scoliosis. d. Kyphoscoliosis. Upon assessment, the nurse practitioner notes unilateral back pain of acute onset that increases when standing and bending. A straight leg raise test is negative. The most likely diagnosis is: a. Herniated nucleus pulposus. b. Muscle strain. c. Osteoarthritis. d. Spondylolisthesis. Joyce, age 87, broke her wrist after falling off a curb. She just had a plaster cast applied to her wrist. In instructing Joyce and her family on allowing the cast to dry properly, tell them to: a. Continuously elevate Joyce’s arm on a pillow. b. Change the position of Joyce’s arm every hour. c. Position a fan near Joyce during the night to ensure even drying of the cast. d. Put a blanket over the cast to absorb the dampness. Anne, age 67, sustained a fall on an outstretched hand. She presents holding her arm against her chest with her elbow flexed. Based on the specific location of her pain, you suspect a radial head fracture. The best initial strategy to assess for a radial head fracture would be: a. To palpate for tenderness, swelling, and crepitus just distal to the lateral epicondyle. b. To palpate for tenderness, swelling, and crepitus along the radial wrist. c. To palpate for tenderness in the “anatomical snuffbox.”

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Davis iEdge- iMusculoskeletal iDisorders iWeek i5


Mr. iMcKinsey, iage i69, iwas irecently igiven ia idiagnosis iof idegenerative ijoint idisease. iWhich
iassessment ishould ithe inurse ipractitioner iuse ito icheck ifor ieffusion iof ithe ipatient’s iknee?

a. Thomas itest
b. Tinel iTest
ic. i Bulge itest

d. i Phalen itest

A inurse ipractitioner iis idriving ihome ifrom iwork iand istops iat ithe iscene iof ia imotorcycle iaccidentithat
imust ihave ijust ioccurred, ias ithere iare ino irescue ivehicles ipresent. iThe idriver iis ilying iunconscious

iat ithe iside iof ithe iroad iwith ian iobvious iopen ifracture iof ihis ifemur. iWhich iof ithe ifollowing iactions

ishould itake ipriority?

a. Stopping ithe ibleeding ifrom ithe iwound.
b. Determining iif ithere ihas ibeen ia icervical ifracture.
ic. i Establishing ian iairway.

d. i Palpating ithe iperipheral ipulses.


The ivalgus istress itest, ivarus istress itest, iLachman itest, iand ithumb isign iare iall iconsidered
istandard itests ito icheck ithe iintegrity iof ithe iligaments iof ithe iknee. iWhich itest iwould ithe inurse

ipractitioner ichoose ito iassess ithe ianterior icruciate iligament i(ACL), iwhich iis ithe imost icommonly

iinvolved istructure iin isevere iknee iinjury?

a. Valgus istress itest.
b. Varus istress itest.
ic. i Lachman itest.

d. i Thumb isign.

You iare iassessing iJamal, iage i16, iafter ia ifootball iinjury ito ihis iright iknee. iYou ielicit ia ipositive
ianterior/posterior idrawer isign. iThis itest iindicates ian iinjury ito ithe:

a. i Lateral imeniscus.
ib. i Cruciate iligament.

c. Medial imeniscus.
d. Collateral iligament.


Cass, iage i67, itells ithe inurse ipractitioner i(NP) ithat ishe ihas ibeen idiagnosed iwith ia icondition ithat
icauses isudden iflares iof ipain, iswelling, iand iredness iof ithe ijoints iin iher itoes. iShe icannot

iremember ithe iname iof ithe idiagnosis, ibut ishe iknows iit iis icaused iby iurate icrystals ithat i“get istuck

iin ithe ijoint iand icause ipain.” iShe iis ion ihydrochlorothiazide i(HCTZ) ifor imanagement iof iher

ihypertension. iThe iNP ishould isuspect ia idiagnosis iof:

A. Septic iarthritis.
B. Gout.

, C. Rheumatoid iarthritis.
D. Charcot ineuro-osteoarthropathy.


Ethan, iage i10, ijumped ioff ia i2-foot iwall, itwisting ihis ifoot iand iankle iupon ilanding. iHis iankle ix-ray
idemonstrates ia ifracture iof ithe idistal itibia, iover ithe iarticular isurface, ithrough ithe iepiphysis iand

iphysis. iBased ion ithe iSalter-Harris iclassification iof igrowth iplate iinjuries, iyou iknow ithis iis ia:

a. Salter-Harris iII ifracture.
ib. i Salter-Harris iIII ifracture.

c. Salter-Harris iIV ifracture.
d. Salter-Harris iV ifracture.


Mrs. iKelly, iage i80, ihas ia icurvature iof ithe ispine. iThis iis ilikely ito iindicate iwhich iage-relatedichange?
a. Lordosis.
b. Dorsal ikyphosis.
c. Scoliosis.
d. Kyphoscoliosis.


Upon iassessment, ithe inurse ipractitioner inotes iunilateral iback ipain iof iacute ionset ithat
iincreases iwhen istanding iand ibending. iA istraight ileg iraise itest iis inegative. iThe imost ilikely

idiagnosis iis:

a. iHerniated inucleus ipulposus.ib.
i Muscle istrain.

c. Osteoarthritis.
d. Spondylolisthesis.


Joyce, iage i87, ibroke iher iwrist iafter ifalling ioff ia icurb. iShe ijust ihad ia iplaster icast iapplied ito iheriwrist.
iIn iinstructing iJoyce iand iher ifamily ion iallowing ithe icast ito idry iproperly, itell ithem ito:

a. i Continuously ielevate iJoyce’s iarm ion ia ipillow.
ib. i Change ithe iposition iof iJoyce’s iarm ievery ihour.

c. Position ia ifan inear iJoyce iduring ithe inight ito iensure ieven idrying iof ithe icast.
d. Put ia iblanket iover ithe icast ito iabsorb ithe idampness.


Anne, iage i67, isustained ia ifall ion ian ioutstretched ihand. iShe ipresents iholding iher iarm iagainst iher
ichest iwith iher ielbow iflexed. iBased ion ithe ispecific ilocation iof iher ipain, iyou isuspect ia iradialihead

ifracture. iThe ibest iinitial istrategy ito iassess ifor ia iradial ihead ifracture iwould ibe:

a. To ipalpate ifor itenderness, iswelling, iand icrepitus ijust idistal ito ithe ilateral iepicondyle.
b. To ipalpate ifor itenderness, iswelling, iand icrepitus ialong ithe iradial iwrist.
c. To ipalpate ifor itenderness iin ithe i“anatomical isnuffbox.”

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