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.”
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.”