Week 14 – Musculoskeletal (MSK)
A school-age child falls off a swing and fractures the humerus close to the elbow joint. What is the most
important assessment for this patient to evaluate possible complications of this injury?
Salter-Harris classification
Palpation for joint laxity
Evaluation of pain with extension
The presence of a spiral fracture
A patient has symptoms of carpal tunnel syndrome. Which diagnostic tests will help confirm this
disorder? (Select all that apply.)
Erythrocyte sedimentation rate
Plain radiographs
Anti-nuclear antibody
Electromyography
Nerve conduction studies
A 62-year-old female presents with atraumatic right knee pain. On exam, she has mildly swollen right
knee that is not warm or tender to touch. She has negative McMurray test. Her x-ray demonstrates
tibial femoral joint space narrowing and visualization of osteophytes. How should the nurse practitioner
interpret the results of this x-ray?
Age-related changes in the knee
A Baker's cyst
Gouty arthritis
Osteoarthritis
In the knee, joint space narrowing indicates a loss of articular cartilage and usually worsening
osteoarthritis. Osteophytes formed in response to degeneration of cartilage and joints. The
McMurray test is commonly used to assess joint motion and meniscal injury.
A patient presents with right shoulder pain after an acute shoulder injury yesterday. He fell against a
brick wall while working at his home. He reports pain that radiates into his upper arm. How should this
be managed?
Prescribe physical therapy for the patient
Ordered x-ray of the right shoulder
Rest, ice, and naproxen for one week
Immobilize the right shoulder for 3 days
, And x-rays generally the initial test used to evaluate trauma that results in acute pain. An x-ray
could demonstrate fracture. It would not be helpful for evaluation of most soft tissue injuries.
No other intervention is appropriate until fracture and dislocation have been ruled out.
An adolescent athlete has injured his ankle playing basketball. He has right ankle pain, ecchymosis, and
significant edema, and he is unable to bear weight at the time of the clinical exam. Which diagnosis is
least likely?
Grade 3 sprain
Grade 2 sprain
Grade 1 sprain
An avulsion fracture
A grade 1 sprain results from minimal stretching or small tears in the ligament. There is mild
tenderness and edema, and the patient is able to bear weight. A grade 2 sprain is more
significant, the clinical signs are more severe stretching and tearing of ligament with moderate
pain, edema, tenderness and ecchymosis. Weightbearing is painful but the patient is able to
walk. A grade 3 sprain is the most severe, and involves complete tear of the ligament, there is
joint instability, severe pain, edema, tenderness, ecchymosis, patients are unable to bear weight
due to pain.
An adult patient who has been taking high-dose corticosteroids reports a dull, aching pain in the groin
and presents with a limp. What condition does the provider suspect, based on this history?
Avascular necrosis of the femoral head
What are included in the initial management of bursitis of the heel? (Select all that apply.)
Nonsteroidal anti-inflammatory medications
Rest, ice, compression, and elevation
Activity modification and bracing
A patient comes to a provider with reports of unilateral arm pain and weakness with mild neck pain. The
provider notes that the patient prefers holding the affected arm crossed in front of the throat. A history
reveals a recent onset of sexual dysfunction. What does the provider suspect based on this history?
Cervical myelopathy
A patient takes HCTZ daily for hypertension. He developed severe pain in his great toe yesterday. He
was diagnosed with gout today and started on the medication. Which medication listed below would be
contraindicated at this time?
A school-age child falls off a swing and fractures the humerus close to the elbow joint. What is the most
important assessment for this patient to evaluate possible complications of this injury?
Salter-Harris classification
Palpation for joint laxity
Evaluation of pain with extension
The presence of a spiral fracture
A patient has symptoms of carpal tunnel syndrome. Which diagnostic tests will help confirm this
disorder? (Select all that apply.)
Erythrocyte sedimentation rate
Plain radiographs
Anti-nuclear antibody
Electromyography
Nerve conduction studies
A 62-year-old female presents with atraumatic right knee pain. On exam, she has mildly swollen right
knee that is not warm or tender to touch. She has negative McMurray test. Her x-ray demonstrates
tibial femoral joint space narrowing and visualization of osteophytes. How should the nurse practitioner
interpret the results of this x-ray?
Age-related changes in the knee
A Baker's cyst
Gouty arthritis
Osteoarthritis
In the knee, joint space narrowing indicates a loss of articular cartilage and usually worsening
osteoarthritis. Osteophytes formed in response to degeneration of cartilage and joints. The
McMurray test is commonly used to assess joint motion and meniscal injury.
A patient presents with right shoulder pain after an acute shoulder injury yesterday. He fell against a
brick wall while working at his home. He reports pain that radiates into his upper arm. How should this
be managed?
Prescribe physical therapy for the patient
Ordered x-ray of the right shoulder
Rest, ice, and naproxen for one week
Immobilize the right shoulder for 3 days
, And x-rays generally the initial test used to evaluate trauma that results in acute pain. An x-ray
could demonstrate fracture. It would not be helpful for evaluation of most soft tissue injuries.
No other intervention is appropriate until fracture and dislocation have been ruled out.
An adolescent athlete has injured his ankle playing basketball. He has right ankle pain, ecchymosis, and
significant edema, and he is unable to bear weight at the time of the clinical exam. Which diagnosis is
least likely?
Grade 3 sprain
Grade 2 sprain
Grade 1 sprain
An avulsion fracture
A grade 1 sprain results from minimal stretching or small tears in the ligament. There is mild
tenderness and edema, and the patient is able to bear weight. A grade 2 sprain is more
significant, the clinical signs are more severe stretching and tearing of ligament with moderate
pain, edema, tenderness and ecchymosis. Weightbearing is painful but the patient is able to
walk. A grade 3 sprain is the most severe, and involves complete tear of the ligament, there is
joint instability, severe pain, edema, tenderness, ecchymosis, patients are unable to bear weight
due to pain.
An adult patient who has been taking high-dose corticosteroids reports a dull, aching pain in the groin
and presents with a limp. What condition does the provider suspect, based on this history?
Avascular necrosis of the femoral head
What are included in the initial management of bursitis of the heel? (Select all that apply.)
Nonsteroidal anti-inflammatory medications
Rest, ice, compression, and elevation
Activity modification and bracing
A patient comes to a provider with reports of unilateral arm pain and weakness with mild neck pain. The
provider notes that the patient prefers holding the affected arm crossed in front of the throat. A history
reveals a recent onset of sexual dysfunction. What does the provider suspect based on this history?
Cervical myelopathy
A patient takes HCTZ daily for hypertension. He developed severe pain in his great toe yesterday. He
was diagnosed with gout today and started on the medication. Which medication listed below would be
contraindicated at this time?
