NR 603 Final Exam
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
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. 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."
D. "It would be crazy to use complementary therapies to treat such a serious condition."
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
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
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
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
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
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
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
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. 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."
D. "It would be crazy to use complementary therapies to treat such a serious condition."
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
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
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
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
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
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
