NR511 Final Exam Questions and Answers with Complete Solutions Graded A 2024

1. The remodeling of a scar can take how long? a. 6 months. b. 3 months. c. 1 month. d. 2 weeks. A. 6 months Question 1. A 13-year-old obese (body mass index [BMI] above the 95th percentile) boy reports low-grade left knee pain for the past 2 months. He denies antecedent trauma but admits to frequent “horseplay” with his friends. The pain has progressively worsened, and he is now unable to bear weight at all on his left leg. His current complaints include left groin, thigh, and medial knee pain and tenderness. His examination demonstrates negative drawer, Lachman, and McMurray tests; left hip with decreased internal rotation and abduction; and external hip rotation with knee flexion. Based on the above scenario, the nurse practitioner should suspect: 1. A left meniscal tear. 2. A left anterior cruciate ligament (ACL) tear. 3. A slipped capital femoral epiphysis (SCFE). 4. Osgood-Schlatter disease. 3. A slipped capital femoral epiphysis (SCFE). Question 2. In assessing the skeletal muscles, the nurse practitioner turns the patient's forearm so that the palm is up. This is called: 1. Supination. 2. Pronation. 3. Abduction. 4. Eversion. 1. Supination Question 3. 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: 1. Septic arthritis. 2. Gout. 3. Rheumatoid arthritis. 4. Charcot neuro-osteoarthropathy. 2. Gout Question 4. Matthew, age 52, is a chef who just severed 2 of his fingers with a meat cutter. You would recommend that he: 1. Wrap the severed fingers tightly in a dry towel for transport to the emergency department with him. 2. Leave the severed fingers at the scene because fingers cannot be reattached. 3. Immediately freeze the severed fingers for reattachment in the near future. 4. Wrap the fingers in a clean, damp cloth; seal them in a plastic bag; and place the bag in an ice water bath. 4. Wrap the fingers in a clean, damp cloth; seal them in a plastic bag; and place the bag in an ice water bath. Question 5. Marsha, age 34, presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia than of chronic fatigue syndrome? 1. Musculoskeletal pain. 2. Difficulty sleeping. 3. Depression. 4. Fatigue. 1. Musculoskeletal pain Question 6. Mrs. Kelly, age 80, has a curvature of the spine. This is likely to indicate which age-related change? 1. Lordosis. 2. Dorsal kyphosis. 3. Scoliosis. 4. Kyphoscoliosis. 2. Dorsal Kyphosis Question 7. 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? 1. Valgus stress test. 2. Varus stress test. 3. Lachman test. 4. Thumb sign. 3. Lachman test Question 8. Lillian, age 70, was told that she has osteoporosis. When she asks you what this is, you respond that osteoporosis: 1. Develops when loss of bone occurs more rapidly than new bone growth. 2. Is a degenerative joint disease characterized by loss of cartilage in certain joints. 3. Is a chronic inflammatory disorder that affects multiple joints. 4. Is a bone disorder that has to do with inadequate mineralization of the bones. 1. Develops when loss of bone occurs more rapidly than new bone growth. Question 9. Mike, age 42, a golf pro, has had chronic back pain for many years. His workup reveals that it is not the result of a degenerative disk problem. His back “goes out” about twice per year, and he is out of work for about a week each time. Which of the following should the nurse practitioner advise him to do? 1. Consider changing careers to something less physical. 2. Begin a planned exercise program to strengthen back muscles. 3. Make an appointment with a neurosurgeon for a surgical consultation. 4. Start on a daily low-dose narcotic to take away the pain. 2. Begin a planned exercise program to strengthen back muscles. Question 10. Janine, age 69, has class III rheumatoid arthritis. According to the American Rheumatism Association, which of the following describes her ability to function? 1. Adequate for normal activities despite a handicap of discomfort or limited motion of one or more joints. 2. Largely or wholly incapacitated, bedridden, or confined to a wheelchair, permitting little or no self-care. 3. Completely able to carry out all usual duties without handicap. 4. Adequate to perform only a few or none of the duties of usual occupation or self-care. 4. Adequate to perform only a few or none of the duties of usual occupation or self-care. Question 11. Mickey, age 18, is on a chemotherapeutic antibiotic for a musculoskeletal neoplasm. Which drug do you think he is taking? 1. Cyclophosphamide (Cytoxan). 2. Doxorubicin (Adriamycin). 3. Methotrexate (Rheumatrex). 4. Cisplatin (Platinol). 2. Doxorubicin (Adriamycin) Question 12. 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: 1. Herniated nucleus pulposus. 2. Muscle strain. 3. Osteoarthritis. 4. Spondylolisthesis. 2. Muscle strain Question 13. A 55-year-old patient presents with complaints of paresthesias in the lower lateral arm, thumb, and middle finger. The nerve roots most commonly related to these symptoms are C6 and C7. The most likely diagnosis would be: 1. Brachial plexus neuritis. 2. Cervical radiculopathy. 3. Peripheral polyneuropathy. 4. Thoracic outlet syndrome. 2. Cervical radiculopathy Question 14. For an adult patient with a knee injury, the nurse practitioner orders a nonsteroidal anti-inflammatory drug (NSAID) to be taken on a routine basis for the next 2 weeks. Patient teaching should include which of the following? 1. "You may take this medication on an empty stomach as long as you eat within two to three hours of taking it." 2. "If one pill does not seem to help, you can double the dose for subsequent doses." 3. "If you notice nausea, vomiting, or black or bloody stools, take the next dose with a glass of milk or a full meal." 4. "If you have additional pain, an occasional acetaminophen (Tylenol) is permitted in between the usual doses of the NSAID." 4. "If you have additional pain, an occasional acetaminophen (Tylenol) is permitted in between the usual doses of the NSAID." Question 15. 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: 1. Lateral meniscus.