NURS 623 FINAL EXAM - MUSCULOSKELETAL
SECTION Questions And Correct Answers
A 13 year old obese (BMI greater than 95%) 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 knee flexion
causing external hip rotation. Based on the above scenario, the NP should
suspect:
a. a left meniscal tear.
b. a left ACL tear
c. a slipped capital femoral epiphysis
d. osgood-schlatter disease.
C.
Colchicine may be used to terminate an acute attack of gouty arthritis as well
as prevent recurrent episodes. The mechanism of action is to:
a. interrupt the cycle of urate crystal deposition and inflammatory response.
b. increase serum uric acid levels.
c. potentiate the excretion of uric acid.
d. inhibit the tubular reabsorption of urate, promoting the excretion of uric
acid.
A.
Cass, age 67, tells the 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 that it is
cause by urate crystals that "get stuck in the joint and cause pain". Joan is on
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
B.
Treatment of choice for polymyalgia rheumatica (PMR) is:
a. acetaminophen or NSAIDS
b. low dose steroids.
c. tricyclic antidepressants.
d. antibiotics
B.
, Dan, age 49, developed osteomyelitis of the femur after a motorcycle accident.
Which of the following statements about the clinical manifestations of
osteomyelitis is correct?
a. integumentary effects involve swelling, erythema, and warmth at the
involved site.
b. there is a low grade fever with intermittent chills
c. musculoskeletal effects include tenderness of the entire leg.
d. cardiovascular effects include bradycardia.
A.
Matthew, age 52, is a chef who just severed two of his fingers with a meat
cutter. You would recommend that he:
a. wrap the severed fingers tightly in a dry towel for transport to the
emergency department with him.
b. leave the severed fingers at the scene because fingers cannot be
reattached.
c. immediately freeze the severed fingers for reattachment in the near future.
d. pack the fingers in a saline-soaked dressing and seal in a plastic bag.
D.
Bursitis is an inflammatory process that may be caused by infection, trauma,
repetitive motion disorders, gout, or neoplastic disease. The most common
cause of septic bursitis due to infection is from which of the following:
a. Mycobacterium tuberculosis
b. Candida
c. Staphylococcus aureus.
d. streptococcus
C.
When a provider elicits a painful Finkelstein's sign he or she is testing for:
a. carpal tunnel syndrone
b. bursitis of the shoulder.
c. de Quervain's tenosynovitis
d. tennis elbow.
C.
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?
a. musculoskeletal pain
b. difficulty sleeping
c. depression
d. fatigue
A.
A coccygeal fracture is treated with:
a. traction
b. surgical repair
SECTION Questions And Correct Answers
A 13 year old obese (BMI greater than 95%) 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 knee flexion
causing external hip rotation. Based on the above scenario, the NP should
suspect:
a. a left meniscal tear.
b. a left ACL tear
c. a slipped capital femoral epiphysis
d. osgood-schlatter disease.
C.
Colchicine may be used to terminate an acute attack of gouty arthritis as well
as prevent recurrent episodes. The mechanism of action is to:
a. interrupt the cycle of urate crystal deposition and inflammatory response.
b. increase serum uric acid levels.
c. potentiate the excretion of uric acid.
d. inhibit the tubular reabsorption of urate, promoting the excretion of uric
acid.
A.
Cass, age 67, tells the 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 that it is
cause by urate crystals that "get stuck in the joint and cause pain". Joan is on
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
B.
Treatment of choice for polymyalgia rheumatica (PMR) is:
a. acetaminophen or NSAIDS
b. low dose steroids.
c. tricyclic antidepressants.
d. antibiotics
B.
, Dan, age 49, developed osteomyelitis of the femur after a motorcycle accident.
Which of the following statements about the clinical manifestations of
osteomyelitis is correct?
a. integumentary effects involve swelling, erythema, and warmth at the
involved site.
b. there is a low grade fever with intermittent chills
c. musculoskeletal effects include tenderness of the entire leg.
d. cardiovascular effects include bradycardia.
A.
Matthew, age 52, is a chef who just severed two of his fingers with a meat
cutter. You would recommend that he:
a. wrap the severed fingers tightly in a dry towel for transport to the
emergency department with him.
b. leave the severed fingers at the scene because fingers cannot be
reattached.
c. immediately freeze the severed fingers for reattachment in the near future.
d. pack the fingers in a saline-soaked dressing and seal in a plastic bag.
D.
Bursitis is an inflammatory process that may be caused by infection, trauma,
repetitive motion disorders, gout, or neoplastic disease. The most common
cause of septic bursitis due to infection is from which of the following:
a. Mycobacterium tuberculosis
b. Candida
c. Staphylococcus aureus.
d. streptococcus
C.
When a provider elicits a painful Finkelstein's sign he or she is testing for:
a. carpal tunnel syndrone
b. bursitis of the shoulder.
c. de Quervain's tenosynovitis
d. tennis elbow.
C.
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?
a. musculoskeletal pain
b. difficulty sleeping
c. depression
d. fatigue
A.
A coccygeal fracture is treated with:
a. traction
b. surgical repair
