NUR 355 Pathophysiology Exam 1
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Disorders of musculoskeletal function objective 1:
State the function of parathyroid hormone, calcitonin, and vitamin D in terms of bone formation
and metabolism - CORRECT ANSWER - Parathyroid Hormone: increases bone uptake,
decreases bone growth, increases intestinal calcium (through vit D) & phosphate uptake,
promptly increases serum calcium levels, prevents increase in serum phosphate levels, decreases
renal excretion of calcium, increases renal excretion of phosphate
Calcitonin: increases renal excretion of calcium & phosphate, decreases bone uptake, decreases
serum levels of calcium & phosphate with pharmacological doses, uncertain effect on bone
formation, (no effect on intestinal absorption of calcium/phosphate)
Vitamin D: increases intestinal uptake of calcium/phosphate, renal excretion of
calcium/phosphate, bone uptake/growth, (no effect on serum calcium/phosphate levels)
Disorders of musculoskeletal function objective 2:
Describe how fractures are classified - CORRECT ANSWER - - position of bone ends
(displaced/nondisplaced)
- completeness of break (complete/incomplete)
- orientation of break (transverse/linear/oblique nondisplaced/oblique displaced, spiral)
- penetration of break (open/closed)
- loose bodies (segmental/comminuted)
Disorders of musculoskeletal function objective 3:
,Describe the fracture healing process - CORRECT ANSWER - Phases of Bone Healing:
1. Hematoma formation & inflammation (week 1, RBCs & WBCs)
2. Fibrocartilaginous (soft) callus formation (weeks 2-3, osteoclasts, chondroblasts, osteoblasts,
fibroblasts, new blood vessels, cannot weightbear)
3. Bony callus formation (weeks 4-16, osteoclasts)
4. Remodeling (week 17+, osteoclasts, compact bone replaces spongy bone
Disorders of musculoskeletal function objective 4:
Differentiate among osteomyelitis due to spread from a contaminated wound, hematogenous
osteomyelitis, and osteomyelitis due to vascular insufficiency in terms of etiologies,
manifestations, and treatment - CORRECT ANSWER - Osteomyelitis from a wound
infection: most common, direct penetration/contamination of open wound, fever, poor healing,
joint infection, drainage, prevented by antibiotics, imaging, surgery, & removal of infected joint
Hematogenous osteomyelitis: through the bloodstream, mostly in children/debilitated adults/IV
drug users, x-rays appear normally at first, treated by antimicrobial agents/debridement/drainage
Vascular osteomyelitis: may develop from lesion (diabetic foot ulcers), pain is often muted by
peripheral neuropathy, treated by debridement, antibiotics, hyperbaric O2 therapy
Disorders of musculoskeletal function objective 5:
Contrast osteogenic sarcoma, Ewing sarcoma, and chondrosarcoma in terms of the most common
age groups and anatomic sites that are affected. - CORRECT ANSWER - Osteogenic
Sarcoma: most common in people <20 years, affects the proximal humerus/distal femur/knee
Ewing Sarcoma: most common in people <20 years, rarely in people >30 years, affects the femur
(diaphysis)/humerus/pubis/vertebrae/ribs/skull/flat bones
Chondrosarcoma: (connective tissue), most common in middle age to elderly adults, affects
articulations (knee/shoulder/hip/pelvis)
, Disorders of musculoskeletal function objective 6:
Describe the function of the epiphyseal growth plate in skeletal growth. - CORRECT
ANSWER - - Epiphyseal plate is the site of bone growth
- Epiphysis is the end of a long bone; diaphysis is the shaft of a long bone
- Nutritional and metabolic disorders can impair the formation of the organic matrix of bone,
causing slowing of growth the epiphyseal plate.
Disorders of musculoskeletal function objective 7:
Describe risk factors that contribute to the development of osteopenia, osteoporosis,
osteomalacia/rickets, and Paget diseases and relate them to the prevention of the disorder. -
CORRECT ANSWER - Osteopenia:
- reduced bone mass
- common to metabolic bone disease
- not a disease, but a condition; a sign of a disease
- risk factors: female, asian, caucasian, small bones, family history, age over 50, menapause, lack
of exercise
Osteoporosis:
- metabolic bone disease characterized by a loss of mineralized bone mass causing increased
porosity of the skeleton and susceptibility to fractures
- risk factors: alcohol use, corticosteroid use, low calcium, low estrogen, smoking, sedentary
lifestyle (ACCESS)
Osteomalacia/Rickets:
- produce a softening of the bones but do not cause bone loss
- caused by vit D deficiency
calcium & phosphate imbalance
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Disorders of musculoskeletal function objective 1:
State the function of parathyroid hormone, calcitonin, and vitamin D in terms of bone formation
and metabolism - CORRECT ANSWER - Parathyroid Hormone: increases bone uptake,
decreases bone growth, increases intestinal calcium (through vit D) & phosphate uptake,
promptly increases serum calcium levels, prevents increase in serum phosphate levels, decreases
renal excretion of calcium, increases renal excretion of phosphate
Calcitonin: increases renal excretion of calcium & phosphate, decreases bone uptake, decreases
serum levels of calcium & phosphate with pharmacological doses, uncertain effect on bone
formation, (no effect on intestinal absorption of calcium/phosphate)
Vitamin D: increases intestinal uptake of calcium/phosphate, renal excretion of
calcium/phosphate, bone uptake/growth, (no effect on serum calcium/phosphate levels)
Disorders of musculoskeletal function objective 2:
Describe how fractures are classified - CORRECT ANSWER - - position of bone ends
(displaced/nondisplaced)
- completeness of break (complete/incomplete)
- orientation of break (transverse/linear/oblique nondisplaced/oblique displaced, spiral)
- penetration of break (open/closed)
- loose bodies (segmental/comminuted)
Disorders of musculoskeletal function objective 3:
,Describe the fracture healing process - CORRECT ANSWER - Phases of Bone Healing:
1. Hematoma formation & inflammation (week 1, RBCs & WBCs)
2. Fibrocartilaginous (soft) callus formation (weeks 2-3, osteoclasts, chondroblasts, osteoblasts,
fibroblasts, new blood vessels, cannot weightbear)
3. Bony callus formation (weeks 4-16, osteoclasts)
4. Remodeling (week 17+, osteoclasts, compact bone replaces spongy bone
Disorders of musculoskeletal function objective 4:
Differentiate among osteomyelitis due to spread from a contaminated wound, hematogenous
osteomyelitis, and osteomyelitis due to vascular insufficiency in terms of etiologies,
manifestations, and treatment - CORRECT ANSWER - Osteomyelitis from a wound
infection: most common, direct penetration/contamination of open wound, fever, poor healing,
joint infection, drainage, prevented by antibiotics, imaging, surgery, & removal of infected joint
Hematogenous osteomyelitis: through the bloodstream, mostly in children/debilitated adults/IV
drug users, x-rays appear normally at first, treated by antimicrobial agents/debridement/drainage
Vascular osteomyelitis: may develop from lesion (diabetic foot ulcers), pain is often muted by
peripheral neuropathy, treated by debridement, antibiotics, hyperbaric O2 therapy
Disorders of musculoskeletal function objective 5:
Contrast osteogenic sarcoma, Ewing sarcoma, and chondrosarcoma in terms of the most common
age groups and anatomic sites that are affected. - CORRECT ANSWER - Osteogenic
Sarcoma: most common in people <20 years, affects the proximal humerus/distal femur/knee
Ewing Sarcoma: most common in people <20 years, rarely in people >30 years, affects the femur
(diaphysis)/humerus/pubis/vertebrae/ribs/skull/flat bones
Chondrosarcoma: (connective tissue), most common in middle age to elderly adults, affects
articulations (knee/shoulder/hip/pelvis)
, Disorders of musculoskeletal function objective 6:
Describe the function of the epiphyseal growth plate in skeletal growth. - CORRECT
ANSWER - - Epiphyseal plate is the site of bone growth
- Epiphysis is the end of a long bone; diaphysis is the shaft of a long bone
- Nutritional and metabolic disorders can impair the formation of the organic matrix of bone,
causing slowing of growth the epiphyseal plate.
Disorders of musculoskeletal function objective 7:
Describe risk factors that contribute to the development of osteopenia, osteoporosis,
osteomalacia/rickets, and Paget diseases and relate them to the prevention of the disorder. -
CORRECT ANSWER - Osteopenia:
- reduced bone mass
- common to metabolic bone disease
- not a disease, but a condition; a sign of a disease
- risk factors: female, asian, caucasian, small bones, family history, age over 50, menapause, lack
of exercise
Osteoporosis:
- metabolic bone disease characterized by a loss of mineralized bone mass causing increased
porosity of the skeleton and susceptibility to fractures
- risk factors: alcohol use, corticosteroid use, low calcium, low estrogen, smoking, sedentary
lifestyle (ACCESS)
Osteomalacia/Rickets:
- produce a softening of the bones but do not cause bone loss
- caused by vit D deficiency
calcium & phosphate imbalance
