i-Human Case Study: 16-Year-Old Male With
Hand Pain 2026 | NURS 6531 Walden University –
Advanced Practice Assessment Guide | Pediatric
Musculoskeletal Evaluation
Q001: The 16-year-old male presents with 3-day right-hand pain after falling on an outstretched
hand during basketball. Which initial history question is most appropriate?
Options:
A. "Do you have any allergies to medications?"
B. "Can you describe exactly how you landed and where the pain is now?" - CORRECT
C. "Have you had recent fever or night sweats?"
D. "Is the pain present in both hands?"
(Correct Answer: C)
Q002: He reports immediate dorsal wrist pain and swelling. Which adolescent-specific social
history is essential?
Options:
A. "How many hours per week do you play video games?"
B. "Are you currently participating in any organized sports or training?" - CORRECT
C. "Do you have a part-time job after school?"
D. "What is your favorite subject in school?"
(Correct Answer: B)
Q003: Patient rates pain 7/10 and notes difficulty gripping his water bottle. Which focused ROS
symptom do you prioritize?
Options:
A. Bilateral knee pain
B. Numbness or tingling in fingers - CORRECT
C. Headaches
D. Abdominal pain
(Correct Answer: B)
Q004: He denies previous injuries but mentions intermittent thumb pain last season. Which
high-risk adolescent behavior do you assess?
Options:
A. Energy drink consumption before games - CORRECT
B. Daily breakfast habits
C. Screen time duration
D. Backpack weight
(Correct Answer: A)
Q005: On inspection, you notice diffuse dorsal swelling and mild ecchymosis. Which
pediatric-specific observation is most concerning?
Options:
A. Swelling extends to metacarpals
, B. Skin is warm and erythematous - CORRECT
C. Nail beds are intact
D. Mild bruising present
(Correct Answer: B)
Q006: You palpate the anatomic snuffbox. Which finding would most suggest scaphoid fracture?
Options:
A. Tenderness over radial styloid
B. Pain with axial loading of thumb - CORRECT
C. Soft tissue crepitus
D. Dorsal wrist fullness
(Correct Answer: B)
Q007: Active ROM reveals 40-degree wrist extension vs 70-degree contralateral. Which
pediatric growth plate consideration is critical?
Options:
A. Epiphyseal plate is stronger than ligaments
B. Ligamentous injury is more common than fractures
C. Distal radius physis is vulnerable to shear forces - CORRECT
D. Growth plates close at age 12 in males
(Correct Answer: C)
Q008: You perform a pediatric neurovascular assessment. Which finding requires immediate
intervention?
Options:
A. Capillary refill 3 seconds
B. Patient reports mild tingling in thumb - CORRECT
C. Radial pulse 2+ bilaterally
D. Pink nail beds
(Correct Answer: B)
Q009: Which pediatric-specific functional test best evaluates median nerve integrity?
Options:
A. Thumb-to-pinky opposition - CORRECT
B. Making a fist
C. Wrist flexion against resistance
D. Finger spread abduction
(Correct Answer: A)
Q010: You suspect a distal radius fracture. Which initial imaging view is most appropriate?
Options:
A. PA and lateral wrist only
B. PA, lateral, and oblique wrist views - CORRECT
C. PA hand view
D. CT scan of wrist
(Correct Answer: B)
Q011: X-ray shows subtle cortical irregularity at distal radius metaphysis. Which additional view
best visualizes growth plate injury?
Options:
Hand Pain 2026 | NURS 6531 Walden University –
Advanced Practice Assessment Guide | Pediatric
Musculoskeletal Evaluation
Q001: The 16-year-old male presents with 3-day right-hand pain after falling on an outstretched
hand during basketball. Which initial history question is most appropriate?
Options:
A. "Do you have any allergies to medications?"
B. "Can you describe exactly how you landed and where the pain is now?" - CORRECT
C. "Have you had recent fever or night sweats?"
D. "Is the pain present in both hands?"
(Correct Answer: C)
Q002: He reports immediate dorsal wrist pain and swelling. Which adolescent-specific social
history is essential?
Options:
A. "How many hours per week do you play video games?"
B. "Are you currently participating in any organized sports or training?" - CORRECT
C. "Do you have a part-time job after school?"
D. "What is your favorite subject in school?"
(Correct Answer: B)
Q003: Patient rates pain 7/10 and notes difficulty gripping his water bottle. Which focused ROS
symptom do you prioritize?
Options:
A. Bilateral knee pain
B. Numbness or tingling in fingers - CORRECT
C. Headaches
D. Abdominal pain
(Correct Answer: B)
Q004: He denies previous injuries but mentions intermittent thumb pain last season. Which
high-risk adolescent behavior do you assess?
Options:
A. Energy drink consumption before games - CORRECT
B. Daily breakfast habits
C. Screen time duration
D. Backpack weight
(Correct Answer: A)
Q005: On inspection, you notice diffuse dorsal swelling and mild ecchymosis. Which
pediatric-specific observation is most concerning?
Options:
A. Swelling extends to metacarpals
, B. Skin is warm and erythematous - CORRECT
C. Nail beds are intact
D. Mild bruising present
(Correct Answer: B)
Q006: You palpate the anatomic snuffbox. Which finding would most suggest scaphoid fracture?
Options:
A. Tenderness over radial styloid
B. Pain with axial loading of thumb - CORRECT
C. Soft tissue crepitus
D. Dorsal wrist fullness
(Correct Answer: B)
Q007: Active ROM reveals 40-degree wrist extension vs 70-degree contralateral. Which
pediatric growth plate consideration is critical?
Options:
A. Epiphyseal plate is stronger than ligaments
B. Ligamentous injury is more common than fractures
C. Distal radius physis is vulnerable to shear forces - CORRECT
D. Growth plates close at age 12 in males
(Correct Answer: C)
Q008: You perform a pediatric neurovascular assessment. Which finding requires immediate
intervention?
Options:
A. Capillary refill 3 seconds
B. Patient reports mild tingling in thumb - CORRECT
C. Radial pulse 2+ bilaterally
D. Pink nail beds
(Correct Answer: B)
Q009: Which pediatric-specific functional test best evaluates median nerve integrity?
Options:
A. Thumb-to-pinky opposition - CORRECT
B. Making a fist
C. Wrist flexion against resistance
D. Finger spread abduction
(Correct Answer: A)
Q010: You suspect a distal radius fracture. Which initial imaging view is most appropriate?
Options:
A. PA and lateral wrist only
B. PA, lateral, and oblique wrist views - CORRECT
C. PA hand view
D. CT scan of wrist
(Correct Answer: B)
Q011: X-ray shows subtle cortical irregularity at distal radius metaphysis. Which additional view
best visualizes growth plate injury?
Options:
