NURSING PATHOPHYSIOLOGY EXAM #6A: ALTERATIONS IN MOBILITY (2026/2027) |
CASE STUDY & STANDARD QUESTIONS WITH CORRECT ANSWERS
Advanced Pathophysiology Examination: Focus on Musculoskeletal & Neuromotor Systems | Core
Domains: Bone/Joint Disorders, Muscular Dystrophies, Spinal Disorders, Neuromuscular Junction
Disorders, and Central Motor Control Disorders | Graduate-Level Nursing Focus | Case Study & Clinical
Application Exam Format
Exam Structure
This exam for the 2026/2027 cycle is a 50-question assessment incorporating case studies (e.g., patient
with rheumatoid arthritis, progressive Parkinson's disease) to evaluate understanding of the specific
structural and functional defects that lead to characteristic patterns of mobility impairment and
associated complications.
Answer Format
All correct answers must be presented in bold and green, followed by rationales that connect the
underlying cellular or neurological defect to the progressive impact on mobility and function described in
the case studies and questions.
Questions (50 Total)
1.
A 5-year-old boy uses Gowers’ maneuver to stand and has calf pseudohypertrophy.
What is the diagnosis?
A. Myasthenia gravis
B. Duchenne muscular dystrophy
C. Amyotrophic lateral sclerosis
D. Multiple sclerosis
Duchenne muscular dystrophy is caused by dystrophin deficiency, leading to progressive muscle
necrosis. Gowers’ sign (using hands to 'walk' up thighs) and calf pseudohypertrophy (fat/fibrous
replacement) are classic.
2.
A patient with a herniated disc at L5–S1 reports radiating pain down the posterior leg to the foot.
,What nerve root is compressed?
A. L3
B. S1
C. L4
D. L2
The S1 nerve root innervates the posterior leg and lateral foot. Compression causes sciatica along this
dermatome, often with diminished ankle reflex.
3.
A patient presents with ptosis, diplopia, and worsening weakness with activity that improves with rest.
What condition is suspected?
A. Parkinson’s disease
B. Myasthenia gravis
C. Multiple sclerosis
D. Guillain-Barré syndrome
Myasthenia gravis is an autoimmune disorder where antibodies attack acetylcholine receptors at the
neuromuscular junction, causing fatigable muscle weakness—worse with use, better with rest.
4.
A 65-year-old male has resting tremor, bradykinesia, rigidity, and postural instability.
What is the primary pathophysiological defect?
A. Loss of GABAergic neurons in basal ganglia
B. Degeneration of dopaminergic neurons in substantia nigra
C. Demyelination of corticospinal tracts
D. Autoimmune attack on motor neurons
, Parkinson’s disease results from loss of dopamine-producing neurons in the substantia nigra pars
compacta, disrupting basal ganglia circuits that regulate movement initiation and control.
5.
A 70-year-old postmenopausal woman sustains a hip fracture after a minor fall.
What is the most likely underlying condition?
A. Osteomalacia
B. Osteoporosis
C. Paget’s disease
D. Rheumatoid arthritis
Osteoporosis involves decreased bone mineral density and microarchitectural deterioration, leading to
fragile bones prone to fracture—especially in postmenopausal women due to estrogen loss.
6.
A 5-year-old boy uses Gowers’ maneuver to stand and has calf pseudohypertrophy.
What is the diagnosis?
A. Myasthenia gravis
B. Duchenne muscular dystrophy
C. Amyotrophic lateral sclerosis
D. Multiple sclerosis
Duchenne muscular dystrophy is caused by dystrophin deficiency, leading to progressive muscle
necrosis. Gowers’ sign (using hands to 'walk' up thighs) and calf pseudohypertrophy (fat/fibrous
replacement) are classic.
7.
A patient with a herniated disc at L5–S1 reports radiating pain down the posterior leg to the foot.
What nerve root is compressed?
CASE STUDY & STANDARD QUESTIONS WITH CORRECT ANSWERS
Advanced Pathophysiology Examination: Focus on Musculoskeletal & Neuromotor Systems | Core
Domains: Bone/Joint Disorders, Muscular Dystrophies, Spinal Disorders, Neuromuscular Junction
Disorders, and Central Motor Control Disorders | Graduate-Level Nursing Focus | Case Study & Clinical
Application Exam Format
Exam Structure
This exam for the 2026/2027 cycle is a 50-question assessment incorporating case studies (e.g., patient
with rheumatoid arthritis, progressive Parkinson's disease) to evaluate understanding of the specific
structural and functional defects that lead to characteristic patterns of mobility impairment and
associated complications.
Answer Format
All correct answers must be presented in bold and green, followed by rationales that connect the
underlying cellular or neurological defect to the progressive impact on mobility and function described in
the case studies and questions.
Questions (50 Total)
1.
A 5-year-old boy uses Gowers’ maneuver to stand and has calf pseudohypertrophy.
What is the diagnosis?
A. Myasthenia gravis
B. Duchenne muscular dystrophy
C. Amyotrophic lateral sclerosis
D. Multiple sclerosis
Duchenne muscular dystrophy is caused by dystrophin deficiency, leading to progressive muscle
necrosis. Gowers’ sign (using hands to 'walk' up thighs) and calf pseudohypertrophy (fat/fibrous
replacement) are classic.
2.
A patient with a herniated disc at L5–S1 reports radiating pain down the posterior leg to the foot.
,What nerve root is compressed?
A. L3
B. S1
C. L4
D. L2
The S1 nerve root innervates the posterior leg and lateral foot. Compression causes sciatica along this
dermatome, often with diminished ankle reflex.
3.
A patient presents with ptosis, diplopia, and worsening weakness with activity that improves with rest.
What condition is suspected?
A. Parkinson’s disease
B. Myasthenia gravis
C. Multiple sclerosis
D. Guillain-Barré syndrome
Myasthenia gravis is an autoimmune disorder where antibodies attack acetylcholine receptors at the
neuromuscular junction, causing fatigable muscle weakness—worse with use, better with rest.
4.
A 65-year-old male has resting tremor, bradykinesia, rigidity, and postural instability.
What is the primary pathophysiological defect?
A. Loss of GABAergic neurons in basal ganglia
B. Degeneration of dopaminergic neurons in substantia nigra
C. Demyelination of corticospinal tracts
D. Autoimmune attack on motor neurons
, Parkinson’s disease results from loss of dopamine-producing neurons in the substantia nigra pars
compacta, disrupting basal ganglia circuits that regulate movement initiation and control.
5.
A 70-year-old postmenopausal woman sustains a hip fracture after a minor fall.
What is the most likely underlying condition?
A. Osteomalacia
B. Osteoporosis
C. Paget’s disease
D. Rheumatoid arthritis
Osteoporosis involves decreased bone mineral density and microarchitectural deterioration, leading to
fragile bones prone to fracture—especially in postmenopausal women due to estrogen loss.
6.
A 5-year-old boy uses Gowers’ maneuver to stand and has calf pseudohypertrophy.
What is the diagnosis?
A. Myasthenia gravis
B. Duchenne muscular dystrophy
C. Amyotrophic lateral sclerosis
D. Multiple sclerosis
Duchenne muscular dystrophy is caused by dystrophin deficiency, leading to progressive muscle
necrosis. Gowers’ sign (using hands to 'walk' up thighs) and calf pseudohypertrophy (fat/fibrous
replacement) are classic.
7.
A patient with a herniated disc at L5–S1 reports radiating pain down the posterior leg to the foot.
What nerve root is compressed?
