DUNPHY FINAL CLINICAL EXAM 2026/27 NURS
671 WITH COMPLETE SOLUTIONS
Section 1: Musculoskeletal
Q1. One of the initial steps in assessing patients with musculoskeletal
complaints is to determine whether the complaint is articular or nonarticular in
origin. Which of the following is an example of an articular structure?
• A) Bone
• B) Synovium
• C) Tendons
• D) Fascia
Correct Answer: B
Rationale: Articular structures include the synovium, cartilage, joint capsule, and
synovial fluid. Tendons, fascia, and bone (when considered separately from the
joint) are nonarticular structures .
Q2. You have detected crepitus on exam and limited ROM with both active AND
passive movement. These findings suggest the origin of the complaint is:
• A) Nonarticular
• B) Articular
• C) Muscular
• D) Neurologic
Correct Answer: B
,Rationale: Articular disorders cause limited ROM with both active and passive
movement, along with crepitus. Nonarticular disorders typically limit active
movement only .
Q3. Which sign or symptom indicates an inflammatory etiology to
musculoskeletal pain?
• A) Decreased CRP
• B) Hyperalbuminemia
• C) Morning stiffness
• D) Weight gain
Correct Answer: C
Rationale: Morning stiffness lasting >30 minutes is a hallmark of inflammatory
arthritis. CRP is elevated (not decreased) in inflammation; weight loss, not gain, is
common .
Q4. The uninvolved side should be examined initially and then compared to the
involved side. Which statement concerning the musculoskeletal exam is true?
• A) The uninvolved side should be examined initially and then compared to
the involved side.
• B) The part of the body causing pain should be examined first.
• C) Patients should not perform active ROM to avoid pain.
• D) Radiographs should be obtained prior to examination.
Correct Answer: A
Rationale: The uninvolved side is examined first for baseline comparison, then the
involved side. This allows for more accurate detection of abnormalities .
Q5. A patient has complete ROM with gravity eliminated. Which numeric muscle
strength grade (1-5) would you assign?
• A) 1
, • B) 2
• C) 3
• D) 4
Correct Answer: B
Rationale: Grade 2 = full ROM with gravity eliminated. Grade 3 = full ROM against
gravity. Grade 4 = some resistance. Grade 5 = full resistance .
Section 2: Shoulder & Upper Extremity
Q6. A 55-year-old woman with diabetes presents with tightness, pain, and
limited movement in her right shoulder. Exam reveals 75% reduction in both
active and passive ROM, tenderness at the deltoid insertion. What supports the
diagnosis of adhesive capsulitis ("frozen shoulder")?
• A) History of diabetes
• B) Right-handed occupation
• C) History of trauma
• D) Age > 50
Correct Answer: A
Rationale: Diabetes is a major risk factor for adhesive capsulitis. Patients with
diabetes have up to a 20% lifetime risk of developing frozen shoulder .
Q7. An 18-year-old falls during soccer, lands on her side with arm extended, and
is diagnosed with a dislocated shoulder. Which statement is true?
• A) Posterior dislocations are more common than anterior
• B) There is a risk of neurovascular trauma; check distal pulses
• C) Recurrent dislocations are uncommon
• D) Surgery is the treatment of choice
, Correct Answer: B
Rationale: Anterior dislocations are more common. Neurovascular injury (axillary
nerve, brachial plexus) is a significant risk; distal pulses and sensation must be
assessed .
Q8. A 35-year-old woman recently diagnosed with carpal tunnel syndrome asks
about her children's risk. What is the correct response?
• A) Carpal tunnel syndrome commonly occurs in families. Genetic factors
account for about half the risk.
• B) Only occupations with repetitive wrist flexion/extension are at risk.
• C) An underlying musculoskeletal disorder must be present.
• D) Carpal tunnel only occurs with hormonal imbalance.
Correct Answer: A
Rationale: Genetic factors are estimated to contribute to about half the risk of
developing carpal tunnel syndrome .
Q9. Which is true regarding carpal tunnel syndrome treatment?
• A) The goal is to prevent all wrist movement.
• B) Splints allow free finger/thumb movement while maintaining wrist in
neutral position.
• C) Corticosteroid injections are discouraged.
• D) All of the above
Correct Answer: B
Rationale: Splints maintain neutral wrist position while allowing finger movement.
Corticosteroid injections can be effective and are not discouraged .
Section 3: Spine & Back
671 WITH COMPLETE SOLUTIONS
Section 1: Musculoskeletal
Q1. One of the initial steps in assessing patients with musculoskeletal
complaints is to determine whether the complaint is articular or nonarticular in
origin. Which of the following is an example of an articular structure?
• A) Bone
• B) Synovium
• C) Tendons
• D) Fascia
Correct Answer: B
Rationale: Articular structures include the synovium, cartilage, joint capsule, and
synovial fluid. Tendons, fascia, and bone (when considered separately from the
joint) are nonarticular structures .
Q2. You have detected crepitus on exam and limited ROM with both active AND
passive movement. These findings suggest the origin of the complaint is:
• A) Nonarticular
• B) Articular
• C) Muscular
• D) Neurologic
Correct Answer: B
,Rationale: Articular disorders cause limited ROM with both active and passive
movement, along with crepitus. Nonarticular disorders typically limit active
movement only .
Q3. Which sign or symptom indicates an inflammatory etiology to
musculoskeletal pain?
• A) Decreased CRP
• B) Hyperalbuminemia
• C) Morning stiffness
• D) Weight gain
Correct Answer: C
Rationale: Morning stiffness lasting >30 minutes is a hallmark of inflammatory
arthritis. CRP is elevated (not decreased) in inflammation; weight loss, not gain, is
common .
Q4. The uninvolved side should be examined initially and then compared to the
involved side. Which statement concerning the musculoskeletal exam is true?
• A) The uninvolved side should be examined initially and then compared to
the involved side.
• B) The part of the body causing pain should be examined first.
• C) Patients should not perform active ROM to avoid pain.
• D) Radiographs should be obtained prior to examination.
Correct Answer: A
Rationale: The uninvolved side is examined first for baseline comparison, then the
involved side. This allows for more accurate detection of abnormalities .
Q5. A patient has complete ROM with gravity eliminated. Which numeric muscle
strength grade (1-5) would you assign?
• A) 1
, • B) 2
• C) 3
• D) 4
Correct Answer: B
Rationale: Grade 2 = full ROM with gravity eliminated. Grade 3 = full ROM against
gravity. Grade 4 = some resistance. Grade 5 = full resistance .
Section 2: Shoulder & Upper Extremity
Q6. A 55-year-old woman with diabetes presents with tightness, pain, and
limited movement in her right shoulder. Exam reveals 75% reduction in both
active and passive ROM, tenderness at the deltoid insertion. What supports the
diagnosis of adhesive capsulitis ("frozen shoulder")?
• A) History of diabetes
• B) Right-handed occupation
• C) History of trauma
• D) Age > 50
Correct Answer: A
Rationale: Diabetes is a major risk factor for adhesive capsulitis. Patients with
diabetes have up to a 20% lifetime risk of developing frozen shoulder .
Q7. An 18-year-old falls during soccer, lands on her side with arm extended, and
is diagnosed with a dislocated shoulder. Which statement is true?
• A) Posterior dislocations are more common than anterior
• B) There is a risk of neurovascular trauma; check distal pulses
• C) Recurrent dislocations are uncommon
• D) Surgery is the treatment of choice
, Correct Answer: B
Rationale: Anterior dislocations are more common. Neurovascular injury (axillary
nerve, brachial plexus) is a significant risk; distal pulses and sensation must be
assessed .
Q8. A 35-year-old woman recently diagnosed with carpal tunnel syndrome asks
about her children's risk. What is the correct response?
• A) Carpal tunnel syndrome commonly occurs in families. Genetic factors
account for about half the risk.
• B) Only occupations with repetitive wrist flexion/extension are at risk.
• C) An underlying musculoskeletal disorder must be present.
• D) Carpal tunnel only occurs with hormonal imbalance.
Correct Answer: A
Rationale: Genetic factors are estimated to contribute to about half the risk of
developing carpal tunnel syndrome .
Q9. Which is true regarding carpal tunnel syndrome treatment?
• A) The goal is to prevent all wrist movement.
• B) Splints allow free finger/thumb movement while maintaining wrist in
neutral position.
• C) Corticosteroid injections are discouraged.
• D) All of the above
Correct Answer: B
Rationale: Splints maintain neutral wrist position while allowing finger movement.
Corticosteroid injections can be effective and are not discouraged .
Section 3: Spine & Back
