NSGl 554/l NSG554l Examl 4l –l Nursel
Practitionersl inl Primaryl Carel Il Guide|l
Wilkesl (Latestl 2026/l 2027l Update)l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Bursitisl s/s
Answer:
-painl andl restrictedl movement
-edema,l erythemal andl warmthl aroundl thel joint,l tendernessl onl palpation,l andl painl withl
jointl movement
-repetitivel motion,l excessivel pressure,l acutel trauma,l orl underlyingl systemicl conditionsl
likel rheumatoidl arthritisl andl gout
Q:l Bursitisl diagnostics
Answer:
1.l Clinical
2.l R/O:l Ifl gout,l RA,l orl infection:l ESR,l CRPl isl elevated
3.l Aspirationl ofl jointl fluidl forl evaluationl forl infx,l RA
Q:l Bursitisl tx
Answer:
Rest
Coldl andl heatl treatments
Elevation
Nonsteroidall anti-inflammatoryl drugsl (NSAIDs)
Bursall aspiration
Intrabursall steroidl injectionsl (withl orl withoutl locall anestheticl agents)
,Q:l Achillesl rupturel s/s
Answer:
Suddenl snapl (kickl inl thel leg)l w/l immediatel painl whichl rapidlyl subsides
Pointl tenderness,l swelling,l discoloration;l decreasedl ROM
Obviousl indentationl andl positivel Thompsonl test
Occursl 2-6l cml proximall thel calcaneall insertion
Calfl weakness,l inabilityl tol standl tipl toel orl walkl properly
Q:l Mediall andl laterall epicondylitis
Answer:
Mediall -l Pitcher's/Golfer'sl Elbow
-Flexl wristl thenl tryl tol pronatel againstl resistancel -l painl tol mediall epicondyle
l
Laterall -l Tennis
-Extendl andl supinatel wristl thenl tryl tol flexl againstl resistancel -l painl tol thel laterall
epicondylel (Cozunl test)
l
Bothl -l treatl withl rest,l RICE,l PT
Q:l DeQuervain'sl tendonitis
Answer:
Al conditionl inl whichl thel tendonsl onl thel thumbl sidel ofl thel wristl arel swollenl andl
irritated.
-pain,l especiallyl whenl grippingl orl movingl thumb
-txl splintl andl rest
Q:l Neckl painl inl hyperextensionl s/s
Answer:
Neckl pain
Stiffness
HA
,Withl orl withoutl neurologicl sx
Posterior,l midlinel bonyl tendernessl raisesl concernsl forl fx
Paraspinall orl laterall softl tissuel tendernessl suggestsl muscular/ligamentousl injury
Anteriorl tendernessl concerningl forl vascularl injury
Carotidl bruitl raisesl concernsl forl carotidl dissection
Q:l Neckl painl inl hyperextensionl howl tol clearl al patient
Answer:
Lowl riskl canl bel clearedl clinicallyl withoutl imagingl usingl eitherl thel Canadianl C-spinel
Rulel (CCR)l orl thel Nationall Emergencyl X-rayl Utilizationl Studyl (NEXUS)
Inl ptsl withl high-riskl mechanisml orl concerningl h&p,l recommendl imaging
Plainl x-raysl forl low-suspicion,l onlyl ifl asymptomatic
Axiall CTl forl mod-highl clinicall suspicionl ofl C-spinel inury
MRIl testl ofl choicel inl CCSl withl directl visualizationl ofl traumaticl cordl lesions:l edemal
orl hematomyelia
CTl angiographyl forl bluntl cerebrovascularl injuryl tol seel vasculaturel also
Q:l CCR:l Canadianl C-Spinel Rule
Answer:
Stablel andl alertl (GCSl >15)l traumal ptl withl nol hxl ofl cervicall spinel dz/surgeryl canl bel
clearedl if:
1-ablel tol activelyl rotatel neckl 45°l leftl andl right
2-nol dangerousl mechanisml (al falll froml anl elevationl ofl 3l feetl orl higher,l anl axiall loadl
tol thel head,l al high-speedl motorl vehiclel collisionl (includingl rolloverl orl ejection),l orl al
bicyclel collision)l orl extremityl paresthesias
3-agel <65l years
4-Atl leastl onel "low-risk"l factor:l simplel rear-endl MVA,l ambulatoryl atl anyl time,l nol
midlinel cervicall tenderness,l delayedl onsetl ofl neckl pain,l orl sittingl positionl inl thel ED
Q:l NEXUSl C-Spinel Rule
Answer:
Clinicallyl clearedl ifl alll thel followingl conditionsl arel met:
1-Nol midlinel tenderness
, 2-Nol evidencel ofl intoxication
3-Normall levell ofl alertness
4-Nol focall neurologicl deficits
5-Nol distractingl injury
Q:l Neckl painl redl flagl findings
Answer:
Fever
Nightl sweats
Photophobia
Weightl loss
Hxl ofl malignancy
Painl notl retractable
Bowel/bladderl dysfunction
Deep,l achingl painl inl neck
Rippingl sensationl inl neck
Dropl attacks
Visionl changes
Q:l Generall txl nonl red-flagl neckl pain
Answer:
NOl cervicall collarl forl whiplash
PTl doesl notl improvel outcomes
Rest
Centrall Cordl Syndrome:l immobilizationl andl PT/occupationall therapy
Cervicall strain:l nol differencel inl outcomesl withl PT,l mayl immobilizel withl softl collarl
x10l daysl forl symptoml relief,l increasel activityl asl tolerated
Q:l Carpall tunnell s/s
Answer:
Nocturnall pain,l N/Tl ofl thumb,l index,l long,l andl radiall portionl ofl thel ringl fingers
-relievedl byl shakingl orl rubbingl thel handsl (knownl asl positivel Flickl sign)
-weaknessl whenl openingl jars
Practitionersl inl Primaryl Carel Il Guide|l
Wilkesl (Latestl 2026/l 2027l Update)l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Bursitisl s/s
Answer:
-painl andl restrictedl movement
-edema,l erythemal andl warmthl aroundl thel joint,l tendernessl onl palpation,l andl painl withl
jointl movement
-repetitivel motion,l excessivel pressure,l acutel trauma,l orl underlyingl systemicl conditionsl
likel rheumatoidl arthritisl andl gout
Q:l Bursitisl diagnostics
Answer:
1.l Clinical
2.l R/O:l Ifl gout,l RA,l orl infection:l ESR,l CRPl isl elevated
3.l Aspirationl ofl jointl fluidl forl evaluationl forl infx,l RA
Q:l Bursitisl tx
Answer:
Rest
Coldl andl heatl treatments
Elevation
Nonsteroidall anti-inflammatoryl drugsl (NSAIDs)
Bursall aspiration
Intrabursall steroidl injectionsl (withl orl withoutl locall anestheticl agents)
,Q:l Achillesl rupturel s/s
Answer:
Suddenl snapl (kickl inl thel leg)l w/l immediatel painl whichl rapidlyl subsides
Pointl tenderness,l swelling,l discoloration;l decreasedl ROM
Obviousl indentationl andl positivel Thompsonl test
Occursl 2-6l cml proximall thel calcaneall insertion
Calfl weakness,l inabilityl tol standl tipl toel orl walkl properly
Q:l Mediall andl laterall epicondylitis
Answer:
Mediall -l Pitcher's/Golfer'sl Elbow
-Flexl wristl thenl tryl tol pronatel againstl resistancel -l painl tol mediall epicondyle
l
Laterall -l Tennis
-Extendl andl supinatel wristl thenl tryl tol flexl againstl resistancel -l painl tol thel laterall
epicondylel (Cozunl test)
l
Bothl -l treatl withl rest,l RICE,l PT
Q:l DeQuervain'sl tendonitis
Answer:
Al conditionl inl whichl thel tendonsl onl thel thumbl sidel ofl thel wristl arel swollenl andl
irritated.
-pain,l especiallyl whenl grippingl orl movingl thumb
-txl splintl andl rest
Q:l Neckl painl inl hyperextensionl s/s
Answer:
Neckl pain
Stiffness
HA
,Withl orl withoutl neurologicl sx
Posterior,l midlinel bonyl tendernessl raisesl concernsl forl fx
Paraspinall orl laterall softl tissuel tendernessl suggestsl muscular/ligamentousl injury
Anteriorl tendernessl concerningl forl vascularl injury
Carotidl bruitl raisesl concernsl forl carotidl dissection
Q:l Neckl painl inl hyperextensionl howl tol clearl al patient
Answer:
Lowl riskl canl bel clearedl clinicallyl withoutl imagingl usingl eitherl thel Canadianl C-spinel
Rulel (CCR)l orl thel Nationall Emergencyl X-rayl Utilizationl Studyl (NEXUS)
Inl ptsl withl high-riskl mechanisml orl concerningl h&p,l recommendl imaging
Plainl x-raysl forl low-suspicion,l onlyl ifl asymptomatic
Axiall CTl forl mod-highl clinicall suspicionl ofl C-spinel inury
MRIl testl ofl choicel inl CCSl withl directl visualizationl ofl traumaticl cordl lesions:l edemal
orl hematomyelia
CTl angiographyl forl bluntl cerebrovascularl injuryl tol seel vasculaturel also
Q:l CCR:l Canadianl C-Spinel Rule
Answer:
Stablel andl alertl (GCSl >15)l traumal ptl withl nol hxl ofl cervicall spinel dz/surgeryl canl bel
clearedl if:
1-ablel tol activelyl rotatel neckl 45°l leftl andl right
2-nol dangerousl mechanisml (al falll froml anl elevationl ofl 3l feetl orl higher,l anl axiall loadl
tol thel head,l al high-speedl motorl vehiclel collisionl (includingl rolloverl orl ejection),l orl al
bicyclel collision)l orl extremityl paresthesias
3-agel <65l years
4-Atl leastl onel "low-risk"l factor:l simplel rear-endl MVA,l ambulatoryl atl anyl time,l nol
midlinel cervicall tenderness,l delayedl onsetl ofl neckl pain,l orl sittingl positionl inl thel ED
Q:l NEXUSl C-Spinel Rule
Answer:
Clinicallyl clearedl ifl alll thel followingl conditionsl arel met:
1-Nol midlinel tenderness
, 2-Nol evidencel ofl intoxication
3-Normall levell ofl alertness
4-Nol focall neurologicl deficits
5-Nol distractingl injury
Q:l Neckl painl redl flagl findings
Answer:
Fever
Nightl sweats
Photophobia
Weightl loss
Hxl ofl malignancy
Painl notl retractable
Bowel/bladderl dysfunction
Deep,l achingl painl inl neck
Rippingl sensationl inl neck
Dropl attacks
Visionl changes
Q:l Generall txl nonl red-flagl neckl pain
Answer:
NOl cervicall collarl forl whiplash
PTl doesl notl improvel outcomes
Rest
Centrall Cordl Syndrome:l immobilizationl andl PT/occupationall therapy
Cervicall strain:l nol differencel inl outcomesl withl PT,l mayl immobilizel withl softl collarl
x10l daysl forl symptoml relief,l increasel activityl asl tolerated
Q:l Carpall tunnell s/s
Answer:
Nocturnall pain,l N/Tl ofl thumb,l index,l long,l andl radiall portionl ofl thel ringl fingers
-relievedl byl shakingl orl rubbingl thel handsl (knownl asl positivel Flickl sign)
-weaknessl whenl openingl jars
