NR 511 Final Exam Questions and Correct
Answers plus Rationales | Latest Update
2026-2027 | Graded A+
1. 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
B. Synovium
Rationale: Articular structures include synovium, cartilage, joint capsule, and joint
fluid. Bone, tendons, and fascia are nonarticular/periarticular.
2. You have detected the presence of crepitus on examination of a patient with a
musculoskeletal complaint. Additionally, there is limited range of motion (ROM)
with both active and passive movement. These findings suggest that the origin
of the musculoskeletal complaint is:
A. Articular
B. Inflammatory
C. Nonarticular
D. A and B
A. Articular
Rationale: Crepitus plus limitation of both active and passive ROM points to
joint/articular involvement.
3. Which of the following signs or symptoms indicate an inflammatory etiology
to musculoskeletal pain?
A. Decreased CRP
B. Hyperalbuminemia
C. Morning stiffness
D. Weight gain
, C. Morning stiffness
Rationale: Inflammatory arthritis classically causes prolonged morning stiffness.
CRP is usually elevated, not decreased.
4. Which of the following statements 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 that is causing the patient pain should be examined first
C. When possible, the patient should not be asked to perform active ROM
exercises to avoid causing pain
D. Radiographs should always be obtained prior to examination so as not to cause
further injury
A. The uninvolved side should be examined initially and then compared to
the involved side
Rationale: Standard musculoskeletal exam compares the unaffected side first.
Source key says C, but C is not standard practice.
5. You are performing muscle strength testing on a patient presenting with
musculoskeletal pain and find that the patient has complete ROM with gravity
eliminated. Which numeric grade of muscle strength would you give this
patient?
A. 1
B. 2
C. 3
D. 4
E. 5
B. 2
Rationale: Grade 2 = active movement with gravity eliminated. Grade 3 = against
gravity.
6. Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and
limited movement in her right shoulder. She denies trauma. Exam reveals 75%
reduction in both active and passive ROM of the right shoulder. She has
tenderness with motion and pain at the deltoid insertion. History: type 1
diabetes mellitus and hypertension. She is a secretary and right-handed. You
,suspect adhesive capsulitis or “frozen shoulder.” Which clue supports this
diagnosis?
A. History of HTN
B. Affected shoulder is dominant arm
C. History of DM
D. Work as secretary predisposes to repetitive motions
C. History of DM
Rationale: Diabetes mellitus is a strong risk factor for adhesive capsulitis.
7. Jennifer is an 18-year-old girl who comes to the ER after a fall during a soccer
game. She fell on her left side and kept her arm out straight to break her fall.
She has severe pain and limited ROM in her left shoulder. The clinician
diagnosed a dislocated shoulder. Which statement is true concerning shoulder
dislocation?
A. Posterior dislocations are more common than anterior dislocations
B. There is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses
C. Recurrent dislocations are uncommon and would require great force
D. Surgery is the most common treatment of choice
B. There is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses
Rationale: Shoulder dislocation can injure nerves/vessels; distal pulse and
sensory/motor checks are essential.
8. Mrs. Anderson is a 35-year-old woman recently diagnosed with carpal tunnel
syndrome. She has two young children and asks the clinician what the chances
are that they will also develop carpal tunnel syndrome. Which response is
correct regarding risk?
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are
thought to account for about half the risk.
B. Only people with occupations requiring repeated wrist flexion/extension,
forceful gripping, or vibrating hand tools are at risk.
C. An underlying musculoskeletal disorder must be present for a person to
develop carpal tunnel.
D. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are
, thought to account for about half the risk.
Rationale: CTS has significant genetic/familial predisposition; occupational factors
are not the only cause.
9. Which of the following statements is true regarding the treatment of carpal
tunnel syndrome?
A. The goal of TX is to prevent flexion and extension movements of the wrist
B. Splints are used because they allow free movement of fingers and thumb while
maintaining the wrist in neutral
C. Corticosteroid injections are discouraged because of risks for median nerve
damage, scarring, and infection
D. All of the above
A and B are true; source key says D, but C is not standard.
Rationale: Neutral wrist splinting and avoiding prolonged wrist flexion/extension
are mainstays. Corticosteroid injections are commonly used and not absolutely
discouraged.
10. Sam is a 25-year-old man diagnosed with low back strain based on localized
low back pain and muscle spasm with normal neuro exam. Low back pain is a
diagnosis of exclusion. Which symptom would alert the clinician to a herniated
nucleus pulposus or ruptured disc?
A. Morning stiffness and limited mobility of the L spine
B. Unilateral radicular pain symptoms that extend below the knee and are equal
to or greater than the back pain
C. Fever, chills, and elevated ESR
D. Pathologic fractures, severe night pain, weight loss, and fatigue
B. Unilateral radicular pain symptoms that extend below the knee and are
equal to or greater than the back pain
Rationale: Radicular pain below the knee suggests nerve root compression, e.g.,
herniated disc.
11. The clinician has instructed Sam, a 25-year-old patient with low back strain,
to use NSAIDs. Which statement is most appropriate when teaching Sam about
NSAIDs?
A. Start with the lowest effective dose because long-term NSAIDs can cause GI
ulcers and hemorrhage.
Answers plus Rationales | Latest Update
2026-2027 | Graded A+
1. 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
B. Synovium
Rationale: Articular structures include synovium, cartilage, joint capsule, and joint
fluid. Bone, tendons, and fascia are nonarticular/periarticular.
2. You have detected the presence of crepitus on examination of a patient with a
musculoskeletal complaint. Additionally, there is limited range of motion (ROM)
with both active and passive movement. These findings suggest that the origin
of the musculoskeletal complaint is:
A. Articular
B. Inflammatory
C. Nonarticular
D. A and B
A. Articular
Rationale: Crepitus plus limitation of both active and passive ROM points to
joint/articular involvement.
3. Which of the following signs or symptoms indicate an inflammatory etiology
to musculoskeletal pain?
A. Decreased CRP
B. Hyperalbuminemia
C. Morning stiffness
D. Weight gain
, C. Morning stiffness
Rationale: Inflammatory arthritis classically causes prolonged morning stiffness.
CRP is usually elevated, not decreased.
4. Which of the following statements 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 that is causing the patient pain should be examined first
C. When possible, the patient should not be asked to perform active ROM
exercises to avoid causing pain
D. Radiographs should always be obtained prior to examination so as not to cause
further injury
A. The uninvolved side should be examined initially and then compared to
the involved side
Rationale: Standard musculoskeletal exam compares the unaffected side first.
Source key says C, but C is not standard practice.
5. You are performing muscle strength testing on a patient presenting with
musculoskeletal pain and find that the patient has complete ROM with gravity
eliminated. Which numeric grade of muscle strength would you give this
patient?
A. 1
B. 2
C. 3
D. 4
E. 5
B. 2
Rationale: Grade 2 = active movement with gravity eliminated. Grade 3 = against
gravity.
6. Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and
limited movement in her right shoulder. She denies trauma. Exam reveals 75%
reduction in both active and passive ROM of the right shoulder. She has
tenderness with motion and pain at the deltoid insertion. History: type 1
diabetes mellitus and hypertension. She is a secretary and right-handed. You
,suspect adhesive capsulitis or “frozen shoulder.” Which clue supports this
diagnosis?
A. History of HTN
B. Affected shoulder is dominant arm
C. History of DM
D. Work as secretary predisposes to repetitive motions
C. History of DM
Rationale: Diabetes mellitus is a strong risk factor for adhesive capsulitis.
7. Jennifer is an 18-year-old girl who comes to the ER after a fall during a soccer
game. She fell on her left side and kept her arm out straight to break her fall.
She has severe pain and limited ROM in her left shoulder. The clinician
diagnosed a dislocated shoulder. Which statement is true concerning shoulder
dislocation?
A. Posterior dislocations are more common than anterior dislocations
B. There is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses
C. Recurrent dislocations are uncommon and would require great force
D. Surgery is the most common treatment of choice
B. There is a risk of neurovascular and neurosensory trauma, so the clinician
should check for distal pulses
Rationale: Shoulder dislocation can injure nerves/vessels; distal pulse and
sensory/motor checks are essential.
8. Mrs. Anderson is a 35-year-old woman recently diagnosed with carpal tunnel
syndrome. She has two young children and asks the clinician what the chances
are that they will also develop carpal tunnel syndrome. Which response is
correct regarding risk?
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are
thought to account for about half the risk.
B. Only people with occupations requiring repeated wrist flexion/extension,
forceful gripping, or vibrating hand tools are at risk.
C. An underlying musculoskeletal disorder must be present for a person to
develop carpal tunnel.
D. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are
, thought to account for about half the risk.
Rationale: CTS has significant genetic/familial predisposition; occupational factors
are not the only cause.
9. Which of the following statements is true regarding the treatment of carpal
tunnel syndrome?
A. The goal of TX is to prevent flexion and extension movements of the wrist
B. Splints are used because they allow free movement of fingers and thumb while
maintaining the wrist in neutral
C. Corticosteroid injections are discouraged because of risks for median nerve
damage, scarring, and infection
D. All of the above
A and B are true; source key says D, but C is not standard.
Rationale: Neutral wrist splinting and avoiding prolonged wrist flexion/extension
are mainstays. Corticosteroid injections are commonly used and not absolutely
discouraged.
10. Sam is a 25-year-old man diagnosed with low back strain based on localized
low back pain and muscle spasm with normal neuro exam. Low back pain is a
diagnosis of exclusion. Which symptom would alert the clinician to a herniated
nucleus pulposus or ruptured disc?
A. Morning stiffness and limited mobility of the L spine
B. Unilateral radicular pain symptoms that extend below the knee and are equal
to or greater than the back pain
C. Fever, chills, and elevated ESR
D. Pathologic fractures, severe night pain, weight loss, and fatigue
B. Unilateral radicular pain symptoms that extend below the knee and are
equal to or greater than the back pain
Rationale: Radicular pain below the knee suggests nerve root compression, e.g.,
herniated disc.
11. The clinician has instructed Sam, a 25-year-old patient with low back strain,
to use NSAIDs. Which statement is most appropriate when teaching Sam about
NSAIDs?
A. Start with the lowest effective dose because long-term NSAIDs can cause GI
ulcers and hemorrhage.
