Exam (elaborations) NR511 WEEK 5 QUIZ (ANSWERED)

Exam (elaborations) NR511 WEEK 5 QUIZ (ANSWERED) A 42-year-old professional golfer complains of chronic back pain for many years. His workup reveals that it is not the result of a degenerative disc problem. His back “goes out” about twice per year, and he is out of work for about a week each time. Which of the following should the clinician advise? Consider changing careers to something less physical. Start on a daily low-dose narcotic to take away the pain. Make an appointment with a neurosurgeon for a surgical consultation. Correct! Begin a planned exercise program to strengthen back muscles. In this case, the patient may benefit from a regular planned exercise program to strengthen his back muscles and attempt to reduce the probability of future episodes of back pain. Question 2 1 / 1 pts A 49-year-old female presents with low back pain radiating into the right leg,. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? Compression fracture. Correct! Herniated nucleus pulposus. Scoliosis. Osteoarthritis. A plain x-ray will not show a herniated nucleus pulposus or a muscle strain. It will show spondylolisthesis, scoliosis, osteoarthritis, and spinal stenosis. Note that x-rays of the spine are not indicated in low back pain unless the cause of the pain is thought to be bony in origin or traumatic in nature or there is a need to rule out systemic disease. Question 3 1 / 1 pts In assessing the skeletal muscles, the clinician turns the patient’s forearm so that the palm is face up. This is called: Pronation. Correct! Supination. Abduction. Eversion. Turning the forearm so that the palm is up is called supination. Question 4 1 / 1 pts A conservative approach is recommended in the initial approach to the management of low back pain. Which of the following would be an appropriate treatment plan for a 32- year-old obese male (BMI 33) diagnosed with an acute lumbar strain? Bedrest. Correct! Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Epidural Steroid Injections (ESI). Surgery. It has been proven that rest has little to no effect on the resolution of LBP. Patients should do whatever activities are tolerable. Almost 90% of cases resolve within 1 to 6 weeks thus the initial management should include non-pharmacologic (masage, heat, etc.), pharmacological (NSAIDs, short term use of muscle relaxants) and activity. Surgery and ESI are not indicated in the initial management of LBP. Question 5 1 / 1 pts A 13-year-old obese (body mass index [BMI] above the 95th percentile) boy reports lowgrade left knee pain for the past 2 months. He denies antecedent trauma but admits to frequent “horseplay” with his friends. The pain has progressively worsened, and he is now unable to bear weight at all on his left leg. His current complaints include left groin, thigh, and medial knee pain and tenderness. His examination demonstrates negative drawer, Lachman, and McMurray tests; left hip with decreased internal rotation and abduction; and external hip rotation with knee flexion. Based on the above scenario, the clinician should suspect which of the following? A left meniscal tear. Osgood-Schlatter disease. A left anterior cruciate ligament (ACL) tear. Correct! A slipped capital femoral epiphysis (SCFE). SCFE is a displacement of the femoral head relative to the femoral neck that occurs through the physis (growth plate) of the femur. The vast majority of clients with this condition are obese, as the added weight increases shear stress across the physis. The mean age at diagnosis is 12 years for females and 13.5 years for males. Surgery is often required via in situ pin fixation (single screw) to stabilize the growth plate to prevent further slippage and avoid complications. Question 6 1 / 1 pts A 55-year-old patient is able to complete range of motion (ROM) against gravity with some resistance. The nurse practitioner would assign which of the following numerical grades to this manual muscle testing description? 2 3 Correct! 4 5 Normal muscle strength and function and complete ROM against gravity with full or normal resistance would be given a numerical grade of 5. Complete ROM against gravity with some resistance is given a numerical grade of 4 and described as good muscle strength. Complete ROM against gravity is indicative of fair muscle strength and function and is given a numerical grade of 3. A grade of 2, denoting poor muscle strength, is given for complete ROM with gravity eliminated. Question 7 1 / 1 pts A 16-year-old male patient presents to the clinic after sustaining a football injury to his right knee. The clinician elicits a positive anterior/posterior drawer sign. This test indicates an injury to the ______? Lateral meniscus. Medial meniscus. Correct! Cruciate ligament. Collateral ligament. Positive anterior and posterior drawer signs indicate injury to the anterior cruciate ligament and posterior cruciate ligament, respectively. The drawer and Lachman tests are utilized to assess for cruciate ligament injury. Question 8 1 / 1 pts A 28-year-old male presents to the clinic for follow-up from the emergency department, where he was seen for right forearm pain 3 days ago. He works as a carpenter and is right hand dominant. He states he was diagnosed with right forearm tendinitis and is not sure what this means. As part of teaching, the clinician explains that the condition is caused by inflammation of one or more of the tendons. Which of the following describes tendons? The fibrocartilaginous disks that separate bony surfaces. The pouches of synovial fluid that cushion bone and other joint structures. Correct! The collagen fibers that connect muscle to bone. The ropelike bundle