MS dunphy Question and answers correctly solved

MS dunphy
13-year-old obese (body mass index [BMI] above the 95th percentile) boy
reports low-grade 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
nurse practitioner should suspect:A left meniscal tear.
2.
A left anterior cruciate ligament (ACL) tear.
3.
A slipped capital femoral epiphysis (SCFE).
4.
Osgood-Schlatter disease. - correct answer ✔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.


Cass, age 67, tells the nurse practitioner (NP) that she has been diagnosed
with a condition that causes sudden flares of pain, swelling, and redness of
the joints in her toes. She cannot remember the name of the diagnosis, but
she knows it is caused by urate crystals that "get stuck in the joint and cause
pain." She is on hydrochlorothiazide (HCTZ) for management of her
hypertension. The NP should suspect a diagnosis of:1.
Septic arthritis.
2.

,Gout.
3.
Rheumatoid arthritis.
4.
Charcot neuro-osteoarthropathy. - correct answer ✔gout is a disorder that
involves abnormal metabolism of uric acid and results in hyperuricemia. High
concentrations of urate precipitate into crystals that collect in tissue and joint
spaces and can cause pain and inflammation. The patient's symptoms may be
aggravated by the use of HCTZ.


Question 3. Matthew, age 52, is a chef who just severed 2 of his fingers with a
meat cutter. You would recommend that he:
1.
Wrap the severed fingers tightly in a dry towel for transport to the emergency
department with him.
2.
Leave the severed fingers at the scene because fingers cannot be reattached.
3.
Immediately freeze the severed fingers for reattachment in the near future.
4.
Wrap the fingers in a clean, damp cloth; seal them in a plastic bag; and place
the bag in an ice water bath. - correct answer ✔If a client has severed his
fingers, the fingers should be wrapped in a clean, damp cloth; sealed in a
plastic bag; placed in an ice water bath; and transported to the emergency
room along with the client.


Question 4. Marsha, age 34, presents with symptoms resembling both
fibromyalgia and chronic fatigue syndrome, which have many similarities.
Which of the following is more characteristic of fibromyalgia than of chronic
fatigue syndrome?

,1.
Musculoskeletal pain.
2.
Difficulty sleeping.
3.
Depression.
4.
Fatigue. - correct answer ✔Option 1:
Musculoskeletal pain is not characteristic of chronic fatigue syndrome; rather,
it is characteristic of fibromyalgia. The musculoskeletal pain, usually an achy
muscle pain that may be localized or involve the entire body, is usually
gradual in onset, although the onset may occasionally be sudden, such as
after a viral illness


Question 5. Mike, age 42, a golf pro, has had chronic back pain for many
years. His workup reveals that it is not the result of a degenerative disk
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 nurse practitioner
advise him to do?
1.
Consider changing careers to something less physical.
2.
Begin a planned exercise program to strengthen back muscles.
3.
Make an appointment with a neurosurgeon for a surgical consultation.
4.
Start on a daily low-dose narcotic to take away the pain. - correct answer
✔In this case, Mike 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 6. Janine, age 69, has class III rheumatoid arthritis. According to the
American Rheumatism Association, which of the following describes her
ability to function?
1.
Adequate for normal activities despite a handicap of discomfort or limited
motion of one or more joints.
2.
Largely or wholly incapacitated, bedridden, or confined to a wheelchair,
permitting little or no self-care.
3.
Completely able to carry out all usual duties without handicap.
4.
Adequate to perform only a few or none of the duties of usual occupation or
self-care. - correct answer ✔The American Rheumatism Association has
established functional classes I to IV to describe a client's ability to accomplish
activities of daily living. Because Janine is class III, her function would be
adequate to perform only a few or none of the duties of usual occupation or
self-care.


American Rheumatism Association functional status - correct answer ✔Class
I refers to the client who can carry out all usual duties without handicap.
Class II refers to the client whose function is adequate for normal activities
despite a handicap of discomfort or limited motion of one or more joints.
The American Rheumatism Association has established functional classes I to
IV to describe a client's ability to accomplish activities of daily living. Because
Janine is class III, her function would be adequate to perform only a few or
none of the duties of usual occupation or self-care.
Class IV refers to the client who is largely or wholly incapacitated, bedridden,
or confined to a wheelchair, permitting little or no self-care.