NUR 603 Final Exam Review questions
with answers
Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1.
She is currently in the emergency room with suspicion of cauda equina compression. Which of the
following is a sign or symptom of cauda equina compression?
A. Gastrocnemius weakness
B. A reduced or absent ankle reflex
C. Numbness in the lateral foot
D. Paresthesia of the perineum and buttocks - ANSWERS🔷🔶D. Paresthesia of the perineum and
buttocks
Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained
to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing
functional independence and mobility, minimizing disability, and preserving quality of life. Mr.
Jackson explains to the clinician that his first choice would be to use complementary therapies to
control his condition and asks what therapies are most effective in treating osteoarthritis. What
would be the most appropriate response from the clinician?
A. "Complementary therapies should be considered only if surgical interventions are not successful."
B. "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to
discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your
condition."
C. "I would be happy to discuss all the treatment options available to you. Compleme -
ANSWERS🔷🔶C. "I would be happy to discuss all the treatment options available to you.
Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use
in the treatment of osteoarthritis and have shown promise when used with standard medical
therapy."
John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football
game. He described twisting his knee and then being unable to extend it completely. John tells the
clinician that he heard a pop when the injury occurred and has been experiencing localized pain.
The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the
presence of a meniscal tear?
,A. Valgus stress test
B. McMurray circumduction test
C. Lachman test
D. Varus stress test - ANSWERS🔷🔶B. McMurray circumduction test
The clinician suspects that a client has patellar instability. In order to test for this, the client is seated
with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced
laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an
abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for
patellar instability in this way is known as:
A. Apprehension sign
B. Bulge sign
C. Thumb sign
D. None of the above - ANSWERS🔷🔶A. Apprehension sign
A clinician has performed a synovial fluid analysis and the results are as follows: visual analysis:
turbid and yellow, viscosity: decreased, 52,000 white blood cells (WBCs) per mm3,
polymorphonuclear leukocytes (PMNs): 75%, protein: 5 g/dL. Which of the following conditions
could this result be attributed to?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis - ANSWERS🔷🔶D. Septic arthritis
Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The
clinician suspects acute gout. Which of the following should the clinician expect in the initial test
results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
C. Decreased urine pH
D. Decreased C-reactive protein - ANSWERS🔷🔶A. Elevated uric acid level
,Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for
median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with
the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform?
A. Allen's test
B. Phalen's test
C. Tinel's sign
D. Finkelstein's test - ANSWERS🔷🔶B. Phalen's test
Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized
low back pain and muscle spasm along with a normal neurological examination. As the clinician,
you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured
disc?
A. Morning stiffness and limited mobility of the lumbar 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 erythrocyte sedimentation rate
D. Pathologic fractures, severe night pain, weight loss, and fatigue - ANSWERS🔷🔶B. Unilateral
radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
Felice is a 66-year-old female who complains that walking and prolonged standing causes pain and
weakness in her legs and buttocks. She expresses that she has short-term relief when she leans on
the shopping cart. When she sleeps on her back, she sometimes wakes up in the night in pain. Which
of the following diagnoses is most likely?
A. Multiple sclerosis
B. Herniated lumbar disc
C. Lumbar spinal stenosis
D. Cervical spondylosis - ANSWERS🔷🔶C. Lumbar spinal stenosis
To diagnose fibromyalgia, there must be tenderness on digital palpation in at least 11 of 18 (nine
pairs) tender point sites, which would include the
, A. occiput, low cervical, trapezius, and supraspinatus
B. proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints of the hands, and the
metatarsophalangeal (MTP) and PIP joints of the foot
C. facet joints of the cervical, thoracic, and lumbar spine
D. radial and ulnar styloids and the medial and lateral malleoli - ANSWERS🔷🔶A. occiput, low
cervical, trapezius, and supraspinatus
Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her
right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both
active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion
and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and
hypertension. Her social history reveals that she is a secretary and that she is right handed. Based on
her examination and medical history, you suspect adhesive capsulitis, or "frozen shoulder." Which
clue in Mrs. Gray's history supports this diagnosis?
A. History of hypertension
B. Her affected shoulder is also her dominant arm.
C. Her history of diabetes mellitus
D. Her work as a secretary predisposes her to repetitive motions. - ANSWERS🔷🔶C. Her history of
diabetes mellitus
The clinician is assessing Sally's diffuse hip pain. How should the clinician begin the examination?
A.Begin the range-of-motion examination with an assessment of the motion that causes pain.
B.Physical examination of the hip must first assess its position at rest.
C.The patient should move the hip prior to radiographic studies to determine whether they are
necessary.
D.Flexion and extension of the affected hips' extremity should only be performed with the knee
straight. - ANSWERS🔷🔶B.Physical examination of the hip must first assess its position at rest.
Which diagnostic test is the diagnostic gold standard for patients that have tendonitis and have failed
conservative treatment?
A. Plain x-ray films
B. Magnetic resonance imaging (MRI)
with answers
Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1.
She is currently in the emergency room with suspicion of cauda equina compression. Which of the
following is a sign or symptom of cauda equina compression?
A. Gastrocnemius weakness
B. A reduced or absent ankle reflex
C. Numbness in the lateral foot
D. Paresthesia of the perineum and buttocks - ANSWERS🔷🔶D. Paresthesia of the perineum and
buttocks
Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained
to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing
functional independence and mobility, minimizing disability, and preserving quality of life. Mr.
Jackson explains to the clinician that his first choice would be to use complementary therapies to
control his condition and asks what therapies are most effective in treating osteoarthritis. What
would be the most appropriate response from the clinician?
A. "Complementary therapies should be considered only if surgical interventions are not successful."
B. "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to
discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your
condition."
C. "I would be happy to discuss all the treatment options available to you. Compleme -
ANSWERS🔷🔶C. "I would be happy to discuss all the treatment options available to you.
Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use
in the treatment of osteoarthritis and have shown promise when used with standard medical
therapy."
John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football
game. He described twisting his knee and then being unable to extend it completely. John tells the
clinician that he heard a pop when the injury occurred and has been experiencing localized pain.
The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the
presence of a meniscal tear?
,A. Valgus stress test
B. McMurray circumduction test
C. Lachman test
D. Varus stress test - ANSWERS🔷🔶B. McMurray circumduction test
The clinician suspects that a client has patellar instability. In order to test for this, the client is seated
with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced
laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an
abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for
patellar instability in this way is known as:
A. Apprehension sign
B. Bulge sign
C. Thumb sign
D. None of the above - ANSWERS🔷🔶A. Apprehension sign
A clinician has performed a synovial fluid analysis and the results are as follows: visual analysis:
turbid and yellow, viscosity: decreased, 52,000 white blood cells (WBCs) per mm3,
polymorphonuclear leukocytes (PMNs): 75%, protein: 5 g/dL. Which of the following conditions
could this result be attributed to?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis - ANSWERS🔷🔶D. Septic arthritis
Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The
clinician suspects acute gout. Which of the following should the clinician expect in the initial test
results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
C. Decreased urine pH
D. Decreased C-reactive protein - ANSWERS🔷🔶A. Elevated uric acid level
,Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for
median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with
the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform?
A. Allen's test
B. Phalen's test
C. Tinel's sign
D. Finkelstein's test - ANSWERS🔷🔶B. Phalen's test
Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized
low back pain and muscle spasm along with a normal neurological examination. As the clinician,
you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured
disc?
A. Morning stiffness and limited mobility of the lumbar 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 erythrocyte sedimentation rate
D. Pathologic fractures, severe night pain, weight loss, and fatigue - ANSWERS🔷🔶B. Unilateral
radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
Felice is a 66-year-old female who complains that walking and prolonged standing causes pain and
weakness in her legs and buttocks. She expresses that she has short-term relief when she leans on
the shopping cart. When she sleeps on her back, she sometimes wakes up in the night in pain. Which
of the following diagnoses is most likely?
A. Multiple sclerosis
B. Herniated lumbar disc
C. Lumbar spinal stenosis
D. Cervical spondylosis - ANSWERS🔷🔶C. Lumbar spinal stenosis
To diagnose fibromyalgia, there must be tenderness on digital palpation in at least 11 of 18 (nine
pairs) tender point sites, which would include the
, A. occiput, low cervical, trapezius, and supraspinatus
B. proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints of the hands, and the
metatarsophalangeal (MTP) and PIP joints of the foot
C. facet joints of the cervical, thoracic, and lumbar spine
D. radial and ulnar styloids and the medial and lateral malleoli - ANSWERS🔷🔶A. occiput, low
cervical, trapezius, and supraspinatus
Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her
right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both
active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion
and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and
hypertension. Her social history reveals that she is a secretary and that she is right handed. Based on
her examination and medical history, you suspect adhesive capsulitis, or "frozen shoulder." Which
clue in Mrs. Gray's history supports this diagnosis?
A. History of hypertension
B. Her affected shoulder is also her dominant arm.
C. Her history of diabetes mellitus
D. Her work as a secretary predisposes her to repetitive motions. - ANSWERS🔷🔶C. Her history of
diabetes mellitus
The clinician is assessing Sally's diffuse hip pain. How should the clinician begin the examination?
A.Begin the range-of-motion examination with an assessment of the motion that causes pain.
B.Physical examination of the hip must first assess its position at rest.
C.The patient should move the hip prior to radiographic studies to determine whether they are
necessary.
D.Flexion and extension of the affected hips' extremity should only be performed with the knee
straight. - ANSWERS🔷🔶B.Physical examination of the hip must first assess its position at rest.
Which diagnostic test is the diagnostic gold standard for patients that have tendonitis and have failed
conservative treatment?
A. Plain x-ray films
B. Magnetic resonance imaging (MRI)
