NSG 6001 Musculoskeletal/Immune Disorder Exam
NSG 6001 Musculoskeletal/Immune Disorder
Exam-South University (Answered) A+ Rated
A patient who is a distance runner reports pain in one heel that is worse in the morning and seems to
improve with exercise. The provider notes localized swelling and a bony prominence at the heel. What is
the initial treatment for this condition?
a. Cessation of all sports activities and exercise
b. Crutches and partial weight bearing
c. Physical therapy for ultrasound therapy
d. Referral to an orthopedist for MRI and evaluation
ANS: A
This patient has symptoms consistent with Achilles tendonitis. Immediate cessation of sports and
exercise is the first step in management. Crutches and partial weight bearing may be indicated if
symptoms do not improve with rest and NSAIDs. Physical therapy is used as adjunctive therapy.
Symptoms that do not improve require referral
A patient has pain on the plantar aspect of the heel with weight bearing after rest. The pain is worsened
with dorsiflexion of the foot. What is the initial treatment for this patient?
a. A series of steroid injections
b. Avoiding all high-impact activities
c. Night splints
d. Wearing flat shoes only
ANS: B
This patient has signs of plantar fasciitis. The initial treatment includes avoiding all high-impact activities.
A single steroid injection may be given with subsequent injections if no improvement. Night splints are
part of second-tier treatment. Flat shoes should be avoided.REF: Plantar Fasciitis/Management
,NSG 6001 Musculoskeletal/Immune Disorder Exam
A patient injures an ankle while playing soccer and reports rolling the foot inward while falling with
immediate pain and swelling of the lateral part of the joint. The patient is able to bear weight and denies
hearing an audible sound at the time of injury. What does this history indicate?
a. Likely ankle sprain with a possible fracture
b. Mild ankle injury without fracture
c. Mild soft tissue injury only
d. Serious ankle injury with certain fracture
ANS: A
Immediate swelling of the joint raises the index of suspicion for a fracture or a substantial amount of
joint involvement. Without radiographs, none of these possibilities can be confirmed.
Which treatments may be used to manage bone pain in patients with bone tumors?
Select all that apply.
a. Bisphosphonates
b. Exercise
c. External beam radiation
d. Massage
e. Vertebralplasty
ANS: A, B, C, E
Bisphosphonates can decrease pain by preventing growth and development of existing and new bone
lesions. Exercise is useful to maintain function and reduce pain. External beam radiation is useful in the
majority of patients. Vertebralplasty involves injecting bone cement to stabilize bone. Massage is not
recommended.
A patient reports persistent lower back pain and constipation. A digital rectal examination reveals a
mass at the sacrum. What will the primary care provider do to manage this patient?
, NSG 6001 Musculoskeletal/Immune Disorder Exam
a. Order spinal radiographs in 3 months
b. Perform an MRI of the sacrum
c. Refer the patient to an oncologist
d. Schedule the patient for a biopsy
C.
Patients with chordoma, which is a type of sarcoma with a predilection for the sacrum will have these
symptoms and a palpable mass coming out of the sacrum. A referral to an oncologist is necessary. These
tumors have a significant risk for malignancy, so waiting 3 months is not an option. The oncologist will
order a CT and body scan and possibly biopsy or surgery
A provider discovers a bone tumor as an incidental finding on a radiograph in a patient who has
sustained an injury to a ligament. The patient has not had pain prior to the injury. What will the provider
do next?
a. Consult with an orthopedic specialist
b. Order a chest CT and full body scan
c. Refer the patient to for a bone biopsy
d. Repeat the radiograph in 6 to 12 months
ANS: D
Latent bone tumors are usually discovered as incidental findings during evaluation for musculoskeletal
injury. If the injury is the source of pain, the radiograph may be repeated in 6 to 12 months to determine
whether it is increasing in size. Consultation with an orthopedic specialist, referral for a biopsy, and
further testing with chest CT or full body scanning are done if there is suspicion of an active tumor
A patient with shoulder pain is seen by an orthopedic specialist who notes erythema, warmth, and
fluctuance of the shoulder joint. What is the next step in treatment for this patient?
a. Admit to the hospital for intravenous antibiotics
b. Inject lidocaine into the joint and reassess in 5 to 10 minutes
c. Order a plain radiograph of the shoulder to identify possible fracture
NSG 6001 Musculoskeletal/Immune Disorder
Exam-South University (Answered) A+ Rated
A patient who is a distance runner reports pain in one heel that is worse in the morning and seems to
improve with exercise. The provider notes localized swelling and a bony prominence at the heel. What is
the initial treatment for this condition?
a. Cessation of all sports activities and exercise
b. Crutches and partial weight bearing
c. Physical therapy for ultrasound therapy
d. Referral to an orthopedist for MRI and evaluation
ANS: A
This patient has symptoms consistent with Achilles tendonitis. Immediate cessation of sports and
exercise is the first step in management. Crutches and partial weight bearing may be indicated if
symptoms do not improve with rest and NSAIDs. Physical therapy is used as adjunctive therapy.
Symptoms that do not improve require referral
A patient has pain on the plantar aspect of the heel with weight bearing after rest. The pain is worsened
with dorsiflexion of the foot. What is the initial treatment for this patient?
a. A series of steroid injections
b. Avoiding all high-impact activities
c. Night splints
d. Wearing flat shoes only
ANS: B
This patient has signs of plantar fasciitis. The initial treatment includes avoiding all high-impact activities.
A single steroid injection may be given with subsequent injections if no improvement. Night splints are
part of second-tier treatment. Flat shoes should be avoided.REF: Plantar Fasciitis/Management
,NSG 6001 Musculoskeletal/Immune Disorder Exam
A patient injures an ankle while playing soccer and reports rolling the foot inward while falling with
immediate pain and swelling of the lateral part of the joint. The patient is able to bear weight and denies
hearing an audible sound at the time of injury. What does this history indicate?
a. Likely ankle sprain with a possible fracture
b. Mild ankle injury without fracture
c. Mild soft tissue injury only
d. Serious ankle injury with certain fracture
ANS: A
Immediate swelling of the joint raises the index of suspicion for a fracture or a substantial amount of
joint involvement. Without radiographs, none of these possibilities can be confirmed.
Which treatments may be used to manage bone pain in patients with bone tumors?
Select all that apply.
a. Bisphosphonates
b. Exercise
c. External beam radiation
d. Massage
e. Vertebralplasty
ANS: A, B, C, E
Bisphosphonates can decrease pain by preventing growth and development of existing and new bone
lesions. Exercise is useful to maintain function and reduce pain. External beam radiation is useful in the
majority of patients. Vertebralplasty involves injecting bone cement to stabilize bone. Massage is not
recommended.
A patient reports persistent lower back pain and constipation. A digital rectal examination reveals a
mass at the sacrum. What will the primary care provider do to manage this patient?
, NSG 6001 Musculoskeletal/Immune Disorder Exam
a. Order spinal radiographs in 3 months
b. Perform an MRI of the sacrum
c. Refer the patient to an oncologist
d. Schedule the patient for a biopsy
C.
Patients with chordoma, which is a type of sarcoma with a predilection for the sacrum will have these
symptoms and a palpable mass coming out of the sacrum. A referral to an oncologist is necessary. These
tumors have a significant risk for malignancy, so waiting 3 months is not an option. The oncologist will
order a CT and body scan and possibly biopsy or surgery
A provider discovers a bone tumor as an incidental finding on a radiograph in a patient who has
sustained an injury to a ligament. The patient has not had pain prior to the injury. What will the provider
do next?
a. Consult with an orthopedic specialist
b. Order a chest CT and full body scan
c. Refer the patient to for a bone biopsy
d. Repeat the radiograph in 6 to 12 months
ANS: D
Latent bone tumors are usually discovered as incidental findings during evaluation for musculoskeletal
injury. If the injury is the source of pain, the radiograph may be repeated in 6 to 12 months to determine
whether it is increasing in size. Consultation with an orthopedic specialist, referral for a biopsy, and
further testing with chest CT or full body scanning are done if there is suspicion of an active tumor
A patient with shoulder pain is seen by an orthopedic specialist who notes erythema, warmth, and
fluctuance of the shoulder joint. What is the next step in treatment for this patient?
a. Admit to the hospital for intravenous antibiotics
b. Inject lidocaine into the joint and reassess in 5 to 10 minutes
c. Order a plain radiograph of the shoulder to identify possible fracture
