NR511 FINAL QUESTIONS AND ANSWERS
Signs and symptoms and management of musculoskeletal sprains/strains/dislocations
16-15 When Maxwell, age 12, slid into home plate while playing baseball, he injured his
ankle. The nurse practitioner is trying to differentiate between a sprain and a strain.
A sprain
A. is an injury to the ligaments that attach to bones in a joint.
B. is an injury to the tendons that attach to the muscles in a joint.
C. is an injury resulting in extensive tears of the muscles. - Answers - A. is an injury to
the ligaments that attach to bones in a joint.
Alexander, age 12, sprained his ankle playing ice hockey. He is confused as to whether
to apply heat or cold. What should the nurse practitioner tell him?
A. "Use continuous heat for the first 12 hours and then use heat or cold to your own
preference."
B. "Use continuous cold for the fi rst 12 hours and then use heat or cold to your own
preference."
D. "Alternate between cold and heat for 20 minutes each for the fi rst 24 to 48 hours." -
Answers - D. "Alternate between cold and heat for 20 minutes each for the fi rst 24 to 48
hours."
Ankylosis is defi ned as
A. muscle shortening.
B. joint stiffness.
C. malposition of a joint.
D. dislocation of a joint. - Answers - B. joint stiffness.
Jill, age 49, has recently begun a rigorous weight- lifting regimen. She presents to the
primary care office with a shoulder dislocation. Which of the following clinical
manifestations lead the nurse practitioner to suspect an anterior shoulder dislocation
over a posterior dislocation? A. Inability to shrug the shoulder
B. Absence of pain
C. Inability to rotate the shoulder externally
D. Shortening of the arm - Answers - A. Inability to shrug the shoulder
In assessing an infant for developmental dysplasia of the hip (DDH), the practitioner
places the infant supine, fl exes the knees by holding the thumbs on the inner mid-
thighs, with fi ngers outside on the hips touching the greater trochanters, stabilizes one
hip, and abducts and gently pulls anteriorly on the other thigh. If this external rotation
feels smooth with no sound present, there is no hip dislocation. This is
A. the Allis test.
B. Lasègue's sign.
C. the McMurray test.
D. the Ortolani maneuver - Answers - D. the Ortolani maneuver
, Emily, age 12, presents to the clinic with another muscle strain from one of her many
sports activities. The nurse practitioner thinks that the patient was probably never taught
about health promotion and maintenance regarding physical activity. What information
should be included in patient teaching?
A. "After an activity, if any part hurts, apply ice for 20 minutes."
B. "You must fi rst get in shape with a rigorous schedule of weight training, and then
you can participate in any activity once you are physically fi t."
C. "After any strenuous activity, you must completely rest your muscles before
beginning your next activity."
D. "Stretching and warm- up exercises are an important - Answers - D. "Stretching and
warm- up exercises are an important
Upon assessment, the nurse practitioner notes unilateral back pain that had an acute
onset and increases when standing and bending. A straight- leg test is negative. The
most likely differential diagnosis is
A. herniated nucleus pulposus.
B. muscle strain
. C. osteoarthritis.
D. spondylolisthesis. - Answers - A. herniated nucleus pulposus.
June, age 67, presents with back pain with no precipitating event. The pain is located
over her lower back and muscles without sciatica, and it is aggravated by sitting,
standing, and certain movements. It is alleviated with rest. Palpation localizes the pain,
and muscle spasms are felt. There was an insidious onset with progressive
improvement. What is the most likely differential diagnosis?
A. Ankylosing spondylitis
B.Musculoskeletal strain
C. Spondylolisthesis
D. Herniated disk - Answers - B.Musculoskeletal strain
Signs and symptoms and management of spinal disorders (spondylosis, stenosis, etc.)
6-79 Sam, age 73, has lumbar spinal stenosis and asks which exercises he should do
to help his condition. You advise him to
A. do any exercise that results in hyperextension of the lumbar spine.
B. Encourage lumbar flexion and flattening of lordac curveC. refrain from exercising.
D. see a surgeon because surgery is the best treatment option. - Answers - B.
Encourage lumbar flexion and flattening of lordac curve
Clients with spinal cord injuries often have bowel incontinence and need to have a
bowel program instituted. What is the most effective way to stimulate the rectum to
evacuate in the quadriplegic client?
A. Administer stool softeners every night.
B. Insert a rectal suppository and then eventually perform digital stimulation.
C. Administer laxatives every other night.
D. Administer enemas on a regular basis. - Answers - B. Insert a rectal suppository and
then eventually perform digital stimulation
Signs and symptoms and management of musculoskeletal sprains/strains/dislocations
16-15 When Maxwell, age 12, slid into home plate while playing baseball, he injured his
ankle. The nurse practitioner is trying to differentiate between a sprain and a strain.
A sprain
A. is an injury to the ligaments that attach to bones in a joint.
B. is an injury to the tendons that attach to the muscles in a joint.
C. is an injury resulting in extensive tears of the muscles. - Answers - A. is an injury to
the ligaments that attach to bones in a joint.
Alexander, age 12, sprained his ankle playing ice hockey. He is confused as to whether
to apply heat or cold. What should the nurse practitioner tell him?
A. "Use continuous heat for the first 12 hours and then use heat or cold to your own
preference."
B. "Use continuous cold for the fi rst 12 hours and then use heat or cold to your own
preference."
D. "Alternate between cold and heat for 20 minutes each for the fi rst 24 to 48 hours." -
Answers - D. "Alternate between cold and heat for 20 minutes each for the fi rst 24 to 48
hours."
Ankylosis is defi ned as
A. muscle shortening.
B. joint stiffness.
C. malposition of a joint.
D. dislocation of a joint. - Answers - B. joint stiffness.
Jill, age 49, has recently begun a rigorous weight- lifting regimen. She presents to the
primary care office with a shoulder dislocation. Which of the following clinical
manifestations lead the nurse practitioner to suspect an anterior shoulder dislocation
over a posterior dislocation? A. Inability to shrug the shoulder
B. Absence of pain
C. Inability to rotate the shoulder externally
D. Shortening of the arm - Answers - A. Inability to shrug the shoulder
In assessing an infant for developmental dysplasia of the hip (DDH), the practitioner
places the infant supine, fl exes the knees by holding the thumbs on the inner mid-
thighs, with fi ngers outside on the hips touching the greater trochanters, stabilizes one
hip, and abducts and gently pulls anteriorly on the other thigh. If this external rotation
feels smooth with no sound present, there is no hip dislocation. This is
A. the Allis test.
B. Lasègue's sign.
C. the McMurray test.
D. the Ortolani maneuver - Answers - D. the Ortolani maneuver
, Emily, age 12, presents to the clinic with another muscle strain from one of her many
sports activities. The nurse practitioner thinks that the patient was probably never taught
about health promotion and maintenance regarding physical activity. What information
should be included in patient teaching?
A. "After an activity, if any part hurts, apply ice for 20 minutes."
B. "You must fi rst get in shape with a rigorous schedule of weight training, and then
you can participate in any activity once you are physically fi t."
C. "After any strenuous activity, you must completely rest your muscles before
beginning your next activity."
D. "Stretching and warm- up exercises are an important - Answers - D. "Stretching and
warm- up exercises are an important
Upon assessment, the nurse practitioner notes unilateral back pain that had an acute
onset and increases when standing and bending. A straight- leg test is negative. The
most likely differential diagnosis is
A. herniated nucleus pulposus.
B. muscle strain
. C. osteoarthritis.
D. spondylolisthesis. - Answers - A. herniated nucleus pulposus.
June, age 67, presents with back pain with no precipitating event. The pain is located
over her lower back and muscles without sciatica, and it is aggravated by sitting,
standing, and certain movements. It is alleviated with rest. Palpation localizes the pain,
and muscle spasms are felt. There was an insidious onset with progressive
improvement. What is the most likely differential diagnosis?
A. Ankylosing spondylitis
B.Musculoskeletal strain
C. Spondylolisthesis
D. Herniated disk - Answers - B.Musculoskeletal strain
Signs and symptoms and management of spinal disorders (spondylosis, stenosis, etc.)
6-79 Sam, age 73, has lumbar spinal stenosis and asks which exercises he should do
to help his condition. You advise him to
A. do any exercise that results in hyperextension of the lumbar spine.
B. Encourage lumbar flexion and flattening of lordac curveC. refrain from exercising.
D. see a surgeon because surgery is the best treatment option. - Answers - B.
Encourage lumbar flexion and flattening of lordac curve
Clients with spinal cord injuries often have bowel incontinence and need to have a
bowel program instituted. What is the most effective way to stimulate the rectum to
evacuate in the quadriplegic client?
A. Administer stool softeners every night.
B. Insert a rectal suppository and then eventually perform digital stimulation.
C. Administer laxatives every other night.
D. Administer enemas on a regular basis. - Answers - B. Insert a rectal suppository and
then eventually perform digital stimulation
