Differential Diagnosis & Primary Care Practicum
(Verified Answers) Chamberlain
1. 1. The remodeling of a scar can take how long?
l l l l l l l l l
a. 6 months. l
b. 3 months. l
c. 1 month.
l l
d. 2 weeks.: A. 6 months
l l l l l
2. Question 1. A 13-year- l l l
old obese (body mass index [BMI] above the 95th percentile) boy reports low-
l l l l l l l l l l l l
grade left knee pain for the past 2 months. He denies antecedent trauma but admits to freque
l l l l l l l l l l l l l l l l
nt "horseplay" with his friends. The pain has progressively worsened, and he is now unable to
l l l l l l l l l l l l l l l l
bear weight at all on his left leg. His current complaints include left groin, thigh, and medial k
l l l l l l l l l l l l l l l l l
nee pain and tenderness. His examination demonstrates negative drawer, Lachman, and M
l l l l l l l l l l l
cMurray tests; left hip with decreased internal rotation and abduction; and external hip rota
l l l l l l l l l l l l l
tion with knee flexion. Based on the above scenario, the nurse practitioner should suspect:
l l l l l l l l l l l l l
1. A left meniscal tear.
l l l l
2. A left anterior cruciate ligament (ACL) tear.
l l l l l l l
3. A slipped capital femoral epiphysis (SCFE).
l l l l l
4. Osgood-Schlatter disease.: 3.A slipped capital femoral epiphysis (SCFE). l l l l l l l l
3. Question 2. In assessing the skeletal muscles, the nurse practitioner turns the patient's f
l l l l l l l l l l l l l
orearm so that the palm is up.This is called:
l l l l l l l l l
1. Supination.
2. Pronation.
3. Abduction.
4. Eversion.: 1.Supination l l
4. Question 3. Cass, age 67, tells the nurse practitioner (NP) that she has been diagnosed wi
l l l l l l l l l l l l l l l
th a condition that causes sudden flares of pain, swelling, and redness of the joints in her toe
l l l l l l l l l l l l l l l l l
s. She cannot remember the name of the diagnosis, but she knows it is caused by urate cryst
l l l l l l l l l l l l l l l l l
1l/l95
,als that "get stuck in the joint and cause pain." She is on hydrochlorothiazide (HCTZ) for man
l l l l l l l l l l l l l l l l
agement of her hypertension.The NP should suspect a diagnosis of:
l l l l l l l l l l
1. Septic arthritis. l
2. Gout.
3. Rheumatoid arthritis. l
4. Charcot neuro-osteoarthropathy.: 2. Gout
l l l
5. Question 4. Matthew, age 52,is a chef who just severed 2 of his fingers with a meat cutter.Y
l l l l l l l l l l l l l l l l l l l
ou would recommend that he:
l l l l
1. Wrap the severed fingers tightly in a dry towel for transport to the emer-
l l l l l l l l l l l l l
gency department with him.
l l l l
2. Leave the severed fingers at the scene because fingers cannot be reat-
l l l l l l l l l l l
2l/l95
,tached.
3. Immediately freeze the severed fingers for reattachment in the near future. l l l l l l l l l l
4. Wrap the fingers in aclean, damp cloth; seal them in a plastic bag; and place the bag in an ice
l l l l l l l l l l l l l l l l l l l l l
water bath.: 4.Wrap the fingers in a clean, damp cloth;seal them in a plastic bag; and place the ba
l l l l l l l l l l l l l l l l l l l l
g in an ice water bath.
l l l l l
6. Question 5. Marsha, age 34, presents with symptoms resembling both fibromyalgia and
l l l l l l l l l l l l
chronic fatigue syndrome, which have many similarities. Which of the following is more ch
l l l l l l l l l l l l l
aracteristic of fibromyalgia than of chronic fatigue syndrome?
l l l l l l l
1. Musculoskeletal pain. l
2. Difficulty sleeping. l
3. Depression.
4. Fatigue.: 1.Musculoskeletal pain l l l
7. Question 6. Mrs. Kelly, age 80, has a curvature of the spine.This is likely to indicate which a
l l l l l l l l l l l l l l l l l l
ge-related change? l
1. Lordosis.
2. Dorsal kyphosis. l
3. Scoliosis.
4. Kyphoscoliosis.: 2.Dorsal Kyphosis l l l
8. Question 7.The valgus stress test, varus stress test, Lachman test, and thumb sign ar
l l l l l l l l l l l l l l
e all considered standard tests to check the integrity of the ligaments of the knee.Whic
l l l l l l l l l l l l l l l
h test would the nurse practitioner choose to assess the anterior cruciate ligament (AC
l l l l l l l l l l l l l
L), which is the most commonly involved structure in severe knee injury?
l l l l l l l l l l l
1. Valgus stress test. l l
2. Varus stress test. l l
3. Lachman test. l
4. Thumb sign.: 3. Lachman test l l l l
9. Question 8. Lillian, age 70, was told that she has osteoporosis.When she asks you what t
l l l l l l l l l l l l l l l l
his is, you respond that osteoporosis:
l l l l l
1. Develops when loss of bone occurs more rapidly than new bone growth.
l l l l l l l l l l l
2. Is a degenerative joint disease characterized by loss of cartilage in certain joints.
l l l l l l l l l l l l
3. Is a chronic inflammatory disorder that affects multiple joints.
l l l l l l l l
3l/l95
, 4. Is a bone disorder that has to do with inadequate mineralization of the bones.: 1.Develops
l l l l l l l l l l l l l l l
when loss of bone occurs more rapidly than new bone growth.
l l l l l l l l l l l
10. Question 9. Mike, age 42, a golf pro, has had chronic back pain for many years. His work
l l l l l l l l l l l l l l l l l
up reveals that it is not the result of a degenerative disk problem. His back "goes out" about
l l l l l l l l l l l l l l l l l l
twice per year, and he is out of work for
l l l l l l l l l
4l/l95