NGR6202 Final Exam M9-13 With 69 pages
Questions and answers Newest 100% pass
The primary exam techniques used for assessing the musculoskeletal system are:
II! II! II! II! II! II! II! II! II! II!
A. Inspection and palpation
II! II! II!
B. Inspection and percussion
II! II! II!
C. Auscultation and palpation
II! II! II!
D. Palpation and percussion - Correct Answers A. Inspection and palpation
II! II! II! II! II! II! II! II! II! II! II!
II! Typical joints affected are hands, knees, hips and spine.
II! II! II! II! II! II! II! II!
A. OA II!
B. RA II!
C. General joint disease
II! II! II!
D. Osteoporosis - Correct Answers A. OA
II! II! II! II! II! II! II!
The most common symptom of OA is joint pain. OA pain tends to worsen with activity, more often
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
following a period of rest. OA can also cause morning stiffness and generally lasts less than 30 minutes,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
unlike rheumatoid arthritis, which can cause stiffness for 45 minutes or longer. OA is often asymmetrical,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
whereas RA is normally symmetrical and bilateral, especially in the hands. Pain on ROM and limitation of
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
ROM are common to all forms of OA.
II! II! II! II! II! II! II! II!
II! Fred has been diagnosed with a trigger finger of the ring finger. Which of the following management
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! strategies is appropriate? II! II!
A. Surgical removal of the tendon sheath
II! II! II! II! II! II!
B. NSAIDs
II!
C. Local anesthetic injection into the tendon sheath
II! II! II! II! II! II! II!
,D. Splinting - Correct Answers C. Local anesthetic injection into the tendon sheath
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Which of the following statements concerning the musculoskeletal examination is true?
II! II! II! II! II! II! II! II! II! II!
A. The uninvolved side should be examined initially and then compared to the involved side.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
B. The part of the body that is causing the patient pain should be examined first.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. When possible, the patient should not be asked to perform active ROM exercises to avoid causing pain
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
D. Radiographs should always be obtained prior to examination so as to not cause further injury to the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
patient. - Correct Answers A. The uninvolved side should be examined initially and then compared to the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
involved side.
II! II!
II! Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! She has 2 young children and asks the clinician what the chances are that they also will develop carpal
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! tunnel syndrome. Which of the following responses would be correct regarding the risk of developing
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! carpal tunnel syndrome?II! II!
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
one-half the risk of developing carpal tunnel.
II! II! II! II! II! II! II!
B. Only people w/occupations that require repeated flexion extension of the wrist, use of hand tools that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
D. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance. - Correct Answers B.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Only people w/occupations that require repeated flexion extension of the wrist, use of hand tools that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Willow is a 67-year-old female and her bone mineral density is more than 1 SD below the young adult
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! reference mean. What is her diagnosis? II! II! II! II! II!
A. Normal bone mineral density
II! II! II! II!
B. Osteopenia
II!
C. Osteoporosis
II!
D. Severe osteoporosis - Correct Answers B. Osteopenia
II! II! II! II! II! II! II! II!
,II! A 70 year-old female fell 2 weeks ago and developed immediate pain in her left elbow on the lateral
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! epicondyle. She thought she just bruised it, but is now worried because it has not improved. She has used
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Tylenol® and ice at home, and that has helped slightly. During your examination, you find she has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! moderate swelling and ecchymosis, but no overtly obvious deformity. Her ROM is uncomfortable and
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong;
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! and capillary refill is less than 2 seconds. What should you do?
II! II! II! II! II! II! II! II! II! II! II!
A. Make an immediate referral for an orthopedic surgical evaluation without further assessment.
II! II! II! II! II! II! II! II! II! II! II! II!
B. Tell her that it takes time for these bruises to improve, so she should be patient.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. Prescribe a splint for her left wrist and begin corticosteroid injections.
II! II! II! II! II! II! II! II! II! II! II!
D. Send her to the emergency room for reduction of this obvious wrist fracture. - Correct Answers C.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Prescribe a splint for her left wrist and begin corticosteroid injections.
II! II! II! II! II! II! II! II! II! II! II!
II! Tinel's sign and Phalen's maneuver are used in identifying a common workplace condition that the family
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! nurse practitioner recognizes as:
II! II! II!
A. Carpal tunnel syndrome
II! II! II!
B. Lateral epicondylitis
II! II!
C. Dupuytren's disease
II! II!
D. Thoracic outlet syndrome - Correct Answers A. Carpal tunnel syndrome
II! II! II! II! II! II! II! II! II! II! II!
II! Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! The pain has increased following a day of gardening 1 week ago. A physical finding that differentiates the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:
II! II! II! II! II! II! II! II! II! II!
A. Ecchymosis, edema, and erythema over the lateral epicondyle
II! II! II! II! II! II! II! II!
B. Pain at the elbow that radiates into the forearm accompanied by pain and weakness with gripping
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
objects (resisted movements at the wrist and forearm)
II! II! II! II! II! II! II! II!
C. Inability to supinate and pronate the arm
II! II! II! II! II! II! II!
D. Inability to flex or extend the elbow against resistance - Correct Answers B. Pain at the elbow that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
radiates into the forearm accompanied by pain and weakness with gripping objects (resisted movements
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
at the wrist and forearm)
II! II! II! II! II!
, II! The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! known as: II!
A. Apprehension sign
II! II!
B. Bulge sign
II! II!
C. Thumb sign
II! II!
D. Lachman sign - Correct Answers A. Apprehension sign
II! II! II! II! II! II! II! II! II!
II! Felice is a 66-year-old female who complains that walking and prolonged standing causes pain and
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! weakness in her legs and buttocks. She expresses that she has short-term relief when she leans on the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! shopping cart. When she sleeps on her back, she sometimes wakes up in the night in pain. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following diagnoses is most likely? II! II! II! II!
A. Multiple sclerosis
II! II!
B. Herniated lumbar disc
II! II! II!
C. Lumbar spinal stenosis
II! II! II!
D. Cervical spondylosis - Correct Answers C. Lumbar spinal stenosis
II! II! II! II! II! II! II! II! II! II!
II! Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
II! II! II! II! II! II! II! II! II! II! II! II! II!
A. Morning stiffness and limited mobility of the lumbar spine
II! II! II! II! II! II! II! II! II!
B. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
back pain
II! II!
C. Fever, chills, and elevated erythrocyte sedimentation rate
II! II! II! II! II! II! II!
D. Pathologic fractures, severe night pain, weight loss, and fatigue - Correct Answers B. Unilateral
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Questions and answers Newest 100% pass
The primary exam techniques used for assessing the musculoskeletal system are:
II! II! II! II! II! II! II! II! II! II!
A. Inspection and palpation
II! II! II!
B. Inspection and percussion
II! II! II!
C. Auscultation and palpation
II! II! II!
D. Palpation and percussion - Correct Answers A. Inspection and palpation
II! II! II! II! II! II! II! II! II! II! II!
II! Typical joints affected are hands, knees, hips and spine.
II! II! II! II! II! II! II! II!
A. OA II!
B. RA II!
C. General joint disease
II! II! II!
D. Osteoporosis - Correct Answers A. OA
II! II! II! II! II! II! II!
The most common symptom of OA is joint pain. OA pain tends to worsen with activity, more often
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
following a period of rest. OA can also cause morning stiffness and generally lasts less than 30 minutes,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
unlike rheumatoid arthritis, which can cause stiffness for 45 minutes or longer. OA is often asymmetrical,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
whereas RA is normally symmetrical and bilateral, especially in the hands. Pain on ROM and limitation of
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
ROM are common to all forms of OA.
II! II! II! II! II! II! II! II!
II! Fred has been diagnosed with a trigger finger of the ring finger. Which of the following management
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! strategies is appropriate? II! II!
A. Surgical removal of the tendon sheath
II! II! II! II! II! II!
B. NSAIDs
II!
C. Local anesthetic injection into the tendon sheath
II! II! II! II! II! II! II!
,D. Splinting - Correct Answers C. Local anesthetic injection into the tendon sheath
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Which of the following statements concerning the musculoskeletal examination is true?
II! II! II! II! II! II! II! II! II! II!
A. The uninvolved side should be examined initially and then compared to the involved side.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
B. The part of the body that is causing the patient pain should be examined first.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. When possible, the patient should not be asked to perform active ROM exercises to avoid causing pain
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
D. Radiographs should always be obtained prior to examination so as to not cause further injury to the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
patient. - Correct Answers A. The uninvolved side should be examined initially and then compared to the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
involved side.
II! II!
II! Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! She has 2 young children and asks the clinician what the chances are that they also will develop carpal
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! tunnel syndrome. Which of the following responses would be correct regarding the risk of developing
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! carpal tunnel syndrome?II! II!
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
one-half the risk of developing carpal tunnel.
II! II! II! II! II! II! II!
B. Only people w/occupations that require repeated flexion extension of the wrist, use of hand tools that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
D. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance. - Correct Answers B.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Only people w/occupations that require repeated flexion extension of the wrist, use of hand tools that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Willow is a 67-year-old female and her bone mineral density is more than 1 SD below the young adult
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! reference mean. What is her diagnosis? II! II! II! II! II!
A. Normal bone mineral density
II! II! II! II!
B. Osteopenia
II!
C. Osteoporosis
II!
D. Severe osteoporosis - Correct Answers B. Osteopenia
II! II! II! II! II! II! II! II!
,II! A 70 year-old female fell 2 weeks ago and developed immediate pain in her left elbow on the lateral
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! epicondyle. She thought she just bruised it, but is now worried because it has not improved. She has used
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Tylenol® and ice at home, and that has helped slightly. During your examination, you find she has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! moderate swelling and ecchymosis, but no overtly obvious deformity. Her ROM is uncomfortable and
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong;
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! and capillary refill is less than 2 seconds. What should you do?
II! II! II! II! II! II! II! II! II! II! II!
A. Make an immediate referral for an orthopedic surgical evaluation without further assessment.
II! II! II! II! II! II! II! II! II! II! II! II!
B. Tell her that it takes time for these bruises to improve, so she should be patient.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
C. Prescribe a splint for her left wrist and begin corticosteroid injections.
II! II! II! II! II! II! II! II! II! II! II!
D. Send her to the emergency room for reduction of this obvious wrist fracture. - Correct Answers C.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Prescribe a splint for her left wrist and begin corticosteroid injections.
II! II! II! II! II! II! II! II! II! II! II!
II! Tinel's sign and Phalen's maneuver are used in identifying a common workplace condition that the family
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! nurse practitioner recognizes as:
II! II! II!
A. Carpal tunnel syndrome
II! II! II!
B. Lateral epicondylitis
II! II!
C. Dupuytren's disease
II! II!
D. Thoracic outlet syndrome - Correct Answers A. Carpal tunnel syndrome
II! II! II! II! II! II! II! II! II! II! II!
II! Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! The pain has increased following a day of gardening 1 week ago. A physical finding that differentiates the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:
II! II! II! II! II! II! II! II! II! II!
A. Ecchymosis, edema, and erythema over the lateral epicondyle
II! II! II! II! II! II! II! II!
B. Pain at the elbow that radiates into the forearm accompanied by pain and weakness with gripping
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
objects (resisted movements at the wrist and forearm)
II! II! II! II! II! II! II! II!
C. Inability to supinate and pronate the arm
II! II! II! II! II! II! II!
D. Inability to flex or extend the elbow against resistance - Correct Answers B. Pain at the elbow that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
radiates into the forearm accompanied by pain and weakness with gripping objects (resisted movements
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
at the wrist and forearm)
II! II! II! II! II!
, II! The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! known as: II!
A. Apprehension sign
II! II!
B. Bulge sign
II! II!
C. Thumb sign
II! II!
D. Lachman sign - Correct Answers A. Apprehension sign
II! II! II! II! II! II! II! II! II!
II! Felice is a 66-year-old female who complains that walking and prolonged standing causes pain and
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! weakness in her legs and buttocks. She expresses that she has short-term relief when she leans on the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! shopping cart. When she sleeps on her back, she sometimes wakes up in the night in pain. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following diagnoses is most likely? II! II! II! II!
A. Multiple sclerosis
II! II!
B. Herniated lumbar disc
II! II! II!
C. Lumbar spinal stenosis
II! II! II!
D. Cervical spondylosis - Correct Answers C. Lumbar spinal stenosis
II! II! II! II! II! II! II! II! II! II!
II! Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
II! II! II! II! II! II! II! II! II! II! II! II! II!
A. Morning stiffness and limited mobility of the lumbar spine
II! II! II! II! II! II! II! II! II!
B. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
back pain
II! II!
C. Fever, chills, and elevated erythrocyte sedimentation rate
II! II! II! II! II! II! II!
D. Pathologic fractures, severe night pain, weight loss, and fatigue - Correct Answers B. Unilateral
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radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
