NURS 620 test 2 2025/2026 LATEST UPDATE | COMPREHENSIVE QUESTIONS WITH 100%
RATED ANSWERS
Drop arm test (supraspinatus and infraspinatus) passively raise arm to side to 90 degress
and thumb up and then take your hand away. If ruptured, arm will drop
HornBlowers sign (teres minor) Raise arm to the square and try to push it down with a hand
on back shoulder.
Indicates tear of teres minor
belly press (subscapularis tear) Pt put hand on belly and provider tries to pull the hand away
from belly. If it gives, tear.
Lift off test (subscapularis tear) hand behind lower back. - pull away from lower back. If cant
keep off back or
Infraspinatus tear Arms close to body on elbow. adduct and abduct forearm pain with
infraspinatus tear.
Shoulder DX and TX MRI is best for rotator cuff tear. U/S or arthrogram.
TX: full thickness tear - surgery within 2-6 weeks
partial thickness tear - PT, NSAIDS, home stretching, and strengthening exercises. and
subacromial steroid injections. Repeat injections can weaken the tendon and speed
,degradation of the rotator cuff tear. No more than 3 shots. Ice 20-30 min bid for pain. if fail
therapy for 3-6 months refer for surgery.
Foot pain plantar fasciitis - Thin, flat sheet of connective tissue located on the plantar
surface of the foot that assists in providing support for the arch of the foot. Inflammation and
microtears to this tissue due to chronic overuse or repetitive trauma can lead to plantar
fasciitis. (running, dancing), obese, decreased flexibility of the foot and ankle have a greater risk
of dev. plantar fasciitis.
SS: insidious onset of sharp heel pain. First step out of bed is very painful. Increased pain after
standing for a long time. improves with walking and resting.
EXAM: point tenderness on palpation of the heel, most sharply at the origin of the plantar
fascia at the medial calcaneal tuberosity. Passive dorsiflexion of teh toes, foot and ankle will
increase the discomfort.
TX: stretching of fascia and achilles tendon. OTC padded heel cups or shoe inserts can provide
relief. may use a night splint.
Extracorporeal. shock wave tx option if no improvement in 6 mo of tx. Surgery if no
improvement in 6-9 mo.
Interdigital neuroma nerves travel between the metatarsal bones to innovate the toes the
nerve is entrap usually between the 3 & 4 toes
TX metatarsal pad - separate toes. arch support surg.
SS: pain and paresthesias in affected toes and webspaces. worse with tight shoes. relieved with
massages. Running make it worse.
EXAM: pressure on metatarsal spaces and squeezing toes together makes pain worse. Provider
may feel a neuroma, benign nerve tumor in area of pain.
,DX: u/s to confirm neuroma. tell pt to wear flat shoe with a wide box. Steroid injection into
webspace.
Elbow pain Trauma
Epicondylitis
Olecranon bursitis
Nursemaid elbow
Rheumatoid arthritis
Osteoarthritis
palpate skeletal anatomical landmarks of elbow.
Varus and valgus test to stress medial and lateral collateral ligaments. if opens more - laxity of
ligaments.
Tennis elbow (lateral epicondylitis) is caused by chronic inflammation or irritation of the
origin (tendon) of the extensor muscles of the forearm from the lateral epicondyle of the
humerus as a result of unusual or repetitive strain. It is a painful condition. Painful when turning
knobs or using hand tools. Pain in lateral elbow that radiates into forearm. Pain and weakness
in grabbing things like coffee cup sign.
TX: rest, ice, NSAIDS, and PT. Steroid injections and wrist splinting. Can use padded elbow strap
to eert counterpressure on the. soft tissue below the lateral epicondyle reducing strain. at the
muscle insertion. Surgery only if tx didn't work.
, Mills test The patient is instructed to extend the forearm, make a fist, and flex the wrist, and
then maximally pronate (palm down) the forearm. This test can be passively performed by the
doctor. extend arm with wrist down.
Positive sign is pain in lateral elbow indicating lateral epicondylitis
Olecranus bursitis Pain and swelling on posterior part of elbow. after direct injury such as a
fall or follow direct pressure. Coulb be gout, RA, of infection leading to bursitis. ROM is normal
but r/o septic bursitis (aspirate sinovial fluid if needed).
TX with NSAIDS, ice 15-20 min multiple times a day and rest. elbow pad can be used to protect
elbow. Xray or lab studies to test for RA, infx or gout.
Back pain Peripheral nerve injury at the spinal nerve roots
Often due to compression of nerve root by vertebrae or the vertebral disk. It can be a lumbar
strain ( when you train - muscles) or sprain (ligament tears), nerve impingement, nerve
compression, radiculopathy, and fractures.
Fractures: acute onset of pain that radiates around the body and is exacerbated with
movement. Happens with trauma or minimal injury with osteoporosis.
If disc herniation or spinal nerve irritation - radiation of pain into the leg, sensory or reflex
changes, and motor weakness.
Radiculopathy - pain, numbness, and a tingling sensation that radiates down the spinal nerve
distribution (lower back and down the leg in lumbar radiculopathy (sciatica). - caused by spinal
nerve root compression, injury, or inflammation, most commonly due to vertebral disc
herniation or spinal stenosis.
RATED ANSWERS
Drop arm test (supraspinatus and infraspinatus) passively raise arm to side to 90 degress
and thumb up and then take your hand away. If ruptured, arm will drop
HornBlowers sign (teres minor) Raise arm to the square and try to push it down with a hand
on back shoulder.
Indicates tear of teres minor
belly press (subscapularis tear) Pt put hand on belly and provider tries to pull the hand away
from belly. If it gives, tear.
Lift off test (subscapularis tear) hand behind lower back. - pull away from lower back. If cant
keep off back or
Infraspinatus tear Arms close to body on elbow. adduct and abduct forearm pain with
infraspinatus tear.
Shoulder DX and TX MRI is best for rotator cuff tear. U/S or arthrogram.
TX: full thickness tear - surgery within 2-6 weeks
partial thickness tear - PT, NSAIDS, home stretching, and strengthening exercises. and
subacromial steroid injections. Repeat injections can weaken the tendon and speed
,degradation of the rotator cuff tear. No more than 3 shots. Ice 20-30 min bid for pain. if fail
therapy for 3-6 months refer for surgery.
Foot pain plantar fasciitis - Thin, flat sheet of connective tissue located on the plantar
surface of the foot that assists in providing support for the arch of the foot. Inflammation and
microtears to this tissue due to chronic overuse or repetitive trauma can lead to plantar
fasciitis. (running, dancing), obese, decreased flexibility of the foot and ankle have a greater risk
of dev. plantar fasciitis.
SS: insidious onset of sharp heel pain. First step out of bed is very painful. Increased pain after
standing for a long time. improves with walking and resting.
EXAM: point tenderness on palpation of the heel, most sharply at the origin of the plantar
fascia at the medial calcaneal tuberosity. Passive dorsiflexion of teh toes, foot and ankle will
increase the discomfort.
TX: stretching of fascia and achilles tendon. OTC padded heel cups or shoe inserts can provide
relief. may use a night splint.
Extracorporeal. shock wave tx option if no improvement in 6 mo of tx. Surgery if no
improvement in 6-9 mo.
Interdigital neuroma nerves travel between the metatarsal bones to innovate the toes the
nerve is entrap usually between the 3 & 4 toes
TX metatarsal pad - separate toes. arch support surg.
SS: pain and paresthesias in affected toes and webspaces. worse with tight shoes. relieved with
massages. Running make it worse.
EXAM: pressure on metatarsal spaces and squeezing toes together makes pain worse. Provider
may feel a neuroma, benign nerve tumor in area of pain.
,DX: u/s to confirm neuroma. tell pt to wear flat shoe with a wide box. Steroid injection into
webspace.
Elbow pain Trauma
Epicondylitis
Olecranon bursitis
Nursemaid elbow
Rheumatoid arthritis
Osteoarthritis
palpate skeletal anatomical landmarks of elbow.
Varus and valgus test to stress medial and lateral collateral ligaments. if opens more - laxity of
ligaments.
Tennis elbow (lateral epicondylitis) is caused by chronic inflammation or irritation of the
origin (tendon) of the extensor muscles of the forearm from the lateral epicondyle of the
humerus as a result of unusual or repetitive strain. It is a painful condition. Painful when turning
knobs or using hand tools. Pain in lateral elbow that radiates into forearm. Pain and weakness
in grabbing things like coffee cup sign.
TX: rest, ice, NSAIDS, and PT. Steroid injections and wrist splinting. Can use padded elbow strap
to eert counterpressure on the. soft tissue below the lateral epicondyle reducing strain. at the
muscle insertion. Surgery only if tx didn't work.
, Mills test The patient is instructed to extend the forearm, make a fist, and flex the wrist, and
then maximally pronate (palm down) the forearm. This test can be passively performed by the
doctor. extend arm with wrist down.
Positive sign is pain in lateral elbow indicating lateral epicondylitis
Olecranus bursitis Pain and swelling on posterior part of elbow. after direct injury such as a
fall or follow direct pressure. Coulb be gout, RA, of infection leading to bursitis. ROM is normal
but r/o septic bursitis (aspirate sinovial fluid if needed).
TX with NSAIDS, ice 15-20 min multiple times a day and rest. elbow pad can be used to protect
elbow. Xray or lab studies to test for RA, infx or gout.
Back pain Peripheral nerve injury at the spinal nerve roots
Often due to compression of nerve root by vertebrae or the vertebral disk. It can be a lumbar
strain ( when you train - muscles) or sprain (ligament tears), nerve impingement, nerve
compression, radiculopathy, and fractures.
Fractures: acute onset of pain that radiates around the body and is exacerbated with
movement. Happens with trauma or minimal injury with osteoporosis.
If disc herniation or spinal nerve irritation - radiation of pain into the leg, sensory or reflex
changes, and motor weakness.
Radiculopathy - pain, numbness, and a tingling sensation that radiates down the spinal nerve
distribution (lower back and down the leg in lumbar radiculopathy (sciatica). - caused by spinal
nerve root compression, injury, or inflammation, most commonly due to vertebral disc
herniation or spinal stenosis.
