NURS 623 FINAL EXAM - MUSCULOSKELETAL || || || || || ||
SECTION EXAM WITH VERIFIED ANSWERS || || || ||
A 13 year old obese (BMI greater than 95%) boy reports low-grade left knee pain
|| || || || || || || || || || || || || ||
for the past 2 months. He denies antecedent trauma but admits to frequent
|| || || || || || || || || || || || || ||
horseplay with his friends. The pain has progressively worsened, and he is now
|| || || || || || || || || || || || ||
unable to bear weight at all on his left leg. His current complaints include left
|| || || || || || || || || || || || || || ||
groin, thigh, and medial knee pain and tenderness. His examination
|| || || || || || || || || ||
demonstrates negative Drawer, Lachman, and McMurray tests; left hip with || || || || || || || || || ||
decreased internal rotation and abduction; and knee flexion causing external
|| || || || || || || || || ||
hip rotation. Based on the above scenario, the NP should suspect:
|| || || || || || || || || ||
a. a left meniscal tear.
|| || || ||
b. a left ACL tear
|| || || ||
c. a slipped capital femoral epiphysis
|| || || || ||
d. osgood-schlatter disease. - Correct answer ✔C.
|| || || || || ||
Colchicine may be used to terminate an acute attack of gouty arthritis as well as
|| || || || || || || || || || || || || ||
prevent recurrent episodes. The mechanism of action is to:
|| || || || || || || || ||
a. interrupt the cycle of urate crystal deposition and inflammatory response.
|| || || || || || || || || ||
b. increase serum uric acid levels.
|| || || || ||
c. potentiate the excretion of uric acid.
|| || || || || ||
d. inhibit the tubular reabsorption of urate, promoting the excretion of uric
|| || || || || || || || || || || ||
acid. - Correct answer ✔A.
|| || || ||
,Cass, age 67, tells the NP that she has been diagnosed with a condition that
|| || || || || || || || || || || || || || ||
causes sudden flares of pain, swelling, and redness of the joints in her toes. She
|| || || || || || || || || || || || || || ||
cannot remember the name of the diagnosis, but she knows that it is cause by
|| || || || || || || || || || || || || || ||
urate crystals that "get stuck in the joint and cause pain". Joan is on HcTz for
|| || || || || || || || || || || || || || || ||
management of her hypertension. The NP should suspect a diagnosis of: || || || || || || || || || ||
a. septic arthritis
|| ||
b. gout.
||
c. rheumatoid arthritis.
|| ||
d. Charcot neuro-osteoarthropathy - Correct answer ✔B.
|| || || || || ||
Treatment of choice for polymyalgia rheumatica (PMR) is: || || || || || || ||
a. acetaminophen or NSAIDS
|| || ||
b. low dose steroids.
|| || ||
c. tricyclic antidepressants.
|| || ||
d. antibiotics - Correct answer ✔B.
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Dan, age 49, developed osteomyelitis of the femur after a motorcycle accident.
|| || || || || || || || || || || ||
Which of the following statements about the clinical manifestations of
|| || || || || || || || || ||
osteomyelitis is correct? || ||
a. integumentary effects involve swelling, erythema, and warmth at the
|| || || || || || || || || ||
involved site. ||
b. there is a low grade fever with intermittent chills
|| || || || || || || || ||
c. musculoskeletal effects include tenderness of the entire leg.
|| || || || || || || || ||
d. cardiovascular effects include bradycardia. - Correct answer ✔A.
|| || || || || || || ||
, Matthew, age 52, is a chef who just severed two of his fingers with a meat cutter.
|| || || || || || || || || || || || || || || ||
You would recommend that he:
|| || || || ||
a. wrap the severed fingers tightly in a dry towel for transport to the emergency
|| || || || || || || || || || || || || || ||
department with him. || ||
b. leave the severed fingers at the scene because fingers cannot be reattached.
|| || || || || || || || || || || ||
c. immediately freeze the severed fingers for reattachment in the near future.
|| || || || || || || || || || ||
d. pack the fingers in a saline-soaked dressing and seal in a plastic bag. - Correct
|| || || || || || || || || || || || || || ||
answer ✔D.
|| ||
Bursitis is an inflammatory process that may be caused by infection, trauma,
|| || || || || || || || || || || ||
repetitive motion disorders, gout, or neoplastic disease. The most common
|| || || || || || || || || ||
cause of septic bursitis due to infection is from which of the following:
|| || || || || || || || || || || ||
a. Mycobacterium tuberculosis
|| ||
b. Candida
||
c. Staphylococcus aureus.
|| ||
d. streptococcus - Correct answer ✔C.
|| || || || ||
When a provider elicits a painful Finkelstein's sign he or she is testing for:
|| || || || || || || || || || || || ||
a. carpal tunnel syndrone
|| || ||
b. bursitis of the shoulder.
|| || || ||
c. de Quervain's tenosynovitis
|| || ||
d. tennis elbow. - Correct answer ✔C.
|| || || || || ||
Marsha, age 34, presents with symptoms resembling both fibromyalgia and
|| || || || || || || || || ||
chronic fatigue syndrome, which have many similarities. Which of the
|| || || || || || || || || ||
SECTION EXAM WITH VERIFIED ANSWERS || || || ||
A 13 year old obese (BMI greater than 95%) boy reports low-grade left knee pain
|| || || || || || || || || || || || || ||
for the past 2 months. He denies antecedent trauma but admits to frequent
|| || || || || || || || || || || || || ||
horseplay with his friends. The pain has progressively worsened, and he is now
|| || || || || || || || || || || || ||
unable to bear weight at all on his left leg. His current complaints include left
|| || || || || || || || || || || || || || ||
groin, thigh, and medial knee pain and tenderness. His examination
|| || || || || || || || || ||
demonstrates negative Drawer, Lachman, and McMurray tests; left hip with || || || || || || || || || ||
decreased internal rotation and abduction; and knee flexion causing external
|| || || || || || || || || ||
hip rotation. Based on the above scenario, the NP should suspect:
|| || || || || || || || || ||
a. a left meniscal tear.
|| || || ||
b. a left ACL tear
|| || || ||
c. a slipped capital femoral epiphysis
|| || || || ||
d. osgood-schlatter disease. - Correct answer ✔C.
|| || || || || ||
Colchicine may be used to terminate an acute attack of gouty arthritis as well as
|| || || || || || || || || || || || || ||
prevent recurrent episodes. The mechanism of action is to:
|| || || || || || || || ||
a. interrupt the cycle of urate crystal deposition and inflammatory response.
|| || || || || || || || || ||
b. increase serum uric acid levels.
|| || || || ||
c. potentiate the excretion of uric acid.
|| || || || || ||
d. inhibit the tubular reabsorption of urate, promoting the excretion of uric
|| || || || || || || || || || || ||
acid. - Correct answer ✔A.
|| || || ||
,Cass, age 67, tells the NP that she has been diagnosed with a condition that
|| || || || || || || || || || || || || || ||
causes sudden flares of pain, swelling, and redness of the joints in her toes. She
|| || || || || || || || || || || || || || ||
cannot remember the name of the diagnosis, but she knows that it is cause by
|| || || || || || || || || || || || || || ||
urate crystals that "get stuck in the joint and cause pain". Joan is on HcTz for
|| || || || || || || || || || || || || || || ||
management of her hypertension. The NP should suspect a diagnosis of: || || || || || || || || || ||
a. septic arthritis
|| ||
b. gout.
||
c. rheumatoid arthritis.
|| ||
d. Charcot neuro-osteoarthropathy - Correct answer ✔B.
|| || || || || ||
Treatment of choice for polymyalgia rheumatica (PMR) is: || || || || || || ||
a. acetaminophen or NSAIDS
|| || ||
b. low dose steroids.
|| || ||
c. tricyclic antidepressants.
|| || ||
d. antibiotics - Correct answer ✔B.
|| || || || ||
Dan, age 49, developed osteomyelitis of the femur after a motorcycle accident.
|| || || || || || || || || || || ||
Which of the following statements about the clinical manifestations of
|| || || || || || || || || ||
osteomyelitis is correct? || ||
a. integumentary effects involve swelling, erythema, and warmth at the
|| || || || || || || || || ||
involved site. ||
b. there is a low grade fever with intermittent chills
|| || || || || || || || ||
c. musculoskeletal effects include tenderness of the entire leg.
|| || || || || || || || ||
d. cardiovascular effects include bradycardia. - Correct answer ✔A.
|| || || || || || || ||
, Matthew, age 52, is a chef who just severed two of his fingers with a meat cutter.
|| || || || || || || || || || || || || || || ||
You would recommend that he:
|| || || || ||
a. wrap the severed fingers tightly in a dry towel for transport to the emergency
|| || || || || || || || || || || || || || ||
department with him. || ||
b. leave the severed fingers at the scene because fingers cannot be reattached.
|| || || || || || || || || || || ||
c. immediately freeze the severed fingers for reattachment in the near future.
|| || || || || || || || || || ||
d. pack the fingers in a saline-soaked dressing and seal in a plastic bag. - Correct
|| || || || || || || || || || || || || || ||
answer ✔D.
|| ||
Bursitis is an inflammatory process that may be caused by infection, trauma,
|| || || || || || || || || || || ||
repetitive motion disorders, gout, or neoplastic disease. The most common
|| || || || || || || || || ||
cause of septic bursitis due to infection is from which of the following:
|| || || || || || || || || || || ||
a. Mycobacterium tuberculosis
|| ||
b. Candida
||
c. Staphylococcus aureus.
|| ||
d. streptococcus - Correct answer ✔C.
|| || || || ||
When a provider elicits a painful Finkelstein's sign he or she is testing for:
|| || || || || || || || || || || || ||
a. carpal tunnel syndrone
|| || ||
b. bursitis of the shoulder.
|| || || ||
c. de Quervain's tenosynovitis
|| || ||
d. tennis elbow. - Correct answer ✔C.
|| || || || || ||
Marsha, age 34, presents with symptoms resembling both fibromyalgia and
|| || || || || || || || || ||
chronic fatigue syndrome, which have many similarities. Which of the
|| || || || || || || || || ||
