NURS 671 Dunphy Final Clinical Exam – 2025-2026 Simplified
Nurse Practitioner Study Guide with Core Clinical Topics, Case
Summaries, and Practice Questions with Correct Answers||Latest
Version!!!
Mr. W, 53yo, is seen in the clinic w/concerns about his L foot. He has
a 40-yr h/o T1DM w/"fairly good" control on twice-daily insulin. He
denies injury but states that he tripped a few months ago and his foot
is sore when he walks. Physical exam reveals an edematous,
erythemic, and warm foot. There is a superficial ulcer on the plantar
surface. Which of the following is the most likely dx?
-Fallen arch
-Arthritis
-Charcot joint
-Sprained ankle - Answer-Charcot joint
Which of the following tests should you order to confirm Mr. W's dx?
-Bone scan
-CT
-XR of foot
-Culture of ulcer - Answer-XR of foot
A vegetarian pt w/gout asks the clinician about food he should avoid.
The clinician should advise the pt to avoid which of the following
foods?
-Rice
-Carrots
-Spinach
-Potatoes - Answer-Spinach
The clinician should question the pt w/suspected gout about use of
which medication?
pg. 1
,-Low-dose ASA
-Thiazide diuretics
-Ethambutol
-All of the above - Answer-All of the above
The clinician finds numerous nodules on the thyroid of a 65yo
woman. The clinician suspects thyroid cancer. Which of the following
data would be most significant for this pt?
-A h/o tonsillectomy in the 1940's
-Recent exposure to mumps
-Vegetarian diet
-Allergy to iodine - Answer-A h/o tonsillectomy in the 1940's
Which of the following is essential for diagnosing thyroid cancer?
-Fine needle aspiration
-Thyroid ultrasound
-CT scan
-MRI - Answer-Fine needle aspiration
Which of the following are common signs of T2DM?
-Anorexia
-Recurrent yeast infection
-Wt gain
-Elevated HDL - Answer-Recurrent yeast infection
One of the initial steps in assessing pt's w/musculoskeletal complaints
is to determine whether the complaint is articular or nonarticular in
origin. Which of the following is an example of an articular structure?
a. Bone
b. Synovium
pg. 2
,c. Tendons
d. Fascia - Answer-b. Synovium
You have detected the presence of crepitus on exam of a pt with a
musculskeletal complaint. Additionally, there is limited ROM w/both
active and passive movement. These findings suggest that the origin
of the musculoskeletal complaint is: - Answer-Articular
Which of the following signs or symptoms indicate an inflammatory
etiology to musculoskeletal pain?
a. Decreased CRP
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain - Answer-c. Morning stiffness
Which of the following statements concerning the musculoskeletal
exam is true?
a. The uninvolved side should be examined initially and then
compared to the involved side.
b. The part of the body that is causing the pain should be examined
first.
c. When possible, the pt should not be asked to perform active ROM
exercises to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as
not to cause further injury to the pt.
- Answer-a. The uninvolved side should be examined initially and
then compared to the involved side.
You are performing muscle strength testing on a pt presenting
w/musculoskeletal pain and find that the pt has complete ROM
w/gravity eliminated. Which numeric grade of muscle strength would
you give this pt, 1-5? - Answer-2
pg. 3
, Mrs. Gray is a 55yo woman who presents with tightness, pain, and
limited movement in her right shoulder. She denies any h/o trauma.
Her exam reveals a 75% reduction in both active and passive ROM of
the right shoulder. Mrs. Gray also is experiencing tenderness with
motion and pain at the deltoid insertion. Her medical hx is significant
for type 1 diabetes mellitus and HTN. Her social hx reveals that she is
a secretary and that she is right-handed. Based on her examination
and medical hx, you suspect adhesive capsulitis, or "frozen shoulder."
Which clue in Mrs. Gray's hx supports this dx? - Answer-Her h/o
diabetes
Jennifer is an 18yo who comes to the ER after a fall during a soccer
game. Jennifer explains that she fell on her left side and kept her arm
out straight to break her fall. She has been experiencing severe pain
and limited ROM in her left shoulder. The clinician has diagnosed
Jennifer with a dislocated shoulder. Which of the following statements
are true concerning shoulder dislocation?
a. Posterior dislocations are more common than anterior dislocations
b. There is a risk of neurovascular and neurosensory trauma, so the
clinician should check for distal pulses
c. Recurrent dislocations are uncommon and would require great
force to result in injury.
d. Surgery is most commonly the treatment of choice - Answer-b.
There is a risk of neurovascular and neurosensory trauma, so the
clinician should check for distal pulses
Mrs. Anderson is a 35yo woman who has been recently diagnosed
with carpal tunnel syndrome. She has 2 young children and asks the
clinician what the chances are that they also will develop carpal
tunnel syndrome. Which of the following responses would be correct
regarding the risk of developing carpal tunnel syndrome?
a. Carpal tunnel syndrome commonly occurs in families. Genetic
factors are thought to account for about one-half the risk of
developing carpal tunnel.
pg. 4
Nurse Practitioner Study Guide with Core Clinical Topics, Case
Summaries, and Practice Questions with Correct Answers||Latest
Version!!!
Mr. W, 53yo, is seen in the clinic w/concerns about his L foot. He has
a 40-yr h/o T1DM w/"fairly good" control on twice-daily insulin. He
denies injury but states that he tripped a few months ago and his foot
is sore when he walks. Physical exam reveals an edematous,
erythemic, and warm foot. There is a superficial ulcer on the plantar
surface. Which of the following is the most likely dx?
-Fallen arch
-Arthritis
-Charcot joint
-Sprained ankle - Answer-Charcot joint
Which of the following tests should you order to confirm Mr. W's dx?
-Bone scan
-CT
-XR of foot
-Culture of ulcer - Answer-XR of foot
A vegetarian pt w/gout asks the clinician about food he should avoid.
The clinician should advise the pt to avoid which of the following
foods?
-Rice
-Carrots
-Spinach
-Potatoes - Answer-Spinach
The clinician should question the pt w/suspected gout about use of
which medication?
pg. 1
,-Low-dose ASA
-Thiazide diuretics
-Ethambutol
-All of the above - Answer-All of the above
The clinician finds numerous nodules on the thyroid of a 65yo
woman. The clinician suspects thyroid cancer. Which of the following
data would be most significant for this pt?
-A h/o tonsillectomy in the 1940's
-Recent exposure to mumps
-Vegetarian diet
-Allergy to iodine - Answer-A h/o tonsillectomy in the 1940's
Which of the following is essential for diagnosing thyroid cancer?
-Fine needle aspiration
-Thyroid ultrasound
-CT scan
-MRI - Answer-Fine needle aspiration
Which of the following are common signs of T2DM?
-Anorexia
-Recurrent yeast infection
-Wt gain
-Elevated HDL - Answer-Recurrent yeast infection
One of the initial steps in assessing pt's w/musculoskeletal complaints
is to determine whether the complaint is articular or nonarticular in
origin. Which of the following is an example of an articular structure?
a. Bone
b. Synovium
pg. 2
,c. Tendons
d. Fascia - Answer-b. Synovium
You have detected the presence of crepitus on exam of a pt with a
musculskeletal complaint. Additionally, there is limited ROM w/both
active and passive movement. These findings suggest that the origin
of the musculoskeletal complaint is: - Answer-Articular
Which of the following signs or symptoms indicate an inflammatory
etiology to musculoskeletal pain?
a. Decreased CRP
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain - Answer-c. Morning stiffness
Which of the following statements concerning the musculoskeletal
exam is true?
a. The uninvolved side should be examined initially and then
compared to the involved side.
b. The part of the body that is causing the pain should be examined
first.
c. When possible, the pt should not be asked to perform active ROM
exercises to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as
not to cause further injury to the pt.
- Answer-a. The uninvolved side should be examined initially and
then compared to the involved side.
You are performing muscle strength testing on a pt presenting
w/musculoskeletal pain and find that the pt has complete ROM
w/gravity eliminated. Which numeric grade of muscle strength would
you give this pt, 1-5? - Answer-2
pg. 3
, Mrs. Gray is a 55yo woman who presents with tightness, pain, and
limited movement in her right shoulder. She denies any h/o trauma.
Her exam reveals a 75% reduction in both active and passive ROM of
the right shoulder. Mrs. Gray also is experiencing tenderness with
motion and pain at the deltoid insertion. Her medical hx is significant
for type 1 diabetes mellitus and HTN. Her social hx reveals that she is
a secretary and that she is right-handed. Based on her examination
and medical hx, you suspect adhesive capsulitis, or "frozen shoulder."
Which clue in Mrs. Gray's hx supports this dx? - Answer-Her h/o
diabetes
Jennifer is an 18yo who comes to the ER after a fall during a soccer
game. Jennifer explains that she fell on her left side and kept her arm
out straight to break her fall. She has been experiencing severe pain
and limited ROM in her left shoulder. The clinician has diagnosed
Jennifer with a dislocated shoulder. Which of the following statements
are true concerning shoulder dislocation?
a. Posterior dislocations are more common than anterior dislocations
b. There is a risk of neurovascular and neurosensory trauma, so the
clinician should check for distal pulses
c. Recurrent dislocations are uncommon and would require great
force to result in injury.
d. Surgery is most commonly the treatment of choice - Answer-b.
There is a risk of neurovascular and neurosensory trauma, so the
clinician should check for distal pulses
Mrs. Anderson is a 35yo woman who has been recently diagnosed
with carpal tunnel syndrome. She has 2 young children and asks the
clinician what the chances are that they also will develop carpal
tunnel syndrome. Which of the following responses would be correct
regarding the risk of developing carpal tunnel syndrome?
a. Carpal tunnel syndrome commonly occurs in families. Genetic
factors are thought to account for about one-half the risk of
developing carpal tunnel.
pg. 4
