MARYVILLE NURS 623 EXAM 4 UPDATED
EXAM REVIEW 2026 QUESTIONS AND
CORRECT SOLUTIONS GRADED A+
⩥ When assessing the patient with musculoskeletal problems, it is
important to determine if the problem is: Answer: acute or chronic,
articular or nonarticular, inflammatory or noninflammatory, and
localized or systemic in distribution. Acute (less than 6 weeks duration)
or chronic (more than 6 weeks duration), Flammatory or inflammatory
⩥ Articular structures Answer: • synovium, • synovial fluid, • articular
cartilage, • intra-articular ligaments, • joint capsule, • juxta-articular
bone
⩥ Articular problems are characterized by Answer: deep or diffuse pain,
• deep or diffuse pain, • limited ROM (passive & active), • swelling, •
crepitation,
• instability, • 'locking', • Deformity
⩥ Nonarticular (or periarticular) structures Answer: • identified as
supportive extra-articular ligaments,
• tendons, • bursae, • muscle, • fascia, • bone, • nerve,
• overlying skin •
,⩥ Nonarticular disorders are characterized by Answer: painful active,
but not passive ROM,
• demonstrated point or focal ternderness in regions distinct from
articular structures,
• physical findings far from the joint capsule.
• Usually do not find crepitus, instability or deformity
⩥ History Answer: · Chronology of complaint gives important
diagnostic clues
· onset, or did it develop over some time
· evolution of the problem, such as chronic, intermittent,
· migratory and duration of the problem.
⩥ Physical Examination Answer: · Distinguish between mechanical
problems, soft tissue disease, and noninflammatory and inflammatory
joint disease.
· Inspecting the involved site and observe for side to side symmetry
· The uninvolved side should be examined first and compared with the
involved side (this will mean the painful portion of the exam will be last)
· evaluate for warmth over the joint, joint effusion, and pain on joint
motion.
You should have the patient perform as much active ROM as possible
during the exam,
,⩥ Low Back Pain Answer: · Also called low back strain or lumbar strain
· Injury to paravertebral spinal muscles, ligamentous injuries, disc
herniation or leaking of substances from nucleus pulposus
· Back pain associated with neurological deficit, decreased or absent
pulses, or bowel or bladder dysfunction is potentially life threatening &
warrants immediate referral.
· Low back pain is a common complaint seen in primary care.
· Pain may be caused by a herniated disc or from leaking of substances
from the nucleus pulposus that can induce inflammation and cause
irritation.
· often difficult to localize an injury to a specific structure.
⩥ Chronic low back pain is Answer: pain that lasts longer than 3
months.
⩥ Symptoms associated with chronic low back pain are Answer:
typically recurrent and episodic, but may be unremitting.
⩥ Treatment for injury to muscle and ligamentous structures is similar.
Answer: Acute vs. chronic
Acute LBP will often spontaneously resolve and the patient may be
back to functioning normally within a month
⩥ Factors to consider in diagnosing cause of pain: Answer: • Age, pain
onset (acute or insidious),
, • Pain location as unilateral or bilateral can help differentiate among
these differentials.
• Pain increases. Pain decreases, Straight-leg raising
⩥ Younger patients, under 50 years of age, are more likely to have
Answer: spondylolisthesis, • muscle strain, • scoliosis, • herniated disc.
⩥ Older than 50 are more likely to have pain Answer: related to arthritis,
• spinal stenosis, Pain onset, insidious
• acute
⩥ a herniated disk or leaking substances from the nucleus pulposus can
induce Answer: ·inflammation and cause irritation.
⩥ Acute Lumber Radiculopathy Answer: Herniated disc, acute lumbar
radiculopathy, Sciatica
⩥ sciatica Answer: • cause unilateral radicular pain.
• The pain may extend below the knee and the leg pain may be equal to
that of the back pain.
• often acute in onset, pain increases when sitting or bending, decreases
when standing, straight leg raise will be positive. xray will be negative
with a herniated disc, so further diagnostic testing may be indicated.
EXAM REVIEW 2026 QUESTIONS AND
CORRECT SOLUTIONS GRADED A+
⩥ When assessing the patient with musculoskeletal problems, it is
important to determine if the problem is: Answer: acute or chronic,
articular or nonarticular, inflammatory or noninflammatory, and
localized or systemic in distribution. Acute (less than 6 weeks duration)
or chronic (more than 6 weeks duration), Flammatory or inflammatory
⩥ Articular structures Answer: • synovium, • synovial fluid, • articular
cartilage, • intra-articular ligaments, • joint capsule, • juxta-articular
bone
⩥ Articular problems are characterized by Answer: deep or diffuse pain,
• deep or diffuse pain, • limited ROM (passive & active), • swelling, •
crepitation,
• instability, • 'locking', • Deformity
⩥ Nonarticular (or periarticular) structures Answer: • identified as
supportive extra-articular ligaments,
• tendons, • bursae, • muscle, • fascia, • bone, • nerve,
• overlying skin •
,⩥ Nonarticular disorders are characterized by Answer: painful active,
but not passive ROM,
• demonstrated point or focal ternderness in regions distinct from
articular structures,
• physical findings far from the joint capsule.
• Usually do not find crepitus, instability or deformity
⩥ History Answer: · Chronology of complaint gives important
diagnostic clues
· onset, or did it develop over some time
· evolution of the problem, such as chronic, intermittent,
· migratory and duration of the problem.
⩥ Physical Examination Answer: · Distinguish between mechanical
problems, soft tissue disease, and noninflammatory and inflammatory
joint disease.
· Inspecting the involved site and observe for side to side symmetry
· The uninvolved side should be examined first and compared with the
involved side (this will mean the painful portion of the exam will be last)
· evaluate for warmth over the joint, joint effusion, and pain on joint
motion.
You should have the patient perform as much active ROM as possible
during the exam,
,⩥ Low Back Pain Answer: · Also called low back strain or lumbar strain
· Injury to paravertebral spinal muscles, ligamentous injuries, disc
herniation or leaking of substances from nucleus pulposus
· Back pain associated with neurological deficit, decreased or absent
pulses, or bowel or bladder dysfunction is potentially life threatening &
warrants immediate referral.
· Low back pain is a common complaint seen in primary care.
· Pain may be caused by a herniated disc or from leaking of substances
from the nucleus pulposus that can induce inflammation and cause
irritation.
· often difficult to localize an injury to a specific structure.
⩥ Chronic low back pain is Answer: pain that lasts longer than 3
months.
⩥ Symptoms associated with chronic low back pain are Answer:
typically recurrent and episodic, but may be unremitting.
⩥ Treatment for injury to muscle and ligamentous structures is similar.
Answer: Acute vs. chronic
Acute LBP will often spontaneously resolve and the patient may be
back to functioning normally within a month
⩥ Factors to consider in diagnosing cause of pain: Answer: • Age, pain
onset (acute or insidious),
, • Pain location as unilateral or bilateral can help differentiate among
these differentials.
• Pain increases. Pain decreases, Straight-leg raising
⩥ Younger patients, under 50 years of age, are more likely to have
Answer: spondylolisthesis, • muscle strain, • scoliosis, • herniated disc.
⩥ Older than 50 are more likely to have pain Answer: related to arthritis,
• spinal stenosis, Pain onset, insidious
• acute
⩥ a herniated disk or leaking substances from the nucleus pulposus can
induce Answer: ·inflammation and cause irritation.
⩥ Acute Lumber Radiculopathy Answer: Herniated disc, acute lumbar
radiculopathy, Sciatica
⩥ sciatica Answer: • cause unilateral radicular pain.
• The pain may extend below the knee and the leg pain may be equal to
that of the back pain.
• often acute in onset, pain increases when sitting or bending, decreases
when standing, straight leg raise will be positive. xray will be negative
with a herniated disc, so further diagnostic testing may be indicated.
