NSG 464 ACTUAL FINAL EXAM PACK
CERTIFICATION REVIEW SET 2026
ANSWERS GUARANTEED PASS
⫸ Rheumatoid Arthritis (RA) Answer: Symmetric deformity in PIP,
MCP, wrist joints
- Tender, painful, stiff
- DIP, MCP, wrist
- Fusiform or spindle-shaped swelling of PIP joints
- Ulnar deviation
⫸ Pain Provocation Test Answer: Positive: shoulder pain from 60-120
degrees
⫸ Nerve Impingement Sign Answer: Press on scapula, raise patient's
arm
⫸ Hawkins Impingement Sign Answer: flex arm and shoulder 90• w/
palm down and rotate arm internally
-will compress greater tuberosity against coracoacromial ligament
,⫸ External Rotation Lag Test Answer: Flex arm 90 degrees with palm
up, rotate into full external rotation
- Positive: unable to maintain external rotation; supraspinatus and
infraspinatus disorder
⫸ Internal Rotation Lag Test Answer: Ask pt to place dorsum of hand
on low back, elbow flexed 90 degrees
- Lift hand off back, further internally rotating shoulder
- Positive: unable to hold this position; subscapularis disorder
⫸ Drop Arm Test Answer: Fully abduct arm to shoulder level and lower
slowly
- Positive: weakness, supraspinatus rotator cuff tear or bicipital tendinitis
⫸ External Rotation Resistance Test Answer: Adduct and flex arm 90
degrees with thumb turned up
- apply pressure to wrist
positive: infraspinatus disorder
⫸ Empty Can Test Answer: Elevate arms to 90° in front of pt and
internally rotate arms with thumbs pointing down; ask pt to resist as you
place downward pressure on arms
Positive for Rotator cuff tear if weakness present
, ⫸ Lateral Epicondylitis Answer: tennis elbow, characterized by pain on
the outer side of the forearm
⫸ Medial Epicondylitis Answer: golfer's elbow, characterized by pain
on the palm-side of the forearm
⫸ Colles fracture Answer: fracture of the distal radius at the wrist
⫸ Scaphoid fracture Answer: Anatomical Snuffbox > Radial artery here
Avascular necrosis, most commonly injured wrist bone
⫸ Thumb Abduction Test Answer: Ask patient to raise the thumb
straight up as you apply downward resistance
Positive test - weakness on thumb abduction
- Most sensitive carpal tunnel test
⫸ Tinel Test Answer: Percussion on medial nerve
- Positive: aching and numbing, tingling
⫸ Phalen's Sign Answer: Hold backs of hands together with wrists in
flexion for 60 seconds
- Positive: numbness/tingling
⫸ Sensation Test: median nerve Answer: pulp of index finger
CERTIFICATION REVIEW SET 2026
ANSWERS GUARANTEED PASS
⫸ Rheumatoid Arthritis (RA) Answer: Symmetric deformity in PIP,
MCP, wrist joints
- Tender, painful, stiff
- DIP, MCP, wrist
- Fusiform or spindle-shaped swelling of PIP joints
- Ulnar deviation
⫸ Pain Provocation Test Answer: Positive: shoulder pain from 60-120
degrees
⫸ Nerve Impingement Sign Answer: Press on scapula, raise patient's
arm
⫸ Hawkins Impingement Sign Answer: flex arm and shoulder 90• w/
palm down and rotate arm internally
-will compress greater tuberosity against coracoacromial ligament
,⫸ External Rotation Lag Test Answer: Flex arm 90 degrees with palm
up, rotate into full external rotation
- Positive: unable to maintain external rotation; supraspinatus and
infraspinatus disorder
⫸ Internal Rotation Lag Test Answer: Ask pt to place dorsum of hand
on low back, elbow flexed 90 degrees
- Lift hand off back, further internally rotating shoulder
- Positive: unable to hold this position; subscapularis disorder
⫸ Drop Arm Test Answer: Fully abduct arm to shoulder level and lower
slowly
- Positive: weakness, supraspinatus rotator cuff tear or bicipital tendinitis
⫸ External Rotation Resistance Test Answer: Adduct and flex arm 90
degrees with thumb turned up
- apply pressure to wrist
positive: infraspinatus disorder
⫸ Empty Can Test Answer: Elevate arms to 90° in front of pt and
internally rotate arms with thumbs pointing down; ask pt to resist as you
place downward pressure on arms
Positive for Rotator cuff tear if weakness present
, ⫸ Lateral Epicondylitis Answer: tennis elbow, characterized by pain on
the outer side of the forearm
⫸ Medial Epicondylitis Answer: golfer's elbow, characterized by pain
on the palm-side of the forearm
⫸ Colles fracture Answer: fracture of the distal radius at the wrist
⫸ Scaphoid fracture Answer: Anatomical Snuffbox > Radial artery here
Avascular necrosis, most commonly injured wrist bone
⫸ Thumb Abduction Test Answer: Ask patient to raise the thumb
straight up as you apply downward resistance
Positive test - weakness on thumb abduction
- Most sensitive carpal tunnel test
⫸ Tinel Test Answer: Percussion on medial nerve
- Positive: aching and numbing, tingling
⫸ Phalen's Sign Answer: Hold backs of hands together with wrists in
flexion for 60 seconds
- Positive: numbness/tingling
⫸ Sensation Test: median nerve Answer: pulp of index finger
