Exam 4 Advanced health assessment (NUR 631)
questions and answers 2026\2027 A+ Grade
• Myofascial pain
- correct answer asymmetrical trigger points that are medial to the scapula and over the trapezius,
Caused by stress and/or previous neck injuries
• Subacromial bursitis
- correct answer tenderness that can be palpated over the head of the humorous many times on the
dominant extremities, pain elicited with internal and external rotation at 90 degrees and abduction
greater than 30 degrees. Pain at night, abrupt onset, overuse pattern.
• Acromioclavicular joint separation
- correct answer history of direct fall or blow to part of the shoulder
• Shoulder dislocation
- correct answer Any trauma to the shoulder with a mechanism of injury involving external rotation with
abduction, loss of normal contour of shoulder, marked instability ( moves too far back or forward)
• Frozen shoulder
- correct answer total restriction of normal range of motion with an insidious onset of pain.
Inflammatory process. Common in women over 50 and diabetics.
• Clavicle fractures
- correct answer direct trauma to the clavicle, obvious deformity mid shaft, pain on palpation at region
• Colles fracture
- correct answer history of fall on an outstretched hand (FOSH), pain, edema and limited range of
motion with an obvious deformity (dinner fork) of the wrist.
,• Navicular fracture
- correct answer History of FOSH with impact on fingers or distal palms, tenderness over the anatomical
snuffbox, increases with movement of the wrist, possible swelling
• Carpul Tunnel
- correct answer pain increases at night, clumsiness with distribution of numbness location in the
median nerve distribution, possible wasting of thenar eminence, tinel's sign (percussing over median
nerve produces pain and tingling), history of performing repetitive movements, often seen in pregnant
women( edema), alcoholics, pts with arthritis and HTN.
• DeQuevain's tenosynovitis
- correct answer Pain in the radial aspect of the wrist that is aggravation with ulnar deviation of the hand
with a thumb flexed (opening a door knob), a thickening sheath or nodule in the area of tenderness
upon palpation, positive Finkelstein test (having the patient flex his thumb into his palm and then cover
with the other fingers, and passively ulner-devatiting the wrist elicits pain in the affected area)
• Ganglion cyst
- correct answer A nodule on the dorsum aspect of the wrist ( this nodule is really a synovial cyst from a
herniated tendon lining), painless to a dull ache if the nodule is really large
• Gamekeepers thumb/skiers thumb (ulner collateral ligament tear)
- correct answer history of sudden, forceful abduction of the thumb, pain on the ulner side, stress
testing reveals laxity (stress testing is performed by stabilizing the metacarpophalangeal joint in flexion
and radially deviating the thumb. More than 30 degrees deviation or more than 20 degrees deviation
compared to the opposite side suggests significant damage.
• Slipped capital femoral epiphysis
- correct answer child with history of hip, knee, groin, and/or thigh pain and a limp, decreased ROM
during internal rotation of the femur, possible pain with abduction/ adduction, flexion causes external
rotation
• Legg Clave Perthes disease
- correct answer child limps( often painless and intermittent), possible pain noted in the anterior groin
inner thigh or knee, atrophy of the thigh, limitation and pain are noted with internal rotation, limitation
of abduction, particularly in flexion, positive Catterall's sign( passive hip flexion causes external rotation)
, • Stress fracture
- correct answer pain on palpation at the iliac crest, due to poor running technique( running with arms
swinging from side to side, causing abd muscles to pull on the iliac crest)
• Avulsion fracture
- correct answer pain on palpation at the greater trochanter or at the anterior superior iliac spine(ASIS),
possible crepitus or bony fragments felt during palpation, pain with active. Movement and passive
stretching of the involved muscles, popping with acute pain, history of running
• Ischial bursitis
- correct answer pain radiating to the hamstrings when the patient lies on her side with the hip flexed,
history of long distance running
• Hip fracture
- correct answer pain with pressure/palpation on the iliac crest, pts inability to lift the leg while on his
back, foot on injured side is turned outward, pressure on bladder and urge to void, trauma
• Quadricep tear
- correct answer tear is visible upon inspection, pt will not be able to lift her leg
• Trochanteric bursitis
- correct answer pain over the greater trochanter at the widest point of protrusion of the hip which may
radiate the knee, complaint of pain when lying on the affected side
• Patellofemoral syndrome
- correct answer History of aching type of pain that may be described as knife like along the anterior-
medial aspect of the knee; pain on the front on the patella that radiates to the inner and outer aspects
of the knee, pain occurs after sitting for long periods with legs flexed, going up and down stairs/hills or
squatting, no swelling but some puffiness noted, pt feels knee is going to give out. Crepitus and positive
inhibition test (have her straighten the leg and push the patella into the femur
• Iliotibial band syndrome
- correct answer History of running or cycling, pain over lateral femoral condyle with grinding or
snapping felt over the knee, tenderness 2-3cm proximal to the later joint line, positive ober's test
questions and answers 2026\2027 A+ Grade
• Myofascial pain
- correct answer asymmetrical trigger points that are medial to the scapula and over the trapezius,
Caused by stress and/or previous neck injuries
• Subacromial bursitis
- correct answer tenderness that can be palpated over the head of the humorous many times on the
dominant extremities, pain elicited with internal and external rotation at 90 degrees and abduction
greater than 30 degrees. Pain at night, abrupt onset, overuse pattern.
• Acromioclavicular joint separation
- correct answer history of direct fall or blow to part of the shoulder
• Shoulder dislocation
- correct answer Any trauma to the shoulder with a mechanism of injury involving external rotation with
abduction, loss of normal contour of shoulder, marked instability ( moves too far back or forward)
• Frozen shoulder
- correct answer total restriction of normal range of motion with an insidious onset of pain.
Inflammatory process. Common in women over 50 and diabetics.
• Clavicle fractures
- correct answer direct trauma to the clavicle, obvious deformity mid shaft, pain on palpation at region
• Colles fracture
- correct answer history of fall on an outstretched hand (FOSH), pain, edema and limited range of
motion with an obvious deformity (dinner fork) of the wrist.
,• Navicular fracture
- correct answer History of FOSH with impact on fingers or distal palms, tenderness over the anatomical
snuffbox, increases with movement of the wrist, possible swelling
• Carpul Tunnel
- correct answer pain increases at night, clumsiness with distribution of numbness location in the
median nerve distribution, possible wasting of thenar eminence, tinel's sign (percussing over median
nerve produces pain and tingling), history of performing repetitive movements, often seen in pregnant
women( edema), alcoholics, pts with arthritis and HTN.
• DeQuevain's tenosynovitis
- correct answer Pain in the radial aspect of the wrist that is aggravation with ulnar deviation of the hand
with a thumb flexed (opening a door knob), a thickening sheath or nodule in the area of tenderness
upon palpation, positive Finkelstein test (having the patient flex his thumb into his palm and then cover
with the other fingers, and passively ulner-devatiting the wrist elicits pain in the affected area)
• Ganglion cyst
- correct answer A nodule on the dorsum aspect of the wrist ( this nodule is really a synovial cyst from a
herniated tendon lining), painless to a dull ache if the nodule is really large
• Gamekeepers thumb/skiers thumb (ulner collateral ligament tear)
- correct answer history of sudden, forceful abduction of the thumb, pain on the ulner side, stress
testing reveals laxity (stress testing is performed by stabilizing the metacarpophalangeal joint in flexion
and radially deviating the thumb. More than 30 degrees deviation or more than 20 degrees deviation
compared to the opposite side suggests significant damage.
• Slipped capital femoral epiphysis
- correct answer child with history of hip, knee, groin, and/or thigh pain and a limp, decreased ROM
during internal rotation of the femur, possible pain with abduction/ adduction, flexion causes external
rotation
• Legg Clave Perthes disease
- correct answer child limps( often painless and intermittent), possible pain noted in the anterior groin
inner thigh or knee, atrophy of the thigh, limitation and pain are noted with internal rotation, limitation
of abduction, particularly in flexion, positive Catterall's sign( passive hip flexion causes external rotation)
, • Stress fracture
- correct answer pain on palpation at the iliac crest, due to poor running technique( running with arms
swinging from side to side, causing abd muscles to pull on the iliac crest)
• Avulsion fracture
- correct answer pain on palpation at the greater trochanter or at the anterior superior iliac spine(ASIS),
possible crepitus or bony fragments felt during palpation, pain with active. Movement and passive
stretching of the involved muscles, popping with acute pain, history of running
• Ischial bursitis
- correct answer pain radiating to the hamstrings when the patient lies on her side with the hip flexed,
history of long distance running
• Hip fracture
- correct answer pain with pressure/palpation on the iliac crest, pts inability to lift the leg while on his
back, foot on injured side is turned outward, pressure on bladder and urge to void, trauma
• Quadricep tear
- correct answer tear is visible upon inspection, pt will not be able to lift her leg
• Trochanteric bursitis
- correct answer pain over the greater trochanter at the widest point of protrusion of the hip which may
radiate the knee, complaint of pain when lying on the affected side
• Patellofemoral syndrome
- correct answer History of aching type of pain that may be described as knife like along the anterior-
medial aspect of the knee; pain on the front on the patella that radiates to the inner and outer aspects
of the knee, pain occurs after sitting for long periods with legs flexed, going up and down stairs/hills or
squatting, no swelling but some puffiness noted, pt feels knee is going to give out. Crepitus and positive
inhibition test (have her straighten the leg and push the patella into the femur
• Iliotibial band syndrome
- correct answer History of running or cycling, pain over lateral femoral condyle with grinding or
snapping felt over the knee, tenderness 2-3cm proximal to the later joint line, positive ober's test
