DUNPHY FINAL CLINICAL EXAM
2026/27 NURS 671 WITH
COMPLETE SOLUTIONS
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
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
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
What is the treatment of choice for a pt diagnosed with testicular cancer?
- ANSWER-Radical orchidectomy
A pt with testicular cancer is being followed after completing treatment 1
yr ago. He has been symptom-free with no evidence of disease. How often
should he have a CT? - ANSWER-Every 3-4mo
T/F
Pt's treated for Neisseria gonorrhoeae also should be treated for
Chlamydia trachomatis. - ANSWER-True
T/F
Hep A is considered an STI by the CDC. - ANSWER-True
A 35yo female pt is seen in the clinic c/o abdominal pain. Which of the
following should be included in the history and physical exam?
a. Digital rectal exam
b. Pelvic exam
c. Sexual history
d. All of the above - ANSWER-d. All of the above
A pt comes to the office c/o constipation. The pt lists all of the following
meds. Which drug could be responsible for the constipation?
,a. Multivitamin
b. Magnesium hydroxide
c. Pepto-Bismol
d. Ibuprofen - ANSWER-c. Pepto-Bismol
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.
b. Only people w/occupations that require repeated flexion extension of
the wrist, use of hand tools that require forceful gripping, or use of hand
tools that vibrate are at risk for developing carpal tunnel.
c. An underlying musculoskeletal disorder must be present for a person to
develop carpal tunnel.
d. Carpal tunnel syndrome only occurs in the presence of a hormonal
imbalance. - ANSWER-a. Carpal tunnel syndrome commonly occurs in
families. Genetic factors are thought to account for about one-half the risk
of developing carpal tunnel.
Which of the following statements is true regarding the treatment of
carpal tunnel syndrome?
a. The goal of treatment is to prevent flexion and extension movements of
the wrist.
b. Splints are used in carpal tunnel syndrome, because they allow for free
movement of the fingers and thumb while maintaining the wrist in a
neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal
tunnel syndrome because of the risks for median nerve damage, scarring,
and infection.
d. All of the above - ANSWER-d. All of the above
Sam is a 25yo who has been diagnosed with low back strain based on his
h/o localized low back pain and muscle spasm along with a normal
neurological examination. As the clinician, you explain to Sam that low
back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus
pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are
equal to or greater than the back pain.
c. Fever, chills, and elevated erythrocyte sedimentation rate
, d. Pathologic fractures, severe night pain, weight loss, and fatigue -
ANSWER-b. Unilateral radicular pain symptoms that extend below the
knee and are equal to or greater than the back pain
The clinician has instructed Sam, a 25yo pt with low back strain, to use
NSAIDs to manage his symptoms of pain and discomfort. Which of the
following statements would be most appropriate when teaching Sam
about the use of NSAIDs?
a. "You should start with the lowest dose that is effective in managing
your pain, because long-term use of NSAIDs can result in GI disorders
such as ulcers and hemorrhage."
b. "You should start with the lowest dose that is effective in managing
your pain to avoid developing tolerance to the medication."
c. "You should take the maximum recommended dose of NSAIDs so that
you will not need to take narcotics to control your pain."
d. "It is important to take NSAIDs on an empty stomach in order to
increase absorption." - ANSWER-a. "You should start with the lowest dose
that is effective in managing your pain, because long-term use of NSAIDs
can result in GI disorders such as ulcers and hemorrhage."
Janet is a 30yo who has recently been diagnosed with a herniated disc at
the level of L5-S1. She is currently in the ER with suspicion of cauda
equina compression. Which of the following is a sign or symptom of cauda
equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks - ANSWER-d. Paresthesia of
the perineum and buttocks
Which of the following statements is true concerning the management of
the client with a herniated disc?
a. Muscle relaxants and narcotics can be used to control moderate pain
but should be discontinued after 3 weeks of use.
b. An epidural injection is helpful in reducing leg pain that has persisted
for at least 3 weeks after the herniation occurred.
c. Intolerable pain for more than a 3mo period is an indication for surgical
intervention.
d. All of the above. - ANSWER-c. Intolerable pain for more than a 3mo
period is an indication for surgical intervention.
John is a 16yo boy who presents to the ER after hurting his knee in a
football game. He described twisting his knee and then being unable to
extend it completely. John tells the clinician that he heard a pop when the
injury occurred and has been experiencing localized pain. The clinician
suspects a meniscal tear. Which test would be most appropriate to assess
2026/27 NURS 671 WITH
COMPLETE SOLUTIONS
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
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
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
What is the treatment of choice for a pt diagnosed with testicular cancer?
- ANSWER-Radical orchidectomy
A pt with testicular cancer is being followed after completing treatment 1
yr ago. He has been symptom-free with no evidence of disease. How often
should he have a CT? - ANSWER-Every 3-4mo
T/F
Pt's treated for Neisseria gonorrhoeae also should be treated for
Chlamydia trachomatis. - ANSWER-True
T/F
Hep A is considered an STI by the CDC. - ANSWER-True
A 35yo female pt is seen in the clinic c/o abdominal pain. Which of the
following should be included in the history and physical exam?
a. Digital rectal exam
b. Pelvic exam
c. Sexual history
d. All of the above - ANSWER-d. All of the above
A pt comes to the office c/o constipation. The pt lists all of the following
meds. Which drug could be responsible for the constipation?
,a. Multivitamin
b. Magnesium hydroxide
c. Pepto-Bismol
d. Ibuprofen - ANSWER-c. Pepto-Bismol
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.
b. Only people w/occupations that require repeated flexion extension of
the wrist, use of hand tools that require forceful gripping, or use of hand
tools that vibrate are at risk for developing carpal tunnel.
c. An underlying musculoskeletal disorder must be present for a person to
develop carpal tunnel.
d. Carpal tunnel syndrome only occurs in the presence of a hormonal
imbalance. - ANSWER-a. Carpal tunnel syndrome commonly occurs in
families. Genetic factors are thought to account for about one-half the risk
of developing carpal tunnel.
Which of the following statements is true regarding the treatment of
carpal tunnel syndrome?
a. The goal of treatment is to prevent flexion and extension movements of
the wrist.
b. Splints are used in carpal tunnel syndrome, because they allow for free
movement of the fingers and thumb while maintaining the wrist in a
neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal
tunnel syndrome because of the risks for median nerve damage, scarring,
and infection.
d. All of the above - ANSWER-d. All of the above
Sam is a 25yo who has been diagnosed with low back strain based on his
h/o localized low back pain and muscle spasm along with a normal
neurological examination. As the clinician, you explain to Sam that low
back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus
pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are
equal to or greater than the back pain.
c. Fever, chills, and elevated erythrocyte sedimentation rate
, d. Pathologic fractures, severe night pain, weight loss, and fatigue -
ANSWER-b. Unilateral radicular pain symptoms that extend below the
knee and are equal to or greater than the back pain
The clinician has instructed Sam, a 25yo pt with low back strain, to use
NSAIDs to manage his symptoms of pain and discomfort. Which of the
following statements would be most appropriate when teaching Sam
about the use of NSAIDs?
a. "You should start with the lowest dose that is effective in managing
your pain, because long-term use of NSAIDs can result in GI disorders
such as ulcers and hemorrhage."
b. "You should start with the lowest dose that is effective in managing
your pain to avoid developing tolerance to the medication."
c. "You should take the maximum recommended dose of NSAIDs so that
you will not need to take narcotics to control your pain."
d. "It is important to take NSAIDs on an empty stomach in order to
increase absorption." - ANSWER-a. "You should start with the lowest dose
that is effective in managing your pain, because long-term use of NSAIDs
can result in GI disorders such as ulcers and hemorrhage."
Janet is a 30yo who has recently been diagnosed with a herniated disc at
the level of L5-S1. She is currently in the ER with suspicion of cauda
equina compression. Which of the following is a sign or symptom of cauda
equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks - ANSWER-d. Paresthesia of
the perineum and buttocks
Which of the following statements is true concerning the management of
the client with a herniated disc?
a. Muscle relaxants and narcotics can be used to control moderate pain
but should be discontinued after 3 weeks of use.
b. An epidural injection is helpful in reducing leg pain that has persisted
for at least 3 weeks after the herniation occurred.
c. Intolerable pain for more than a 3mo period is an indication for surgical
intervention.
d. All of the above. - ANSWER-c. Intolerable pain for more than a 3mo
period is an indication for surgical intervention.
John is a 16yo boy who presents to the ER after hurting his knee in a
football game. He described twisting his knee and then being unable to
extend it completely. John tells the clinician that he heard a pop when the
injury occurred and has been experiencing localized pain. The clinician
suspects a meniscal tear. Which test would be most appropriate to assess
