NSGl 555/l NSG555l Examl 3l –l Nursel
Practitionersl inl Primaryl Carel IIl Guide|l
Wilkesl (Latestl 2026/l 2027l Update)l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Lowl backl painl imaging
Answer:
Ifl nol redl flagl sx,l DOl NOTl needl x-raysl forl 6l weeks
Q:l Whenl imagingl isl recommendedl forl lowl backl painl evenl ifl lessl thanl 6l weeks
Answer:
-majorl trauma
-minorl traumal inl ptsl 50yol orl greater
-long-terml corticosteroidl use
-osteoporosis
-70yol orl greater
-50yol orl greaterl (possiblel tumorl orl infection)
-lessl thanl 20yo
-Hxl ofl cancer
-constitutionall sx
-recentl bacteriall infx
-injectionl drugl use
-immunosuppression
-supinel pain
-nocturnall pain
Q:l Lowl backl painl tx
Answer:
,-EDUCATION
-NSAIDsl (orall andl topical)
-topicall capsicum
-heatl orl coldl therapy
-spinall manipulation
-acupuncture
-PT,l corel stabilityl andl strengthening
-activityl modification
-stopl smoking
-properl lifting
-musclel relaxantl onlyl ifl truel musclel spasml andl notl justl protectivel response
-acetaminophenl andl corticosteroidsl relativel ineffective
Q:l Septicl arthritisl h&pl (presentation)
Answer:
-acutelyl swollen,l painfull jointl withl limitedl ROM
-oftenl monoarticular
-commonlyl affectsl largel joints
-fever,l chills,l constitutionall symptomsl possible
Q:l Septicl arthritisl riskl factors
Answer:
-advancedl age
-diabetes
-rheumatoidl arthritis
-recentl jointl surgeryl orl prostheticl joint
-skinl infection
-immunosuppression
Q:l Septicl arthritisl mostl commonl cause
Answer:
-staphl aureus
-youngerl populationsl -l n.l gonorrhea
,Q:l Septicl arthritisl diagnosis
Answer:
-urgent
-arthrocentesis
--WBCl >50,000l (synoviall fluid)
--graml stainl andl culture
--PCRl ifl culturel isl negative
-bloodl culturesl ifl fever
-ESRl andl CRPl usuallyl elevated
-imagingl mayl assistl butl shouldl notl delayl arthrocentesisl (US,l MRI)
Q:l Septicl arthritisl tx
Answer:
-abxl afterl cultures
-Vancomycinl +l 3rdl genl cephalosporin
-tailorl tol culturel results
-2-6l weeksl (orall usuallyl adequate)
-jointl drainagel (repeatedl aspirationl orl surgery)
Q:l Goutl managementl ofl acute,l initiall flare
Answer:
-NSAIDsl (naproxenl 500mgl BIDl orl indomethacinl 25-50mgl Q8H)l x7-10l days
-colchicinel ifl lessl thanl 36l hoursl (loadingl dosel ofl 1.2mgl followedl byl al dosel ofl 0.6mgl
1l hourl later,l thereafterl 0.6mgl BIDl untill resolution)
-corticosteroidsl usefull forl contraindicationsl tol NSAIDs.l IVl orl POl orl intra-articularl
injection.l POl 40-60mgl prednisone/dayl x5-10l daysl orl atl fulll dosel 2-5l daysl thenl taperedl
overl 7-10l days.l Performl aspirationl andl sendl fluidl forl cxl whenl givingl intra-articular.
Interleukin-1l inhibitorsl (Anakinral andl canakinumab)l forl hospitalizedl pts.
Q:l Goutl managementl ofl acute,l subsequentl flare
, Answer:
-ifl takingl colchicinel 0.6mg/day,l takel acutel dosel ofl 1.2mgl followedl byl 0.6mgl 1l hourl
laterl thenl resumel dailyl dosingl thel nextl day
-NSAIDs,l colchicine,l orl corticosteroidsl +l allopurinoll orl febuxostat
Q:l Goutl managementl betweenl attacks
Answer:
-forl repeatedl attacksl (2l orl morel perl year)l orl CKDl 2l orl worsel orl tophaceousl deposits
-eliminatel high-purinel foodsl (organl meats,l highl fructosel cornl syrupl drinks)
-losel weight
-reducel alcohol
-eliminatel medsl (thiazidel &l loopl diuretics,l niacin,l ASA)
-increasel waterl intake
-colchicinel 0.6mgl daily
-allopurinoll andl febuxostatl (startl afterl colchicine)
-canakinumabl (alternativesl notl possible)
Q:l Osteoporosisl diagnosis
Answer:
Screenl forl secondaryl causes
-BUN
-Cr
-albumin
-seruml calcium
-phosphate
-alkalinel phosphatase
-25-hydroxyvitaminl D
-seruml PTHl ifl calciuml abnormal
-CBCl (butl usul normal)
-alsol thyroid,l hypogonadism,l celiac,l primaryl biliaryl cholangitisl ifl warranted
Q:l T-scores
Practitionersl inl Primaryl Carel IIl Guide|l
Wilkesl (Latestl 2026/l 2027l Update)l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Lowl backl painl imaging
Answer:
Ifl nol redl flagl sx,l DOl NOTl needl x-raysl forl 6l weeks
Q:l Whenl imagingl isl recommendedl forl lowl backl painl evenl ifl lessl thanl 6l weeks
Answer:
-majorl trauma
-minorl traumal inl ptsl 50yol orl greater
-long-terml corticosteroidl use
-osteoporosis
-70yol orl greater
-50yol orl greaterl (possiblel tumorl orl infection)
-lessl thanl 20yo
-Hxl ofl cancer
-constitutionall sx
-recentl bacteriall infx
-injectionl drugl use
-immunosuppression
-supinel pain
-nocturnall pain
Q:l Lowl backl painl tx
Answer:
,-EDUCATION
-NSAIDsl (orall andl topical)
-topicall capsicum
-heatl orl coldl therapy
-spinall manipulation
-acupuncture
-PT,l corel stabilityl andl strengthening
-activityl modification
-stopl smoking
-properl lifting
-musclel relaxantl onlyl ifl truel musclel spasml andl notl justl protectivel response
-acetaminophenl andl corticosteroidsl relativel ineffective
Q:l Septicl arthritisl h&pl (presentation)
Answer:
-acutelyl swollen,l painfull jointl withl limitedl ROM
-oftenl monoarticular
-commonlyl affectsl largel joints
-fever,l chills,l constitutionall symptomsl possible
Q:l Septicl arthritisl riskl factors
Answer:
-advancedl age
-diabetes
-rheumatoidl arthritis
-recentl jointl surgeryl orl prostheticl joint
-skinl infection
-immunosuppression
Q:l Septicl arthritisl mostl commonl cause
Answer:
-staphl aureus
-youngerl populationsl -l n.l gonorrhea
,Q:l Septicl arthritisl diagnosis
Answer:
-urgent
-arthrocentesis
--WBCl >50,000l (synoviall fluid)
--graml stainl andl culture
--PCRl ifl culturel isl negative
-bloodl culturesl ifl fever
-ESRl andl CRPl usuallyl elevated
-imagingl mayl assistl butl shouldl notl delayl arthrocentesisl (US,l MRI)
Q:l Septicl arthritisl tx
Answer:
-abxl afterl cultures
-Vancomycinl +l 3rdl genl cephalosporin
-tailorl tol culturel results
-2-6l weeksl (orall usuallyl adequate)
-jointl drainagel (repeatedl aspirationl orl surgery)
Q:l Goutl managementl ofl acute,l initiall flare
Answer:
-NSAIDsl (naproxenl 500mgl BIDl orl indomethacinl 25-50mgl Q8H)l x7-10l days
-colchicinel ifl lessl thanl 36l hoursl (loadingl dosel ofl 1.2mgl followedl byl al dosel ofl 0.6mgl
1l hourl later,l thereafterl 0.6mgl BIDl untill resolution)
-corticosteroidsl usefull forl contraindicationsl tol NSAIDs.l IVl orl POl orl intra-articularl
injection.l POl 40-60mgl prednisone/dayl x5-10l daysl orl atl fulll dosel 2-5l daysl thenl taperedl
overl 7-10l days.l Performl aspirationl andl sendl fluidl forl cxl whenl givingl intra-articular.
Interleukin-1l inhibitorsl (Anakinral andl canakinumab)l forl hospitalizedl pts.
Q:l Goutl managementl ofl acute,l subsequentl flare
, Answer:
-ifl takingl colchicinel 0.6mg/day,l takel acutel dosel ofl 1.2mgl followedl byl 0.6mgl 1l hourl
laterl thenl resumel dailyl dosingl thel nextl day
-NSAIDs,l colchicine,l orl corticosteroidsl +l allopurinoll orl febuxostat
Q:l Goutl managementl betweenl attacks
Answer:
-forl repeatedl attacksl (2l orl morel perl year)l orl CKDl 2l orl worsel orl tophaceousl deposits
-eliminatel high-purinel foodsl (organl meats,l highl fructosel cornl syrupl drinks)
-losel weight
-reducel alcohol
-eliminatel medsl (thiazidel &l loopl diuretics,l niacin,l ASA)
-increasel waterl intake
-colchicinel 0.6mgl daily
-allopurinoll andl febuxostatl (startl afterl colchicine)
-canakinumabl (alternativesl notl possible)
Q:l Osteoporosisl diagnosis
Answer:
Screenl forl secondaryl causes
-BUN
-Cr
-albumin
-seruml calcium
-phosphate
-alkalinel phosphatase
-25-hydroxyvitaminl D
-seruml PTHl ifl calciuml abnormal
-CBCl (butl usul normal)
-alsol thyroid,l hypogonadism,l celiac,l primaryl biliaryl cholangitisl ifl warranted
Q:l T-scores
