NURS 623 Exam 4 Review Questions with
Verified Correct Answers
Electromyography/nerve conduction velocity (EMG/NCV)
Carrie Sue is a 29-year-old female who presents for evaluation of wrist symptoms. She
reports that she often has an aching in her wrist that radiates to the bottom of her thumb. She
did not think much of it until she started waking up sometimes at night with pain and
numbness in her hand and fingers. Which of the following diagnostic tests would best support
the presumed diagnosis?
1.Electromyography/nerve conduction velocity (EMG/NCV)
2.Magnetic resonance imaging (MRI)
3.Radiograph
4.Sharp/dull discrimination testing
Muscle strain
Upon assessment, the nurse practitioner notes unilateral back pain of acute onset that
increases when standing and bending. A straight leg raise test is negative. What is the most
likely diagnosis?
1.Herniated nucleus pulposus
2.Muscle strain
3.Osteoarthritis
4.Spondylolisthesis
Scaphoid fracture
Margaret, age 55, presents to you for evaluation of left hand and wrist pain and swelling after
a slip and fall on the ice yesterday. On examination, you note tenderness at her "anatomical
snuffbox." You know this probably indicates which?
,1.Ulnar styloid fracture
2.Scaphoid fracture
3.Hamate fracture
4.Radial head fracture
It develops when loss of bone occurs more rapidly than new bone growth.
Lillian, age 70, was told that she has osteoporosis. When she asks you what this is, how do
you respond?
1.It develops when loss of bone occurs more rapidly than new bone growth.
2.It is a degenerative joint disease characterized by loss of cartilage in certain joints.
3.It is a chronic inflammatory disorder that affects multiple joints.
4.It is a bone disorder that has to do with inadequate mineralization of the bones.
Advancing the cane with the ipsilateral leg
When teaching patients about using a cane, tell them to advance the cane with the
ipsilateral (affected) leg.
When teaching Alice, age 77, to use a cane because of osteoarthritis of her left knee, which is
an important point to stress?
1.Carrying the cane in the ipsilateral hand
2.Advancing the cane with the ipsilateral leg
3.Making sure the cane length equals the height of the iliac crest
4.Using the cane to aid in joint protection and safety
Herniated nucleus pulposus
A plain x-ray will not show a herniated nucleus pulposus or a muscle strain. It will show
spondylolisthesis, scoliosis, osteoarthritis, and spinal stenosis. Note that x-rays of the
,spine are not indicated in low back pain unless the cause of the pain is thought to be
bony in origin or traumatic in nature or there is a need to rule out systemic disease.
Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within
normal limits. Which of the following diagnoses do you explore further?
1.Scoliosis
2.Osteoarthritis
3.Spinal stenosis
4.Herniated nucleus pulposus
Weakness to adduction
Marilyn is a 59-year-old female who has experienced neck pain off and on for several years.
She has never had an acute injury, but she has been evaluated for this and reports that she
really has been compliant with performing the neck exercises that have been prescribed. Her
symptoms have gradually progressed, and today upon physical examination the nurse
practitioner (NP) suspects spondylotic myelopathy when she finds all of the following on
physical examination except which?
1.Unsteady gait
2.Fine motor deficit
3.Diminished dexterity
4.Weakness to adduction
Hyponatremia
Painful contractions of muscles after exertion, such as heat cramps, may be related to
hyponatremia or other electrolyte imbalances. Usually, the gastrocnemius and
hamstring muscles are involved. Treatment of heat cramps includes passive muscle
, stretching, cessation of activities, transfer to a cooler environment, and drinking cool
liquids. Sports drinks that contain electrolytes, such as Gatorade, may be beneficial.
Greg, age 26, runs marathons and frequently complains of painful contractions of his calf
muscles after running. What do you attribute this to?
1.Hypercalcemia
2.Hyponatremia
3.Heat exhaustion
4.Dehydration
NSAIDs
You are caring for a patient who has a history of psoriasis and is now showing signs of joint
involvement. Seropositivity provides a definitive diagnosis of psoriatic arthritis (PsA). What
is the initial treatment choice for management of the patient?
1.Disease-modifying antirheumatic drugs (DMARDs)
2.NSAIDs
3.Tumor necrosis factor-alpha (TNF-a) inhibitors
4.Uricosuric medications
Musculoskeletal strain
June, age 67, presents with back pain with no precipitating event. The pain is located over her
lower back muscles and spine, without sciatica, and it is aggravated by sitting, standing, and
certain movements. It is alleviated with rest. Palpation localizes the pain, and muscle spasms
are felt. There was an insidious onset with progressive improvement. What is the most likely
diagnosis?
1.Ankylosing spondylitis
2.Musculoskeletal strain
Verified Correct Answers
Electromyography/nerve conduction velocity (EMG/NCV)
Carrie Sue is a 29-year-old female who presents for evaluation of wrist symptoms. She
reports that she often has an aching in her wrist that radiates to the bottom of her thumb. She
did not think much of it until she started waking up sometimes at night with pain and
numbness in her hand and fingers. Which of the following diagnostic tests would best support
the presumed diagnosis?
1.Electromyography/nerve conduction velocity (EMG/NCV)
2.Magnetic resonance imaging (MRI)
3.Radiograph
4.Sharp/dull discrimination testing
Muscle strain
Upon assessment, the nurse practitioner notes unilateral back pain of acute onset that
increases when standing and bending. A straight leg raise test is negative. What is the most
likely diagnosis?
1.Herniated nucleus pulposus
2.Muscle strain
3.Osteoarthritis
4.Spondylolisthesis
Scaphoid fracture
Margaret, age 55, presents to you for evaluation of left hand and wrist pain and swelling after
a slip and fall on the ice yesterday. On examination, you note tenderness at her "anatomical
snuffbox." You know this probably indicates which?
,1.Ulnar styloid fracture
2.Scaphoid fracture
3.Hamate fracture
4.Radial head fracture
It develops when loss of bone occurs more rapidly than new bone growth.
Lillian, age 70, was told that she has osteoporosis. When she asks you what this is, how do
you respond?
1.It develops when loss of bone occurs more rapidly than new bone growth.
2.It is a degenerative joint disease characterized by loss of cartilage in certain joints.
3.It is a chronic inflammatory disorder that affects multiple joints.
4.It is a bone disorder that has to do with inadequate mineralization of the bones.
Advancing the cane with the ipsilateral leg
When teaching patients about using a cane, tell them to advance the cane with the
ipsilateral (affected) leg.
When teaching Alice, age 77, to use a cane because of osteoarthritis of her left knee, which is
an important point to stress?
1.Carrying the cane in the ipsilateral hand
2.Advancing the cane with the ipsilateral leg
3.Making sure the cane length equals the height of the iliac crest
4.Using the cane to aid in joint protection and safety
Herniated nucleus pulposus
A plain x-ray will not show a herniated nucleus pulposus or a muscle strain. It will show
spondylolisthesis, scoliosis, osteoarthritis, and spinal stenosis. Note that x-rays of the
,spine are not indicated in low back pain unless the cause of the pain is thought to be
bony in origin or traumatic in nature or there is a need to rule out systemic disease.
Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within
normal limits. Which of the following diagnoses do you explore further?
1.Scoliosis
2.Osteoarthritis
3.Spinal stenosis
4.Herniated nucleus pulposus
Weakness to adduction
Marilyn is a 59-year-old female who has experienced neck pain off and on for several years.
She has never had an acute injury, but she has been evaluated for this and reports that she
really has been compliant with performing the neck exercises that have been prescribed. Her
symptoms have gradually progressed, and today upon physical examination the nurse
practitioner (NP) suspects spondylotic myelopathy when she finds all of the following on
physical examination except which?
1.Unsteady gait
2.Fine motor deficit
3.Diminished dexterity
4.Weakness to adduction
Hyponatremia
Painful contractions of muscles after exertion, such as heat cramps, may be related to
hyponatremia or other electrolyte imbalances. Usually, the gastrocnemius and
hamstring muscles are involved. Treatment of heat cramps includes passive muscle
, stretching, cessation of activities, transfer to a cooler environment, and drinking cool
liquids. Sports drinks that contain electrolytes, such as Gatorade, may be beneficial.
Greg, age 26, runs marathons and frequently complains of painful contractions of his calf
muscles after running. What do you attribute this to?
1.Hypercalcemia
2.Hyponatremia
3.Heat exhaustion
4.Dehydration
NSAIDs
You are caring for a patient who has a history of psoriasis and is now showing signs of joint
involvement. Seropositivity provides a definitive diagnosis of psoriatic arthritis (PsA). What
is the initial treatment choice for management of the patient?
1.Disease-modifying antirheumatic drugs (DMARDs)
2.NSAIDs
3.Tumor necrosis factor-alpha (TNF-a) inhibitors
4.Uricosuric medications
Musculoskeletal strain
June, age 67, presents with back pain with no precipitating event. The pain is located over her
lower back muscles and spine, without sciatica, and it is aggravated by sitting, standing, and
certain movements. It is alleviated with rest. Palpation localizes the pain, and muscle spasms
are felt. There was an insidious onset with progressive improvement. What is the most likely
diagnosis?
1.Ankylosing spondylitis
2.Musculoskeletal strain
