NR 546 FINAL EXAM - COMPLETE QUESTIONS AND DETAILED
SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: Which of the following information is essential before
prescribing Bactrim DS to a 24-year-old woman with a UTI?
A. Last menstrual period
B. Method of birth control
C. Last unprotected sexual contact
D. All of the above
Answer:
All of the above
Question 2: Certain patterns of pain, numbness, and tingling are
associated with carpal tunnel syndrome.
Answer:
Katz hand diagram
Question 3: Tinel sign
Answer:
Median nerve integrity
Tinel sign is tested by striking the patient's wrist with your index or middle finger
where the median nerve passes under the flexor retinaculum and volar carpal
ligament.
Question 4: A tingling sensation radiating from the wrist to the
hand in the distribution of the median nerve is a positive Tinel sign
and is suggestive of carpal tunnel syndrome. Median Nerve
,Integrity/ Carpal Tunnel testing
Answer:
Tinel sign, Phalen, Thumb abduction
Question 5: Thumb abduction
Answer:
Have the patient place the hand palm up and raise the thumb perpendicular to it.
Apply downward pressure on the thumb to test muscle strength.
Question 6: Full resistance to pressure is expected. Weakness is
associated with carpal tunnel syndrome. Phalen test
Answer:
To perform the Phalen test, ask the patient to hold both wrists in a fully palmar-flexed
position with the dorsal surfaces pressed together for 1 minute
Question 7: Numbness and paresthesia in the distribution of the
median nerve are suggestive of carpal tunnel syndrome. Hawkins
test
Answer:
Shoulder rotator cuff impingement of tear
Question 8: The Hawkins test is performed by abducting the
shoulder to 90 degrees, flexing the elbow to 90 degrees, and then
internally rotating the arm to its limit. Increased shoulder pain is
associated with rotator cuff inflammation or a tear Mcmurray test
Answer:
Torn meniscus in the knee
,Question 9: The mcmurray test is used to detect a torn medial or
lateral meniscus. Mcmurray test
Answer:
Have the patient lie supine and flex one knee. Position your thumb and fingers on
either side of the joint space. Hold the heel with your other hand, fully flexing the
knee, and rotate the foot and knee outward (VALGUS stress) to a lateral position.
Extend and then flex the patient's knee.
Any palpable or audible click, grinding, pain, or limited extension of the knee is a
positive sign of a torn medial meniscus.
Question 10: Valgus-varus stress test
Answer:
Medial or lateral collateral ligament instability in knee
Question 11: The varus (abduction) and valgus (adduction) Have
the patient lie supine and extend the knee. Stabilize the femur with
one hand and hold the ankle with your other hand. Apply varus
force against the ankle (toward the midline) and internal rotation.
Excessive laxity is felt as joint opening. Laxity in this position
indicates injury to the lateral collateral ligament. Then apply valgus
force against the ankle (away from the midline) and external
rotation. Laxity in this position indicates injury to the medial
collateral ligament. Repeat the movements with the patient's knee
flexed to 30 degrees. No excessive medial or lateral movement of
the knee is expected. Acute knee injury diagnostic
Answer:
Acute Knee Injury In cases of acute knee injury, the Ottawa Knee Rules identify the
characteristics of patients who should have a radiograph of the knee.
, Question 12: The rules include any of the following findings: •Age
older than 55 years •Tenderness at head of fibula •Isolated
tenderness of the patella •Inability to flex the knee to 90 degrees
Straight leg test
Answer:
L4, L5, S1 nerve root irritation
Question 13: Have the patient lie supine with the neck slightly
flexed. Ask the patient to raise the leg, keeping the knee extended.
No pain should be felt below the knee with leg raising. Radicular
pain below the knee may be associated with disk herniation.
Flexion of the knee often eliminates the pain with leg raising.
Repeat the procedure on the unaffected leg. Crossover pain in the
affected leg with this maneuver is more indicative of sciatic nerve
impingements. Femoral stretch/hip extension test
Answer:
L1, L2, L3, L4 nerve root irritation
Question 14: The femoral stretch test or hip extension test is used
to detect inflammation of the nerve root at the L1, L2, L3, and
sometimes L4 level. Have the patient lie prone and extend the hip.
No pain is expected. The presence of pain on extension is a
positive sign of nerve root irritation. Bulge sign
Answer:
Effusion in the knee
Question 15: With the patients knee extended, milk the medial
aspect of the knee upward two or three times, and then milk the
lateral side of the patella. Observe for a bulge of returning fluid to
the hollow area medial to the patella ROM for upper and lower
SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: Which of the following information is essential before
prescribing Bactrim DS to a 24-year-old woman with a UTI?
A. Last menstrual period
B. Method of birth control
C. Last unprotected sexual contact
D. All of the above
Answer:
All of the above
Question 2: Certain patterns of pain, numbness, and tingling are
associated with carpal tunnel syndrome.
Answer:
Katz hand diagram
Question 3: Tinel sign
Answer:
Median nerve integrity
Tinel sign is tested by striking the patient's wrist with your index or middle finger
where the median nerve passes under the flexor retinaculum and volar carpal
ligament.
Question 4: A tingling sensation radiating from the wrist to the
hand in the distribution of the median nerve is a positive Tinel sign
and is suggestive of carpal tunnel syndrome. Median Nerve
,Integrity/ Carpal Tunnel testing
Answer:
Tinel sign, Phalen, Thumb abduction
Question 5: Thumb abduction
Answer:
Have the patient place the hand palm up and raise the thumb perpendicular to it.
Apply downward pressure on the thumb to test muscle strength.
Question 6: Full resistance to pressure is expected. Weakness is
associated with carpal tunnel syndrome. Phalen test
Answer:
To perform the Phalen test, ask the patient to hold both wrists in a fully palmar-flexed
position with the dorsal surfaces pressed together for 1 minute
Question 7: Numbness and paresthesia in the distribution of the
median nerve are suggestive of carpal tunnel syndrome. Hawkins
test
Answer:
Shoulder rotator cuff impingement of tear
Question 8: The Hawkins test is performed by abducting the
shoulder to 90 degrees, flexing the elbow to 90 degrees, and then
internally rotating the arm to its limit. Increased shoulder pain is
associated with rotator cuff inflammation or a tear Mcmurray test
Answer:
Torn meniscus in the knee
,Question 9: The mcmurray test is used to detect a torn medial or
lateral meniscus. Mcmurray test
Answer:
Have the patient lie supine and flex one knee. Position your thumb and fingers on
either side of the joint space. Hold the heel with your other hand, fully flexing the
knee, and rotate the foot and knee outward (VALGUS stress) to a lateral position.
Extend and then flex the patient's knee.
Any palpable or audible click, grinding, pain, or limited extension of the knee is a
positive sign of a torn medial meniscus.
Question 10: Valgus-varus stress test
Answer:
Medial or lateral collateral ligament instability in knee
Question 11: The varus (abduction) and valgus (adduction) Have
the patient lie supine and extend the knee. Stabilize the femur with
one hand and hold the ankle with your other hand. Apply varus
force against the ankle (toward the midline) and internal rotation.
Excessive laxity is felt as joint opening. Laxity in this position
indicates injury to the lateral collateral ligament. Then apply valgus
force against the ankle (away from the midline) and external
rotation. Laxity in this position indicates injury to the medial
collateral ligament. Repeat the movements with the patient's knee
flexed to 30 degrees. No excessive medial or lateral movement of
the knee is expected. Acute knee injury diagnostic
Answer:
Acute Knee Injury In cases of acute knee injury, the Ottawa Knee Rules identify the
characteristics of patients who should have a radiograph of the knee.
, Question 12: The rules include any of the following findings: •Age
older than 55 years •Tenderness at head of fibula •Isolated
tenderness of the patella •Inability to flex the knee to 90 degrees
Straight leg test
Answer:
L4, L5, S1 nerve root irritation
Question 13: Have the patient lie supine with the neck slightly
flexed. Ask the patient to raise the leg, keeping the knee extended.
No pain should be felt below the knee with leg raising. Radicular
pain below the knee may be associated with disk herniation.
Flexion of the knee often eliminates the pain with leg raising.
Repeat the procedure on the unaffected leg. Crossover pain in the
affected leg with this maneuver is more indicative of sciatic nerve
impingements. Femoral stretch/hip extension test
Answer:
L1, L2, L3, L4 nerve root irritation
Question 14: The femoral stretch test or hip extension test is used
to detect inflammation of the nerve root at the L1, L2, L3, and
sometimes L4 level. Have the patient lie prone and extend the hip.
No pain is expected. The presence of pain on extension is a
positive sign of nerve root irritation. Bulge sign
Answer:
Effusion in the knee
Question 15: With the patients knee extended, milk the medial
aspect of the knee upward two or three times, and then milk the
lateral side of the patella. Observe for a bulge of returning fluid to
the hollow area medial to the patella ROM for upper and lower
