Dunphy Musculoskeletal Exam Questions with Correct Answers 1. One of the initial steps in assessing patients with 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-a. Bone
2. You have detected the presence of crepitus on examination of a patient with a musculoskeletal
complaint. Additionally, there is limited range of motion (ROM) with both active and passive
movement. These findings suggest that the origin of the musculoskeletal complaint is:
a. Articular
b. Inflammatory
c. Nonarticular
d. A and B - Answer-a. Articular
3. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal
pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain - Answer-c. Morning stiffness
4. Which of the following statements concerning the musculoskeletal examination 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 patient pain should be examined first.
c. When possible, the patient should not be asked to perform active range-of-motion
(ROM) exercises to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause
further injury to the patient. - Answer-a. The uninvolved side should be examined initially
and then compared to the
involved side. 5. You are performing muscle strength testing on a patient presenting with musculoskeletal pain and
find that the patient has complete ROM with gravity eliminated. Which numeric grade of muscle
strength would you give this patient?
a. 1
b. 2
c. 3
d. 4
e. 5 - Answer-b. 2
Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her
right shoulder. She denies any history of trauma. Her examination 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 history is significant for type 1 diabetes
mellitus and hypertension. Her social history reveals that she is a secretary and that she
is right-
handed. Based on her examination and medical history, you suspect adhesive capsulitis, or "frozen
shoulder." Which clue in Mrs. Gray's history supports this diagnosis?
a. History of hypertension
b. Her affected shoulder is also her dominant arm.
c. Her history of diabetes mellitus
d. Her work as a secretary predisposes her to repetitive motions. - Answer-c. Her history of diabetes mellitus
7. Jennifer is an 18-year-old who comes to the emergency room 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.
8. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel
syndrome. She has two 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 with 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.
9. 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
10. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of 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 11. The clinician has instructed Sam, a 25-year-old patient 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 gastrointestinal (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 gastrointestinal (GI) disorders such
as ulcers and hemorrhage."
12. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1.
She is currently in the emergency room 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
13. 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 3-month period is an indication for surgical
intervention.
d. All of the above - Answer-c. Intolerable pain for more than a 3-month period is an indication for surgical
intervention.
14. John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football
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-a. Bone
2. You have detected the presence of crepitus on examination of a patient with a musculoskeletal
complaint. Additionally, there is limited range of motion (ROM) with both active and passive
movement. These findings suggest that the origin of the musculoskeletal complaint is:
a. Articular
b. Inflammatory
c. Nonarticular
d. A and B - Answer-a. Articular
3. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal
pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain - Answer-c. Morning stiffness
4. Which of the following statements concerning the musculoskeletal examination 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 patient pain should be examined first.
c. When possible, the patient should not be asked to perform active range-of-motion
(ROM) exercises to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause
further injury to the patient. - Answer-a. The uninvolved side should be examined initially
and then compared to the
involved side. 5. You are performing muscle strength testing on a patient presenting with musculoskeletal pain and
find that the patient has complete ROM with gravity eliminated. Which numeric grade of muscle
strength would you give this patient?
a. 1
b. 2
c. 3
d. 4
e. 5 - Answer-b. 2
Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her
right shoulder. She denies any history of trauma. Her examination 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 history is significant for type 1 diabetes
mellitus and hypertension. Her social history reveals that she is a secretary and that she
is right-
handed. Based on her examination and medical history, you suspect adhesive capsulitis, or "frozen
shoulder." Which clue in Mrs. Gray's history supports this diagnosis?
a. History of hypertension
b. Her affected shoulder is also her dominant arm.
c. Her history of diabetes mellitus
d. Her work as a secretary predisposes her to repetitive motions. - Answer-c. Her history of diabetes mellitus
7. Jennifer is an 18-year-old who comes to the emergency room 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.
8. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel
syndrome. She has two 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 with 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.
9. 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
10. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of 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 11. The clinician has instructed Sam, a 25-year-old patient 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 gastrointestinal (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 gastrointestinal (GI) disorders such
as ulcers and hemorrhage."
12. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1.
She is currently in the emergency room 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
13. 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 3-month period is an indication for surgical
intervention.
d. All of the above - Answer-c. Intolerable pain for more than a 3-month period is an indication for surgical
intervention.
14. John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football
