NR 511 Final Exam / NR511 Final Exam (100 Q
& A)(2024-2025)A+ Graded: Differential
Diagnosis and Primary Care Practicum
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
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check
for distal pulses
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.
,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
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
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."
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
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.
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 for the presence of a meniscal tear?
McMurray circumduction test
The clinician suspects that a client has a patellar instability. In order to test for this, the
client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the
patella is displaced laterally, and the knee flexed to 30 degrees. If instability is present,
this maneuver displaces the patella to an abnormal position on the lateral femoral
condyle, and the client will perceive pain. Testing for patellar instability in this way is
known as:
Apprehension sign
The clinician is caring for Diane, a 22yo woman who presents with an injured ankle. Diane
asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is
not always necessary for an injured ankle and that the decision to obtain radiographs is
dependent on the examination and Diane's description of her injury. Which of the
following clues in Diane's exam or history would alert the clinician to the need for
obtaining radiographs?
a. Inability to bear weight immediately after the injury
b. Development of marked ankle swelling and discoloration after the injury
c. Crepitation with palpation or movement of the ankle
d. All of the above
d. All of the above
Mr. Jackson is a 65yo man recently diagnosed with osteoarthritis. The clinician has
explained to Mr. Jackson that the goals for managing osteoarthritis include controlling
pain, maximizing functional independence and mobility, minimizing disability, and
preserving quality of life. Mr. Jackson explains to the clinician that his first choice would
be to use complementary therapies to control his condition and asks what therapies are
most effective in treating osteoarthritis. What would be the appropriate response from
& A)(2024-2025)A+ Graded: Differential
Diagnosis and Primary Care Practicum
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
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check
for distal pulses
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.
,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
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
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."
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
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.
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 for the presence of a meniscal tear?
McMurray circumduction test
The clinician suspects that a client has a patellar instability. In order to test for this, the
client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the
patella is displaced laterally, and the knee flexed to 30 degrees. If instability is present,
this maneuver displaces the patella to an abnormal position on the lateral femoral
condyle, and the client will perceive pain. Testing for patellar instability in this way is
known as:
Apprehension sign
The clinician is caring for Diane, a 22yo woman who presents with an injured ankle. Diane
asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is
not always necessary for an injured ankle and that the decision to obtain radiographs is
dependent on the examination and Diane's description of her injury. Which of the
following clues in Diane's exam or history would alert the clinician to the need for
obtaining radiographs?
a. Inability to bear weight immediately after the injury
b. Development of marked ankle swelling and discoloration after the injury
c. Crepitation with palpation or movement of the ankle
d. All of the above
d. All of the above
Mr. Jackson is a 65yo man recently diagnosed with osteoarthritis. The clinician has
explained to Mr. Jackson that the goals for managing osteoarthritis include controlling
pain, maximizing functional independence and mobility, minimizing disability, and
preserving quality of life. Mr. Jackson explains to the clinician that his first choice would
be to use complementary therapies to control his condition and asks what therapies are
most effective in treating osteoarthritis. What would be the appropriate response from
