Nursing5336 FNP Final Exam 2024
The following statements about the pathophysiology of OA are all true except: - OA
affects only bone and cartilage
WHich statement or statements about OA is (are) not true? - A) Although excessive
weight may contribute to the development of OA, weight loss has NOT been shown
to lead to improvement in symptoms or functionality.
C) Strength training has not been shown to be helpful for patients with OA and is
likely to exacerbate symptoms.
Which statement about OA is not true? - Patients with OA of the lower extremities
should avoid tai chi as it has been shown to exacerbate lower extremity OA.
New International Recommendations for diagnosis of myofascial pain syndrome from
include: - All of the above
Which of the following statements are true regarding needle based interventions for
myofascial pain syndrome? - B & C
B) Dry and wet needling appear to have similar benefits in the short term.
C) Wet needling appears to have improved benefit in the medium-term vs dry
needling, although the long-term significance of this are unknown.
Which of the following statements are true regarding physical therapy interventions
for myofascial pain syndrome? - There is good evidence that the best outcomes are
derived from the combination of individualized clinic therapies supported by active
self-management techniques (exercise, stretching, relaxation).
A 44-year-old male patient presents to your clinic for evaluation of persistent low
back pain symptoms. He would like to discuss getting a magnetic resonance imaging
scan and explore his treatment options. He has a prior history of intermittent low
back pain with flares approximately twice per year for 10 years, but has had
persistent daily symptoms for the past 6 months. He reports bilateral paraspinal pain
that does not radiate past the buttocks. He has tried nonsteroidal antiinflammatory
drugs, which provided some relief, but caused stomach discomfort, and he has
completed a course of physical therapy without significant improvement. In your
discussion of treatment options, all are reasonable approaches to include, except: -
Epidural steroid injection
Your patient asks your opinion on mind-body techniques to help with pain
management. Which of the following statements is consistent with current evidence?
- Behavioral therapies as a whole have shown improvements in functional status in
patients with low back pain.
Which of the follow statements about acupuncture are incorrect? - The American
College of Physicians (ACP) low back pain guidelines list acupuncture as a primary
treatment option for acute low back pain.
,Out of the following listed choices, which one has the strongest association with
chronic pain? - Physiological factors
Which of the following statements is correct regarding acupuncture treatments for
neck pain? - Overall, there is moderate evidence in favor of acupuncture for
treatment of chronic neck pain
when compared to sham acupuncture
Which of the following is true regarding the evidence base for hands-on approach to
the treatment of chronic neck pain? - A multimodal, team-based approach that
utilizes several modalities, including hands-on body work, often results in the most
effective long-term pain relief.
When managing chronic gouty arthritis, titrate urate-lowering therapies to achieve
serum uric acid levels less than: - 6
Lifestyle recommendations for gout should include all of the following except: -
Avoidance of all purine-rich foods
Appropriate pharmacological treatments of acute gouty flairs include (choose all
correct): - a. Indomethacin
b. Naproxen
d. Prednisone
f. Colchicine (low dose)
A 43-year-old female working in janitorial services presents with pain and weakness
in her right hand. She admits that symptoms have worsened over the past couple of
years and now remain almost constant and have affected her ability to grip a mop
and squeeze a spray bottle. She frequently awakens at night and has to "shake out"
the pain and numbness she is experiencing. On physical exam there is decreased
sensation to pinprick over the first through third phalanges and you note the right
thenar eminence is much less robust than the left. Based of the condition in this
patient? - Refer patient for electrodiagnostic studies and to visit a hand surgeon.
A 29-year-old female at the end of her second trimester is experiencing increasing
discomfort of both hands. She states that pain and numbness are most noticeable
while performing daily
tasks around the house and washing dishes. After a thorough history and physical
the most likely etiology is determined to be carpal tunnel syndrome (CTS). Which of
the following management
options would not be recommended for this patient - Obtaining electrodiagnostic
studies to evaluate the need for surgery.
After determining a management plan, the patient wonders if there is anything aside
from medications that she could take to help with her pain relief. Of note she also
mentions she has had occasional nausea throughout her pregnancy. Which of the
following would be an
appropriate option for this patient? - Suggest daily dosing of ginger capsules.
, The underlying progression of pathology of lateral and medial epicondylosis is
currently viewed as: - Acutely inflammatory and chronically degenerative
Which of the following needle or injection-based therapies have for epicondylosis
shown positive outcomes in randomized controlled trials? Select all that apply. - a.
Acupuncture
b. Platelet rich plasma
c. Prolotherapy
d. ********All of the above *******
Current "best evidence" favors corticosteroid injections as standard of care for most
cases of lateral and medical epicondylosis. - False
1. When counseling a patient about the long-term effects of fibromyalgia syndrome,
what is important to include in teaching? - A multidisciplinary approach to treatment
is most effective.
1. Which are symptoms associated with fibromyalgia?
Select all that apply. - Gastrointestinal complaints
Musculoskeletal pain
Non-restorative sleep
1. Which cause is implicated in patients with fibromyalgia syndrome (FMS)? - Central
nervous system dysfunction
1. A patient with gout and impaired renal function who uses urate-lowering therapy
(ULT) is experiencing an acute gout flare involving one joint. What is the
recommended treatment? - Administration of intra-articular corticosteroid
1. A patient experiences a second gouty flare and the provider decides to begin
urate-lowering therapy (ULT). How should this be prescribed? - Start ULT in 5 weeks
along with an anti-inflammatory drug
1. A post-menopausal female patient has a blood test that reveals hyperuricemia,
although the patient has no symptoms of gout. What will the provider do? - Ask the
patient about medications and medical history
1. A patient with chronic hip pain cannot take NSAIDs and tells the provider that
acetaminophen is minimally helpful. What might the provider recommend initially to
improve pain relief? - Capsaicin
1. An adult patient who has been taking high-dose corticosteroids reports a dull,
aching pain in the groin and presents with a limp. What condition does the provider
suspect, based on this history? - Avascular necrosis of the femoral head
1. A patient reports the sudden onset of pain, redness, and swelling in one knee joint
along with a no fever. The provider elicits exquisite pain with manipulation of the joint
and notes no decrease in pain when the joint is at rest. Which is the likely cause of
this arthritis? - Bacterial infection
The following statements about the pathophysiology of OA are all true except: - OA
affects only bone and cartilage
WHich statement or statements about OA is (are) not true? - A) Although excessive
weight may contribute to the development of OA, weight loss has NOT been shown
to lead to improvement in symptoms or functionality.
C) Strength training has not been shown to be helpful for patients with OA and is
likely to exacerbate symptoms.
Which statement about OA is not true? - Patients with OA of the lower extremities
should avoid tai chi as it has been shown to exacerbate lower extremity OA.
New International Recommendations for diagnosis of myofascial pain syndrome from
include: - All of the above
Which of the following statements are true regarding needle based interventions for
myofascial pain syndrome? - B & C
B) Dry and wet needling appear to have similar benefits in the short term.
C) Wet needling appears to have improved benefit in the medium-term vs dry
needling, although the long-term significance of this are unknown.
Which of the following statements are true regarding physical therapy interventions
for myofascial pain syndrome? - There is good evidence that the best outcomes are
derived from the combination of individualized clinic therapies supported by active
self-management techniques (exercise, stretching, relaxation).
A 44-year-old male patient presents to your clinic for evaluation of persistent low
back pain symptoms. He would like to discuss getting a magnetic resonance imaging
scan and explore his treatment options. He has a prior history of intermittent low
back pain with flares approximately twice per year for 10 years, but has had
persistent daily symptoms for the past 6 months. He reports bilateral paraspinal pain
that does not radiate past the buttocks. He has tried nonsteroidal antiinflammatory
drugs, which provided some relief, but caused stomach discomfort, and he has
completed a course of physical therapy without significant improvement. In your
discussion of treatment options, all are reasonable approaches to include, except: -
Epidural steroid injection
Your patient asks your opinion on mind-body techniques to help with pain
management. Which of the following statements is consistent with current evidence?
- Behavioral therapies as a whole have shown improvements in functional status in
patients with low back pain.
Which of the follow statements about acupuncture are incorrect? - The American
College of Physicians (ACP) low back pain guidelines list acupuncture as a primary
treatment option for acute low back pain.
,Out of the following listed choices, which one has the strongest association with
chronic pain? - Physiological factors
Which of the following statements is correct regarding acupuncture treatments for
neck pain? - Overall, there is moderate evidence in favor of acupuncture for
treatment of chronic neck pain
when compared to sham acupuncture
Which of the following is true regarding the evidence base for hands-on approach to
the treatment of chronic neck pain? - A multimodal, team-based approach that
utilizes several modalities, including hands-on body work, often results in the most
effective long-term pain relief.
When managing chronic gouty arthritis, titrate urate-lowering therapies to achieve
serum uric acid levels less than: - 6
Lifestyle recommendations for gout should include all of the following except: -
Avoidance of all purine-rich foods
Appropriate pharmacological treatments of acute gouty flairs include (choose all
correct): - a. Indomethacin
b. Naproxen
d. Prednisone
f. Colchicine (low dose)
A 43-year-old female working in janitorial services presents with pain and weakness
in her right hand. She admits that symptoms have worsened over the past couple of
years and now remain almost constant and have affected her ability to grip a mop
and squeeze a spray bottle. She frequently awakens at night and has to "shake out"
the pain and numbness she is experiencing. On physical exam there is decreased
sensation to pinprick over the first through third phalanges and you note the right
thenar eminence is much less robust than the left. Based of the condition in this
patient? - Refer patient for electrodiagnostic studies and to visit a hand surgeon.
A 29-year-old female at the end of her second trimester is experiencing increasing
discomfort of both hands. She states that pain and numbness are most noticeable
while performing daily
tasks around the house and washing dishes. After a thorough history and physical
the most likely etiology is determined to be carpal tunnel syndrome (CTS). Which of
the following management
options would not be recommended for this patient - Obtaining electrodiagnostic
studies to evaluate the need for surgery.
After determining a management plan, the patient wonders if there is anything aside
from medications that she could take to help with her pain relief. Of note she also
mentions she has had occasional nausea throughout her pregnancy. Which of the
following would be an
appropriate option for this patient? - Suggest daily dosing of ginger capsules.
, The underlying progression of pathology of lateral and medial epicondylosis is
currently viewed as: - Acutely inflammatory and chronically degenerative
Which of the following needle or injection-based therapies have for epicondylosis
shown positive outcomes in randomized controlled trials? Select all that apply. - a.
Acupuncture
b. Platelet rich plasma
c. Prolotherapy
d. ********All of the above *******
Current "best evidence" favors corticosteroid injections as standard of care for most
cases of lateral and medical epicondylosis. - False
1. When counseling a patient about the long-term effects of fibromyalgia syndrome,
what is important to include in teaching? - A multidisciplinary approach to treatment
is most effective.
1. Which are symptoms associated with fibromyalgia?
Select all that apply. - Gastrointestinal complaints
Musculoskeletal pain
Non-restorative sleep
1. Which cause is implicated in patients with fibromyalgia syndrome (FMS)? - Central
nervous system dysfunction
1. A patient with gout and impaired renal function who uses urate-lowering therapy
(ULT) is experiencing an acute gout flare involving one joint. What is the
recommended treatment? - Administration of intra-articular corticosteroid
1. A patient experiences a second gouty flare and the provider decides to begin
urate-lowering therapy (ULT). How should this be prescribed? - Start ULT in 5 weeks
along with an anti-inflammatory drug
1. A post-menopausal female patient has a blood test that reveals hyperuricemia,
although the patient has no symptoms of gout. What will the provider do? - Ask the
patient about medications and medical history
1. A patient with chronic hip pain cannot take NSAIDs and tells the provider that
acetaminophen is minimally helpful. What might the provider recommend initially to
improve pain relief? - Capsaicin
1. An adult patient who has been taking high-dose corticosteroids reports a dull,
aching pain in the groin and presents with a limp. What condition does the provider
suspect, based on this history? - Avascular necrosis of the femoral head
1. A patient reports the sudden onset of pain, redness, and swelling in one knee joint
along with a no fever. The provider elicits exquisite pain with manipulation of the joint
and notes no decrease in pain when the joint is at rest. Which is the likely cause of
this arthritis? - Bacterial infection
