Final Exam: NR511 / NR 511 (Latest Update
) Differential Diagnosis &
Primary Care Practicum | Exam Review
Questions & Answers| 100% Correct | Grade
A - Chamberlain
Question 1. A 13-year-old obese (body mass index [BMI] above the 95th
percentile) boy reports low-grade left knee pain for the past 2 months. He denies
antecedent trauma but admits to frequent "horseplay" with his friends. The pain has
progressively worsened, and he is now unable to bear weight at all on his left leg.
His current complaints include left groin, thigh, and medial knee pain and
tenderness. His examination demonstrates negative drawer, Lachman, and
McMurray tests; left hip with decreased internal rotation and abduction; and
external hip rotation with knee flexion. Based on the above scenario, the nurse
practitioner should suspect:
1. A left meniscal tear.
2. A left anterior cruciate ligament (ACL) tear.
3. A slipped capital femoral epiphysis (SCFE).
4. Osgood-Schlatter disease. - ANSWER 3. A slipped capital femoral
epiphysis (SCFE).
Question 2. In assessing the skeletal muscles, the nurse practitioner turns the
patient's forearm so that the palm is up. This is called:
1. Supination.
2. Pronation.
3. Abduction.
4. Eversion. - ANSWER 1. Supination
,Question 3. Cass, age 67, tells the nurse practitioner (NP) that she has been
diagnosed with a condition that causes sudden flares of pain, swelling, and redness
of the joints in her toes. She cannot remember the name of the diagnosis, but she
knows it is caused by urate crystals that "get stuck in the joint and cause pain." She
is on hydrochlorothiazide (HCTZ) for management of her hypertension. The NP
should suspect a diagnosis of:
1. Septic arthritis.
2. Gout.
3. Rheumatoid arthritis.
4. Charcot neuro-osteoarthropathy. - ANSWER 2. Gout
Question 4. Matthew, age 52, is a chef who just severed 2 of his fingers with a
meat cutter. You would recommend that he:
1. Wrap the severed fingers tightly in a dry towel for transport to the emergency
department with him.
2. Leave the severed fingers at the scene because fingers cannot be reattached.
3. Immediately freeze the severed fingers for reattachment in the near future.
4. Wrap the fingers in a clean, damp cloth; seal them in a plastic bag; and place the
bag in an ice water bath. - ANSWER 4. Wrap the fingers in a clean, damp
cloth; seal them in a plastic bag; and place the bag in an ice water bath.
Question 5. Marsha, age 34, presents with symptoms resembling both fibromyalgia
and chronic fatigue syndrome, which have many similarities. Which of the
following is more characteristic of fibromyalgia than of chronic fatigue syndrome?
1. Musculoskeletal pain.
2. Difficulty sleeping.
3. Depression.
4. Fatigue. - ANSWER 1. Musculoskeletal pain
Question 6. Mrs. Kelly, age 80, has a curvature of the spine. This is likely to
indicate which age-related change?
,1. Lordosis.
2. Dorsal kyphosis.
3. Scoliosis.
4. Kyphoscoliosis. - ANSWER 2. Dorsal Kyphosis
Question 7. The valgus stress test, varus stress test, Lachman test, and thumb sign
are all considered standard tests to check the integrity of the ligaments of the knee.
Which test would the nurse practitioner choose to assess the anterior cruciate
ligament (ACL), which is the most commonly involved structure in severe knee
injury?
1. Valgus stress test.
2. Varus stress test.
3. Lachman test.
4. Thumb sign. - ANSWER 3. Lachman test
Question 8. Lillian, age 70, was told that she has osteoporosis. When she asks you
what this is, you respond that osteoporosis:
1. Develops when loss of bone occurs more rapidly than new bone growth.
2. Is a degenerative joint disease characterized by loss of cartilage in certain joints.
3. Is a chronic inflammatory disorder that affects multiple joints.
4. Is a bone disorder that has to do with inadequate mineralization of the bones. -
ANSWER 1. Develops when loss of bone occurs more rapidly than new bone
growth.
Question 9. Mike, age 42, a golf pro, has had chronic back pain for many years.
His workup reveals that it is not the result of a degenerative disk problem. His back
"goes out" about twice per year, and he is out of work for about a week each time.
Which of the following should the nurse practitioner advise him to do?
1. Consider changing careers to something less physical.
2. Begin a planned exercise program to strengthen back muscles.
3. Make an appointment with a neurosurgeon for a surgical consultation.
4. Start on a daily low-dose narcotic to take away the pain. - ANSWER 2.
Begin a planned exercise program to strengthen back muscles.
, Question 10. Janine, age 69, has class III rheumatoid arthritis. According to the
American Rheumatism Association, which of the following describes her ability to
function?
1. Adequate for normal activities despite a handicap of discomfort or limited
motion of one or more joints.
2. Largely or wholly incapacitated, bedridden, or confined to a wheelchair,
permitting little or no self-care.
3. Completely able to carry out all usual duties without handicap.
4. Adequate to perform only a few or none of the duties of usual occupation or
self-care. - ANSWER 4. Adequate to perform only a few or none of the duties
of usual occupation or self-care.
Question 11. Mickey, age 18, is on a chemotherapeutic antibiotic for a
musculoskeletal neoplasm. Which drug do you think he is taking?
1. Cyclophosphamide (Cytoxan).
2. Doxorubicin (Adriamycin).
3. Methotrexate (Rheumatrex).
4. Cisplatin (Platinol). - ANSWER 2. Doxorubicin (Adriamycin)
Question 12. 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. The most likely diagnosis is:
1. Herniated nucleus pulposus.
2. Muscle strain.
3. Osteoarthritis.
4. Spondylolisthesis. - ANSWER 2. Muscle strain
Question 13. A 55-year-old patient presents with complaints of paresthesias in the
lower lateral arm, thumb, and middle finger. The nerve roots most commonly
related to these symptoms are C6 and C7. The most likely diagnosis would be:
1. Brachial plexus neuritis.
2. Cervical radiculopathy.
) Differential Diagnosis &
Primary Care Practicum | Exam Review
Questions & Answers| 100% Correct | Grade
A - Chamberlain
Question 1. A 13-year-old obese (body mass index [BMI] above the 95th
percentile) boy reports low-grade left knee pain for the past 2 months. He denies
antecedent trauma but admits to frequent "horseplay" with his friends. The pain has
progressively worsened, and he is now unable to bear weight at all on his left leg.
His current complaints include left groin, thigh, and medial knee pain and
tenderness. His examination demonstrates negative drawer, Lachman, and
McMurray tests; left hip with decreased internal rotation and abduction; and
external hip rotation with knee flexion. Based on the above scenario, the nurse
practitioner should suspect:
1. A left meniscal tear.
2. A left anterior cruciate ligament (ACL) tear.
3. A slipped capital femoral epiphysis (SCFE).
4. Osgood-Schlatter disease. - ANSWER 3. A slipped capital femoral
epiphysis (SCFE).
Question 2. In assessing the skeletal muscles, the nurse practitioner turns the
patient's forearm so that the palm is up. This is called:
1. Supination.
2. Pronation.
3. Abduction.
4. Eversion. - ANSWER 1. Supination
,Question 3. Cass, age 67, tells the nurse practitioner (NP) that she has been
diagnosed with a condition that causes sudden flares of pain, swelling, and redness
of the joints in her toes. She cannot remember the name of the diagnosis, but she
knows it is caused by urate crystals that "get stuck in the joint and cause pain." She
is on hydrochlorothiazide (HCTZ) for management of her hypertension. The NP
should suspect a diagnosis of:
1. Septic arthritis.
2. Gout.
3. Rheumatoid arthritis.
4. Charcot neuro-osteoarthropathy. - ANSWER 2. Gout
Question 4. Matthew, age 52, is a chef who just severed 2 of his fingers with a
meat cutter. You would recommend that he:
1. Wrap the severed fingers tightly in a dry towel for transport to the emergency
department with him.
2. Leave the severed fingers at the scene because fingers cannot be reattached.
3. Immediately freeze the severed fingers for reattachment in the near future.
4. Wrap the fingers in a clean, damp cloth; seal them in a plastic bag; and place the
bag in an ice water bath. - ANSWER 4. Wrap the fingers in a clean, damp
cloth; seal them in a plastic bag; and place the bag in an ice water bath.
Question 5. Marsha, age 34, presents with symptoms resembling both fibromyalgia
and chronic fatigue syndrome, which have many similarities. Which of the
following is more characteristic of fibromyalgia than of chronic fatigue syndrome?
1. Musculoskeletal pain.
2. Difficulty sleeping.
3. Depression.
4. Fatigue. - ANSWER 1. Musculoskeletal pain
Question 6. Mrs. Kelly, age 80, has a curvature of the spine. This is likely to
indicate which age-related change?
,1. Lordosis.
2. Dorsal kyphosis.
3. Scoliosis.
4. Kyphoscoliosis. - ANSWER 2. Dorsal Kyphosis
Question 7. The valgus stress test, varus stress test, Lachman test, and thumb sign
are all considered standard tests to check the integrity of the ligaments of the knee.
Which test would the nurse practitioner choose to assess the anterior cruciate
ligament (ACL), which is the most commonly involved structure in severe knee
injury?
1. Valgus stress test.
2. Varus stress test.
3. Lachman test.
4. Thumb sign. - ANSWER 3. Lachman test
Question 8. Lillian, age 70, was told that she has osteoporosis. When she asks you
what this is, you respond that osteoporosis:
1. Develops when loss of bone occurs more rapidly than new bone growth.
2. Is a degenerative joint disease characterized by loss of cartilage in certain joints.
3. Is a chronic inflammatory disorder that affects multiple joints.
4. Is a bone disorder that has to do with inadequate mineralization of the bones. -
ANSWER 1. Develops when loss of bone occurs more rapidly than new bone
growth.
Question 9. Mike, age 42, a golf pro, has had chronic back pain for many years.
His workup reveals that it is not the result of a degenerative disk problem. His back
"goes out" about twice per year, and he is out of work for about a week each time.
Which of the following should the nurse practitioner advise him to do?
1. Consider changing careers to something less physical.
2. Begin a planned exercise program to strengthen back muscles.
3. Make an appointment with a neurosurgeon for a surgical consultation.
4. Start on a daily low-dose narcotic to take away the pain. - ANSWER 2.
Begin a planned exercise program to strengthen back muscles.
, Question 10. Janine, age 69, has class III rheumatoid arthritis. According to the
American Rheumatism Association, which of the following describes her ability to
function?
1. Adequate for normal activities despite a handicap of discomfort or limited
motion of one or more joints.
2. Largely or wholly incapacitated, bedridden, or confined to a wheelchair,
permitting little or no self-care.
3. Completely able to carry out all usual duties without handicap.
4. Adequate to perform only a few or none of the duties of usual occupation or
self-care. - ANSWER 4. Adequate to perform only a few or none of the duties
of usual occupation or self-care.
Question 11. Mickey, age 18, is on a chemotherapeutic antibiotic for a
musculoskeletal neoplasm. Which drug do you think he is taking?
1. Cyclophosphamide (Cytoxan).
2. Doxorubicin (Adriamycin).
3. Methotrexate (Rheumatrex).
4. Cisplatin (Platinol). - ANSWER 2. Doxorubicin (Adriamycin)
Question 12. 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. The most likely diagnosis is:
1. Herniated nucleus pulposus.
2. Muscle strain.
3. Osteoarthritis.
4. Spondylolisthesis. - ANSWER 2. Muscle strain
Question 13. A 55-year-old patient presents with complaints of paresthesias in the
lower lateral arm, thumb, and middle finger. The nerve roots most commonly
related to these symptoms are C6 and C7. The most likely diagnosis would be:
1. Brachial plexus neuritis.
2. Cervical radiculopathy.
