Graded A+
Mickey, age 18, is on a chemotherapeutic diagnosis is 12 years for females and 13.5 years
antibiotic for a musculoskeletal neoplasm. Which for males. Surgery is often required via in situ pin
drug do you think he is taking? fixation (single screw) to stabilize the growth
plate to prevent further slippage and avoid
1.Cyclophosphamide (Cytoxan). complications.
2.Doxorubicin (Adriamycin).
3.Methotrexate (Rheumatrex).
4.Cisplatin (Platinol). - ANSWER - The valgus stress test, varus stress test,
Doxorubicin (Adriamycin). Lachman test, and thumb sign are all considered
standard tests to check the integrity of the
rationale: The only antineoplastic antibiotic listed ligaments of the knee. Which test would the
is doxorubicin (Adriamycin). All of the other nurse practitioner choose to assess the anterior
medications are chemotherapeutic agents of cruciate ligament (ACL), which is the most
other classifications that may be used for commonly involved structure in severe knee
musculoskeletal neoplasms. injury?
1.Valgus stress test.
A 13-year-old obese (body mass index [BMI] 2.Varus stress test.
above the 95th percentile) boy reports low-grade 3.Lachman test.
left knee pain for the past 2 months. He denies 4.Thumb sign. - ANSWER -Lachman test
antecedent trauma but admits to frequent
"horseplay" with his friends. The pain has rationale: The Lachman test assesses the ACL.
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 In assessing the skeletal muscles, the nurse
knee pain and tenderness. His examination practitioner turns the patient's forearm so that the
demonstrates negative drawer, Lachman, and palm is up. This is called:
McMurray tests; left hip with decreased internal
rotation and abduction; and external hip rotation 1.Supination.
with knee flexion. Based on the above scenario, 2.Pronation.
the nurse practitioner should suspect: 3.Abduction.
4.Eversion. - ANSWER -Supination.
1.A left meniscal tear.
2.A left anterior cruciate ligament (ACL) tear. rationale: Turning the forearm so that the palm is
3.A slipped capital femoral epiphysis (SCFE). up is called supination.
4.Osgood-Schlatter disease. - ANSWER -A
slipped capital femoral epiphysis (SCFE).
Lillian, age 70, was told that she has
rationale: SCFE is a displacement of the femoral osteoporosis. When she asks you what this is,
head relative to the femoral neck that occurs you respond that osteoporosis:
through the physis (growth plate) of the femur.
The vast majority of clients with this condition are 1.Develops when loss of bone occurs more
obese, as the added weight increases shear rapidly than new bone growth.
stress across the physis. The mean age at 2.Is a degenerative joint disease characterized by
, Week 5 Musculoskeletal Test Questions and Answers
Graded A+
loss of cartilage in certain joints. 1.Acetaminophen, tramadol, and intra-articular
3.Is a chronic inflammatory disorder that affects corticosteroid injections.
multiple joints. 2.Oral nonsteroidal anti-inflammatory drugs
4.Is a bone disorder that has to do with (NSAIDs), tramadol, and articular corticosteroid
inadequate mineralization of the bones. - injections.
ANSWER -Develops when loss of bone 3.Acetaminophen, topical capsaicin, and topical
occurs more rapidly than new bone growth. nonsteroidal anti-inflammatory drugs (NSAIDs).
4.Topical capsaicin, topical nonsteroidal anti-
rationale: Osteoporosis develops when bone inflammatory drugs (NSAIDs), and oral NSAIDs. -
resorption occurs more rapidly than bone ANSWER -Topical capsaicin, topical
deposition. nonsteroidal anti-inflammatory drugs (NSAIDs),
and oral NSAIDs.
Cass, age 67, tells the nurse practitioner (NP) rationale: Topical capsaicin, topical NSAIDs, oral
that she has been diagnosed with a condition NSAIDs, and tramadol are recommended by the
that causes sudden flares of pain, swelling, and ACR for the treatment of OA of the hand.
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 Christian, age 22, is a carpenter who is right
stuck in the joint and cause pain." She is on hand dominant. He comes to the clinic for follow-
hydrochlorothiazide (HCTZ) for management of up from the emergency department, where he
her hypertension. The NP should suspect a was seen for right forearm pain. He states he
diagnosis of: was diagnosed with right forearm tendinitis and
wants the provider to explain this diagnosis to
1.Septic arthritis. him. Patient teaching should explain that he has
2.Gout. inflammation of one or more tendons, which are:
3.Rheumatoid arthritis.
4.Charcot neuro-osteoarthropathy. - 1.The ropelike bundles of collagen fibrils that
ANSWER -Gout. connect bone to bone.
2.The collagen fibers that connect muscle to
rationale: Gout is a disorder that involves bone.
abnormal metabolism of uric acid and results in 3.The pouches of synovial fluid that cushion bone
hyperuricemia. High concentrations of urate and other joint structures.
precipitate into crystals that collect in tissue and 4.The fibrocartilaginous disks that separate bony
joint spaces and can cause pain and surfaces. - ANSWER -The collagen fibers
inflammation. The patient's symptoms may be that connect muscle to bone.
aggravated by the use of HCTZ.
rationale: Tendons are the collagen fibers that
connect muscle to bone.
Sean, a factory line worker, has osteoarthritis
(OA) of the right hand. According to the
American College of Rheumatology (ACR), the Steve, age 32, fell off a roof while shingling it. He
guidelines for pharmacologic treatment include: is complaining of pain in his left hip and leg area.
Other than an x-ray, what would make you