NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
1. 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: D. Paresthesia of the perineum and buttocks
2. Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis.
The clinician has explained to Mr. Jackson that the goals for managing os-
teoarthritis 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 most appropriate response from
the clinician?
A. "Complementary therapies should be considered only if surgical interven-
tions are not successful."
B. "I am unfamiliar with the available complementary therapies for os-
teoarthritis and prefer to discuss more mainstream treatments, such as
NSAIDs and physical therapy, to manage your condition."
C. "I would be happy to discuss all the treatment options available to you.
Complementary therapies, such as acupuncture, acupressure, and tai-chi,
are being studied for use in the treatment of osteoarthritis and have shown
promise when used with standard medical therapy."
D. "It would be crazy to use complementary therapies to treat such a serious
condition.": C. "I would be happy to discuss all the treatment options available to you. Complementary therapies,
such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have
shown promise when used with standard medical therapy."
3. John is a 16-year-old boy who presents to the emergency room 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
, NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
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?
A. Valgus stress test
B. McMurray circumduction test
C. Lachman test
D. Varus stress test: B. McMurray circumduction test
4. The clinician suspects that a client has 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°.
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:
A. Apprehension sign
B. Bulge sign
C. Thumb sign
D. None of the above: A. Apprehension sign
5. A clinician has performed a synovial fluid analysis and the results are as
follows: visual analysis: turbid and yellow, viscosity: decreased, 52,000 white
blood cells (WBCs) per mm3, polymorphonuclear leukocytes (PMNs): 75%,
protein: 5 g/dL. Which of the following conditions could this result be attrib-
uted to?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis: D. Septic arthritis
6. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of
his left great toe. The clinician suspects acute gout. Which of the following
should the clinician expect in the initial test results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
, NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
C. Decreased urine pH
D. Decreased C-reactive protein: A. Elevated uric acid level
7. Debbie is a 43-year-old female being evaluated for a wrist injury. The clin-
ician is assessing for median nerve compression by having Debbie maintain
forced flexion of her wrist for 1 minute with the dorsal surface of each hand
pressed together. Which of these tests did the clinician just perform?
A. Allen's test
B. Phalen's test
C. Tinel's sign
D. Finkelstein's test: B. Phalen's test
8. 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: B. Unilateral
radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
9. Felice is a 66-year-old female who complains that walking and prolonged
standing causes pain and weakness in her legs and buttocks. She expresses
that she has short-term relief when she leans on the shopping cart. When she
sleeps on her back, she sometimes wakes up in the night in pain. Which of the
following diagnoses is most likely?
A. Multiple sclerosis
B. Herniated lumbar disc
C. Lumbar spinal stenosis
D. Cervical spondylosis: C. Lumbar spinal stenosis
, NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
10. To diagnose fibromyalgia, there must be tenderness on digital palpation in
at least 11 of 18 (nine pairs) tender point sites, which would include the
A. occiput, low cervical, trapezius, and supraspinatus
B. proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints of the
hands, and the metatarsophalangeal (MTP) and PIP joints of the foot
C. facet joints of the cervical, thoracic, and lumbar spine
D. radial and ulnar styloids and the medial and lateral malleoli: A. occiput, low cervical,
trapezius, and supraspinatus
11. 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.: C. Her history of
diabetes mellitus
12. The clinician is assessing Sally's diffuse hip pain. How should the clinician
begin the examination?
A. Begin the range-of-motion examination with an assessment of the motion
that causes pain.
B. Physical examination of the hip must first assess its position at rest.
C. The patient should move the hip prior to radiographic studies to determine
whether they are necessary.
D. Flexion and extension of the affected hips' extremity should only be per-
formed with the knee straight.: B.Physical examination of the hip must first assess its position at rest.
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
1. 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: D. Paresthesia of the perineum and buttocks
2. Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis.
The clinician has explained to Mr. Jackson that the goals for managing os-
teoarthritis 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 most appropriate response from
the clinician?
A. "Complementary therapies should be considered only if surgical interven-
tions are not successful."
B. "I am unfamiliar with the available complementary therapies for os-
teoarthritis and prefer to discuss more mainstream treatments, such as
NSAIDs and physical therapy, to manage your condition."
C. "I would be happy to discuss all the treatment options available to you.
Complementary therapies, such as acupuncture, acupressure, and tai-chi,
are being studied for use in the treatment of osteoarthritis and have shown
promise when used with standard medical therapy."
D. "It would be crazy to use complementary therapies to treat such a serious
condition.": C. "I would be happy to discuss all the treatment options available to you. Complementary therapies,
such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have
shown promise when used with standard medical therapy."
3. John is a 16-year-old boy who presents to the emergency room 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
, NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
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?
A. Valgus stress test
B. McMurray circumduction test
C. Lachman test
D. Varus stress test: B. McMurray circumduction test
4. The clinician suspects that a client has 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°.
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:
A. Apprehension sign
B. Bulge sign
C. Thumb sign
D. None of the above: A. Apprehension sign
5. A clinician has performed a synovial fluid analysis and the results are as
follows: visual analysis: turbid and yellow, viscosity: decreased, 52,000 white
blood cells (WBCs) per mm3, polymorphonuclear leukocytes (PMNs): 75%,
protein: 5 g/dL. Which of the following conditions could this result be attrib-
uted to?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Septic arthritis: D. Septic arthritis
6. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of
his left great toe. The clinician suspects acute gout. Which of the following
should the clinician expect in the initial test results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
, NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
C. Decreased urine pH
D. Decreased C-reactive protein: A. Elevated uric acid level
7. Debbie is a 43-year-old female being evaluated for a wrist injury. The clin-
ician is assessing for median nerve compression by having Debbie maintain
forced flexion of her wrist for 1 minute with the dorsal surface of each hand
pressed together. Which of these tests did the clinician just perform?
A. Allen's test
B. Phalen's test
C. Tinel's sign
D. Finkelstein's test: B. Phalen's test
8. 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: B. Unilateral
radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
9. Felice is a 66-year-old female who complains that walking and prolonged
standing causes pain and weakness in her legs and buttocks. She expresses
that she has short-term relief when she leans on the shopping cart. When she
sleeps on her back, she sometimes wakes up in the night in pain. Which of the
following diagnoses is most likely?
A. Multiple sclerosis
B. Herniated lumbar disc
C. Lumbar spinal stenosis
D. Cervical spondylosis: C. Lumbar spinal stenosis
, NUR 603 FINAL EXAM REVIEW 2025–2026 COMPREHENSIVE ADVANCED PRACTICE NURSING STUDY GUIDE WITH
RATIONALES, CASE STUDIES, AND CLINICAL MANAGEMENT QUESTIONS AND ANSWERS A+ VERIFIED
10. To diagnose fibromyalgia, there must be tenderness on digital palpation in
at least 11 of 18 (nine pairs) tender point sites, which would include the
A. occiput, low cervical, trapezius, and supraspinatus
B. proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints of the
hands, and the metatarsophalangeal (MTP) and PIP joints of the foot
C. facet joints of the cervical, thoracic, and lumbar spine
D. radial and ulnar styloids and the medial and lateral malleoli: A. occiput, low cervical,
trapezius, and supraspinatus
11. 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.: C. Her history of
diabetes mellitus
12. The clinician is assessing Sally's diffuse hip pain. How should the clinician
begin the examination?
A. Begin the range-of-motion examination with an assessment of the motion
that causes pain.
B. Physical examination of the hip must first assess its position at rest.
C. The patient should move the hip prior to radiographic studies to determine
whether they are necessary.
D. Flexion and extension of the affected hips' extremity should only be per-
formed with the knee straight.: B.Physical examination of the hip must first assess its position at rest.
