FNP NR511 STUDY GUIDE TEST PAPER
QUESTIONS AND CORRECT ANSWERS
TESTED PREP MATERIAL
●● Lumbar spinal stenosis
Answer: Narrowing of one or more levels of the L spinal canal and
compression of nerve roots. L1-2 most common
- S: symptoms may follow lifting accident or minor trauma or gradually
occur. pseudoclaudication causing radicular complaints in calves, butt,
upp thighs, weakness in legs and butt. may improve by leaning forward.
leg/back pain after sleeping on back
O: + romberg test, impaired proprioception, sensory changes, decr anal
sphincter tone
dx: x-ray, MRi
tx: b/b incontinence, neuro changes or gait disturbances may need
surgery. NSAIDs, Folic acid, B12, PT/OT, decr belly fat, bicycling,
lumbar epidural corticosteroid injection
●● Cauda Equina Syndrome
Answer: *medical emergency*
S: BLE weakness, anesthesia, or paresthesia of the perineum and
buttocks (saddle anesthesia). may or may not be B/B incontinence or
bladder retention (may not be reversed). S/S may be acute or insidious.
,stumbling, weak quads or hip extensors, unable to walk on heels and
toes, foot drop.
dx:MRI
management: surgical lumbar decompression
●● s/s and management of sprains
Answer: - usually have swelling, pain and disability (or deformity)
-1st: stretching of ligamentous fibers- symptom Tx
-2nd: tear of part of the ligament, with pain and swelling-
Immobilization to protect injured part, but full healing expected
-3rd: complete ligamentous separation- immobilization; possible surgery
- Hx of sudden injury or fall
-redness/bruising over the joint, decr A&P ROM,pain with movement of
joint
●● s/s and management of strains
Answer: - affect the muscles or tendons that connect to a muscle to a
bone.
-don't usually cause swelling or redness
-ROM may be limited, but can still use limb
- if severe, the entire muscle or tendon may be torn, causing
inflammation and swelling, weakness, and loss of function
- surgery may be needed
, ●● Spurling's maneuver- neck pain
Answer: 1. With the patient's neck in extension, rotate neck to the
affected side.
2. Apply downward pressure on the head.
3. Assess for patient complaint of or accentuation of limb pain or
paresthesia (a positive finding). Also observe for obvious atrophy in the
neck.
-assess nerve root compression
●● Radiculopathy
Answer: -caused by spinal root compression, injury, or inflammation-
most commonly d/t disc herniation or spinal stenosis from degenerative
disease.
●● straight leg test
Answer: 1. The patient is placed in a supine position.
2. Grasp the heel of the leg to be tested and raise the leg by flexing the
hip.
3. Assess for pain or reproduction of symptoms before the end of the
normal range of motion (70 degrees).
- nerve root compression test. used to evaluate lumbar nerve root
impingement
-positive if pain
QUESTIONS AND CORRECT ANSWERS
TESTED PREP MATERIAL
●● Lumbar spinal stenosis
Answer: Narrowing of one or more levels of the L spinal canal and
compression of nerve roots. L1-2 most common
- S: symptoms may follow lifting accident or minor trauma or gradually
occur. pseudoclaudication causing radicular complaints in calves, butt,
upp thighs, weakness in legs and butt. may improve by leaning forward.
leg/back pain after sleeping on back
O: + romberg test, impaired proprioception, sensory changes, decr anal
sphincter tone
dx: x-ray, MRi
tx: b/b incontinence, neuro changes or gait disturbances may need
surgery. NSAIDs, Folic acid, B12, PT/OT, decr belly fat, bicycling,
lumbar epidural corticosteroid injection
●● Cauda Equina Syndrome
Answer: *medical emergency*
S: BLE weakness, anesthesia, or paresthesia of the perineum and
buttocks (saddle anesthesia). may or may not be B/B incontinence or
bladder retention (may not be reversed). S/S may be acute or insidious.
,stumbling, weak quads or hip extensors, unable to walk on heels and
toes, foot drop.
dx:MRI
management: surgical lumbar decompression
●● s/s and management of sprains
Answer: - usually have swelling, pain and disability (or deformity)
-1st: stretching of ligamentous fibers- symptom Tx
-2nd: tear of part of the ligament, with pain and swelling-
Immobilization to protect injured part, but full healing expected
-3rd: complete ligamentous separation- immobilization; possible surgery
- Hx of sudden injury or fall
-redness/bruising over the joint, decr A&P ROM,pain with movement of
joint
●● s/s and management of strains
Answer: - affect the muscles or tendons that connect to a muscle to a
bone.
-don't usually cause swelling or redness
-ROM may be limited, but can still use limb
- if severe, the entire muscle or tendon may be torn, causing
inflammation and swelling, weakness, and loss of function
- surgery may be needed
, ●● Spurling's maneuver- neck pain
Answer: 1. With the patient's neck in extension, rotate neck to the
affected side.
2. Apply downward pressure on the head.
3. Assess for patient complaint of or accentuation of limb pain or
paresthesia (a positive finding). Also observe for obvious atrophy in the
neck.
-assess nerve root compression
●● Radiculopathy
Answer: -caused by spinal root compression, injury, or inflammation-
most commonly d/t disc herniation or spinal stenosis from degenerative
disease.
●● straight leg test
Answer: 1. The patient is placed in a supine position.
2. Grasp the heel of the leg to be tested and raise the leg by flexing the
hip.
3. Assess for pain or reproduction of symptoms before the end of the
normal range of motion (70 degrees).
- nerve root compression test. used to evaluate lumbar nerve root
impingement
-positive if pain
