NR 509 Midterm Exam LATEST EXAM 2025 WITH ACTUAL QUESTIONS AND
DETAILED ANSWERS ALREADY GRADED A+
Rotator cuff injury - DETAILED ANSWER-Atrophy of the supraspinatus and
infraspinatus with increased prominence of scapular spine can appear within 2 to
3 weeks of a rotator cuff tear; infraspinatus atrophy has a positive likelihood ratio
(LR) of 2 for rotator cuff disease. prioritizing patient complaints - DETAILED
ANSWER-Problem list
- Most active and serious problems first
- then, problems that need future observation and attention
Condylar joints - DETAILED ANSWER-Knee & TMJ
-Movement of two articulating surfaces not dissociable
Acute RA - DETAILED ANSWER-Tender, painful, stiff joints in RA, usually with
symmetric involvement on both sides of the body. The distal interphalangeal
(DIP), metacarpophalangeal (MCP), and wrist joints are the most frequently
affected. Note the fusiform or spindle-shaped swelling of the PIP joints in acute
disease.
Chronic RA - DETAILED ANSWER-swelling and thickening of the MCP and PIP
joints. Range of motion becomes limited, and fingers may deviate toward the
ulnar side. The interosseous muscles atrophy. The fingers may show "swan
neck" deformities (hyperextension of the PIP joints with fixed flexion of the distal
interphalangeal [DIP] joints). Less common is a boutonnière deformity (persistent
flexion of the PIP joint with hyperextension of the DIP joint). Rheumatoid nodules
are seen in the acute or the chronic stage.
, subjective data - DETAILED ANSWER-- Symptoms
- What pt tells you -goes under ROS
sources of joint pain - DETAILED ANSWER--If age <60 years, consider repetitive
strain or overuse syndromes like tendinitis or bursitis, crystalline arthritis (gout;
crystalline pyrophosphate deposition disease [CPPD]) (males), rheumatoid
arthritis (RA), psoriatic arthritis and reactive (Reiter) arthritis (in inflammatory
bowel disease [IBD]), and infectious arthritis from gonorrhea, Lyme disease, or
viral or bacterial infections.
- If age >60 years, look for OA, gout and pseudogout, polymyalgia
rheumatica (PMR), osteoporotic fracture, and septic bacterial arthritis.
- congenital, inflammatory or infectious, immunologic, neoplastic, metabolic,
nutritional, degenerative, vascular, traumatic, and toxic?
CN 1-6 - DETAILED ANSWER-1) Olfactory- smell
2)Optic- visual acuity with eye chart & pupil response
3)Oculomotor- conjugate gaze with EOM
4)Trochlear- conjugate gaze with EOM
5) Trigeminal- palpate masseter & touch face and have pt identify where
6) Abducens- Conjugate gaze with EOM
CN 7-12 - DETAILED ANSWER-7)Facial- Blow cheeks out, smile, frown, pucker lips
8)Vestibulocochlear (Acoustic)- Whisper test
9) Glossopharyngeal- Gag reflex
10)Vagus- say "ahhh". soft palate and uvula rise symmetrically
11) Accessory- shrug shoulders
12) Hypoglossal- Stick out tongue and move left to right epistaxis causes -
DETAILED ANSWER-nosebleed
DETAILED ANSWERS ALREADY GRADED A+
Rotator cuff injury - DETAILED ANSWER-Atrophy of the supraspinatus and
infraspinatus with increased prominence of scapular spine can appear within 2 to
3 weeks of a rotator cuff tear; infraspinatus atrophy has a positive likelihood ratio
(LR) of 2 for rotator cuff disease. prioritizing patient complaints - DETAILED
ANSWER-Problem list
- Most active and serious problems first
- then, problems that need future observation and attention
Condylar joints - DETAILED ANSWER-Knee & TMJ
-Movement of two articulating surfaces not dissociable
Acute RA - DETAILED ANSWER-Tender, painful, stiff joints in RA, usually with
symmetric involvement on both sides of the body. The distal interphalangeal
(DIP), metacarpophalangeal (MCP), and wrist joints are the most frequently
affected. Note the fusiform or spindle-shaped swelling of the PIP joints in acute
disease.
Chronic RA - DETAILED ANSWER-swelling and thickening of the MCP and PIP
joints. Range of motion becomes limited, and fingers may deviate toward the
ulnar side. The interosseous muscles atrophy. The fingers may show "swan
neck" deformities (hyperextension of the PIP joints with fixed flexion of the distal
interphalangeal [DIP] joints). Less common is a boutonnière deformity (persistent
flexion of the PIP joint with hyperextension of the DIP joint). Rheumatoid nodules
are seen in the acute or the chronic stage.
, subjective data - DETAILED ANSWER-- Symptoms
- What pt tells you -goes under ROS
sources of joint pain - DETAILED ANSWER--If age <60 years, consider repetitive
strain or overuse syndromes like tendinitis or bursitis, crystalline arthritis (gout;
crystalline pyrophosphate deposition disease [CPPD]) (males), rheumatoid
arthritis (RA), psoriatic arthritis and reactive (Reiter) arthritis (in inflammatory
bowel disease [IBD]), and infectious arthritis from gonorrhea, Lyme disease, or
viral or bacterial infections.
- If age >60 years, look for OA, gout and pseudogout, polymyalgia
rheumatica (PMR), osteoporotic fracture, and septic bacterial arthritis.
- congenital, inflammatory or infectious, immunologic, neoplastic, metabolic,
nutritional, degenerative, vascular, traumatic, and toxic?
CN 1-6 - DETAILED ANSWER-1) Olfactory- smell
2)Optic- visual acuity with eye chart & pupil response
3)Oculomotor- conjugate gaze with EOM
4)Trochlear- conjugate gaze with EOM
5) Trigeminal- palpate masseter & touch face and have pt identify where
6) Abducens- Conjugate gaze with EOM
CN 7-12 - DETAILED ANSWER-7)Facial- Blow cheeks out, smile, frown, pucker lips
8)Vestibulocochlear (Acoustic)- Whisper test
9) Glossopharyngeal- Gag reflex
10)Vagus- say "ahhh". soft palate and uvula rise symmetrically
11) Accessory- shrug shoulders
12) Hypoglossal- Stick out tongue and move left to right epistaxis causes -
DETAILED ANSWER-nosebleed
