Question 1
Anita is a 2-week-old female who was a term C-section delivery because of failure to
progress and was large for gestational age (LGA). You are doing your physical exam and
during Ortolani's maneuver a "clunk" is noted and reproduced on the left side. The right
side is normal. Her gluteal folds are also asymmetric. All of the following are true except:
a) Anita needs to have an xray done to confirm the diagnosis.
b) Most commonly in breech babies.
c) This finding may be concerning for developmental dysplasia of the hip and if persists will
require a referral to an orthopedic surgeon.
d) Females are more at risk then males for this condition.
CORRECT ANSWER
answer: Anita needs to have an xray done to confirm the diagnosis.
Ultrasounds are indicated not x-rays-- in newborn most of the hip joint is cartilaginous not
bone. see Burns textbook.
Question 2
A 72 yom (year old male) presents to your clinic with a CC of low back pain. Which of the
following is considered a "red flag" for an underlying serious health concern?
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@THE STUDY VAULT
,a) pain worsens with bending over
b) pain is described as dull aching on right side of low back
c) worsening numbness and tingling down the left lower extremity
d) pain is not relieved with Tylenol or ibuprofen
CORRECT ANSWER
answer: worsening numbness and tingling down the left lower extremity
see: Red flags of back pain in the Bickley textbook. Dains also provides details of "red flags"
Question 3
Which of the following patients is MOST at risk for osteoporosis?
a) 50 yof (year old female) with a longstanding history of DM type 2, obesity and daily use of
ibuprofen
b) 62 yo postmenopausal female, BMI 24, quit smoking 10 years ago.
c) 72 yof (year old female), BMI 21, history of stage 2 right breast cancer, has been on
aromatase inhibitor for 6 years.
d) 42 yof (year old female), BMI 26, personal history of thyroid disease and family history of
osteoporosis
CORRECT ANSWER
2
@THE STUDY VAULT
,answer: 72 yof (year old female), BMI 21, history of stage 2 right breast cancer, has been on
aromatase inhibitor for 6 years.
All patients are at risk for osteoporosis- the patient at MOST risk is the underweight
postmenopausal female who has been on an aromatase inhibitor for 6 years.
Question 4
Bill Brown presents to your clinic after a traumatic fall. His CC is severe left lower leg pain.
Which of the following is the MOST appropriate PE to complete FIRST?
a) Palpate the point of maximal pain.
b) Assess pulses and cap refill in the left foot.
c) Have patient bear weight on left leg.
d) Assess right leg for symmetry.
CORRECT ANSWER
answer: Assess pulses and cap refill in the left foot.
with any injury you must establish have intact "CSMs"- circulation, sensation and movement.
Out of the options given, checking for circulation is the most appropriate -- you need to
establish good blood flow.
Question 5
Which of the following is a positive Finkelstein test?
3
@THE STUDY VAULT
, a) Hips and iliac crests are unequal indicating scoliosis
b) Patient is unable to maintain arm resistance in the abducted position indicating a torn
rotator cuff
c) Pain while grasping thumb to palm and moving wrist toward midline indicating de
Quervain tenosynovitis
d) Numbness and tingling of the left wrist medial nerve distribution indicating carpal tunnel
syndrome
CORRECT ANSWER
answer: Pain while grasping thumb to palm and moving wrist toward midline indicating de
Quervain tenosynovitis
option A- scoliosis test
option B- empty can test for rotator cuff
option C- correct answer
option D- Tinel's test.
Question 6
The CC is elbow pain for 2 days following a fall. As the APRN you are performing an
examination of the affected joint. Which of the following statements is most accurate?
a) It is important to assess the proximal and distal joint of the affected site.
b) Normal range of motion of the elbow includes supination, pronation, rotation and
extension.
4
@THE STUDY VAULT
Anita is a 2-week-old female who was a term C-section delivery because of failure to
progress and was large for gestational age (LGA). You are doing your physical exam and
during Ortolani's maneuver a "clunk" is noted and reproduced on the left side. The right
side is normal. Her gluteal folds are also asymmetric. All of the following are true except:
a) Anita needs to have an xray done to confirm the diagnosis.
b) Most commonly in breech babies.
c) This finding may be concerning for developmental dysplasia of the hip and if persists will
require a referral to an orthopedic surgeon.
d) Females are more at risk then males for this condition.
CORRECT ANSWER
answer: Anita needs to have an xray done to confirm the diagnosis.
Ultrasounds are indicated not x-rays-- in newborn most of the hip joint is cartilaginous not
bone. see Burns textbook.
Question 2
A 72 yom (year old male) presents to your clinic with a CC of low back pain. Which of the
following is considered a "red flag" for an underlying serious health concern?
1
@THE STUDY VAULT
,a) pain worsens with bending over
b) pain is described as dull aching on right side of low back
c) worsening numbness and tingling down the left lower extremity
d) pain is not relieved with Tylenol or ibuprofen
CORRECT ANSWER
answer: worsening numbness and tingling down the left lower extremity
see: Red flags of back pain in the Bickley textbook. Dains also provides details of "red flags"
Question 3
Which of the following patients is MOST at risk for osteoporosis?
a) 50 yof (year old female) with a longstanding history of DM type 2, obesity and daily use of
ibuprofen
b) 62 yo postmenopausal female, BMI 24, quit smoking 10 years ago.
c) 72 yof (year old female), BMI 21, history of stage 2 right breast cancer, has been on
aromatase inhibitor for 6 years.
d) 42 yof (year old female), BMI 26, personal history of thyroid disease and family history of
osteoporosis
CORRECT ANSWER
2
@THE STUDY VAULT
,answer: 72 yof (year old female), BMI 21, history of stage 2 right breast cancer, has been on
aromatase inhibitor for 6 years.
All patients are at risk for osteoporosis- the patient at MOST risk is the underweight
postmenopausal female who has been on an aromatase inhibitor for 6 years.
Question 4
Bill Brown presents to your clinic after a traumatic fall. His CC is severe left lower leg pain.
Which of the following is the MOST appropriate PE to complete FIRST?
a) Palpate the point of maximal pain.
b) Assess pulses and cap refill in the left foot.
c) Have patient bear weight on left leg.
d) Assess right leg for symmetry.
CORRECT ANSWER
answer: Assess pulses and cap refill in the left foot.
with any injury you must establish have intact "CSMs"- circulation, sensation and movement.
Out of the options given, checking for circulation is the most appropriate -- you need to
establish good blood flow.
Question 5
Which of the following is a positive Finkelstein test?
3
@THE STUDY VAULT
, a) Hips and iliac crests are unequal indicating scoliosis
b) Patient is unable to maintain arm resistance in the abducted position indicating a torn
rotator cuff
c) Pain while grasping thumb to palm and moving wrist toward midline indicating de
Quervain tenosynovitis
d) Numbness and tingling of the left wrist medial nerve distribution indicating carpal tunnel
syndrome
CORRECT ANSWER
answer: Pain while grasping thumb to palm and moving wrist toward midline indicating de
Quervain tenosynovitis
option A- scoliosis test
option B- empty can test for rotator cuff
option C- correct answer
option D- Tinel's test.
Question 6
The CC is elbow pain for 2 days following a fall. As the APRN you are performing an
examination of the affected joint. Which of the following statements is most accurate?
a) It is important to assess the proximal and distal joint of the affected site.
b) Normal range of motion of the elbow includes supination, pronation, rotation and
extension.
4
@THE STUDY VAULT
