2025 Dunphy Final Clinical Exam NURS 671 - In-
Depth Study Guide, Key Concepts, Expert
Answers, and Success Strategies with 120
Questions
1. One of the initial steps in assessing patients with musculoskeletal complaints is
to determine whether the complaint is articular or nonarticular in origin. Which of
the following is an example of an articular structure?
a. Bone
b. Synovium
c. Tendons
d. Fascia
Correct Answer: b. Synovium
Rationale: The synovium is an articular structure that lines the joint space and
produces synovial fluid for lubrication. Articular structures are those involved in the
joint itself, including synovium, cartilage, and joint capsule.
2. You have detected the presence of crepitus on examination of a patient with a
musculoskeletal complaint. Additionally, there is limited range of motion with both
active and passive movement. These findings suggest that the origin of the
musculoskeletal complaint is:
a. Nonarticular
b. Articular
c. Tendon-related
d. Ligament-related
Correct Answer: b. Articular
Rationale: Crepitus and limited range of motion, both active and passive, are indicative
of an articular issue, suggesting that the joint itself is the source of the problem.
3. Which of the following signs or symptoms indicate an inflammatory etiology to
musculoskeletal pain?
a. Decreased CRP
b. Hyperalbuminemia
,c. Morning stiffness
d. Weight gain
Correct Answer: c. Morning stiffness
Rationale: Morning stiffness is a hallmark symptom of inflammatory musculoskeletal
disorders like rheumatoid arthritis, indicating an inflammatory etiology. CRP would
typically be elevated in such cases, not decreased.
4. Which of the following statements concerning the musculoskeletal exam is true?
a. The uninvolved side should be examined initially and then compared to the involved
side.
b. The part of the body that is causing the pain should be examined first.
c. When possible, the patient should not be asked to perform active range of motion
exercises to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause
further injury to the patient.
Correct Answer: a. The uninvolved side should be examined initially and then
compared to the involved side.
Rationale: It is standard practice to first examine the uninvolved side to establish a
baseline and then compare it with the involved side for differences in range of motion,
tenderness, and function.
5. You are performing muscle strength testing on a patient presenting with
musculoskeletal pain and find that the patient has complete range of motion with
gravity eliminated. Which numeric grade of muscle strength would you give this
patient, 1-5?
a. 1
b. 2
c. 3
d. 4
Correct Answer: b. 2
Rationale: A grade of 2 indicates that the patient has complete range of motion with
gravity eliminated, but cannot move against gravity. This is indicative of fair muscle
strength.
6. 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 exam
, reveals a 75% reduction in both active and passive range of motion 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. Her history of diabetes
b. Her occupation as a secretary
c. Her right-handedness
d. Her hypertension
Correct Answer: a. Her history of diabetes
Rationale: Diabetes is a significant risk factor for adhesive capsulitis, or "frozen
shoulder." The condition is more common in patients with diabetes, making this a key
clue in her diagnosis.
7. Jennifer is an 18-year-old who comes to the ER after a fall during a soccer game.
Jennifer explains that she fell on her left side and kept her arm out straight to break
her fall. She has been experiencing severe pain and limited range of motion in her
left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder.
Which of the following statements are true concerning shoulder dislocation?
a. Posterior dislocations are more common than anterior dislocations
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should
check for distal pulses
c. Recurrent dislocations are uncommon and would require great force to result in injury
d. Surgery is most commonly the treatment of choice
Correct Answer: b. There is a risk of neurovascular and neurosensory trauma, so the
clinician should check for distal pulses
Rationale: Shoulder dislocations, particularly anterior dislocations, can cause injury to
nearby neurovascular structures. It is important to check for distal pulses to ensure that
the blood flow to the arm is intact.
8. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with
carpal tunnel syndrome. She has two young children and asks the clinician what
the chances are that they also will develop carpal tunnel syndrome. Which of the
following responses would be correct regarding the risk of developing carpal tunnel
syndrome?
Depth Study Guide, Key Concepts, Expert
Answers, and Success Strategies with 120
Questions
1. One of the initial steps in assessing patients with musculoskeletal complaints is
to determine whether the complaint is articular or nonarticular in origin. Which of
the following is an example of an articular structure?
a. Bone
b. Synovium
c. Tendons
d. Fascia
Correct Answer: b. Synovium
Rationale: The synovium is an articular structure that lines the joint space and
produces synovial fluid for lubrication. Articular structures are those involved in the
joint itself, including synovium, cartilage, and joint capsule.
2. You have detected the presence of crepitus on examination of a patient with a
musculoskeletal complaint. Additionally, there is limited range of motion with both
active and passive movement. These findings suggest that the origin of the
musculoskeletal complaint is:
a. Nonarticular
b. Articular
c. Tendon-related
d. Ligament-related
Correct Answer: b. Articular
Rationale: Crepitus and limited range of motion, both active and passive, are indicative
of an articular issue, suggesting that the joint itself is the source of the problem.
3. Which of the following signs or symptoms indicate an inflammatory etiology to
musculoskeletal pain?
a. Decreased CRP
b. Hyperalbuminemia
,c. Morning stiffness
d. Weight gain
Correct Answer: c. Morning stiffness
Rationale: Morning stiffness is a hallmark symptom of inflammatory musculoskeletal
disorders like rheumatoid arthritis, indicating an inflammatory etiology. CRP would
typically be elevated in such cases, not decreased.
4. Which of the following statements concerning the musculoskeletal exam is true?
a. The uninvolved side should be examined initially and then compared to the involved
side.
b. The part of the body that is causing the pain should be examined first.
c. When possible, the patient should not be asked to perform active range of motion
exercises to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause
further injury to the patient.
Correct Answer: a. The uninvolved side should be examined initially and then
compared to the involved side.
Rationale: It is standard practice to first examine the uninvolved side to establish a
baseline and then compare it with the involved side for differences in range of motion,
tenderness, and function.
5. You are performing muscle strength testing on a patient presenting with
musculoskeletal pain and find that the patient has complete range of motion with
gravity eliminated. Which numeric grade of muscle strength would you give this
patient, 1-5?
a. 1
b. 2
c. 3
d. 4
Correct Answer: b. 2
Rationale: A grade of 2 indicates that the patient has complete range of motion with
gravity eliminated, but cannot move against gravity. This is indicative of fair muscle
strength.
6. 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 exam
, reveals a 75% reduction in both active and passive range of motion 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. Her history of diabetes
b. Her occupation as a secretary
c. Her right-handedness
d. Her hypertension
Correct Answer: a. Her history of diabetes
Rationale: Diabetes is a significant risk factor for adhesive capsulitis, or "frozen
shoulder." The condition is more common in patients with diabetes, making this a key
clue in her diagnosis.
7. Jennifer is an 18-year-old who comes to the ER after a fall during a soccer game.
Jennifer explains that she fell on her left side and kept her arm out straight to break
her fall. She has been experiencing severe pain and limited range of motion in her
left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder.
Which of the following statements are true concerning shoulder dislocation?
a. Posterior dislocations are more common than anterior dislocations
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should
check for distal pulses
c. Recurrent dislocations are uncommon and would require great force to result in injury
d. Surgery is most commonly the treatment of choice
Correct Answer: b. There is a risk of neurovascular and neurosensory trauma, so the
clinician should check for distal pulses
Rationale: Shoulder dislocations, particularly anterior dislocations, can cause injury to
nearby neurovascular structures. It is important to check for distal pulses to ensure that
the blood flow to the arm is intact.
8. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with
carpal tunnel syndrome. She has two young children and asks the clinician what
the chances are that they also will develop carpal tunnel syndrome. Which of the
following responses would be correct regarding the risk of developing carpal tunnel
syndrome?
