NURS 611 FINAL EXAM LATEST MARYVILLE UNIVERSITY
QUESTIONS AND COMPLETE SOLUTIONS GRADED A+
3 types of joints - Answer: 1. Synovial (freely movable, knee and shoulder)
2. Cartilaginous (slightly movable, vertebral bodies, symphysis pubis, sternomanubrial joint)
3. Fibrous (immovable, skull sutures)
Types of synovial joints - Answer: 1. Ball and socket (shoulder/hip)
2. Hinge (wrist, interphalangeal joints of hands/foot)
3. Condylar (knee, temporomandibular joint)
Tips for assessing joint pain - Answer: 1. Point to the pain
2. Clarify onset, mechanism of injury, activity
3. Articular or extraarticular, acute or chronic, inflammatory or
noninflammatory, localized (monoarticular) or diffuse (polyarticular)
4. Clarify the attributes of each symptom including context, associations, etc.
5. Symptom analysis
Describe the following types
of pain Muscle
Nerve
,root
Nerve
Sympathetic
nerve Bone
Fracture
Vascular - Answer: Muscle: dull, cramping,
aching Nerve root: sharp shooting
nerve: sharp, lightening like
Sympathetic: burning, pressure like,
stinging Bone: deep, nagging, dull
Fracture: sharp, severe,
intolerable Vascular:
throbbing, diffuse
Red flags for lower back pain - Answer:
Age <20 or >50 History of cancer
Unexplained weight loss, fever, or general
decline in health Pain lasting >1mo,
unresponsive to treatment
Pain worse at night or present at rest
history of IVDA, addiction,
immunosuppression Presence of active
infection or HIV
Long term steroid
therapy Saddle
anesthesia
Bladder or bowel
incontinence Neurological
,deficits
Lower extremity weakness
Shoulder pain can be two nonmusculoskeletal reasons - Answer: Referred
abdominal pain Cardiac pain
Hawkins
test
Indication
Movemen
t
Positive - Answer: Subacromial
impingement 90 degree arm, 90
degree elbow flexed Forcibly
internally rotate
Positive if pain, nerve burning
Empty can test
Indication
Movement
Positive - Answer: Impingement, rotater cuff tear
, ARms elevated 90 degrees, then internally rotate 30 degrees
(dumping out cans) Resist abduction
Unable, positive
Apley's
test
Indicatio
n
Moveme
nt
Positive - Answer: Rotator cuff tendonitis
REach overhead, reach behind as far as possible
Apprehension
test Indication
Movement
Positive - Answer: Arm at 90 degrees, shoulder at 90 degrees,
abducted. Externally rotate patient's arm, look for slipping,
apprehension, resistance Anterior joint instability
Lateral epichondylitis - Answer: tennis elbow
Medial epichondylitis - Answer: golfer's elbow
QUESTIONS AND COMPLETE SOLUTIONS GRADED A+
3 types of joints - Answer: 1. Synovial (freely movable, knee and shoulder)
2. Cartilaginous (slightly movable, vertebral bodies, symphysis pubis, sternomanubrial joint)
3. Fibrous (immovable, skull sutures)
Types of synovial joints - Answer: 1. Ball and socket (shoulder/hip)
2. Hinge (wrist, interphalangeal joints of hands/foot)
3. Condylar (knee, temporomandibular joint)
Tips for assessing joint pain - Answer: 1. Point to the pain
2. Clarify onset, mechanism of injury, activity
3. Articular or extraarticular, acute or chronic, inflammatory or
noninflammatory, localized (monoarticular) or diffuse (polyarticular)
4. Clarify the attributes of each symptom including context, associations, etc.
5. Symptom analysis
Describe the following types
of pain Muscle
Nerve
,root
Nerve
Sympathetic
nerve Bone
Fracture
Vascular - Answer: Muscle: dull, cramping,
aching Nerve root: sharp shooting
nerve: sharp, lightening like
Sympathetic: burning, pressure like,
stinging Bone: deep, nagging, dull
Fracture: sharp, severe,
intolerable Vascular:
throbbing, diffuse
Red flags for lower back pain - Answer:
Age <20 or >50 History of cancer
Unexplained weight loss, fever, or general
decline in health Pain lasting >1mo,
unresponsive to treatment
Pain worse at night or present at rest
history of IVDA, addiction,
immunosuppression Presence of active
infection or HIV
Long term steroid
therapy Saddle
anesthesia
Bladder or bowel
incontinence Neurological
,deficits
Lower extremity weakness
Shoulder pain can be two nonmusculoskeletal reasons - Answer: Referred
abdominal pain Cardiac pain
Hawkins
test
Indication
Movemen
t
Positive - Answer: Subacromial
impingement 90 degree arm, 90
degree elbow flexed Forcibly
internally rotate
Positive if pain, nerve burning
Empty can test
Indication
Movement
Positive - Answer: Impingement, rotater cuff tear
, ARms elevated 90 degrees, then internally rotate 30 degrees
(dumping out cans) Resist abduction
Unable, positive
Apley's
test
Indicatio
n
Moveme
nt
Positive - Answer: Rotator cuff tendonitis
REach overhead, reach behind as far as possible
Apprehension
test Indication
Movement
Positive - Answer: Arm at 90 degrees, shoulder at 90 degrees,
abducted. Externally rotate patient's arm, look for slipping,
apprehension, resistance Anterior joint instability
Lateral epichondylitis - Answer: tennis elbow
Medial epichondylitis - Answer: golfer's elbow
