NURS 623 FINAL EXAM -
MUSCULOSKELETAL SECTION 100% GRADE
A+ SOLUTIONS
A 13 year old obese (BMI greater than 95%) boy reports low-grade left
knee pain for the past 2 months. He denies antecedent trauma but
admits to frequent horseplay with his friends. The pain has
progressively worsened, and he is now unable to bear weight at all on
his left leg. His current complaints include left groin, thigh, and
medial knee pain and tenderness. His examination demonstrates
negative Drawer, Lachman, and McMurray tests; left hip with decreased
internal rotation and abduction; and knee flexion causing external
hip rotation. Based on the above scenario, the NP should suspect:
a. a left meniscal tear.
b. a left ACL tear
c. a slipped capital femoral epiphysis
d. osgood-schlatter disease.
C.
Colchicine may be used to terminate an acute attack of gouty
arthritis as well as prevent recurrent episodes. The mechanism of
action is to:
a. interrupt the cycle of urate crystal deposition and inflammatory
response.
b. increase serum uric acid levels.
c. potentiate the excretion of uric acid.
d. inhibit the tubular reabsorption of urate, promoting the excretion
of uric acid.
A.
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Cass, age 67, tells the NP that she has been diagnosed with a
condition that causes sudden flares of pain, swelling, and redness of
the joints in her toes. She cannot remember the name of the diagnosis,
but she knows that it is cause by urate crystals that "get stuck in
the joint and cause pain". Joan is on HcTz for management of her
hypertension. The NP should suspect a diagnosis of:
a. septic arthritis
b. gout.
c. rheumatoid arthritis.
d. Charcot neuro-osteoarthropathy
B.
Treatment of choice for polymyalgia rheumatica (PMR) is:
a. acetaminophen or NSAIDS
b. low dose steroids.
c. tricyclic antidepressants.
d. antibiotics
B.
Dan, age 49, developed osteomyelitis of the femur after a motorcycle
accident. Which of the following statements about the clinical
manifestations of osteomyelitis is correct?
a. integumentary effects involve swelling, erythema, and warmth at
the involved site.
b. there is a low grade fever with intermittent chills
c. musculoskeletal effects include tenderness of the entire leg.
d. cardiovascular effects include bradycardia.
A.
Matthew, age 52, is a chef who just severed two of his fingers with a
meat cutter. You would recommend that he:
a. wrap the severed fingers tightly in a dry towel for transport to
the emergency department with him.
b. leave the severed fingers at the scene because fingers cannot be
reattached.
c. immediately freeze the severed fingers for reattachment in the
near future.
d. pack the fingers in a saline-soaked dressing and seal in a plastic
bag.
D.
Bursitis is an inflammatory process that may be caused by infection,
trauma, repetitive motion disorders, gout, or neoplastic disease. The
most common cause of septic bursitis due to infection is from which
of the following:
a. Mycobacterium tuberculosis
, b. Candida
c. Staphylococcus aureus.
d. streptococcus
C.
When a provider elicits a painful Finkelstein's sign he or she is
testing for:
a. carpal tunnel syndrone
b. bursitis of the shoulder.
c. de Quervain's tenosynovitis
d. tennis elbow.
C.
Marsha, age 34, presents with symptoms resembling both fibromyalgia
and chronic fatigue syndrome, which have many similarities. Which of
the following is more characteristic of fibromyalgia than of chronic
fatigue syndrome?
a. musculoskeletal pain
b. difficulty sleeping
c. depression
d. fatigue
A.
A coccygeal fracture is treated with:
a. traction
b. surgical repair
c. analgesia and by use of a donut cushion when sitting
d. prolonged bedrest for 6 weeks.
C.
The most common cause of cauda equina syndrome is:
a. fracture
b. hematoma
c. lumbar intervertebral disk herniation.
d. space occupying lesion.
C.
If any limitation or any increase in range of motion occurs when
assessing the musculoskeletal system, the angles of the bones should
be measured using:
a. Phalen's test
b. skeletometry
c. The Thomas test
d. a goniometer.
D.
Management of fibromyalgia would include:
a. giving psychotropic drugs, such as amitriptyline (Elavil), in a
low dose at bedtime.
b. instructing clients to keep as busy as possible to keep their
MUSCULOSKELETAL SECTION 100% GRADE
A+ SOLUTIONS
A 13 year old obese (BMI greater than 95%) boy reports low-grade left
knee pain for the past 2 months. He denies antecedent trauma but
admits to frequent horseplay with his friends. The pain has
progressively worsened, and he is now unable to bear weight at all on
his left leg. His current complaints include left groin, thigh, and
medial knee pain and tenderness. His examination demonstrates
negative Drawer, Lachman, and McMurray tests; left hip with decreased
internal rotation and abduction; and knee flexion causing external
hip rotation. Based on the above scenario, the NP should suspect:
a. a left meniscal tear.
b. a left ACL tear
c. a slipped capital femoral epiphysis
d. osgood-schlatter disease.
C.
Colchicine may be used to terminate an acute attack of gouty
arthritis as well as prevent recurrent episodes. The mechanism of
action is to:
a. interrupt the cycle of urate crystal deposition and inflammatory
response.
b. increase serum uric acid levels.
c. potentiate the excretion of uric acid.
d. inhibit the tubular reabsorption of urate, promoting the excretion
of uric acid.
A.
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
0:15
Full screen
,Brainpower
Read More
Cass, age 67, tells the NP that she has been diagnosed with a
condition that causes sudden flares of pain, swelling, and redness of
the joints in her toes. She cannot remember the name of the diagnosis,
but she knows that it is cause by urate crystals that "get stuck in
the joint and cause pain". Joan is on HcTz for management of her
hypertension. The NP should suspect a diagnosis of:
a. septic arthritis
b. gout.
c. rheumatoid arthritis.
d. Charcot neuro-osteoarthropathy
B.
Treatment of choice for polymyalgia rheumatica (PMR) is:
a. acetaminophen or NSAIDS
b. low dose steroids.
c. tricyclic antidepressants.
d. antibiotics
B.
Dan, age 49, developed osteomyelitis of the femur after a motorcycle
accident. Which of the following statements about the clinical
manifestations of osteomyelitis is correct?
a. integumentary effects involve swelling, erythema, and warmth at
the involved site.
b. there is a low grade fever with intermittent chills
c. musculoskeletal effects include tenderness of the entire leg.
d. cardiovascular effects include bradycardia.
A.
Matthew, age 52, is a chef who just severed two of his fingers with a
meat cutter. You would recommend that he:
a. wrap the severed fingers tightly in a dry towel for transport to
the emergency department with him.
b. leave the severed fingers at the scene because fingers cannot be
reattached.
c. immediately freeze the severed fingers for reattachment in the
near future.
d. pack the fingers in a saline-soaked dressing and seal in a plastic
bag.
D.
Bursitis is an inflammatory process that may be caused by infection,
trauma, repetitive motion disorders, gout, or neoplastic disease. The
most common cause of septic bursitis due to infection is from which
of the following:
a. Mycobacterium tuberculosis
, b. Candida
c. Staphylococcus aureus.
d. streptococcus
C.
When a provider elicits a painful Finkelstein's sign he or she is
testing for:
a. carpal tunnel syndrone
b. bursitis of the shoulder.
c. de Quervain's tenosynovitis
d. tennis elbow.
C.
Marsha, age 34, presents with symptoms resembling both fibromyalgia
and chronic fatigue syndrome, which have many similarities. Which of
the following is more characteristic of fibromyalgia than of chronic
fatigue syndrome?
a. musculoskeletal pain
b. difficulty sleeping
c. depression
d. fatigue
A.
A coccygeal fracture is treated with:
a. traction
b. surgical repair
c. analgesia and by use of a donut cushion when sitting
d. prolonged bedrest for 6 weeks.
C.
The most common cause of cauda equina syndrome is:
a. fracture
b. hematoma
c. lumbar intervertebral disk herniation.
d. space occupying lesion.
C.
If any limitation or any increase in range of motion occurs when
assessing the musculoskeletal system, the angles of the bones should
be measured using:
a. Phalen's test
b. skeletometry
c. The Thomas test
d. a goniometer.
D.
Management of fibromyalgia would include:
a. giving psychotropic drugs, such as amitriptyline (Elavil), in a
low dose at bedtime.
b. instructing clients to keep as busy as possible to keep their
