Download NUR 603 Final Exam Review: Musculoskeletal Conditions - Questions and Answers and more Exams Nursing in PDF only on Docsity!
NUR 603 Final Exam Review
QUESTIONS WITH 100% CORRECT
ANSWERS. NEW UPDATE!!
Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? A. Gastrocnemius weakness B. A reduced or absent ankle reflex C. Numbness in the lateral foot
D. Paresthesia of the perineum and buttocks - CORRECT ANSWER -D.
Paresthesia of the perineum and buttocks Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most appropriate response from the clinician? A. "Complementary therapies should be considered only if surgical interventions are not successful." B. "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition." C. "I would be happy to discuss all the treatment options available to you. Compleme -
CORRECT ANSWER -C. "I would be happy to discuss all the treatment options
available to you. Complementary therapies, such as acupuncture, acupressure, and tai- chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy." John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? A. Valgus stress test B. McMurray circumduction test C. Lachman test
D. Varus stress test - CORRECT ANSWER -B. McMurray circumduction test
The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as: A. Apprehension sign B. Bulge sign C. Thumb sign
D. None of the above - CORRECT ANSWER -A. Apprehension sign
A clinician has performed a synovial fluid analysis and the results are as follows: visual analysis: turbid and yellow, viscosity: decreased, 52,000 white blood cells (WBCs) per mm3, polymorphonuclear leukocytes (PMNs): 75%, protein: 5 g/dL. Which of the following conditions could this result be attributed to? A. Rheumatoid arthritis B. Osteoarthritis C. Gout
D. Septic arthritis - CORRECT ANSWER -D. Septic arthritis
Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient? A. Elevated uric acid level B. Elevated blood urea nitrogen C. Decreased urine pH
D. Decreased C-reactive protein - CORRECT ANSWER -A. Elevated uric acid
level Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform? A. Allen's test B. Phalen's test C. Tinel's sign
D. Finkelstein's test - CORRECT ANSWER -B. Phalen's test
Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? A. Morning stiffness and limited mobility of the lumbar spine
B.Physical examination of the hip must first assess its position at rest. C.The patient should move the hip prior to radiographic studies to determine whether they are necessary. D.Flexion and extension of the affected hips' extremity should only be performed with
the knee straight. - CORRECT ANSWER -B.Physical examination of the hip must
first assess its position at rest. Which diagnostic test is the diagnostic gold standard for patients that have tendonitis and have failed conservative treatment? A. Plain x-ray films B. Magnetic resonance imaging (MRI) C. Computed tomography (CT) scan
D. Surgical exploration - CORRECT ANSWER -B. Magnetic resonance imaging
(MRI)
Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? A. Decreased C-reactive protein B. Hyperalbuminemia C. Morning stiffness
D. Weight gain - CORRECT ANSWER -C. Morning stiffness
The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane's description of her injury. Which of the following clues in Diane's examination or history would alert the clinician to the need for obtaining radiographs? A. Inability to bear weight immediately after the injury B. Development of marked ankle swelling and discoloration after the injury C. Crepitation with palpation or movement of the ankle
D. All of the above - CORRECT ANSWER -D. All of the above
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
The clinician sees a patient who has a body mass index (BMI) of 32.4 kg/m2. How would the clinician classify this patient? A. Overweight B. Obesity Class 1
C. Obesity Class 2
D. Obesity Class 3 - CORRECT ANSWER -B. Obesity Class 1
A patient is 11 years old and recently had her tonsils removed. Which of the following medications is safe to give to this patient? A. Ultram B. Ultracet C. Codeine
D. Tylenol - CORRECT ANSWER -D. Tylenol
•What to give to children? Mild, moderate to severe
•Adults? - CORRECT ANSWER -
According to the American Pain Society, an example of the first-line therapy for mild pain includes which of the following? A. Tylenol B. Hydrocodone C. An opioid
D. Muscle relaxant - CORRECT ANSWER -A. Tylenol
For acute pain, how many days are considered sufficient for treatment with opioids? A. 3 B. 5 C. 4
D. 9 - CORRECT ANSWER -A. 3
Which of the following best describes the onset of action for a fentanyl patch after application? A. 12 to 16 hours B. 1 to 2 hours C. 17 to 19 hours
D. 4 to 6 hours - CORRECT ANSWER -A. 12 to 16 hours
What is the likely result of the over-prescription, over-supply, and over-production of opioids? A. Opioid use B. Opioid abuse C. Opioid dependence
D. Opioid resistance - CORRECT ANSWER -B. Opioid abuse
Which of the following is considered first-line treatment for panic disorders? A. Benzodiazepines B. Selective serotonin reuptake inhibitors (SSRIs) C. Tricyclic antidepressants
B. Depressed middle-aged adults C. Individuals with a depressed immune system
D. Individuals who are hypochondriacs - CORRECT ANSWER -A. Active, highly
functional adults You have a patient who is a positive for strep on rapid antigen testing (rapid strep test). You order amoxicillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5°F in office). You also note significant lymphadenopathy, most notably in the posterior and anterior cervical chains, some hepatosplenomegaly, and a diffuse rash. You decide: A. To refer the patient B. That he is having an allergic response and needs to be changed to a macrolide antibiotic C. That his antibiotic dosage is not sufficient and should be changed D. That he possibly has mononucleosis concurrent with his strep infection -
CORRECT ANSWER -D. That he possibly has mononucleosis concurrent with
his strep infection Infectious mononucleosis results from an acute infection with which of the following? A. Epstein-Barr virus B. Acute HIV infection C. Guillain-Barré
D. Hepatitis - CORRECT ANSWER -A. Epstein-Barr virus
What is the mainstay of management for infectious mononucleosis? A. Antivirals B. Symptom control C. Corticosteroids
D. Isolation - CORRECT ANSWER -B. Symptom control
Keratoconjunctivitis sicca is a classic sign of which condition? A. Systemic lupus erythematosus B. Sjögren's syndrome C. Fibromyalgia syndrome
D. Lyme disease - CORRECT ANSWER -B. Sjögren's syndrome
When analyzing synovial fluid, if it has 10,000 white blood cells/mcL with 80% polymorphonuclear neutrophils (PMNs), it may be indicative of which of the following conditions? A. None, this is a normal result B. Scleroderma C. Rheumatoid arthritis
D. Sickle cell disease - CORRECT ANSWER -C. Rheumatoid arthritis
When analyzing synovial fluid, if it has 10,000 white blood cells/mcL with 80% polymorphonuclear neutrophils (PMNs), it may be indicative of which of the following conditions? A. None, this is a normal result B. Scleroderma C. Rheumatoid arthritis
D. Sickle cell disease - CORRECT ANSWER -C. Rheumatoid arthritis
Which phrase describes rheumatoid arthritis (RA)? A. Localized synovial joint destruction B. Chronic exocrine dysfunction C. Systemic inflammatory disease
D. Antibody-mediated cellular cytotoxicity response - CORRECT ANSWER -C.
Systemic inflammatory disease Which person is four times more likely to develop systemic lupus erythematosus (SLE) than a Caucasian? A. One of African descent B. An Asian C. A Hispanic
D. One from the Middle East - CORRECT ANSWER -A. One of African descent
A 35-year-old woman presents with symptoms of hypoglycemia. There is no history of diabetes mellitus. Which condition should be included in the differential diagnosis? A. Peripheral vascular disease B. Pheochromocytoma C. Cushing's disease
D. Acromegaly - CORRECT ANSWER -B. Pheochromocytoma
A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? A. Ketoacidosis B. Cirrhosis C. Hypoglycemic episodes
d. All of the above - CORRECT ANSWER -D. All of the above
How often should the clinician examine the feet of a person with diabetes? A. Every year B. Every 6 months C. Every 3 months
D. Every visit - CORRECT ANSWER -D. Every visit
A. Becoming overhydrated B. Taking folic acid supplements C. Becoming physically overtaxed
D. Taking rest periods during the day - CORRECT ANSWER -C. Becoming
physically overtaxed Which blood cell is excessively elevated in a person who has polycythemia? A. Platelets B. Neutrophils C. Red blood cells
D. All types of blood cells - CORRECT ANSWER -C. Red blood cells
Which treatment would the clinician recommend for a patient who has relative polycythemia? A. Rehydration B. Antihistamines C. Weekly phlebotomies
D. Referral to hematologist - CORRECT ANSWER -A. Rehydration
The clinician should examine which area for gynecomastia? A. Female's vagina B. Male's breast C. Male's penis
D. Female's ovaries - CORRECT ANSWER -B. Male's breast
You are providing end-of-life care to an elderly patient with a history of heart failure. The patient complains of dyspnea. What is often the first line treatment for this condition? A. Oxygen B. Benzodiazepines C. Opioids
D. Nonpharmacological solution - CORRECT ANSWER -A. Oxygen
After returning from visiting his grandchildren in Connecticut, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. Which disease should the clinician be considering? A. Rubella B. Lyme disease C. Fibromyalgia syndrome
D. Shingles - CORRECT ANSWER -B. Lyme disease
If left untreated, this condition will progress to complaints that include multiple joint arthritis. A. Sjögren's syndrome
B. HIV/AIDS
C. Guillain-Barré
D. Lyme disease - CORRECT ANSWER -D. Lyme disease
Which condition if left untreated will progress to complaints that include multiple joint arthritis? A. Sjögren's syndrome B. HIV/AIDS C. Guillain-Barré
D. Lyme disease - CORRECT ANSWER -D. Lyme disease
Lyme disease treatment - CORRECT ANSWER -treatment for Lyme disease
(doxycycline) Diana, 55, complains of ear pain, right facial weakness, and loss of taste. What diagnosis would you consider? A. Lyme disease B. Stroke C. Ear infection
D. Brain tumor - CORRECT ANSWER -A. Lyme disease
Bipolar disorder requires differential diagnosis from all of the following except? A. Substance abuse and medication effects B. Medical and neurological disorders Downloaded by J. Joyce Stanton (stantonjj@mail.irsc.edu)lOMoARcPSD| C. Cluster B personality disorders and depression
D. Obsessive-compulsive disorder - CORRECT ANSWER -D. Obsessive-
compulsive disorder Which medication is used as a first-line treatment in the management of bipolar disorder? A. Gabapentin B. Lamotrigine C. Carbamazepine
D. Topiramate - CORRECT ANSWER -C. Carbamazepine
Alexa is a 17-year-old female who participates in figure skating. Which of the following issues is she at risk for being in an aesthetic sport? A. Bulimia B. Drug abuse C. Asthma
D. Presyncope - CORRECT ANSWER -A. Bulimia
C. History of broken bones
D. History of cancer - CORRECT ANSWER -B. History of heart disease
After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor? A. 2 weeks B. 3 weeks C. 4 weeks
D. 5 weeks - CORRECT ANSWER -D. 5 weeks
•MAOIs and drug interactions - CORRECT ANSWER -MAOI AND SSRIs cause
Seratonin Syndrome It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? A. Prior to the antidepressant reaching therapeutic levels B. As the mood lifts in response to antidepressant treatment C. During dosage or medication adjustments
D. After the patient reveals suicidal thoughts or plans - CORRECT ANSWER -B.
As the mood lifts in response to antidepressant treatment Suicide plans are assessed on all of the following, EXCEPT: A. Specificity B. Possibility C. Availability
D. Lethality - CORRECT ANSWER -B. Possibility
The stooped posture, motor slowness, and minor cognitive impairments of patients with major depressive disorders are similar to the signs of disorders of the basal ganglia, such as: A. Parkinson's disease B. Stevens-Johnson syndrome C. Neurological disease
D. Huntington's disease - CORRECT ANSWER -A. Parkinson's disease
A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease? A. Sinus bradycardia B. Atrial fibrillation C. Supraventricular tachycardia
D. U waves - CORRECT ANSWER -A. Sinus bradycardia
The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? A. High sensitivity thyroid-stimulating hormone (TSH) and free T B. Free T4 and serum calcium C. Free T3 and T
D. TSH and thyroxin antibodies - CORRECT ANSWER -A. High sensitivity
thyroid-stimulating hormone (TSH) and free T A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which test should be ordered next?A. Serum calcium B. Thyroid-stimulating hormone C. Electrolytes
D. Urine specific gravity - CORRECT ANSWER -B. Thyroid-stimulating hormone
After 6 months of Synthroid therapy, the clinician should expect which result in the repeat thyroid-stimulating hormone studies? A. Elevated B. Normal C. Low
D. Undetectable - CORRECT ANSWER -B. Normal
Which of the following is essential for diagnosing thyroid cancer? A. Fine needle aspiration biopsy B. Thyroid ultrasound C. Computed tomography scan
D. Magnetic resonance imaging - CORRECT ANSWER -A. Fine needle
aspiration biopsy The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: A. 1 month B. 3 months C. 6 months
D. 12 months - CORRECT ANSWER -C. 6 months
The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? A. Acetylcholine B. Gamma-aminobutyric acid (GABA) C. Dopamine
C. Avoid nuts and seeds
D. Eat six small meals a day - CORRECT ANSWER -D. Eat six small meals a
day Which laboratory test result is diagnostic for hypoglycemia? A. A1c 7.0% B. Fasting blood sugar of 75 mg/dL C. Glucose level 43 mg/dL
D. Random glucose level 64 mg/dL - CORRECT ANSWER -C. Glucose level 43
mg/dL A patient presents to the emergency department with delirium, dilated pupils bilaterally, and hypoactive bowel sounds. Skin is flushed and dry; mucous membranes are dry. Upon admission, a urinary catheter was inserted with no output. These clinical manifestations describe which common toxidrome? A. Cholinergic B. Sedative-hypnotic C. Anticholinergic
D. Sympathomimetic - CORRECT ANSWER -C. Anticholinergic
What condition is sometimes confused with anaphylaxis from an insect sting? A. Heat stroke B. Toxic syndrome C. Vasovagal reaction
D. Inflammatory response - CORRECT ANSWER -C. Vasovagal reaction
Which diagnostic test is the best to diagnose a subdural hematoma? A. History B. Positron emission tomography C. Magnetic resonance imaging (MRI)
D. Computed tomography (CT) scan - CORRECT ANSWER -C. Magnetic
resonance imaging (MRI) Which causes the greatest percentage of mammalian bites? A. Dogs B. Cats C. Humans
D. Rodents - CORRECT ANSWER -A. Dogs
Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue? A. Tick B. Brown recluse spider C. Wasp
D. Stinging caterpillar - CORRECT ANSWER -B. Brown recluse spider
Why are people with cystic fibrosis (CF) especially vulnerable to heat stroke? A. Intravascular coagulation prevents the production of chloride. B. Blood flow to the skin is impaired in temperatures above 95°. C. Sweat glands are inactive in CF.
D. Salts from perspiration are not reabsorbed after sweating. - CORRECT
ANSWER -D. Salts from perspiration are not reabsorbed after sweating.
Why do benzodiazepines have less potential for toxicity than barbiturates? A. They cause decreased neuronal activity, depressed central sympathetic tone, and inhibit cardiac contractility. B. They increase ligand affinity and the frequency of ion channel opening, but not the duration of time the channel remains open. C. They act directly on inhibitory gamma-aminobutyric acid (GABA) receptors.
D. They increase the average opening time of chloride ion channels. - CORRECT
ANSWER -B. They increase ligand affinity and the frequency of ion channel opening,
but not the duration of time the channel remains open. A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which affected cranial nerve? A. CN II B. CN III C. CN IV
D. CN V - CORRECT ANSWER -C. CN IV
CSF may leak through the cribriform plate region of the skull following a head injury and cause which of the following? A. Ear CSF otorrhea B. Leakage of CSF from the eye C. Nasal CSF rhinorrhea
D. Leakage of CSF from the mouth - CORRECT ANSWER -C. Nasal CSF
rhinorrhea HITS is a validated instrument used to identifying intimate partner violence. What does HITS stand for? A. Hit, Injured, Threatened, Scared B. Hurt, Insult, Threaten, Scream C. Humiliated, Isolated, Tortured, Scarred
D. Harm, Injury, Terror, Shame - CORRECT ANSWER -B. Hurt, Insult, Threaten,
Scream If a suspected pneumothorax is discovered in the primary-care setting, what should happen first?
ADHD: •Treatment of choice for adults and children - CORRECT ANSWER -
BEHAVIOR THERAPY
If stimulant drugs are not tolerated or contraindicated for the treatment of ADHD, what medication may produce a therapeutic effect? A. Daytrana B. Vyvanse C. Warfarin
D. Atomoxetine - CORRECT ANSWER -D. Atomoxetine
What is the advantage of guanfacine (i.e., Tenex, Intuniv) over clonidine (i.e., Catapres, Kapvay) for the treatment of ADHD? A. Tapering off is not required on discontinuation B. Therapeutic effect is instantaneous C. Wider range of available dosages
D. Less sedation and longer duration of action - CORRECT ANSWER -D. Less
sedation and longer duration of action Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)? A. Liver function B. Vision C. Growth parameters
D. Renal function - CORRECT ANSWER -C. Growth parameters
The current goal of treatment for a patient with HIV infection is which of the following? A. Viral suppression of HIV to undetectable levels in the peripheral blood B. Compete eradication of the virus C. Encouraging the person to have no contact with uninfected individuals
D. Complete abstinence - CORRECT ANSWER -A. Viral suppression of HIV to
undetectable levels in the peripheral blood What does the I stand for in the mnemonic DELIRIUM used to assess causes for delirium in an older patient? A. Infection B. Identity crisis C. Influenza
D. Internal injury - CORRECT ANSWER -A. Infection
The clinician is using the mnemonic ETHICAL to solve a practice dilemma. What does the "A" represent? A. Accountability B. Autonomy C. Assess
D. Act - CORRECT ANSWER -D. Act
Spontaneous bruising may be seen with platelet counts below what level? A. 100,000 cells/mL B. 75,000 cells/mL C. 50,000 cells/mL
D. 30,000 cells/mL - CORRECT ANSWER -D. 30,000 cells/mL
As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? A. Two B. Three C. Four
D. Five - CORRECT ANSWER -B. Three
What blood alcohol level corresponds with the signs of stupor and confusion? A. 0. B. 0. C. 0.
D. 0.3 - CORRECT ANSWER -D. 0.
•Alkaline urine- what is it and how to treat - CORRECT ANSWER -
Which blood test would confirm a diagnosis of diabetes mellitus? A. A1c 5.5% B. Fasting plasma glucose level of 120 mg/dL C. Oral glucose tolerance test 250 mg/dL (2-hour level)
D. Random plasma glucose level 175 mg/dL - CORRECT ANSWER -C. Oral
glucose tolerance test 250 mg/dL (2-hour level) Which lab test would the clinician order to monitor for a significant side effect from tenofovir disoproxil fumarate? A. Urine protein B. Allele genetic testing C. Sodium level
D. Hemoglobin - CORRECT ANSWER -A. Urine protein
Which laboratory finding should the clinician observe in a patient with untreated Graves' disease? A. Elevated TSH B. Decreased T C. Decreased TSH receptor antibody test
D. Elevated antithyroglobulin antibodies - CORRECT ANSWER -D. Elevated
antithyroglobulin antibodies
