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NURS 623 EXAM 4 QUESTIONS WITH ACCURATE SOLUTIONS, Exams of Nursing

NURS 623 EXAM 4 QUESTIONS WITH ACCURATE SOLUTIONS

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NURS 623 EXAM 4 QUESTIONS WITH ACCURATE
SOLUTIONS
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 -- Answer โœ”โœ” b. Synovium
2) You have detected the presence of crepitus on examination of a patient with a
musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with
both active and passive movement. These findings suggest that the origin of the
musculoskeletal complaint is:
a. Articular
b. Inflammatory
c. Nonarticular
d. A and B -- Answer โœ”โœ” a. Articular
3) 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 -- Answer โœ”โœ” c. Morning stiffness
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NURS 623 EXAM 4 QUESTIONS WITH ACCURATE

SOLUTIONS

  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 -- Answer โœ”โœ” b. Synovium
  2. You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: a. Articular b. Inflammatory c. Nonarticular d. A and B -- Answer โœ”โœ” a. Articular
  3. 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 -- Answer โœ”โœ” c. Morning stiffness
  1. Which of the following statements concerning the musculoskeletal examination 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 patient pain should be examined first. c. When possible, the patient should not be asked to perform active range- of-motion (ROM) exercises to avoid causing pain. d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. -- Answer โœ”โœ” a. The uninvolved side should be examined initially and then compared to the involved side.
  2. You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ROM with gravity eliminated. Which numeric grade of muscle strength would you give this patient? a. 1 b. 2 c. 3 d. 4 e. 5 -- Answer โœ”โœ” b. 2
  3. 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 examination reveals a 75% reduction in both active and passive ROM 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. History of hypertension b. Her affected shoulder is also her dominant arm. c. Her history of diabetes mellitus d. Her work as a secretary predisposes her to repetitive motions. -- Answer โœ”โœ” c. Her history of diabetes mellitus

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. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. Pathologic fractures, severe night pain, weight loss, and fatigue -- Answer โœ”โœ” b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

    1. The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? a. "You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage." b. "You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication." c. "You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain." d. "It is important to take NSAIDs on an empty stomach in order to increase absorption." -- Answer โœ”โœ” a. "You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage."
  1. 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 -- Answer โœ”โœ” d. Paresthesia of the perineum and buttocks

  1. Which of the following statements is true concerning the management of the client with a herniated disc? a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use. b. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred. c. Intolerable pain for more than a 3-month period is an indication for surgical intervention. d. All of the above -- Answer โœ”โœ” c. Intolerable pain for more than a 3- month period is an indication for surgical intervention.
  2. 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 -- Answer โœ”โœ” b. McMurray circumduction test
  3. Normal estrogen function is important for preventing osteoporosis in both men and women. Estrogen works to prevent osteoporosis in which of the following ways? a. By decreasing the erosive activity of osteoclasts b. By promoting osteoclastogenesis c. By inhibiting osteoclast apoptosis d. All of the above -- Answer โœ”โœ” a. By decreasing the erosive activity of osteoclasts
  1. Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: a. Ecchymosis, edema, and erythema over the lateral epicondyle b. Pain at the elbow with resisted movements at the wrist and forearm c. Inability to supinate and pronate the arm d. Inability to flex or extend the elbow against resistance -- Answer โœ”โœ” b. Pain at the elbow with resisted movements at the wrist and forearm
  2. T/F-Osteoarthritis is primarily a noninflammatory condition. -- Answer โœ”โœ” True
  3. Evaluation of the knee? ACL -- Answer โœ”โœ” Lachmanโ€™s test Anterior Drawer test
  4. Evaluation of the knee? MCL & LCL -- Answer โœ”โœ” Valgus/Varus stress
  5. Evaluation of the knee? Meniscal tears -- Answer โœ”โœ” McMurray & Apley
  6. Evaluation of the knee? PCL -- Answer โœ”โœ” Posterior drawer
  7. Evaluation of the knee? For patellar disloc. -- Answer โœ”โœ” Apprehension
  8. Which of these characteristics is true with someone with dementia? a. Tremors at rest

b. Abrupt onset c. it is progressive to irreversible d. blank stare -- Answer โœ”โœ” c

  1. How do you test meningeal movement? -- Answer โœ”โœ” Kernig & Brudinzki
  2. Which statement about confusion is true? a. Confusion is a disease process. b. Confusion is always temporary. c. Age is a reliable predictor of confusion. d. Polypharmacy is a major contributor to confusion in older adults. -- Answer โœ”โœ” D. Polypharmacy
  3. Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? a. Meclizine b. Diphenhydramine c. Diamox d. Promethazine -- Answer โœ”โœ” C- Diamox
  4. The hallmark of an absence seizure is: a. No activity at all b. A blank stare c. Urine is usually voided involuntarily d. The attack usually lasts several minutes -- Answer โœ”โœ” B
  5. The hallmark of an simple partial seizure is: a. No activity at all b. A blank stare c. Consciousness intact d. The attack usually lasts several minutes -- Answer โœ”โœ” C
  6. The hallmark of an complex partial seizure is:

a. Cholinesterase inhibitors b. Anxiolytics c. Antidepressants d. Atypical antipsychotics -- Answer โœ”โœ” A

  1. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? a. CN V b. CN VII c. CN IX d. CN X -- Answer โœ”โœ” A
  2. Which patient is more likely to have a cluster headache? a. A female in her reproductive years b. A 40-year-old African American male c. A 55-year-old female who drinks 10 cups of coffee daily d. A 45-year-old male awakened at night -- Answer โœ”โœ” D
  3. Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? a. Dementia b. Alzheimer's disease c. Parkinson's disease d. Delirium -- Answer โœ”โœ” D
  4. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus? a. Purulent meningitis b. Chronic meningitis c. Aseptic meningitis d. Herpes meningitis -- Answer โœ”โœ” c
  5. What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

a. A stabbing pain on one small area of the body b. A vesicular skin lesion on one side of the body c. A pain that is worse upon awakening d. A lesion on the exterior ear canal -- Answer โœ”โœ” B

  1. Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? a. "Most patients have complete recovery in 3 to 6 months." b. "Unfortunately, you'll probably have a small amount of residual damage." c. "Don't worry, I'll take care of everything." d. "You may have a few more episodes over the course of your lifetime but no permanent damage." -- Answer โœ”โœ” A
  2. Sam, aged 65, is started on L-dopa for his Parkinson's disease (PD). He asks why this is necessary. You tell him: a. "L-dopa is neuroprotective." b. "The primary goal of therapy is to replace depleted stores of dopamine." c. "This is the only drug that can provide symptomatic benefit." d. "This is the initial monotherapy drug." -- Answer โœ”โœ” B
  3. Which of the following is the most commonly experienced symptom of migraine? a. Light sensitivity b. Pulsatile pain c. Sound sensitivity d. Experiencing an aura -- Answer โœ”โœ” B
  4. Which of the following characteristics differentiates peripheral vertigo from central vertigo? a. The duration of central vertigo is shorter than that of peripheral vertigo. b. There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo. c. Central vertigo is positional, and peripheral vertigo is not. d. The onset of central vertigo is more sudden than that of peripheral vertigo. -- Answer โœ”โœ” B

d. Huntington's disease -- Answer โœ”โœ” B

  1. What is the main overall goal of therapy for the client with Parkinsonโ€™s disease? a. to halt the progression of the disease b. to keep the client functioning independently as long as possible c. to control the symptoms of the disease d. to ease the depression assoc. w/ the disease -- Answer โœ”โœ” b
  2. Which seizure type involves alteration of consciousness? a. myoclonic seizures b. absence seizures c. clonic seizures -- Answer โœ”โœ” b
  3. You are performing some neurological assessment tests on Daniel. When you ask Daniel to lie supine and flex his head to his chest, what are you assessing? a. Brudzinski's sign b. Kernig's sign c. Decorticate posturing d. Decerebrate posturing -- Answer โœ”โœ” a
  4. Which of the following drugs used for Parkinsonism mmimics dopamine? a. anticholinergics b. levodopa (L-dopa) c. bromocriptine d. tolcapone -- Answer โœ”โœ” c
  5. The older adult with delirium would present with which of the following behaviors? a. fatigue, apathy, and occ. agitation b. agitation, apathy, and wandering behavior c. agitation and restlessness d. slowness and absence of purpose -- Answer โœ”โœ” c
  6. What is the leading cause of bacterial meningitis in adults?

a. Heamophilus influenza b. meningococcal c. streptococcus pneumoniae d. gram negative pneumonia -- Answer โœ”โœ” c

  1. You suspect Sarah, age 72, has a herniated disk. You elevate her affected leg when she is in the supine position, and so elicita back pain and sciatic pain, which indicates a positive test. This is known as which test or sign? a. femoral stretch teat b. cross straight-leg-raising test c. doorbell sign d. straight leg raising test -- Answer โœ”โœ” d. straight leg
  2. Don, age 62, calls to complain of a severe HA. Which of his following statements most concerns you? a. "it hurts when I turn my head a specific way" b. "It's the worst HA I've ever had" c. "Nothing I do seems to help this constant pain" d. "I'm so worried. Can you do a CT scan?" -- Answer โœ”โœ” b
  3. Carol, age 62, has swollen, boney proximal interphalangeal joints. You describe these as: a. heberdens nodes b. bouchards nodes c. oslers nodes d. murphys nodes -- Answer โœ”โœ” b
  4. Sandra, a computer programmer, has just been given a new disgnosis of carpal tunnel syndrome. Your next step is to: a. refer her to a hand surgeon b. take a more complete hx c. try neutral position wrist splinting and order an oral NSAID d. order a nerve conduction study such as electromyography -- Answer โœ”โœ” c