MARYVILLE NURS 623 EXAM 4 AND STUDY

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MARYVILLE NURS 623 EXAM 4 AND STUDY

GUIDE 2024 ACTUAL EXAM COMPLETE 160

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NURS 623 EXAM 4 MARYVILLE UNIVERSITY

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?

• Morning stiffness and limited mobility of the lumbar spine
• Unilateral radicular pain symptoms that extend below the

knee and are equal to or greater than the back pain

• Fever, chills, and elevated erythrocyte sedimentation rate
• Pathologic fractures, severe night pain, weight loss, and

fatigue - ANSWER- b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain 1 / 4

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• 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?

• "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."

• "You should start with the lowest dose that is effective in

managing your pain to avoid developing tolerance to the medication."

• "You should take the maximum recommended dose of

NSAIDs so that you will not need to take narcotics to control your pain."

• "It is important to take NSAIDs on an empty stomach in order

to increase absorption." - ANSWER- 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."

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. 2 / 4

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Which of the following is a sign or symptom of cauda equina compression?

• Gastrocnemius weakness
• A reduced or absent ankle reflex
• Numbness in the lateral foot
• Paresthesia of the perineum and buttocks - ANSWER- d.

Paresthesia of the perineum and buttocks

Which of the following statements is true concerning the management of the client with a herniated disc?

• Muscle relaxants and narcotics can be used to control

moderate pain but should be discontinued after 3 weeks of use.

• An epidural injection is helpful in reducing leg pain that has

persisted for at least 3 weeks after the herniation occurred.

• Intolerable pain for more than a 3-month period is an

indication for surgical intervention.

• All of the above - ANSWER- c. Intolerable pain for more

than a 3-month period is an indication for surgical intervention.

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 3 / 4

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a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

• Valgus stress test
• McMurray circumduction test
• Lachman test
• Varus stress test - ANSWER- b. McMurray circumduction

test

Normal estrogen function is important for preventing osteoporosis in both men and women. Estrogen works to prevent osteoporosis in which of the following ways?

• By decreasing the erosive activity of osteoclasts
• By promoting osteoclastogenesis
• By inhibiting osteoclast apoptosis
• All of the above - ANSWER- a. By decreasing the erosive

activity of osteoclasts

Which of the following tests is considered the gold standard for definitively diagnosing osteoporosis?

• Bone alkaline phosphatase levels
• Urinary N-telopeptide assay
• Bone mass density measurement by densitometry
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