NR511 NR 511 Final Exam Latest: Differential Diagnosis Primary Care

NR511 / NR 511 Final Exam (Latest 2023 /

2024): Differential Diagnosis & Primary Care

Practicum – Chamberlain

210 Q/A

One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complain is articular or nonarticular in origin. Which of the following in an example of an articular structure?

• Bone
• Synovium
• Tendons
• Fascia - ANSWER Synovium

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:

• Articular
• Inflammatory
• Nonarticular
• A and B - ANSWER Articular 1 / 4

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

• Decreased CRP

B.hyperalbuminemia

• Morning stiffness
• Weight gain - ANSWER Morning stiffness

Which of the following statements concerning the musculoskeletal exam is true?

• The uninvolved side should be examined initially and then compared to the

involved side

• The part of the body that is causing the patient pain should be examined first
• When possible, the patient should not be asked to perform active ROM

exercises to avoid causing pain

• Radiographs should always be obtained prior to examination so as not to cause

further injury to the patient. - ANSWER When possible, the patient should not be asked to perform active ROM exercises to avoid causing pain 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?

• 1
• 2
• 3
• 4
• 5 - ANSWER B 2 / 4

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 exam reveals a 75% reduction in both active and passive range of motion of the right shoulder. Mrs. Gray is also 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 exam and medical history, you suspect adhesive capulitis or "frozen shoulder." Which clue in Mrs. Gray's history supports this diagnosis?

A. HX HTN

• Her affected shoulder is her dominant arm
• Her HX of DM
• Her work as a secretary predisposes her to repetitive motions - ANSWER

HX of DM Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

• Posterior dislocations are more common than anterior dislocations
• There is a risk of neurovascular and neurosensory trauma, so the clinician

should check for distal pulses

• Recurrent dislocations are uncommon and would require great force to result

in injury

• Surgery is the most common treatment of choice - ANSWER

There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses 3 / 4

Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they will also develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?

• Carpal tunnel syndrome commonly occurs in families. Genetic factors are

thought to account for about half the risk of developing carpal tunnel.

• Only people with occupations that require repeated flexion extension of the

wrist, use of hand tools that require forceful gripping, or hand tools that vibrate are at risk for developing carpal tunnel.

• An underlying musculoskeletal disorder must be present for a person to develop

carpal tunnel.

• Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance. -

ANSWER Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about half the risk of developing carpal tunnel.Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

• The goal of TX is to prevent flexion and extension movements of the wrist
• Splints are used in carpal tunnel syndrome, because they allow for free

movement the fingers and thumb while maintaining the wrist in a neutral position C Corticosterioid injections are discouraged in the treatment of CTS because of the risks for median nerve damage, scarring, and infection

• All of the above - ANSWER All of the above
• / 4