TEST BANK MORE THAN 370 QA

NR511 / NR 511 Final Exam Q & A

(Latest 2023 / 2024): Differential

Diagnosis & Primary Care Practicum – Chamberlain

TEST BANK MORE THAN 370 Q/A

A 13-year-old obese (body mass index [BMI] above the 95th percentile) 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 external hip rotation with knee flexion. Based on the above scenario, the nurse

practitioner should suspect:

• A left meniscal tear.
• A left anterior cruciate ligament (ACL) tear.
• A slipped capital femoral epiphysis (SCFE).
• Osgood-Schlatter disease. - ANSWER Option 3: SCFE is a

displacement of the femoral head relative to the femoral neck that occurs 1 / 4

through the physis (growth plate) of the femur. The vast majority of clients with this condition are obese, as the added weight increases shear stress across the physis. The mean age at diagnosis is 12 years for females and 13.5 years for males. Surgery is often required via in situ pin fixation (single screw) to stabilize the growth plate to prevent further slippage and avoid complications.In assessing the skeletal muscles, the nurse practitioner turns the patient's

forearm so that the palm is up. This is called:

• Supination.
• Pronation.
• Abduction.
• Eversion. - ANSWER Option 1: Turning the forearm so that the

palm is up is called supination. 2 / 4

Cass, age 67, tells the nurse practitioner (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 it is caused by urate crystals that "get stuck in the joint and cause pain." She is on hydrochlorothiazide (HCTZ) for management of her hypertension. The NP should

suspect a diagnosis of:

• Septic arthritis.
• Gout.
• Rheumatoid arthritis.
• Charcot neuro-osteoarthropathy. - ANSWER Option 2: Gout is a

disorder that involves abnormal metabolism of uric acid and results in hyperuricemia. High concentrations of urate precipitate into crystals that collect in tissue and joint spaces and can cause pain and inflammation. The patient's symptoms may be aggravated by the use of HCTZ.Matthew, age 52, is a chef who just severed 2 of his fingers with a meat cutter.

You would recommend that he: 3 / 4

• Wrap the severed fingers tightly in a dry towel for transport to the emergency

department with him.

• Leave the severed fingers at the scene because fingers cannot be reattached.
• Immediately freeze the severed fingers for reattachment in the near future.
• Wrap the fingers in a clean, damp cloth; seal them in a plastic bag; and place

the bag in an ice water bath. - ANSWER Option 4: If a client has severed his fingers, the fingers should be wrapped in a clean, damp cloth; sealed in a plastic bag; placed in an ice water bath; and transported to the emergency room along with the client.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?

• Musculoskeletal pain.
• Difficulty sleeping.
• Depression.
• Fatigue. - ANSWER Musculoskeletal pain is not characteristic of

chronic fatigue syndrome; rather, it is characteristic of fibromyalgia. The musculoskeletal pain, usually an achy muscle pain that may be localized or involve

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