Davis Edge- Musculoskeletal Disorders Week 5

Mr. McKinsey, age 69, was recently given a diagnosis of degenerative joint disease. Which assessment should the nurse practitioner use to check for effusion of the patient’s knee? a. Thomas test b. Tinel Test c. Bulg ...

Mr. McKinsey, age 69, was recently given a diagnosis of degenerative joint disease. Which assessment should the nurse practitioner use to check for effusion of the patient’s knee? a. Thomas test b. Tinel Test c. Bulge test d. Phalen test A nurse practitioner is driving home from work and stops at the scene of a motorcycle accident that must have just occurred, as there are no rescue vehicles present. The driver is lying unconscious at the side of the road with an obvious open fracture of his femur. Which of the following actions should take priority? a. Stopping the bleeding from the wound. b. Determining if there has been a cervical fracture. c. Establishing an airway. d. Palpating the peripheral pulses. The valgus stress test, varus stress test, Lachman test, and thumb sign are all considered standard tests to check the integrity of the ligaments of the knee. Which test would the nurse practitioner choose to assess the anterior cruciate ligament (ACL), which is the most commonly involved structure in severe knee injury? a. Valgus stress test. b. Varus stress test. c. Lachman test. d. Thumb sign. You are assessing Jamal, age 16, after a football injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: a. Lateral meniscus. b. Cruciate ligament. c. Medial meniscus. d. Collateral ligament. 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: A. Septic arthritis. B. Gout. C. Rheumatoid arthritis. D. Charcot neuro-osteoarthropathy. Ethan, age 10, jumped off a 2-foot wall, twisting his foot and ankle upon landing. His ankle x-ray demonstrates a fracture of the distal tibia, over the articular surface, through the epiphysis and physis. Based on the Salter-Harris classification of growth plate injuries, you know this is a: a. Salter-Harris II fracture. b. Salter-Harris III fracture. c. Salter-Harris IV fracture. d. Salter-Harris V fracture. Mrs. Kelly, age 80, has a curvature of the spine. This is likely to indicate which age-related change? a. Lordosis. b. Dorsal kyphosis. c. Scoliosis. d. Kyphoscoliosis. Upon assessment, the nurse practitioner notes unilateral back pain of acute onset that increases when standing and bending. A straight leg raise test is negative. The most likely diagnosis is: a. Herniated nucleus pulposus. b. Muscle strain. c. Osteoarthritis. d. Spondylolisthesis. Joyce, age 87, broke her wrist after falling off a curb. She just had a plaster cast applied to her wrist. In instructing Joyce and her family on allowing the cast to dry properly, tell them to: a. Continuously elevate Joyce’s arm on a pillow. b. Change the position of Joyce’s arm every hour. c. Position a fan near Joyce during the night to ensure even drying of the cast. d. Put a blanket over the cast to absorb the dampness. Anne, age 67, sustained a fall on an outstretched hand. She presents holding her arm against her chest with her elbow flexed. Based on the specific location of her pain, you suspect a radial head fracture. The best initial strategy to assess for a radial head fracture would be: a. To palpate for tenderness, swelling, and crepitus just distal to the lateral epicondyle. b. To palpate for tenderness, swelling, and crepitus along the radial wrist. c. To palpate for tenderness in the “anatomical snuffbox.”