NSG 6020- Orthopedics

A thickened nodule overlying the flexor tendon of the 4th finger and possibly the 5th finger near the distal palmar crease is suggestive of:

Dupuytren's contracture

Restrictions of internal and external rotation of the hip are sensitive indicators of:

arthritis

Upon examination of the left shoulder, the left arm is at the patient's side. The elbow is flexed 90 degrees and the patient is instructed to supinate the forearm against the nurse practitioner's resistance; increased pain in the bicipital grove results. This finding confirms:

bicipital tendinitis

a 64 year old man complains of worsening pain that radiates from the right buttocks to the posterior upper thigh. This is a common complaint associated with:

sciatica

Decreased spinal mobility in the lumbar region could be suggestive of:

osteoarthritis

Restriction abduction of the hip in an adult is common hip:

osteoarthritis

Blue sclera, weak muscles, and increased joint flexibility during a newborn assessment may be suggestive of:

osteogenesis imperfecta

Women who wear high-heeled shoes with narrow toe boxes are at risk of developing all of the following forefoot abnormalities except:

achilles tendinitis

When performing a musculoskeletal examination, the nurse practitioner instructs the patient to move his arm in front of his body. This motion of the shoulder girdle would be an example of:

flexion

When performing a musculoskeletal examiniation, the nurse practitioner instructs the patient to move his arm in front of himself.... and overhead. This motion of the shoulder girdle would be an example:

flexion

A decrease in the degree of density in a bone that results in fragile bones is referred to as:

osteoporosis

When performing a spinal exam, the nurse practitioner notices unequal heights of the iliac crest. This finding could be suggestive of:

unequal leg length

when performing a spinal exam, the patient complains of vertebral tenderness. this finding could be suggestive of:

A vertebral fracture

Which of the following symptoms would be suggestive of lumbar spinal stenosis?

Thigh pain after 30 seconds of lumbar extension

Genu varum refers to:

bow leggedness

To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the:

upper edge of the tibial plateau

Physical signs associated with cervical radiculopathy from nerve root compression include:

weakness in the triceps and finger flexors and extrensors

Thenar atrophy suggests:

A median nerve disorder

The Lachman Test is used to assess instability of the:

anterior cruciate ligament (ACL)

When inspecting the should and shoulder girdle, the rounded lateral aspect of the should appears flattened. This finding could be associated with:

Anterior should dislocation

Which one of the following ligaments of the foot is most at risk of injury from inversion?

Anterior talofibular ligament

A condition resulting from a forceful throwing motion and causing the should to :slip out of the joint" when the arm is abducted and externally rotated is known as:

anterior dislocation of the humerus

When examining the knee, which of the following symptoms could be indicative of a positive Adduction (Varus) stress test?

Pain in the lateral joint line

When performing a musculoskeletal examination, the nurse practitioner instructs the patient to move his arm behind himself. This motion of the should girdle would be an example of:

Extension

When evaluating a patient who complains of thumb pain, the nurse practitioner would test thumb movement by instructing the patient to place his thumb in the palm and then move the wrist toward the midline in ulnar deviation. This maneuver is commonly known as:

Finkelstein's test

To test the anterior and lateral deltoid, pectoralis major, coracobrachialis and biceps brachii muscles, the nurse practitioner would have the patient perform which should movement?

Flexion

On examination of the foot, the nurse practitioner notes acute inflammation of the first metatarsophalangeal joint. This finding could be consistent wit h

Gout

When assessing a 3-month-old for developmental dysplasia of the hips (DDH), which one of the following symptoms would be suspicious of dysplasia?

Limitation of abduction of the affected extremity, shortening of the femur and positive Ortolani's sign

On examination of the six-week-old infant, developmental hip dysplasia (DDH) is suspected. If DHH is present, it might be evidenced by:

Limited abduction of the affected leg

Which nerve in the arm is located in the ventral forearm and is just medial to the brachial artery in the antecubital fossa?

Median nerve

Which one of the following conditions can plantar fasciitis be associated?

Rheumatoid arthritis

When inspecting the shoulder and shoulder girdle, an elevation of the right should was noted this finding could be associated with:

Scoliosis

When testing hand grip strength on a patient, the nurse practitioner asks the patient to squeeze which finger(s)?:

Second and third fingers

The forward slippage of one vertebrae resulting in spinal cord compression is referred to as:

Spondylolisthesis

When performing a spinal exam, the nurse practitioner noted the appearance of poor posture and a "hump" appearance of the upper back. This finding could be suggestive of:

Thoracic kyphosis

When examining the foot of a patient, the nurse practitioner notes tenderness of the posterior medial malleolus. This could be suggestive of:

Tibial tendinitis

Contracture of the sternocleidomastoid muscle could result in lateral deviation and rotation of the head. This condition is suggestive of:

Torticollis

The nurse practitioner suspects a rotator cuff tear in a patient who is unable to:

Touch his left scapula with his right hand

Which nerve in the arm run posteriorly in the ulnar groove between the medial epicondyle and the olecranon process?

Ulnar nerve

When examining the foot of a patient, the nurse practitioner notes a bony projection along the edge of the right calcaneus with minimal pain and tenderness to touch. This could be suggestive of:

a bone spur

On examination of the left wrist, the nurse practitioner notes a slightly tender .75 cm swelling along the joint capsule during flexion of the wrist. This finding could be suggestive of:

a ganglion cyst

When examining the foot of a patient, the nurse practitioner notes localized tenderness over the ankle joint. this could be suggestive of:

a ligamentous injury

Tenderness over the patellar tendon or inability to move the knee, suggests:

a partial or complete patellar tendon tear

A defect in the gastrocnemius and soleus muscles with tenderness and swelling could be suggestive of:

a ruptured achilles tendon

When grading muscle strength, a five would indicate:

active movement against full resistance without fatigue

When grading muscle strength, a grade of two would indicate:

active movement of the body part with gravity eliminated

On examination of the feet, the nurse practitioner notes a dusky red swelling extending beyond the margin of the metatarsophalangeal joint of the right great toe. It is hot on palpation and the patient states it is painful to touch. These findings are suggestive of

acute gouty arthritis

The nurse practitioner instructs the patient to move his extended fingers so that each touches its nearest finger. This motion assesses the fingers and thumbs for:

adduction

Upon examination of the left shoulder, the patient complains of a dull, aching pain when attempting active or passive range of motion and localized tenderness with external rotation. these symptoms could be suggestive of:

adhesive capsulitis

With the patient standing and the examiner sitting in the chair, the examiner should observe:

alignment of legs and feet

Upon examination of the foot and ankle, the nurse practitioner notes point tenderness over the posterior aspects of the right malleolus. Additionally, the patient is unable to bear weight after 4 steps. This finding is most consistent with:

an ankle fracture

Tenderness over the sacroiliac joint is commonly noted in patients with:

ankylosing sponsylitis

When examining the elbow, swelling over the olecranon process is noted. This finding could be suggestive of:

bursitis

A patient complains of a sharp burning pain in the neck and right arm with associated parenthesias and weakness. These symptoms may be associated with:

cervical radiculopathy

When performing an examination of painful left wrist in an adult, there is a palpable crunching sound during flexion. This finding is referred to as:

crepitus

The medial and lateral menisci:

cushions the action of the femur on the tibia

After attempting to elicit the Moro reflex in a newborn, the nurse practitioner identifies absence of movement of the left arm. The next assessment would be to:

examine the clavical

Prepatellar bursitis arises from:

excessive kneeling

The nurse practitioner instructs the patient bend backward as far as possible. This maneuver would elicit:

extension of the lumbar spine

When assessing the knee, the examiner instructs the patient to sit and swing his lower leg away from midline. This motion would assess knee:

external rotation

The nurse practitioner instructs the patient to bend forward try to touch his toes. This maneuver would elicit:

flexion of the lumbar spine

Olecranon bursitis may be caused by all the following except:

frozen shoulder

When observing for thenar atrophy of the hands, a typical observation is:

furrowing in the spaces between the metacarpals

Stiffness in a joint and limited motion after inactivity is commonly referred to as:

gelling

A normal finding in the musculoskeletal assessment of a 3-year-old child would be the presence of:

genu-valgum

Where the head of the humerus articulates with the shallow glenoid fossa of the scapula is known as the:

glenohumeral joitn

The nurse practitioner instructs the patient to lie supine, bend his knee, and turn his lower leg and foot away from the midline. This maneuver would assess hip:

internal rotation

The nurse practitioner instructs the patient to place one hand behidn his back and touch his shoulder blade. This should movement elicits:

internal rotation

A small, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow joint referred to as the:

lateral epicondyle of the humerus

passive flexion, varus stress, and external rotation of the lower leg evaluates the:

lateral menisucs

Flexion contracture of the knee suggests hamstring tightness or:

limb paralysis

Physical signs associated with mechanical neck pain include:

local neck muscle tenderness

A patient experienced a neck injury yesterday and presents to the nurse practitioner with aching paracervical pain and stiffness. Other complaints include dizziness, malaise, and fatigue. These findings may be associated with:

mechanical neck pain with whiplash

With the patient in the dorsal decubitus position, have him slowly extend the knee while maintaining the varus stress and external rotation. If a snap on the medial joint line is palpated, this may indicate a positive test for a :

medial meniscal tear

Passive flexion, valgus stress, and internal rotation of the lower leg evaluate the:

medial meniscus

The nerve that provides sensation to the palm and palmar surface of most of the thumb, second and third fingers, and half of the fourth digit is the:

median nerve.

When examining the ankle and foot, the nurse practitioner moves the proximal phalanx of each toe up and down. This maneuver assesses the:

metatarsophalangeal joint

Joint pain that is localized and involves one joint, would be documented as:

monoarticular joint pain

When assessing apatient with complaints consistent with carpal tunnel syndrome, which one of the following symptoms is unlikely?

numbness of the last two digits of the hand

A dislocation of the elbow joint caused by the sudden pull on the extended pronation forearm is referred to as:

nursemaid's elbow

When screening for scoliosis, assessment should include:

observing the back while the child is bending forward

The area located between the olecranon process and the skin is known as the:

olecranon bursa

to palpate the trochanteric bursa, position the patient:

on one side, hip flexed, and internally rotated

Crepitus with flexion and extension of the knee suggests:

osteoarthritis

A six year old male complains of ankle pain and difficulty walking ,but denies any recent injuries. Findings reveal ankle tenderness, decreased mobility and range of motion. The patients temperature of 102 degrees. These fingins are consistent with

osteomyelitis

A decrease in the amount of density in a bone is referred to as:

osteopenia

Metatarsalgia is term used to describe:

pain and tenderness in the metatarsals

When describing muscle strength, the term paraplegia means:

paralysis of the legs

What test is performed when the nurse practitioner instructs the patient to hold his wrists in flexion for 60 seconds while pressing back on his hands together to form right angles:

phalen's test

To test the thumb for abduction, ask the patient to:

place the fingers and thumbs in the neutral position with the palm up and then move the tumbe anteriorly away from the palm

The hamstring muscles flex the knee and are located on the:

posterior aspect of the thigh

The posterior drawer sign is used to assess instability of the:

posterior cruciate ligament (PCL)

When examining the medial and lateral meniscus, a click along the medial joint with valgus stress, external rotation, and leg extension suggest a probable tear of the:

posterior portion of the medial meniscus

The gastrocnemius and soleus muscles are located by palpating the:

posterior surface of the lower leg

When examining the elbow for range of motion, the nurse practitioner instructs the patient to turn his palms downward. This motion is an example of:

pronation

Stumbling or "giving way" of the knee during the heel strike phase of gait suggests:

quadriceps weakness

The nerve that provides sensation to the dorsal web of the thumb and index finger is the:

radial nerve

Apatient complains of shooting pains below the knee radiating into the lateral leg and calf. This type of low back pain is referred to as:

radicular low back pain

When a patient complains of joint pain as progressing from one joint to another, the examiner should consider this pattern of involvement as migratory. This type of involvement would most likely be observed in a patient who has:

rheumatic fever

A 35 year old female patient presents to the nurse practitioner with complaints of pain in the joints of both hands accompanied by stiffness, especially in the morning with tenderness and warmth to touch. Examination reveals swelling of the synovial tissue and limitation of motion. These findings are consistent with:

rheumatoid arthritis

Vasculitis on extremities and erythematous to salmon-colored rash over the trunk are skin lesions that may be attributed to:

rheumatoid arthritis

A patient reports sharp "Catches" of pain, grating, and weakness in the right shoulder when lifting the arm overhead. These symptoms could be suggestive of:

rotator cuff tendinitis

Acromioclavicular arthritis usually arises from prior direct injury to the:

shoulder girdle

On examination of the should, tenderness is noted just below the tip of the acromion with pain on abduction and rotation and loss of smooth movement. This finding could be suggestive of:

subacromial bursitis

Tenderness at cervical vertebrae 1 - 2 (C1-2) in a patient with rheumatoid arthritis suggests possible risk for:

subluxation

When examining the elbow for range of motion, the nurse practitioner instructs the patient to turn his palm upward. This motion is an example of:

supination

Inspection of the hip begins with careful observation of a patient's gait. A patient's foot moves froward without bearing weight. This is known as the:

swing phase of gait

when performing an examination of the painful left hip on the adult, there is a palpable bogginess over the area. This finding is referred to as:

synovitis

Tenderness over the scapulohumeral muscle group with the inability to abduct the arm above the should level would be consistent with all the following conditions except:

synovitis of the glenohumeral joint

While evaluating the thumb, ask the patient to point this thumb upward as the nurse practitioner applies downward resistance. this maneuver tests:

thumb abduction

A popliteal or "baker's" cyst arises from:

trauma

The nurse that provides sensation to half of the fourth digit and fifth digit is the:

ulnar nerve