NURS660 Exam 3 Maryville NURS

NURS660 Exam 3 Maryville NURS 660 Exam 3 Actual Exam Questions and Correct Answers Rated A+

Describe what a patient will feel if they have a herniated disc. - ANSWER-Unilateral radicular pain that extends below the knee and usually hurts worse than their back pain.

What medications are typically indicated for acute low back pain, and which are not? -ANSWER-NSAIDs and steroids not indicated Tylenol recommended, Flexeril can be prescribed PRN Caution w/ opioids

Describe what a back strain would feel like, what symptoms the patient would have. -ANSWER-Strains are not usually accompanied by any neurological deficits!Usually just pain and spasms If functional tests are positive, something more.

Is imaging indicated for a suspected back strain? -ANSWER-no unless radiculopathy or progressive deficits

What joints are most commonly affected in osteoarthritis? -ANSWER- hands, knees, hips, spine, back

Describe the morning stiffness of OA. -ANSWER-Morning stiffness that improves with regular activity (can be worsened with excessive activity)

Are x-rays useful in OA? -ANSWER-Not in early disease, x-ray findings do not correlate with well clinical symptoms early

Briefly differentiate between rheumatoid arthritis and osteoarthritis. - ANSWER-OA typically unilateral/asymmetric, RA typically symmetrical/bilateral.RA usually has more systemic symptoms and extra-auricular involvement. Morning stiffness lasting >30 minutes.

OA is due to cartilage loss while RA is due to inflamed synovium.

Differentiate between Heberden and Bouchard nodules. -ANSWER- Both are common In osteoarthritis.Heberden usually occur at the distal interphalangeal joints while Bouchard occur in the proximal IP joints.

Will serologic markers be elevated in OA? -ANSWER-no

What is the treatment of OA? -ANSWER-combination of pharmacotherapy (NSAIDs, tylenol, tramadol, etc) and treatment like PT/OT, weight control, complementary medicine, etc ultimately surgery (joint replacements)

What is carpal tunnel and what are the causes? -ANSWER-peripheral nerve compression of the median nerve in the wrist

risk factors: age, female, pregnancy, working in a job where you are

repeatedly flexing or extending wrist out of neutral position

Describe the clinical presentation of carpal tunnel. -ANSWER-Aching, tingling sensation with pain radiating to thumb, index/middle/medial aspect of the ring finger (pinky usually unaffected), can extend to

forearm or even shoulder, paresthesia, numbness, nighttime awakening with pain and numbness

Phalen test -ANSWER-a diagnostic test for carpal tunnel

Hold dorsal sides of hands together for 1 min, positive if patient experiences tingling in the thumb, index, middle, or part of ring finger.

Tinel's test -ANSWER-carpal tunnel

tap on carpal tunnel at wrist positive if tingling or paresthesia occurs in thumb, index, middle, or part of ring finger

Pediatric injuries/fractures to the bone at what area are most concerning? -ANSWER-epiphyseal plate/growth plate can cause permanent injury or deformity

Which are stronger in children vs adults? bone or ligaments/tendons?-ANSWER-In children, the ligaments/tendons are stronger than bones, which means they are more likely to break a bone by doing the same thing an adult would do that wouldn't break an adult bone

Your peds patient has a wrist injury, you are unable to tell if it's a fracture or a sprain. While doing your assessment, you notice palor and coolness of the hand. What do you do? -ANSWER-emergent referral to ED or ortho if you can get them in that second

Another name for annual ligament displacement is -ANSWER- nursemaid's elbow

How do children with nursemaids elbow usually appear? -ANSWER- they will typically be "Craddling" the affected arm because this stops the pain

immediately after the injury, refusal to bend arm

Management of nursemaid's elbow -ANSWER-does not require x-ray if story is convincing (parent picking child up by arms or pulling on arm, etc) should not require ED or ortho referral should be able to return to place with supination/flexion or pronation technique

Salter-Harris classification is used for -ANSWER-growth plate fractures and grading their severity/likeliness of complications

Salter-Harris Type 1 -ANSWER-Fracture in physis/not surrounding the bone. Growth plate only.rare to have growth disturbances

Salter-Harris Type 2 -ANSWER-Fracture through physis and extending into metaphysis rare to have growth disturbances

Salter-Harris TYpe 3 -ANSWER-Physis separation, requires anatomic reduction.threat to growth and joint

Salter-Harris Type 4 -ANSWER-Fracture that extends through the epiphysis, physis and metaphysis serious threat to growth and joint