NURSING MISC APEA TEST BANK WITH RATIONALE
Question:
A patient complains of a sharp burning pain in the neck and right arm with associated
paresthesias
... [Show More] and weakness. These symptoms may be associated with:
Cervical
radiculopathy
Explanation:
With cervical radiculopathy, nerve root compression is the etiology. Symptoms may include
sharp burning or tingling pain in the neck and one arm with associated paresthesias.
Mechanical neck pain is described as aching pain in the cervical paraspinal muscles and
ligaments with associated muscle spasm and stiffness and tightness in the upper back and
shoulder, lasting up to6 weeks. Inpatients with mechanical neckpain with whiplash, the
paracervical pain and stiffnessbegins the day after injury and may be accompanied by
occipital headaches, dizziness, and malaise. In cervical myelopathy, cervical cord
compression, the neck pain is associated with bilateral weakness and paresthesias in both
upper and lower extremities.
Question:
A patient complains of lateral hip pain while pointing near the trochanter. This type of pain
couldbe suggestive of:
Bursitis
Explanation:
Lateral hip pain near the greater trochanter suggests trochanteric bursitis. Sciatica
symptoms usually includeashooting pain below theknee, commonly inthe lateral leg or
posterior calf andaccompanied by low back pain. Radicular pain refers to pain that radiates
along the dermatome of a nerve due to inflammation or irritation of a nerve root, as with
sciatica pain. Polyarticular arthritis refers to arthritis involving several joints.
Question:
The muscle of the scapulohumeral group that crosses the glenohumeral joint
posteriorly andinserts on thegreater tubercle is known as the:
infraspinatus muscle
Explanation:
One of the muscles of the scapulohumeral group that crosses the glenohumeral joint
posteriorly and inserts on the greater tubercle is the infraspinatus muscle. The other one is
the teres minor muscle. The pectoralis major muscle is situated on theanterior chest. The
musclethat runs abovethe glenohumeral joint and inserts on the greater tubercle is known as
the supraspinatus. The subscapularis muscle originates on the anterior surface of the
scapula and crosses the joint anteriorly and inserts on the lesser tubercle.
Question:
A tool for assessing risk factors for osteoporotic fractures is the:
FRAX
Explanation:
The FRAX calculator generates fracture risk based on age, body mass index, parental
fracture history, use of glucocorticoids, presence of rheumatoid arthritis or secondary
osteoporosis, and tobacco and alcohol use. It has been validated for black, Hispanic, and
Asian women in the USA and has calculators that are country and continent specific. Duel
energy x-ray absorptiometry, DEXA, is theoptimal standard for measuring bonedensity.
BRAC1 is agene thatcan mutate andincrease the risk of breast cancer. HAARM is the
melanoma risk model.
Question:
Anserinebursitis arises from:
excessive running. Correct excessive kneeling. Incorrectarthritis.trauma
Explanation:
Anserine bursitis arises from excessive running, valgus knee deformity, fibromyalgias, and
osteoarthritis. Prepatellar bursitis (“housemaid’s knee”) arises from excessive kneeling. A
popliteal or “baker’s” cyst arises from distention of thegastrocnemius semimembranous
bursafrom underlying arthritis or trauma.
Question:
When examining the knee, which of the following symptoms could be indicative of a
positiveAdduction (Varus) Stress Test?
Paininthelateral
jointExplanation:
The Adduction (or Varus) Stress Test is a maneuver that evaluates the function of the lateral
collateral ligament. To perform this test, the knee is held in 30 degrees of flexion. With one
handon the medial side of the knee and one hand on the ankle, an adduction force is gently
applied. Ifpain is noted in the lateral joint line, this could be indicative of a lateral collateral
ligament tear. When tenderness extends more to the proximal or distal joint line, the
collateral ligament may bethe cause of pain instead of the meniscus.
Question:
When assessing the knee, the examiner instructs the patient tostraighten his knee. This
motionwould assess knee:
Extension
Explanation:
Having the patient straighten his leg assesses extension of the knee. The examiner instructs
the patient to bend his knee. This maneuver assesses knee flexion. Internal rotation of the
knee couldbe elicited by having the patient swing his lower leg toward the midline while
sitting. Instructingthe patient to swing his leg away from his midline while sitting assesses
external rotation of the knee.
Question:
When performing an examination of a tender left finger on an adult, the surrounding
tissuereveals warmth, edema, and redness. This finding could besuggestive of:
gouty
arthritis
Explanation:
Redness, warmth, and edema over a tender joint suggest septic or gouty arthritis
infection, orpossibly rheumatoid arthritis.
Question:
An exampleof a fibrous joint would bethe:
Skull
Explanation:
The skull is an example of the fibrous joint. Examples of synovial joints include the shoulder,
knee,hip, wrist,distal radioulnar, elbow,andcarpals.Vertebralbodies of thespineand the
pubicsymphysis of the pelvis are examples of cartilaginous joints.
Question:
Topalpate the medial meniscus, slightly internally rotatethe tibiaand palpate the medial soft
tissue along the:
upper edge of the tibial
plateauExplanation:
To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial
soft tissue along the upper edge of the tibial plateau. The lateral meniscus is palpated on the
lateral joint linebyplacing thepatient's kneeinslight flexion. Topalpatethe tibiofemoral
joint, face thepatient's knee and place the thumbs in the soft-tissue depressions on either
side of the patellar tendon.
Question:
The muscle of the scapulohumeral group that originates on the anterior surface of the
scapulaand crosses the joint anteriorly and inserts on the lesser tubercle is the:
Answer:
A. Infraspinatus muscle
B. Teres minor muscle
C. Subscapularis muscle (correct)
D. Supraspinatus muscle
Question:
Inspectionof the hip begins with careful observation of apatient's gait. A patient's foot moves
forward without bearing weight. This is known as the:
Swing phase of
gaitExplanation:
Inspection of the hip begins with careful observation of a patient's gait. There are 2 phases
of gait: stanceand swing. The swing phaseoccurs when the foot moves forward and does
notbearweight. The stance phase occurs when the foot is on the ground bearing weight.
Question:
The axioscapular group of
muscles:Pulls the shoulder
backward Explanation:
The axioscapular group pulls the shoulder backward and rotates thescapula. The
scapulohumeralgroup of muscles rotates the shoulder laterally, including the rotator cuff,
and depresses and rotates the head of the humerus. The axiohumeral group produces
internal rotation of the shoulder. Theserratus anterior draws the shoulder blade forward.
Question:
When assessing the knee, the examiner instructs the patient tosit and swing his lower leg
towardmidline. This motion assesses knee:
Internal
rotation
Explanation:
Internal rotation of the knee is elicited by having the patient swing his lower leg toward the
midline while sitting. Instructing the patient to bend his knee assesses knee flexion. Having
the patient straighten his leg assesses extension of the knee. Instructing the patient to
swing his leg away from his midline whilesitting would bea maneuver toassess external
rotation of the knee. [Show Less]