ATI RN
Musculoskeletal disorder Questions
Question 1 of 5
A young adolescent reports chest pain associated with coughing and lifting. Physical examination reveals tenderness over several ribs, radiating to the back. Auscultation of the heart, lungs, and abdomen are normal. There is no history of injury. What will the PNP do?
Correct Answer: D
Rationale: The symptoms suggest costochondritis, a common benign condition in adolescents with no trauma history and normal auscultation. Ibuprofen, stretching, and ice (D) are appropriate initial management. EKG (A) and x-ray (B) are unnecessary without cardiac or pulmonary signs, and referral (C) is premature.
Question 2 of 5
Ben is an 11-year-old soccer player and presents in the clinic with pain and swelling in both knees. A physical examination reveals swelling and focal tenderness at the tibial tuberosities, with pain worsening when asked to extend the knees against resistance. What is the treatment for this condition?
Correct Answer: C
Rationale: This presentation is consistent with Osgood-Schlatter disease, a common overuse injury in active children. Ice and activity restriction (C) are the mainstay of treatment. Radiographs (A) and referral (B) are unnecessary unless symptoms persist or worsen, and stretching (D) may exacerbate pain initially.
Question 3 of 5
An overweight adolescent boy complains of pain in his hip that radiates to the medial aspect of his knee. He denies trauma and has not had a fever. You note upon exam that he is walking with a limp. The most likely diagnosis is:
Correct Answer: A
Rationale: Slipped capital femoral epiphysis (SCFE) (A) is common in overweight adolescents, presenting with hip pain radiating to the knee and a limp, without trauma or fever. Transient synovitis (B) is more common in younger children, Legg-Calve-Perthes (C) typically affects younger kids, and septic arthritis (D) usually involves fever.
Question 4 of 5
A 14-year-old boy who is overweight develops a unilateral limp with pain in the hip and knee on the affected side. Physical exam reveals external rotation of the hip when flexed and pain associated with attempts to internally rotate the hip. What is most important initially when managing this child’s condition
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
3-year-old Sarah is brought to the clinic by her mother who reports that the child refuses to use the right arm after being swung by both arms while playing. The child is sitting with the right arm held slightly flexed and close to the body. What will the primary care pediatric nurse practitioner do?
Correct Answer: B
Rationale: This is classic for nursemaid’s elbow (radial head subluxation), common after pulling injuries in young children. Gentle supination and flexion (B) often reduces it. Immobilization and referral (A) or x-ray (D) are unnecessary unless reduction fails, and maltreatment (C) isn’t indicated without other signs.