ATI RN
Musculoskeletal disorder Questions
Question 1 of 5
What clinical sign will the PNP elicit when assessing a child with a Grade II ankle sprain?
Correct Answer: A
Rationale: A Grade II ankle sprain involves partial ligament tearing, leading to moderate pain, swelling, tenderness, and ecchymosis (A). Mild symptoms (B) suggest Grade I, severe symptoms with ecchymosis (C) suggest Grade III, and deformity (D) indicates a fracture or severe sprain.
Question 2 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 3 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: This presentation suggests slipped capital femoral epiphysis (SCFE). Preventing weight bearing with crutches or a wheelchair (C) is critical initially to avoid further slippage until orthopedic evaluation. Weight loss (A) and PT (B) are long-term, and referral (D) follows after stabilization.
Question 4 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.
Question 5 of 5
Serum creatine kinase levels are increased when a person has which of the following?
Correct Answer: A
Rationale: Serum creatine kinase (CK) is elevated with muscle damage (A), such as in muscular dystrophy or trauma, as it’s released from injured muscle cells. Rheumatoid arthritis (B), spondyloarthritis (C), and SLE (D) typically don’t elevate CK unless muscle involvement occurs, which is rare.