OCS - Medbridge practice exam 2- 75 Questions with Verified Answers Latest Update 2023, Exams of Nursing

Download OCS - Medbridge practice exam 2- 75 Questions with Verified Answers Latest Update 2023 and more Exams Nursing in PDF only on Docsity! OCS - Medbridge practice exam 2- 75 Questions with Verified Answers Latest Update 2023 Sutlive CPR for Dx of Hip OA in individuals with unilateral hip pain - ✓✓✓(1) self- reported squatting as an aggravating factor (2) active hip flexion causing lateral hip pain (3) scour test with adduction causing lateral hip or groin pain (4) active hip extension causing pain (5) passive internal rotation of less than or equal to 25° Renal pain referral - ✓✓✓- pelvis, low back, AND SHOULDER per wiki: "Kehr's sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classic symptom of a ruptured spleen.[1] May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ruptured ectopic pregnancy." ankylosing spondylitis risk factor - ✓✓✓- Crohn's disease and IBS are high Hill-Sachs lesion - ✓✓✓- A Hill-Sachs lesion is a compression fracture or depression defect on the posterior humerus that can occur when the humeral head impacts the inferior rim of the glenoid during a shoulder dislocation. Intervention to reduce impact of bone mineral density loss - ✓✓✓There is moderate evidence to suggest that high intensity aerobic exercise may be the most appropriate intervention to either reduce the loss or reverse the loss of bone mineral density. (Dutton 2008) [Type here] [Type here] [Type here] Which of the following is most helpful in the diagnosis of cauda equina due to its high sensitivity? - ✓✓✓Urinary dysfunction is common in those who have cauda equina, but urinary retention is more common than urinary incontinence and has a 90% sensitivity. (Small 2005) Non-msk generator for lower abdomen, middle lumbar spine, and buttock region sx? - ✓✓✓Individuals who have involvement of the large intestine will exhibit most of their symptoms in the buttock, middle lumbar spine and the lower abdomen, with the symptoms located in the region of T11-L1. (Goodman and Snyder 2013) Lower GI pathology - ✓✓✓Yes: - bloody diarrhea - central lbp - fecal incontinence - melena No: - Upper thigh pain is more closely related to reproductive or urinary tract pathologies than lower GI pathologies. (Goodman and Snyder 2013) What is the MCID for the Oswestry Disability Index for patients with chronic low back pain? - ✓✓✓Ten points or 20% is the MCID reported in the literature for patients with chronic low back pain. (Davidson 2002) S1 nerve root - ✓✓✓Individuals with nerve root involvement of S1 will often have difficulty with plantarflexion and great toe movement, as well as an inability to walk on their toes. In this case, the patient's atrophy of the gastroc/soleus also pointed to an S1 issue. (Cleland and Koppenhaver 2011) A physical therapist is performing an examination/evaluation on a patient with low back pain that radiates to the posterior thigh. During the active range of motion assessment, the patient has a replication of symptoms during lumbar flexion. What should the [Type here] [Type here] [Type here] compressive cause for cervical radiculopathy - ✓✓✓Hypertrophy of the uncovertebral joints idiopathic carpal tunnel syndrome, what is the most common cause? - ✓✓✓Increased pressure in the carpal tunnel that leads to compression of the median nerve Reason: Because of a mismatch between the size of the median nerve and the carpal tunnel themselves, there is an increase in pressure in the carpal tunnel, which can lead to the pathology, when there is an idiopathic cause of carpal tunnel syndrome. (Uchiyama 2010) PS, Amyloid deposition often occurs in those who have long term dialysis for kidney pathologies. However, this is a secondary cause of carpal tunnel syndrome, not an idiopathic cause. carpal tunnel syndrome treatment options. Based on current evidence, which is true? - ✓✓✓- Surgical treatment is more effective than splinting Reason: Although it is unclear if this statement is true for those with mild symptoms, the studies included in a recent Cochrane Review revealed that surgical treatment is more effective than splinting. (Verdugo 2008) UNCLEAR IF SURGERY IS BETTER THAN CSI pain with third digit proximal interphalangeal flexion, resisted elbow flexion, and forearm supination. There is mild weakness seen with the strength assessment of the same muscles. Which pathology? - ✓✓✓Pronator teres syndrome Reason: Pronator teres syndrome, or compression of the median nerve between the two heads of the pronator teres muscle, would cause the symptoms seen with this patient. (Netter 2014 and Magee 2014) Motions to avoid with posterolateral corner injury - ✓✓✓- tibia ER - hyperextension - knee varus [Type here] [Type here] [Type here] grade 3 posterior cruciate ligament injury, what is recommended regarding weight bearing status - ✓✓✓Partial weight bearing for 2-4 weeks after injury Reason: Patients who have a grade 3 posterior cruciate ligament injury should be partial weight bearing for 2-4 weeks after injury or surgery with hinge brace locked in extension, and then move to full weight bearing after that point (Janousek 1999 and Logerstedt 2 2010). external rotation recurvatum test and the posterior sag sign are positive - ✓✓✓Posterolateral corner injury and posterior cruciate ligament injury Reason: This patient tests positive with the posterior sag sign and the external rotation recurvatum test, and the posterior sag sign tests for the integrity of the posterior cruciate ligament whereas the external rotation recurvatum test is looking at the posterior cruciate ligament and the posterolateral corner of the kene. (Magee 2014) Finding consistent with posterolateral corner injury? - ✓✓✓Sharp pain in the knee during terminal stance and push off during gait Reason: DeLeo et. al discuss the finding of sharp pain during terminal stance and push off as being a finding common to posterolateral corner injuries. (DeLeo 2003) Ottawa Knee Rules - ✓✓✓Age 55 or older OR Isolated tenderness of the patella No bone tenderness of knee other than patella OR Tenderness of the head of the fibula OR Cannot flex to 90 degrees OR Unable to bear weight both immediately and in the emergency room department for 4 steps [Type here] [Type here] [Type here] activity is most likely to be limited in the long term after a posterior cruciate ligament injury - ✓✓✓Reason: In those who had posterior cruciate ligament tears, high speed running was the activity most affected in the long term as reported by Logerstedt et al in the APTA's clinical practice guidelines on knee ligament sprains. (Logerstedt 2 2010) ruling in a posterior cruciate ligament tear - ✓✓✓Reason: The posterior drawer test has a specificity of 99% as discussed by Logerstedt et al in the clinical practice guidelines for ligament sprains from the orthopaedic section of the APTA. However, the posterior sag sign has a specificity of 100%. What is the percentage of individuals who have a rotator cuff lesion, but are asymptomatic? - ✓✓✓67% Reason: Two thirds of individuals with small rotator cuff tears are asymptomatic per Fermont et al. (Fermont 2014) If a patient had which of the following, what would be helpful in ruling in adhesive capsulitis? - ✓✓✓(x)History of shoulder dislocation (x)Patient's age is 72 years Reproduction of symptoms with (o) end range glenohumeral motions Reason: With passive range of motion, patients with adhesive capsulitis regularly show end range limitations and reproduction of symptoms, depending on which stage they are in of the pathology (Kelley 2013). (x)Weakness of the supraspinatus, infraspinatus, and biceps brachii combination of tests would be most appropriate in determining if a SLAP lesion is present? - ✓✓✓Active compression test and Jobe relocation test Reason: Powell et al found that a combination of the active compression test and the Jobe relocation test or a second combination of the Jobe relocation test and the anterior apprehension maneuver was most helpful in ruling in a SLAP lesion. (Powell 2008) [Type here] [Type here] [Type here] - patients in a supervised physical therapy group and patients in a home exercise program group had equal maintenance of improvements - those who received supervised physical therapy were less likely to be taking medication at one year after intervention Cleland CPR for use of thoracic spine manipulation for neck pain - ✓✓✓▪ Symptoms <30 d ▪ No symptoms distal to the shoulder ▪ Looking up does not aggravate symptoms ▪ FABQPA score <12 ▪ Diminished upper thoracic spine kyphosis ▪ Cervical extension ROM <30° Tongue on roof of mouth deactivates - ✓✓✓Activation of the platysma and the hyoid muscles will be decreased if the patient places their tongue on the roof of their mouth. (Childs 2008 and Netter 2014) neck pain with radiating pain should be treated with - ✓✓✓- Mechanical Intermittent Traction Reason: For patients with chronic neck pain and radiating pain, clinicians should provide mechanical intermittent traction combined with other interventions based on the 2017 Neck Pain CPG. - PS on the 2008 neck pain clinical practice guidelines, upper quarter and nerve mobilization procedures have moderate evidence; however this has been updated in the 2017 guidelines and are no longer recommended for patients with neck pain with radiating pain. neck pain with radiating pain, would not expect? - ✓✓✓Neck pain that radiates during cervical flexion [Type here] [Type here] [Type here] Reason: It is highly unlikely to see neck pain that radiates during cervical flexion. Instead, it would typically radiate during cervical extension, side bending and rotation (Childs 2008). which TFCC ligament should be taught in supination? - ✓✓✓palmar radiolunar ligament (dorsal should be taut in pronation) Long thoracic nerve injury - ✓✓✓cardinal sign is winging of the scapula/serratus weakness Spinal accessory n injury - ✓✓✓- trapezius and SCM are very weak - may present with; depressed shoulder girdle, scapular winging during shoulder abduction, decreased shoulder flexion and abduction ROM - commonly seen with blunt trauma injuries Accessory/secondary muscles for radial deviation - ✓✓✓APL, EPL, EPB Manual therapy for DeQuervain's tenosynovitis sx - ✓✓✓- would involve first CMC, intercarpals, and radiocarpal joints - NOT radioulnar Heel pain and calcaneal spurs - ✓✓✓Radiographs that show a calcaneal spur in patients with heel pain does not confirm the diagnosis of plantar fasciitis Reason: Per clinical practice guidelines provided by the Journal of Orthopaedic and Sports Physical Therapy, any evidence of a calcaneal spur on a radiograph is not a key feature necessary to make a diagnosis. (Martin 2014) Self mobilization for patients with heel pain - ✓✓✓- Self mobilization for ankle eversion - A mobilization with movement to improve dorsiflexion was a part of the Cleland et al study for improving heel pain symptoms, but it was not included in the home exercise program. [Type here] [Type here] [Type here] Anterior interosseous nerve syndrome - ✓✓✓- median nerve pathology WITHOUT any sensory deficit - PS: an elbow ligament sprain could lead to neuro sx by proximity Lateral elbow pain treatment - ✓✓✓- cervical spine treatment should be used (as should the elbow, of course) Vicenzino clinical prediction rule: lateral elbow pain tx with mobilization with movement at elbow - ✓✓✓- NOT A FREE ARTICLE, but apparently: 1) age < 49 yo 2) affected UE pain-free grip > 25 lb 3) UNafected UE pain-free grip < 75.7 Hand/wrist manual therapy for lateral elbow sx - ✓✓✓- Is this the one where they did over 100 manipulations total? - A scaphoid thrust manipulation was used by Struijs et al in a study in Physical Therapy. In this study, patients were treated for six weeks with a maximal number of nine intervention sessions, and patients with lateral elbow pain had positive results with this technique. (Struijs 2003) lateral ulnar collateral ligament - ✓✓✓is on the lateral side of the elbow Tongue depressor bite test (TMJ) suggests what type of disorder - ✓✓✓Joint arthralgia Reason: This is the correct answer since an individual with joint arthralgia will most commonly feel joint pain on the opposite pain of where they are biting down on the separator. (Harrison 2014) Clinical prediction rule: thoracic manipulation for those with shoulder pain (Mintken 2010) - ✓✓✓1) Pain-free shoulder flexion <127° 2) Shoulder internal rotation <53° at 90° of abduction [Type here] [Type here] [Type here]