AANP Musculoskeletal and Orthopedic Disorders

Question 1

Which finding in an adult with an ankle injury indicates the need for ankle radiographs under the Ottawa ankle rules?

Accepted Answer

Inability to bear weight for four steps

Answer

The Ottawa ankle rules call for imaging with bone tenderness at the malleolar zone or inability to bear weight for four steps, both immediately and in the exam room.

Question 2

A 55-year-old man with normal renal function and no GI history has an acute gout flare of the first MTP joint. What is an appropriate initial treatment?

Accepted Answer

Indomethacin

Answer

Acute gout flares are treated with an NSAID, colchicine, or glucocorticoids. Urate-lowering therapy is not the treatment for the flare itself.

Question 3

Which DXA result establishes the diagnosis of osteoporosis in a postmenopausal woman?

Accepted Answer

T-score of -2.5 or lower

Answer

Osteoporosis is defined as a T-score of -2.5 or lower. Scores between -1.0 and -2.5 indicate osteopenia.

Question 4

A 68-year-old has bilateral shoulder and hip girdle stiffness lasting over an hour each morning and an ESR of 85 mm/hr. What is the most appropriate treatment?

Accepted Answer

Low-dose oral prednisone

Answer

This presentation is classic for polymyalgia rheumatica, which responds rapidly to low-dose glucocorticoids such as prednisone 12.5-25 mg daily.

Question 5

A patient with low back pain reports urinary retention and saddle anesthesia. What is the next step?

Accepted Answer

Urgent MRI and surgical referral

Answer

Urinary retention and saddle anesthesia are red flags for cauda equina syndrome, which is a surgical emergency needing urgent MRI.

AANP - American Association of Nurse Practitioners Practice Test

AANP - American Association of Nurse Practitioners Practice Test

AANP Musculoskeletal and Orthopedic Disorders