NCLEX-RN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #2 : Musculoskeletal Conditions

Rheumatoid arthritis typically presents with what type of deformity in the distal joints of the fingers? 

Possible Answers:

Swan neck deformity

Pencil-in-cup deformity

Shepherd's crook deformity

Heberden node

Correct answer:

Swan neck deformity

Explanation:

Swan neck deformity is often seen in patients with rheumatoid arthritis. This is a state in which the distal interphalangeal joint (DIP) becomes hyperflexed (bends toward the palm) while the proximal interphalangeal joint (PIP) is hyperextended (bending away from the palm). Shepherd's crook deformity is seen in Paget's disease of the bone, pencil-in-cup deformity is seen in psoriatic arthritis, and Heberden nodes are frequently seen in the distal phalanges of patients with osteoarthritis.

 

Example Question #1 : Musculoskeletal Conditions

What is the most common form of muscular dystrophy?

Possible Answers:

Duchenne

Myotonic 

Emery-Dreifuss

Becker 

Correct answer:

Duchenne

Explanation:

Duchenne's is the most common and most severe form of muscular dystrophy, accounting for a full 50% of cases of muscular dystrophy in the US. The next most common type is Becker's, followed by myotonic muscular dystrophy and Emery-Dreifuss.

Example Question #3 : Musculoskeletal Conditions

Which of the following conditions is associated with auto antibodies to presynaptic calcium channels?

Possible Answers:

Myasthenia gravis

Lambert-Eaton syndrome

Dermatomyositis

Multiple sclerosis

Correct answer:

Lambert-Eaton syndrome

Explanation:

Lambert-Eaton syndrome is a condition of progressive muscle weakness caused by an auto antibodies to presynaptic calcium channels in the neuromuscular junction. This does not allow calcium to enter the presynaptic cell, which is required for neurotransmitter release into the synaptic cleft. Without the release of neurotransmitter, there will be no muscular response. Myasthenia gravis is an autoimmune condition in which antibodies are formed against acetylcholine receptors, and muscular weakness in multiple sclerosis is caused by destruction of myelin in the CNS due to antibodies against oligodendrocytes. Dermatomyositis is an inflammatory connective tissue condition that may be associated with a post-viral autoimmune reaction or triggered by a paraneoplastic syndrome. 

Example Question #4 : Musculoskeletal Conditions

What are the classic histological findings of dermatomyositis?

Possible Answers:

Fibrosed muscle fibers and fatty infiltrates

Mixed B cell and T cell perivascular inflammatory infiltrate and perifascicular muscle fiber atrophy

Granulomas and necrotic muscle fibers

Perifascicular muscle fiber atrophy and fatty infiltrates

Correct answer:
Mixed B cell and T cell perivascular inflammatory infiltrate and perifascicular muscle fiber atrophy
Explanation:

Histological findings of dermatomyositis will generally reveal mixed B cell and T cell perivascular inflammatory infiltrate and perifascicular muscle fiber atrophy.

Fibrosed muscle fibers and fatty infiltrates are typical of Duchenne's muscular dystrophy, while granulomas in muscle are rare but may be seen in sarcoidosis and other conditions of granulomatous myositis.

Example Question #5 : Musculoskeletal Conditions

90% of adult rhabdomyomas are located in what area?

Possible Answers:

The neck

The lower back

The calf

The upper arm

Correct answer:

The neck

Explanation:

A rhabdomyoma is a benign tumors of striated muscle. 90% of adult rhabdomyomas present as round masses in the neck. 

Example Question #1 : Musculoskeletal Conditions

What dermatological condition is often seen with dermatomyositis?

Possible Answers:

Periorbital heliotrope rash 

Dermatitis herpetiformis

Perioral dermatitis

Malar rash

Correct answer:

Periorbital heliotrope rash 

Explanation:

A periorbital heliotrope rash is often seen in dermatomyositis. It is bilateral, symmetric, purpuric, and macular, and erupts over the eyelids and surrounding periorbital area. Malar rash (often called a "butterfly rash") is seen in patients with systemic lupus erythematosus (SLE). Dermatitis herpetiformis is a rash on the elbows and knees generally seen with gluten allergy (celiac disease). Perioral dermatitis is an iatrogenic condition often associated with prolonged use of topical steroid creams. 

Example Question #6 : Musculoskeletal Conditions

What condition typically presents as symmetric proximal muscle weakness in the upper and lower extremities, often without the presence of distal muscle weakness?

Possible Answers:

Guillain-Barre syndrome

Dermatomyositis

Polymyositis

Myasthenia gravis

Correct answer:

Polymyositis

Explanation:

Polymyositis is characterized by symmetric proximal muscle weakness in the upper and lower extremities, often without the presence of distal muscle weakness. The first sign is often weakness in the thighs while walking, the inability to rise from a seated position without assistance, or the inability to raise the arms above the head. 

Dermatomyositis generally includes a characteristic periorbital rash. Weakness is expressed in the neck, arms, and legs. Guillain-Barre syndrome is an ascending paralysis: symptoms start in the hands and feet, then spread proximally as it progresses. Muscular weakness in myasthenia gravis is often especially expressed in muscles of the face and head, especially those that control eye and eyelid movement, facial expression, chewing, swallowing, and speaking.

Example Question #1131 : Nclex

What condition is characterized by high bone turnover due to accelerated osteoclast and osteoblast activity?

Possible Answers:

Multiple myeloma

Paget's disease of bone

Giant cell tumor

Osteogenesis imperfecta

Correct answer:

Paget's disease of bone

Explanation:

Paget's disease of bone is a condition characterized by high bone turnover due to accelerated osteoclast and osteoblast activity. This results in increased calcification of bones, especially prominent in the skull, pelvis, femur, and tibia. 

Osteogenesis imperfecta is an issue with collagen formation that causes fragile bones and multiple fractures. Multiple myeloma is a malignancy of plasma calls, and giant cell tumors are rare tumors that generally originate from the epiphysis of long bones (with no effect on bone deposition).

Example Question #12 : Musculoskeletal Conditions

At what age will Paget's disease of the bone generally first present?

Possible Answers:

Over 55

Over 70

Children ages 6-12

Early adolescence

Correct answer:

Over 55

Explanation:

Paget's disease of the bone generally presents in after the age of 55, and is very rare in younger individuals. The prevalence in individuals over 55 is as high as 3%.

Example Question #13 : Musculoskeletal Conditions

Which of the following is a benign, bone-forming tumor characterized by a small area of neoplastic growth surrounded by an area of mature, reactive bone?

Possible Answers:

Osteosarcoma

Osteoid osteoma

Fibrosarcoma

Ewing's sarcoma

Correct answer:

Osteoid osteoma

Explanation:

Osteoid osteoma is a benign, bone-forming tumor characterized by a small area of neoplastic growth surrounded by an area of mature, reactive bone.

Fibrosarcoma, osteosarcoma, and Ewing's sarcoma are all malignancies. 

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