Musculoskeletal Results | Turned In Patient Assessment and
Experience Overview
Patient: Tina Jones
Digital Clinical Experience Score
100% This score measures your performance on the Student Performance Index in relation to other students in comparable academic programs. Your instructor has chosen to scale your Student Performance Index score so that the average score on the index is a 80.0%. This score may not be your final grade if your instructor chooses to include additional components, such as documentation or time spent.
Student Performance Index
50.6 out of
51 Proficiency Level:
Proficient
Beginning
Developing
Proficient
Students rated as “beginning” are starting to develop their nursing competencies and clinical reasoning skills. In comparable nursing programs, 50% of students perform at the level of a beginning nurse. Review your results in the tabs on the left side of the page to identify areas for improvement. Students rated as “developing” demonstrate increasing clinical reasoning abilities as they apply their nursing knowledge. In comparable nursing programs, 25% of students perform at the level of a developing nurse. Review your results in the tabs on the left side of the page to identify areas for improvement. Students rated as “proficient” demonstrate entrylevel expertise in nursing competencies and clinical reasoning skills. In comparable nursing programs, the top 25% of students perform at the level of a proficient nurse.
Subjective Data Collection
23 out of
23
Objective Data Collection
27.6 out of 28
Time
43 minutes total spent in assignment
Interaction with patient
35 minutes
Post-exam activities
8 minutes
Transcript
Started:Mar 29, 2019 | Patient Exam Time:35 min
All Lines (136)Interview Questions (56)Statements (0)Exam Actions (80)
Hello!
Question 03/29/19 2:22 PM EDT
Hi. I’m Preceptor Diana. I will explain the details of this assignment and your objectives, just as a preceptor would in real life. Pay close attention to this information as it will help guide your exam.At the end of this prebrief, you will answer a short question about the upcoming assignment.During the simulation, you may return to these instructions at any time by scrolling to the top of your transcript.
What is the situation?
Question 03/29/19 2:22 PM EDT
It’s 8 a.m. on Tina Jones’ second morning as a patient here at Shadow General Hospital. Ms. Jones has a physical therapy consultation later today. Your role in this simulation is that of healthcare provider who will perform a full musculoskeletal system exam on Ms. Jones so that her therapist can understand Ms. Jones’ musculoskeletal health and customize therapy accordingly.
What are my objectives in this assessment?
Question 03/29/19 2:22 PM EDT
In your interview with Ms. Jones, you will ask about her musculoskeletal system and identify any risk factors or complications.If you discover any disease states, ask about symptoms and the patient’s experiences of them. Your questioning should cover a broad array of the symptoms’ characteristics. You will also inquire into the health history of Ms. Jones’ family with regards to the musculoskeletal system so you can determine her genetic predisposition to any diseases. Regardless of whether you have assessed Tina previously, ask all questions that are medically relevant to her musculoskeletal system.In addition to collecting subjective data, you will perform a physical exam on Ms. Jones’ musculoskeletal system to gather objective data about the system’s health and physiology.
While you should communicate with patients using accessible, everyday language, it is standard practice to use professional medical terminology everywhere else, such as in documenting physical findings and nursing notes.You may complete the exam activities in any order and move between them as needed.
What else will this exam involve?
Question 03/29/19 2:23 PM EDT
You will complete nursing tasks to protect the patients safety, privacy, and health.You can document your findings, including vital signs, in the Electronic Health Record. This record provides necessary information for healthcare professionals who will continue patient care. Activities other than Subjective and Objective Data Collection, such as Documentation and Education and Empathy, provide valuable practice for their realworld counterparts. However, they are not automatically graded by the simulation.
How will I be evaluated?
Question 03/29/19 2:24 PM EDT
In this assignment, you will be evaluated on your Subjective and Objective Data Collection.The evaluation of your interview is dependent on how you word your questions therapeutically and precisely and explore all relevant topics with comprehensive breadth and depth.The evaluation of your physical exam is based on how successfully you report on your physical findings by selecting among clinical terms in the Electronic Health Record.This assignment takes on average between 50 and 60 minutes. You can pause and resume the assignment at any time; your work is always saved automatically.
How does this assignment prepare me for the real world?
Question 03/29/19 2:24 PM EDT
In this assessment, you will become familiarized with the structure and content of musculoskeletal exams so that with reallife patients, you can: º ask effective and comprehensive questions º use therapeutic language º evaluate the patient’s risk of disease, infection, injury, and complications º and obtain and assess objective data.
In 1 or 2 sentences, answer this question to help prepare for the upcoming exam: What precautions should you take with a patient that is a fall risk?
With a patient in a fall risk, you should have them only get up when there is someone with them, use bed alarm and have them wear a fall risk band.
Statement 03/29/19 2:26 PM EDT
Time to begin.
Good Morning Tina, My name is jenn i will be your nurse today
Greet 03/29/19 2:28 PM EDT
Hey.
Can you tell me your name and date of birth
Question 03/29/19 2:28 PM EDT
My name’s Tina Jones, and my birthday’s February 17th.
Vitals measured
Exam Action 03/29/19 2:29 PM EDT
ON a 010 scale, how would you rate your pain right now tina
Question 03/29/19 2:29 PM EDT
I’d give it a 5 or 6 out of 10 right now.
do you have any problems with your joints
Question 03/29/19 2:30 PM EDT
No, my joints are fine.
do you have any pain in your joints
Question 03/29/19 2:30 PM EDT
My joints don’t hurt.
have you noticed any swelling in your joints
Question 03/29/19 2:31 PM EDT
No, I’ve never had joint problems.
do you have any muscle pain
Question 03/29/19 2:31 PM EDT
My muscles don’t hurt.
do you have any muscle weakness
Question 03/29/19 2:31 PM EDT
No, I wouldn’t say I feel weak.
do you have any bone pain
Question 03/29/19 2:31 PM EDT
My bones aren’t hurting me, no.
have you had any recent injury or trauma to your bones
Question 03/29/19 2:32 PM EDT
I haven’t had anything really serious before. I think my foot right now is the worst injury I’ve had!
are you able o bathe yourself normally (No matching questions found.)
Question 03/29/19 2:32 PM EDT
are you able to bathe yourself
Question 03/29/19 2:32 PM EDT
I’ve been stuck sitting on my butt for the last few days with my foot hurting so much. I could get out of bed, but my walk was basically a hobble so I stayed at home.
have you needed any help pto shower
Question 03/29/19 2:33 PM EDT
I don’t need anything right now, thanks.
do you have chronic health issues
Question 03/29/19 2:33 PM EDT
I’ve had asthma since I was little, and I have sugar diabetes, too.
do you have family history of joint disease (Clarified to Any family member with degenerative joint disorder?.)
Question 03/29/19 2:34 PM EDT
No, I don’t think so. (Clarified to if I have a family history of degenerative joint disease.)
do you have any history of arthritis (Clarified to Has anyone in your family had arthritis?.)
Question 03/29/19 2:34 PM EDT
No, I don’t know about that. (Clarified to if anyone in my family has arthritis.)
do you have a history with arthritis
Question 03/29/19 2:35 PM EDT
No, I don’t have arthritis! I’m a little young for that. . .
do you have any family history of hip replacements (Clarified to Does obesity run in your family?.)
Question 03/29/19 2:35 PM EDT
No, I don’t think so. My brother and my dad are kind of big, but I wouldn’t say they were obese or anything. (Clarified to if obesity runs in my family.)
Have you been able to function normally (Clarified to Can you change positions?.)
Question 03/29/19 2:36 PM EDT
I can sit up and everything, but I’d definitely need some help to stand up or walk since my foot is still hurting so bad. (Clarified to if I can change positions.)
have you been able to do normal activities on your own (Clarified to Have you been able to work?.)
Question 03/29/19 2:36 PM EDT
I’ve had to miss work for sureI’m on my feet all day for my job, and that obviously wouldn’t work with my foot the way it is, if I could even get over there. (Clarified to if I have been able to work.)
Inspected front of neck
Exam Action 03/29/19 2:37 PM EDT
Inspected left side of neck
Exam Action 03/29/19 2:37 PM EDT
Inspected back of neck
Exam Action 03/29/19 2:37 PM EDT
Inspected right side of neck
Exam Action 03/29/19 2:37 PM EDT
Inspected front of neck
Exam Action 03/29/19 2:37 PM EDT
Inspected shoulders from the front
Exam Action 03/29/19 2:37 PM EDT
Inspected left shoulder
Exam Action 03/29/19 2:37 PM EDT
Inspected upper back
Exam Action 03/29/19 2:37 PM EDT
Inspected right shoulder
Exam Action 03/29/19 2:37 PM EDT
Inspected shoulders from the front
Exam Action 03/29/19 2:37 PM EDT
Inspected left arm
Exam Action 03/29/19 2:37 PM EDT
Inspected right arm
Exam Action 03/29/19 2:37 PM EDT
Inspected left elbow
Exam Action 03/29/19 2:38 PM EDT
Inspected right elbow
Exam Action 03/29/19 2:38 PM EDT
Inspected left wrist
Exam Action 03/29/19 2:38 PM EDT
Inspected both wrists
Exam Action 03/29/19 2:38 PM EDT
Inspected right wrist
Exam Action 03/29/19 2:38 PM EDT
Inspected both hands
Exam Action 03/29/19 2:38 PM EDT
Inspected left hand
Exam Action 03/29/19 2:38 PM EDT
Inspected right hand
Exam Action 03/29/19 2:38 PM EDT
Inspected front of hips
Exam Action 03/29/19 2:38 PM EDT
Inspected left side of hips
Exam Action 03/29/19 2:38 PM EDT
Inspected back of hips
Exam Action 03/29/19 2:38 PM EDT
Inspected right side of hips
Exam Action 03/29/19 2:38 PM EDT
Inspected front of thighs
Exam Action 03/29/19 2:39 PM EDT
Inspected left thigh
Exam Action 03/29/19 2:39 PM EDT
Inspected back of thighs
Exam Action 03/29/19 2:39 PM EDT
Inspected right thigh
Exam Action 03/29/19 2:39 PM EDT
Inspected front of knees
Exam Action 03/29/19 2:39 PM EDT
Inspected left knee
Exam Action 03/29/19 2:39 PM EDT
Inspected back of knees
Exam Action 03/29/19 2:39 PM EDT
Inspected right knee
Exam Action 03/29/19 2:39 PM EDT
Inspected front of legs
Exam Action 03/29/19 2:39 PM EDT
Inspected left leg
Exam Action 03/29/19 2:39 PM EDT
Inspected back of legs
Exam Action 03/29/19 2:39 PM EDT
Inspected right leg
Exam Action 03/29/19 2:39 PM EDT
Inspected left ankle
Exam Action 03/29/19 2:40 PM EDT
Inspected both ankles
Exam Action 03/29/19 2:40 PM EDT
Inspected right ankle
Exam Action 03/29/19 2:40 PM EDT
Inspected left foot
Exam Action 03/29/19 2:40 PM EDT
Inspected soles of feet: Right: Laceration and swelling, expected curvature. Left: No visible abnormal findings, expected curvature.
Exam Action 03/29/19 2:40 PM EDT
Inspected right foot
Exam Action 03/29/19 2:40 PM EDT
Tested ROM of neck extension: Expected
Exam Action 03/29/19 2:41 PM EDT
Tested ROM of neck flexion: Expected
Exam Action 03/29/19 2:41 PM EDT
Tested ROM of neck lateral bending: Expected
Exam Action 03/29/19 2:41 PM EDT
Tested ROM of neck rotation: Expected
Exam Action 03/29/19 2:41 PM EDT
Tested ROM of shoulders adduction: Expected
Exam Action 03/29/19 2:41 PM EDT
Tested ROM of shoulders extension: Expected
Exam Action 03/29/19 2:42 PM EDT
Tested ROM of shoulders flexion: Expected
Exam Action 03/29/19 2:42 PM EDT
Tested ROM of elbows flexion and extension: Expected
Exam Action 03/29/19 2:42 PM EDT
Tested ROM of elbows supination and pronation: Expected
Exam Action 03/29/19 2:42 PM EDT
Tested ROM of wrists ulnar and radial deviation: Expected
Exam Action 03/29/19 2:43 PM EDT
Tested ROM of wrists extension: Expected
Exam Action 03/29/19 2:43 PM EDT
Tested ROM of wrists flexion: Expected
Exam Action 03/29/19 2:43 PM EDT
Tested spinal ROM extension: Expected
Exam Action 03/29/19 2:43 PM EDT
Tested spinal ROM flexion: Expected
Exam Action 03/29/19 2:43 PM EDT
Tested spinal ROM lateral bending: Expected
Exam Action 03/29/19 2:44 PM EDT
Tested spinal ROM rotation to the left: Expected
Exam Action 03/29/19 2:44 PM EDT
Tested spinal ROM rotation to the right: Expected
Exam Action 03/29/19 2:44 PM EDT
Tested ROM of hips abduction: Expected
Exam Action 03/29/19 2:44 PM EDT
Tested ROM of hips adduction: Expected
Exam Action 03/29/19 2:45 PM EDT
Tested ROM of hips extension: Expected
Exam Action 03/29/19 2:45 PM EDT
Tested ROM of hips flexion: Expected
Exam Action 03/29/19 2:45 PM EDT
Tested ROM of knees extension: Expected
Exam Action 03/29/19 2:46 PM EDT
Tested ROM of knees flexion: Expected
Exam Action 03/29/19 2:46 PM EDT
Tested ROM of ankles inversion and eversion: Expected
Exam Action 03/29/19 2:46 PM EDT
Tested ROM of ankles dorsiflexion and plantar flexion: Right, reduced dorsi and plantar flexion; Left, expected
Exam Action 03/29/19 2:47 PM EDT
Tested neck strength head down: 5/5
Exam Action 03/29/19 2:47 PM EDT
Tested neck strength head turned to the left: 5/5
Exam Action 03/29/19 2:47 PM EDT
Tested neck strength head tilted to the left: 5/5
Exam Action 03/29/19 2:48 PM EDT
Tested neck strength head turned to the right: 5/5
Exam Action 03/29/19 2:48 PM EDT
Tested neck strength head tilted to the right: 5/5
Exam Action 03/29/19 2:48 PM EDT
Tested right and left shoulder strength: 5/5
Exam Action 03/29/19 2:48 PM EDT
Tested elbow strength during extension: 5/5
Exam Action 03/29/19 2:49 PM EDT
Tested wrist strength during extension down: 5/5
Exam Action 03/29/19 2:49 PM EDT
Tested right and left hand strength with grip test: 5/5
Exam Action 03/29/19 2:49 PM EDT
Tested right and left hip strength: 5/5
Exam Action 03/29/19 2:50 PM EDT
Tested right and left knee strength: 5/5
Exam Action 03/29/19 2:50 PM EDT
Tested right and left ankle strength: Right 4/5, Left 5/5
Exam Action 03/29/19 2:50 PM EDT
Thank you for your time tina
Question 03/29/19 2:51 PM EDT
Alright, thanks.
Tina I have a few more question for you (Clarified to I would like to ask questions about your medical history?.)
Question 03/29/19 3:05 PM EDT
Ok. What about? (Clarified to you would like to ask about my medical history.)
Do you have any mobility issues
Question 03/29/19 3:05 PM EDT
I can walk on my foot now, but it still hurts a lot.
do you have a history of walking problems
Question 03/29/19 3:05 PM EDT
I could walk fine before I hurt my foot.
how have you been since being in the hospital ambulating (No matching questions found.)
Question 03/29/19 3:06 PM EDT
do you have any pain while walking
Question 03/29/19 3:06 PM EDT
I can walk on my foot now, but it still hurts a lot.
how much does it hurt when you walk
Question 03/29/19 3:07 PM EDT
It still hurts a lot to put weight on my foot, but I can do it now without help, at least.
can you stand on your own
Question 03/29/19 3:07 PM EDT
Last time I tried to stand normally it really hurt my foot, but at least I was able to stand on it. I’m hoping it’ll be better soon.
on a scale 010 how bad does it hurt when you walk (Clarified to Can you rate the pain when walking on a scale from 1 to 10?.)
Question 03/29/19 3:07 PM EDT
It still hurts a lot to walk on. I’d say at least 7, maybe 8. (Clarified to how I would rate my pain when walking.)
Do you have any history of muscle soreness
Question 03/29/19 3:08 PM EDT
My muscles don’t really get sore ever.
Do you have any ankle issues
Question 03/29/19 3:08 PM EDT
My ankles are fine.
IS your work dangerous?
Question 03/29/19 3:08 PM EDT
I never feel like I’m in danger at work. I’m mostly just walking around with a clipboard, anyway.
Have you ever had any difficulty bathing
Question 03/29/19 3:09 PM EDT
I was having trouble doing that stuff before, but my foot’s getting better now, so I think I’m fine.
Do you have any difficulty going from a sitting position to a standing position (Clarified to Do you have trouble standing up?.)
Question 03/29/19 3:09 PM EDT
I was having trouble doing that stuff before, but my foot’s getting better now, so I think I’m fine. (Clarified to if I have trouble standing up.)
DO you have any joint stiffness
Question 03/29/19 3:09 PM EDT
No, I’m not stiff anywhere now.
do you have back pain
Question 03/29/19 3:10 PM EDT
No, I don’t usually have back pain.
do you have a history of back pain
Question 03/29/19 3:10 PM EDT
I don’t usually have any back pain. Sometimes it aches a little, but nothing bad.
do you have any history of muscle injury
Question 03/29/19 3:10 PM EDT
No, I don’t think so.
do you have any current muscle injuries (Clarified to Do you have any muscle injuries?.)
Question 03/29/19 3:10 PM EDT
No, I don’t think so. (Clarified to if I have muscle injuries.)
do you ave any joint injuries
Question 03/29/19 3:11 PM EDT
No, not really.
Do you have a history of joint injury
Question 03/29/19 3:11 PM EDT
No, not really.
do you have any history of sprains?
Question 03/29/19 3:11 PM EDT
I can’t remember spraining anything before. . . maybe in grade school? I did something to one of my fingers playing tether ball, I think. But nothing since then.
Do you have any history of bone problems?
Question 03/29/19 3:12 PM EDT
I don’t know of any bone problems in the family.
do you have any neck injuries
Question 03/29/19 3:12 PM EDT
No.
do you have any range of motion issues (Clarified to Do you have limited movement?.)
Question 03/29/19 3:12 PM EDT
Well. . . my foot is maybe feeling a little better, but I still wouldn’t want to put weight on it or try to walk anywhere just yet. (Clarified to if I have limited range of motion.)
Do you have any decreased range of motion anywhere in your body (Clarified to Do you have full range of motion of your legs?.)
Question 03/29/19 3:13 PM EDT
It hurts to move my foot, but I can do it. And everything else seems fine. [AUDIO COMING SOON] (Clarified to if I have full range motion of my legs.)
have you ever fallen
Question 03/29/19 3:13 PM EDT
I didn’t fall onto the ground. . . it was like, my foot just slipped as I stepped onto the ladder, but I caught my balance before I could topple over or anything.
when did you last fall
Question 03/29/19 3:13 PM EDT
Well, I mean, I sort of fell on the ladder a week ago, but before that I can’t remember the last time I fell or hurt myself.
do you have a family history of bone cancer
Question 03/29/19 3:14 PM EDT
Oh wow no, not that I know of.
do you have family history of osteoarthritis
Question 03/29/19 3:14 PM EDT
No one in the family has osteoporosis that I know of.
thank you for your time tina
Question 03/29/19 3:14 PM EDT
Alright, thanks.
Subjective Data Collection: 23 of 23 (100.0%) Hover To Reveal…
Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions.
Found:
Indicates an item that you found.
Available:
Indicates an item that is available to be found.
Category
Scored Items
Experts selected these topics as essential components of a strong, thorough interview with this patient.
Patient Data
Not Scored
A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.
Relevant Medical History Finding:
Asked about joint problems
Finding:
Denies joint pain
(Found)
Pro Tip: Uncovering if Tina has any joint pain is important, as they could be a result of her recent foot injury and could contribute to impaired mobility.
Example Question:
Do you have joint pain?
Finding:
Denies joint swelling
(Found)
Pro Tip: Uncovering if Tina has any swollen joints is important, as they could be a result of her recent foot injury and could contribute to impaired mobility.
Example Question:
Do you have swollen joints?
Finding:
Asked about mobility
Finding:
Denies history of walking problems
(Found)
Pro Tip: Discovering if Tina has a history of walking problems is imperative because it could show that her mobility issues predate the foot wound.
Example Question:
Have you ever had problems walking?
Finding:
Reports recent foot wound hindered mobility
(Found)
Pro Tip: People with severe pain might find that they are limited in their movements. Asking Tina whether the pain makes it hard for her to walk would illustrate whether her pain is preventing her from some of the activities that comprise her daily life.
Example Question:
Has your wound affected your mobility?
Finding:
Reports ability to walk on foot has recently improved
(Found)
Pro Tip: Determining if Tina’s mobility has recently improved will provide key information as to the healing process and what further steps are needed.
Example Question:
Has your mobility changed lately?
Finding:
Asked pain rating when walking
Finding:
Reports pain as a 7 or 8/10 when walking
(Found)
Pro Tip: People with severe pain might find that they are limited in their movements. Having Tina rank her pain on a scale will help you judge the severity of the wound and help you determine treatment needs.
Example Question:
How would you rate your pain when walking?
Finding:
Asked about ability to stand
Finding:
Denies trouble standing before foot problems
(Available)
Pro Tip: Asking Tina if she has a history of standing problems will reveal the severity of her injury and whether her standing problem predated her foot injury.
Example Question:
Do you have a history of standing problems?
Finding:
Reports recent foot wound hindered standing
(Found)
Pro Tip: Asking Tina if she can stand on her foot will reveal the severity of her injury and whether or not she is able to put weight on her foot.
Example Question:
Has your wound affected your ability to stand?
Finding:
Reports improved ability to stand on injured foot
(Found)
Pro Tip: Asking Tina if she can stand on her foot will reveal the severity of her injury and whether or not she is able to put weight on her foot.
Example Question:
Are you able to stand on your foot?
Finding:
Asked pain rating when standing
Finding:
Reports pain as a 7 or 8/10 when bearing weight on foot
(Available)
Pro Tip: Asking Tina about the pain if she’s standing will reveal the severity of her injury and whether or not standing exacerbates her pain.
Example Question:
How would you rate your pain on a scale of 1 to 10 when you are standing?
Finding:
Asked about muscle soreness
Finding:
Denies history of muscle soreness
(Found)
Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she has ever had muscle soreness specifies the way her symptoms and pain manifest.
Example Question:
Have you ever had muscle soreness?
Finding:
Denies current muscle soreness
(Found)
Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she is having muscle soreness specifies the way her symptoms and pain manifest.
Example Question:
Are you having muscle soreness?
Finding:
Asked about joints in proximity of injury
Finding:
Denies current ankle problems
(Found)
Pro Tip: Ankle problems can greatly affect a patient’s mobility. Asking Tina if she has problems with her ankles can reveal a major health concern.
Example Question:
Are your ankles giving you trouble?
Finding:
Asked about occupational impact on injury
Finding:
Denies work being dangerous
(Found)
Pro Tip: Determining if Tina’s workplace is safe will allow you to establish any occupational dangers that could exacerbate her current health issues or pose further risks.
Example Question:
Is your work dangerous?
Finding:
Denies work involving repetitive motion
(Available)
Pro Tip: Establishing if Tina’s job requires repetitive motion, such as picking up boxes, can help you determine if those motions have had an impact on her health or pose potential risks.
Example Question:
Does your work involve repetitive motion?
Finding:
Reports foot wound prevented her from working
(Found)
Pro Tip: People with severe pain might find that they are unable to perform all of their daily activities. Asking Tina whether she has been able to work in spite of the pain would illustrate whether her pain is preventing her from activities that constitute her daily life.
Example Question:
Did your wound prevent you from working?
Finding:
Asked about activities of daily living
Finding:
Denies difficulty transferring from sitting to standing
(Found)
Pro Tip: As a result of Tina’s foot would, there is the risk that certain activities of daily living have been compromised. It is important to identify any difficulties with transferring so her quality of life does not suffer.
Example Question:
Are you able to go from sitting to standing?
Finding:
Denies difficulty bathing
(Found)
Pro Tip: As a result of Tina’s foot would, there is the risk that certain activities of daily living have been compromised. It is important to identify any difficulties with bathing so her quality of life does not suffer.
Example Question:
Can you bathe yourself?
Review of Systems Finding:
Asked about joint stiffness
Finding:
Denies joint stiffness
(Available)
Pro Tip: Because Tina’s foot wound has recently impaired mobility, which often leads to joint stiffness, it is important to ask Tina about her joints to ascertain the impact of her wound and what treatment she may require.
Example Question:
Do you feel stiff anywhere?
Finding:
Asked about back pain
Finding:
Denies history of back pain
(Found)
Pro Tip: Back pain can be a serious complaint that compromises a patient’s quality of life. It is important to determine Tina has suffered from back pain so you can most effectively treat the issue.
Example Question:
Have you had back pain before?
Finding:
Denies current back pain
(Found)
Pro Tip: Back pain can be a serious complaint that compromises a patient’s quality of life. It is important to determine if Tina is currently suffering from back pain so you can most effectively treat the issue.
Example Question:
Are you having back pain?
Finding:
Asked about muscle injury
Finding:
Denies history of muscle injury
(Found)
Pro Tip: It is important to establish if Tina has a history of muscle injuries because it may contribute to her recent mobility issues.
Example Question:
Have you ever had a muscle injury?
Finding:
Denies current muscle injury
(Found)
Pro Tip: It is important to establish if Tina has a muscle injury because it might contribute to her recent mobility issues.
Example Question:
Do you have a muscle injury?
Finding:
Asked about joint injury
Finding:
Denies past joint injury
(Found)
Pro Tip: It is important to establish if Tina has a history of joint injuries because it may contribute to her recent mobility issues.
Example Question:
Have you experienced a joint injury in the past?
Finding:
Denies current joint injury
(Found)
Pro Tip: It is important to establish if Tina has a joint injury because it might contribute to her recent mobility issues.
Example Question:
Do you have a joint injury?
Finding:
Asked history of fracture
Finding:
Denies history of fractures
(Found)
Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a patient’s chief complaint. Asking Tina whether she’s ever broken a bone might reveal relevant concerns she’d previously experienced.
Example Question:
Have you ever broken a bone?
Finding:
Asked history of sprains
Finding:
Denies history of sprains
(Found)
Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a patient’s chief complaint. Asking Tina whether she has a history of getting sprains might reveal relevant concerns she’d previously experienced.
Example Question:
Do you have a history of getting sprains?
Finding:
Asked about bone problems
Finding:
Denies history of bone problems
(Available)
Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a patient’s chief complaint. Asking Tina whether she ever had bone problems might reveal relevant concerns she’d previously experienced.
Example Question:
Have you ever had bone problems?
Finding:
Denies current bone problems
(Found)
Pro Tip: Soliciting your patient’s medical history can help you to understand the nature of a patient’s chief complaint. Asking Tina whether she has bone problems might reveal relevant concerns she’d previously experienced.
Example Question:
Do you have bone problems?
Finding:
Asked about neck
Finding:
Denies history of neck problems
(Found)
Pro Tip: A history of neck problems may imply an illness or a problematic behavior in the patient. Asking Tina whether she has had neck problems in the past could prompt you to follow up on potential causes.
Example Question:
Have you had neck problems?
Finding:
Denies current neck problems
(Available)
Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she may be experiencing with her injury, like neck pain, details the way her individual symptoms and pain manifest.
Example Question:
Do you have neck problems?
Finding:
Asked about range of motion of body parts
Finding:
Reports normal range of motion
(Found)
Pro Tip: People with severe pain might find that they are limited in their movements. Asking Tina whether she is limited in her movements would illustrate whether her pain is preventing her from some of the activities that comprise her daily life.
Example Question:
Do you have full range of motion?
Finding:
Asked about muscle problems
Finding:
Denies muscle weakness
(Found)
Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her injury, like muscle weakness, details the way her individual symptoms and pain manifest.
Example Question:
Are you experiencing any muscle weakness?
Finding:
Denies muscle cramping
(Available)
Pro Tip: Symptoms often vary from patient to patient. Asking Tina about the symptoms she is experiencing with her injury, like muscle cramping, details the way her individual symptoms and pain manifest.
Example Question:
Are you experiencing any muscle cramping?
Risk Factors Finding:
Asked fall history
Finding:
Reports fall
(Found)
Pro Tip: Changes in bone composition can leave a patient more at risk for falling. Asking Tina about her history of falling could provide you with information about her bone density.
Example Question:
Have you fallen before?
Finding:
Reports fall was one week ago
(Found)
Pro Tip: Changes in bone composition can leave a patient more at risk for falling. Asking Tina about her history of falling could provide you with information about her bone density.
Example Question:
When was the last time you fell?
Finding:
Reports belief that she is not particularly prone to falls
(Found)
Pro Tip: Changes in bone composition can leave a patient more at risk for falling. Asking Tina if she is prone to falling could provide you with information about her bone density.
Example Question:
Are you prone to falling?
Relevant Family History Finding:
Asked family history of osteoporosis
Finding:
Denies family history of osteoporosis
(Found)
Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her family has osteoporosis can indicate a potential predisposition.
Example Question:
Does anyone in your family have osteoporosis?
Finding:
Asked family history of joint problems
Finding:
Denies family history of joint problems
(Available)
Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her family has had joint problems can indicate a potential predisposition.
Example Question:
Has anyone in your family had joint problems?
Finding:
Denies family history of arthritis
(Found)
Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her family has arthritis can indicate a potential predisposition.
Example Question:
Does arthritis run in your family?
Finding:
Asked family history of bone cancer
Finding:
Denies family history of bone cancer
(Found)
Pro Tip: Family histories can suggest a genetic predisposition. Asking Tina if anyone in her family has a history of bone cancer can indicate a potential predisposition.
Example Question:
Has anyone in your family had bone cancer?
Objective Data Collection: 27.6 of 28 (98.57%)
Correct
Partially correct
Incorrect
Missed
Inspected neck 1 of 1 point
Inspected shoulders 1 of 1 point
Inspected arms 1 of 1 point
Inspected elbows 1 of 1 point
Inspected wrists 1 of 1 point
Inspected hands and fingers 1 of 1 point
Inspected hips 1 of 1 point
Inspected thighs 1 of 1 point
Inspected knees 1 of 1 point
Inspected lower legs 1 of 1 point
Inspected ankles
1 of 1 point
Inspected feet 0.6 of 1 point
Tested neck range of motion 1 of 1 point
Tested shoulder range of motion 1 of 1 point
Tested elbow range of motion 1 of 1 point
Tested wrist range of motion 1 of 1 point
Tested spine range of motion 1 of 1 point
Tested hip range of motion 1 of 1 point
Tested knee range of motion 1 of 1 point
Tested ankle range of motion 1 of 1 point
Tested neck strength 1 of 1 point
Tested shoulder strength 1 of 1 point
Tested elbow strength 1 of 1 point
Tested wrist strength 1 of 1 point
Tested hand strength 1 of 1 point
Tested hip strength 1 of 1 point
Tested knee strength 1 of 1 point
Tested ankle strength 1 of 1 point
Documentation / Electronic Health Record
The Documentation is loading. (Est 5 min) Please contact Support if this fails to load.
Hallway Activity Time: 3 min
Ron Registered Nurse
Hey, I heard you just finished Ms. Jones’ musculoskeletal exam. I’m headed to her room now; what do I need to know?
This is you.
Ms. Jones has a healthy muscolskeletal system. The only thing that needs to be monitored is her right foot where her wound is. She is a fall risk due to this wound.
Arun Physical Therapist
Hi there, I’m Arun, the physical therapist. We’re conducting fall prevention checks on patients on this floor. Ms. Jones was selected because she will be here for a few days. What do you think puts her at risk for falling? How do you plan to keep her safe?
This is you.
I thik what puts her at risk for a fall risk is her foot wound and her decreased strength on that leg due to the wound. I plan to keep her safe by making the alarms be on in her bed, as well as making her a standby assist to ensure that she has someone with her at all times when she ambulates.
Diana Your Preceptor
Hopefully, you took note that Tina Jones needs assistance walking due to the pain from her infected foot wound. What goals would you set for Tina Jones’ impaired walking, and what evidencebased practice would you implement to help her achieve those objectives? How will you know if your intervention worked?
This is you.
I would make the goal of trying to lessen the infection. I would ensure she is getting proper wound care and eating healthy to help with her nutritional status to have proper wound healing.
Lifespan Activity Time: 2 min
A 3-year-old child with Down’s syndrome is in the cardiac ICU of
Shadow General Hospital following open heart surgery. Which of the
following musculoskeletal physical exam findings would you expect
to find on this child?
Correct:Children with Down’s syndrome often have palmar simian crease, hyperextensible joints, and short, broad extremities.
Fixed joints
Lordosis
Hyperextensible joints (Correct Response)
Scoliosis
An 86-year-old woman has been admitted to the Shadow General
surgical floor after a knee replacement. She has a history of
degenerative joint disease (DJD). What physical exam findings would
you expect to find?
Correct:Persons with DJD have limitations in strength and range of motion, joint crepitus, and pain with activity that is relieved with rest. Humpback, or kyphosis, is commonly due to osteoporosis, while shuffling gait and postural instability are commonly seen in those with Parkinson’s disease.
Joint deformity (Correct Response)
Shuffling gait
Postural instability
Humpback
Review Questions Activity Time: 2 min
If Tina had displayed limited abduction of the left shoulder, it would
mean that:
Correct:Abduction is defined as a motion in which a body part is moved away from the body’s midline.
She has limited movement forward
She has limited movement in a circular motion
She has limited movement toward her body
She has limited movement away from her body (Correct Response)
Suppose you noted that Tina’s left knee was swollen. Which of the
following tests should be done?
Correct:The bulge sign is a test for excess fluid accumulation in the knee. It is performed by rubbing the knee capsule in upward strokes to displace fluid and observing for the creation of a bulge when the fluid returns to its original position.
Balloon test
Fluid wave
Bulge sign (Correct Response)
Tinel’s sign
Imagine that Tina was unable to move her right ankle. You notice
that her muscles contract as she attempts to dorsiflex her ankle, but
no movement occurs. How would you grade her ankle strength?
Correct:According to the Oxford Scale, a muscle group that has no mobility but displays visible muscle contraction is graded as a 1/5 strength.
1/5 (Correct Response)
2/5
4/5
3/5
When assessing Tina’s uninjured ankle, what range of motion would
you expect of this joint? Student Response:I would expect 5/5 range of motion in her uninjured ankle. Model Note:Normal range of motion of the ankle joint includes dorsiflexion and plantarflexion, inversion and eversion, and abduction and adduction.
When assessing Tina’s wrist, what range of motion would you
expect? Student Response:I would expect 5/5 range of motion in her wrist. Model Note:Normal range of motion of the wrist joint includes flexion and extension, and abduction and adduction (also known as radial and ulnar movements).
Because of her injury, Tina’s right ankle is inflamed. What are the
characteristics of inflammation? Student Response:Redness, heat, swelling and pain. THese are the four basic characteristics of inflammation. Model Note:The classic local signs of inflammation are heat, redness, edema, pain, and loss of function. Systemic signs of inflammation can include fever, leukocytosis, and increased plasma protein synthesis such as increased Creactive protein and erythrocyte sedimentation rate.
Self-Reflection Activity Time: 1 min
After completing this assessment, what goals can you set for
yourself for the next time you complete a similar assessment? Think
about efficiency, organization, time management, and holistic care
of the patient. Student Response: I think I would try to ask the questions as i am doing the physical assessment that way the time is cut in half and i can coordinate my questions for each system.
- Musculoskeletal Results | Turned In Patient Assessment and
- Experience Overview
- Patient: Tina Jones
- Digital Clinical Experience Score
- 100%
- Student Performance Index
- Proficiency Level:
- Proficient
- Subjective Data Collection
- Objective Data Collection
- Time
- Interaction with patient
- Post-exam activities
- Transcript
- Subjective Data Collection: 23 of 23 (100.0%)
- Hover To Reveal…
- Category
- Scored Items
- Patient Data
- Not Scored
- Relevant Medical History
- Finding:
- Finding:
- (Found)
- Example Question:
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- Review of Systems
- Finding:
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- Example Question:
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- (Found)
- Example Question:
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- (Available)
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- (Found)
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- (Found)
- Example Question:
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- (Found)
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- (Found)
- Example Question:
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- (Available)
- Example Question:
- Risk Factors
- Finding:
- Finding:
- (Found)
- Example Question:
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- (Found)
- Example Question:
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- (Found)
- Example Question:
- Relevant Family History
- Finding:
- Finding:
- (Found)
- Example Question:
- Finding:
- Finding:
- (Available)
- Example Question:
- Finding:
- (Found)
- Example Question:
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- (Found)
- Example Question:
- Objective Data Collection: 27.6 of 28 (98.57%)
- Documentation / Electronic Health Record
- Hallway Activity Time: 3 min
- Lifespan Activity Time: 2 min
- A 3-year-old child with Down’s syndrome is in the cardiac ICU of Shadow General Hospital following open heart surgery. Which of the following musculoskeletal physical exam findings would you expect to find on this child?
- An 86-year-old woman has been admitted to the Shadow General surgical floor after a knee replacement. She has a history of degenerative joint disease (DJD). What physical exam findings would you expect to find?
- Review Questions Activity Time: 2 min
- If Tina had displayed limited abduction of the left shoulder, it would mean that:
- Suppose you noted that Tina’s left knee was swollen. Which of the following tests should be done?
- Imagine that Tina was unable to move her right ankle. You notice that her muscles contract as she attempts to dorsiflex her ankle, but no movement occurs. How would you grade her ankle strength?
- When assessing Tina’s uninjured ankle, what range of motion would you expect of this joint?
- When assessing Tina’s wrist, what range of motion would you expect?
- Because of her injury, Tina’s right ankle is inflamed. What are the characteristics of inflammation?
- Self-Reflection Activity Time: 1 min
- After completing this assessment, what goals can you set for yourself for the next time you complete a similar assessment? Think about efficiency, organization, time management, and holistic care of the patient.