Final Exam - Chamberlain
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1. A 31-year-old female presents to the clinic with a worsening stiff, painful
neck. On inspection, the patients head is laterally deviated toward the shoul-
der and rotated. Given this specific physical assessment finding, what condi-
tion should the NP suspect as a differential diagnosis?
A-torticollis
B-ankylosing spondylitis
C-osteoarthritis (OA)
D-spondylolisthesis
E-thoracic kyphosis
Answer
A
Torticollis
2. A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of
,the following are expected assessment findings consistent with the diagno-
sis?
A-Swelling of the synovial tissue in joints and tendon sheaths
B-The first metatarsophalangeal joint is frequently involved.
C-Asymmetrical joint distribution.
D-Tophi present in the subcutaneous tissue
E-Stiffness follows joint activity.
Answer
A
Swelling of the synovial tissue in joints and tendon sheaths
3. A 66-year-old female presents to the office for a focused visit to discuss
hypertension management strategies. During the interview, the patient asks
the MP if she could be screened today for cervical cancer/HPV. Review of her
medical record reveals she was screened at ages 57, 60, and 63, with no
abnormal findings, and no history of cancer. What is the best action the NP
should take regarding the patients request for screening?
A-Deny her request, inform her that she is past due for cervical cancer/HPV
screening, and
schedule another visit in 6 months.
,B-Honor her request, perform the screening today, and reschedule the ap-
pointment to discuss
hypertension management strategies.
C-Deny her request, inform the patient that she has had three negative screen-
ings in the last 10 years
and no longer requires screening, and focus on the reason for
the visit.
D-Deny her request, inform the patient she is not due to be screened for two
more years, and focus on
the reason for the visit.
E-Honor her request, perform the screening today, and inform her that if the
results are negative, she
will no longer require screening
Answer
C
Deny her request, inform the patient that she has had three negative screenings in
the last 10 years
and no longer requires screening, and focus on the reason for
, the visit.
4. A 45-year-old female presents to the primary care clinic. She complains of
recently experiencing a change in the patterns of her bowel movements. Her
PMH is significant for bleeding ulcers as well as Crohns disease. Her family
medical history includes a maternal aunt who died of colon cancer at age 49
years. Which of the following historical elements would be most concerning
for colon cancer in this patient?
A-recent onset of small-caliber stools
B-new-onset anal fissures
C-recent history of black, tarry stools
D-long-term history of hemorrhoids
E-remote history of anal pruritus
Answer
A
recent onset of small-caliber stools
5. Which of the following physical assessment finding is most suggestive of
peritonitis secondary to a ruptured appendix?
A pain with internal rotation of the right hip