NR509 MIDTERM EXAM WITH DETAILED
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS GRADED A+
A 55-year-old data entry operator comes to the clinic to establish
care. She has the following
symptoms: headache, neck pain, sinus congestion, sore throat,
ringing in ears, sharp brief chest
pains at rest, burning abdominal pain with spicy foods,
constipation, urinary frequency that is worse with coughing and
sneezing, and swelling in legs. This cluster of symptoms is
explained
by:
A) One disease process
B) More than one disease process Correct Answer B) More than
one disease process
The patient appears to have several possible conditions: allergic
rhinitis, arthritis,
conductive hearing loss, pleuritic chest pains, heartburn, stress
urinary incontinence, and venous stasis, among other conditions.
Although we always try, it is very difficult to assign all of these
,symptoms to one cohesive diagnosis.
A 62-year-old teacher presents to the clinic for evaluation of the
following symptoms: fever, headache, sinus congestion, sore
throat, green nasal discharge, and cough. This cluster of
symptoms is best explained by:
A) One disease process
B) More than one disease process Correct Answer A) One
disease process
This cluster of symptoms is most consistent with sinusitis. The
chance that all of these symptoms are caused by multiple
synchronous conditions in the same patient is much less than the
possibility of having one problem which accounts for all of them.
Steve has just seen a 5-year-old girl who wheezes when exposed
to cats. The patient's family history is positive for asthma. You
think the child most likely has asthma. What have you just
accomplished?
A) You have tested your hypothesis.
B) You have developed a plan.
C) You have established a working diagnosis.
,D) You have created a hypothesis. Correct Answer D) You have
created a hypothesis.
As you go through a history and examination, you will start to
generate ideas to explain the patient's symptoms. It is best to
keep an open mind and make as many hypotheses
as you can, to avoid missing a possibility. A common mistake is to
latch onto one idea too early.
Ms. Washington is a 67-year-old who had a heart attack last
month. Now she complains of shortness of breath and not being
able to sleep in a flat position (orthopnea). On examination you
note increased jugular venous pressure, an S3 gallop, crackles
low in the lung fields, and swollen ankles (edema). This is an
example of a:
A) Pathophysiologic problem
B) Psychopathologic problem Correct Answer A)
Pathophysiologic problem
This is an example of a pathophysiologic problem because Ms.
Washington's
symptoms are consistent with a pathophysiologic process. The
heart attack reduced the ability of her heart to handle her volume
status and subsequently produced the many features of
congestive heart failure.
, On the way to see your next patient, you glance at the calendar
and make a mental note to
buy a Mother's Day card. Your patient is Ms. Hernandez, a 76-
year-old widow who lost her
husband in May, two years ago. She comes in today with a
headaches, abdominal pain, and
general malaise. This happened once before, about a year ago,
according to your detailed office
notes. You have done a thorough evaluation but are unable to
arrive at a consistent picture to
tie these symptoms together. This is an example of a:
A) Pathophysiologic problem
B) Psychopathologic problem Correct Answer B)
Psychopathologic problem
It is not uncommon for patients to experience psychopathologic
symptoms around
the anniversary of a traumatic event. The time of year and the
lack of an obvious connection
between Ms. Hernandez's symptoms would make you consider
this as a possibility. You will note that although this might have
been an early consideration in your hypothesis generation, it is
ACTUAL EXAM QUESTIONS AND CORRECT
ANSWERS GRADED A+
A 55-year-old data entry operator comes to the clinic to establish
care. She has the following
symptoms: headache, neck pain, sinus congestion, sore throat,
ringing in ears, sharp brief chest
pains at rest, burning abdominal pain with spicy foods,
constipation, urinary frequency that is worse with coughing and
sneezing, and swelling in legs. This cluster of symptoms is
explained
by:
A) One disease process
B) More than one disease process Correct Answer B) More than
one disease process
The patient appears to have several possible conditions: allergic
rhinitis, arthritis,
conductive hearing loss, pleuritic chest pains, heartburn, stress
urinary incontinence, and venous stasis, among other conditions.
Although we always try, it is very difficult to assign all of these
,symptoms to one cohesive diagnosis.
A 62-year-old teacher presents to the clinic for evaluation of the
following symptoms: fever, headache, sinus congestion, sore
throat, green nasal discharge, and cough. This cluster of
symptoms is best explained by:
A) One disease process
B) More than one disease process Correct Answer A) One
disease process
This cluster of symptoms is most consistent with sinusitis. The
chance that all of these symptoms are caused by multiple
synchronous conditions in the same patient is much less than the
possibility of having one problem which accounts for all of them.
Steve has just seen a 5-year-old girl who wheezes when exposed
to cats. The patient's family history is positive for asthma. You
think the child most likely has asthma. What have you just
accomplished?
A) You have tested your hypothesis.
B) You have developed a plan.
C) You have established a working diagnosis.
,D) You have created a hypothesis. Correct Answer D) You have
created a hypothesis.
As you go through a history and examination, you will start to
generate ideas to explain the patient's symptoms. It is best to
keep an open mind and make as many hypotheses
as you can, to avoid missing a possibility. A common mistake is to
latch onto one idea too early.
Ms. Washington is a 67-year-old who had a heart attack last
month. Now she complains of shortness of breath and not being
able to sleep in a flat position (orthopnea). On examination you
note increased jugular venous pressure, an S3 gallop, crackles
low in the lung fields, and swollen ankles (edema). This is an
example of a:
A) Pathophysiologic problem
B) Psychopathologic problem Correct Answer A)
Pathophysiologic problem
This is an example of a pathophysiologic problem because Ms.
Washington's
symptoms are consistent with a pathophysiologic process. The
heart attack reduced the ability of her heart to handle her volume
status and subsequently produced the many features of
congestive heart failure.
, On the way to see your next patient, you glance at the calendar
and make a mental note to
buy a Mother's Day card. Your patient is Ms. Hernandez, a 76-
year-old widow who lost her
husband in May, two years ago. She comes in today with a
headaches, abdominal pain, and
general malaise. This happened once before, about a year ago,
according to your detailed office
notes. You have done a thorough evaluation but are unable to
arrive at a consistent picture to
tie these symptoms together. This is an example of a:
A) Pathophysiologic problem
B) Psychopathologic problem Correct Answer B)
Psychopathologic problem
It is not uncommon for patients to experience psychopathologic
symptoms around
the anniversary of a traumatic event. The time of year and the
lack of an obvious connection
between Ms. Hernandez's symptoms would make you consider
this as a possibility. You will note that although this might have
been an early consideration in your hypothesis generation, it is
