NUR 631 ADVANCED PHYSIOLOGY AND
PATHOPHYSIOLOGY ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS EXAM
PREP
◉ A 19-year-old college student, Todd, is brought to your clinic by his
mother. She is concerned that there is something seriously wrong with
him. She states for the past 6 months his behavior has become
peculiar and he has flunked out of college. Todd denies any recent
illness or injuries. His past medical history is remarkable only for a
broken foot. His parents are both healthy. He has a paternal uncle who
had similar symptoms in college. The patient admits to smoking
cigarettes and drinking alcohol. He also admits to marijuana use but
none in the last week. He denies using any other substances. He
denies any feelings of depression or anxiety. While speaking with
Todd and his mother you do a complete physical examination, which
is essentially normal. When you question him on how he is feeling, he
says that he is very worried that Microsoft has stolen his software for
creating a better browser. He tells you he has se. Answer: D)
Schizophrenia
◉ A 24-year-old secretary comes to your clinic, complaining of
difficulty sleeping, severe nightmares, and irritability. She states it all
began 6 months ago when she went to a fast food restaurant at
midnight. While she was waiting in her car a man entered through the
passenger door and put a gun to her head. He had her drive to a
remote area, where he took her money and threatened to kill her.
,When the gun jammed he panicked and ran off. Ever since this
occurred the patient has been having these symptoms. She states she
jumps at every noise and refuses to drive at night. She states her
anxiety has had such a marked influence on her job performance she
is afraid she will be fired. She denies any recent illnesses or injuries.
Her past medical history is unremarkable. On examination you find a
nervous woman appearing her stated age. Her physical examination is
unremarkable. You recommend medication and counseling.
What. Answer: C) Post-traumatic stress disorder
◉ A 75-year-old homemaker brings her 76-year-old husband to your
clinic. She states that 4 months ago he had a stroke and ever since she
has been frustrated with his problems with communication. They were
at a restaurant after church one Sunday when he suddenly became
quiet. When she realized something was wrong he was taken to the
hospital by EMS. He spent 2 weeks in the hospital with right-sided
weakness and difficulty speaking. After hospitalization he was in a
rehab center, where he regained the ability to walk and most of the
use of his right hand. He also began to speak more, but she says that
much of the time "he doesn't make any sense." She gives an example
that when she reminded him the car needed to be serviced he told her
"I will change the Kool-Aid out of the sink myself with the ludrip."
She says that these sayings are becoming frustrating. She wants you
to tell her what is wrong and what you can do about. Answer: A)
Wernicke's aphasia
◉ A 32-year-old white female comes to your clinic, complaining of
overwhelming sadness. She says for the past 2 months she has had
crying episodes, difficulty sleeping, and problems with overeating.
She says she used to go out with her friends from work but now she
,just wants to go home and be by herself. She also thinks that her work
productivity has been dropping because she just is too tired to care or
concentrate. She denies any feelings of guilt or any suicidal ideation.
She states that she has never felt this way in the past. She denies any
recent illness or injuries. Her past medical history consists of an
appendectomy when she was a teenager; otherwise, she has been
healthy. She is single and works as a clerk in a medical office. She
denies tobacco, alcohol, or illegal drug use. Her mother has high
blood pressure and her father has had a history of mental illness. On
examination you see a woman appearing her st. Answer: C) Major
depressive episode
◉ A 27-year-old woman is brought to your office by her mother. The
mother tells you that her daughter has been schizophrenic for the last
8 years and is starting to decompensate despite medication. The
patient states that she has been taking her antipsychotic and she is
doing just fine. Her mother retorts that her daughter has become quite
paranoid. When asked why, the mother gives an example about the
mailman. She says that her daughter goes and gets the mail every day
and then microwaves the letters. The patient agrees that she does this
but only because she sees the mailman flipping through the envelopes
and she knows he's putting anthrax on the letters. Her mother turns to
her and says, "He's only sorting the mail!"
Which best describes the patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state. Answer: A) Illusion
, ◉ A 22-year-old man is brought to your office by his father to discuss
his son's mental health disorder. The patient was diagnosed with
schizophrenia 6 months ago and has been taking medication since.
The father states that his son's dose isn't high enough and you need to
raise it. He states that his son has been hearing things that don't exist.
You ask the young man what is going on and he tells you that his
father is just jealous because his sister talks only to him. His father
turns to him and says, "Son, you know your sister died 2 years ago!"
His son replies "Well, she still talks to me in my head all the time!"
Which best describes this patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state. Answer: B) Hallucination
◉ A 26-year-old violinist comes to your clinic, complaining of
anxiety. He is a first chair violinist in the local symphony orchestra
and has started having symptoms during performances, such as
sweating, shaking, and hyperventilating. It has gotten so bad that he
has thought about giving up his first chair status so he does not have
to play the solo during one of the movements. He says that he never
has these symptoms during rehearsals or when he is practicing. He
denies having any of these symptoms at any other time. His past
medical history is unremarkable. He denies any tobacco use, drug use,
or alcohol abuse. His parents are both healthy. On examination you
see a young man who appears worried. His vital signs and physical
examination are unremarkable.
What type of anxiety disorder best describes his situation?
A) Panic disorder
B) Specific phobia
PATHOPHYSIOLOGY ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS EXAM
PREP
◉ A 19-year-old college student, Todd, is brought to your clinic by his
mother. She is concerned that there is something seriously wrong with
him. She states for the past 6 months his behavior has become
peculiar and he has flunked out of college. Todd denies any recent
illness or injuries. His past medical history is remarkable only for a
broken foot. His parents are both healthy. He has a paternal uncle who
had similar symptoms in college. The patient admits to smoking
cigarettes and drinking alcohol. He also admits to marijuana use but
none in the last week. He denies using any other substances. He
denies any feelings of depression or anxiety. While speaking with
Todd and his mother you do a complete physical examination, which
is essentially normal. When you question him on how he is feeling, he
says that he is very worried that Microsoft has stolen his software for
creating a better browser. He tells you he has se. Answer: D)
Schizophrenia
◉ A 24-year-old secretary comes to your clinic, complaining of
difficulty sleeping, severe nightmares, and irritability. She states it all
began 6 months ago when she went to a fast food restaurant at
midnight. While she was waiting in her car a man entered through the
passenger door and put a gun to her head. He had her drive to a
remote area, where he took her money and threatened to kill her.
,When the gun jammed he panicked and ran off. Ever since this
occurred the patient has been having these symptoms. She states she
jumps at every noise and refuses to drive at night. She states her
anxiety has had such a marked influence on her job performance she
is afraid she will be fired. She denies any recent illnesses or injuries.
Her past medical history is unremarkable. On examination you find a
nervous woman appearing her stated age. Her physical examination is
unremarkable. You recommend medication and counseling.
What. Answer: C) Post-traumatic stress disorder
◉ A 75-year-old homemaker brings her 76-year-old husband to your
clinic. She states that 4 months ago he had a stroke and ever since she
has been frustrated with his problems with communication. They were
at a restaurant after church one Sunday when he suddenly became
quiet. When she realized something was wrong he was taken to the
hospital by EMS. He spent 2 weeks in the hospital with right-sided
weakness and difficulty speaking. After hospitalization he was in a
rehab center, where he regained the ability to walk and most of the
use of his right hand. He also began to speak more, but she says that
much of the time "he doesn't make any sense." She gives an example
that when she reminded him the car needed to be serviced he told her
"I will change the Kool-Aid out of the sink myself with the ludrip."
She says that these sayings are becoming frustrating. She wants you
to tell her what is wrong and what you can do about. Answer: A)
Wernicke's aphasia
◉ A 32-year-old white female comes to your clinic, complaining of
overwhelming sadness. She says for the past 2 months she has had
crying episodes, difficulty sleeping, and problems with overeating.
She says she used to go out with her friends from work but now she
,just wants to go home and be by herself. She also thinks that her work
productivity has been dropping because she just is too tired to care or
concentrate. She denies any feelings of guilt or any suicidal ideation.
She states that she has never felt this way in the past. She denies any
recent illness or injuries. Her past medical history consists of an
appendectomy when she was a teenager; otherwise, she has been
healthy. She is single and works as a clerk in a medical office. She
denies tobacco, alcohol, or illegal drug use. Her mother has high
blood pressure and her father has had a history of mental illness. On
examination you see a woman appearing her st. Answer: C) Major
depressive episode
◉ A 27-year-old woman is brought to your office by her mother. The
mother tells you that her daughter has been schizophrenic for the last
8 years and is starting to decompensate despite medication. The
patient states that she has been taking her antipsychotic and she is
doing just fine. Her mother retorts that her daughter has become quite
paranoid. When asked why, the mother gives an example about the
mailman. She says that her daughter goes and gets the mail every day
and then microwaves the letters. The patient agrees that she does this
but only because she sees the mailman flipping through the envelopes
and she knows he's putting anthrax on the letters. Her mother turns to
her and says, "He's only sorting the mail!"
Which best describes the patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state. Answer: A) Illusion
, ◉ A 22-year-old man is brought to your office by his father to discuss
his son's mental health disorder. The patient was diagnosed with
schizophrenia 6 months ago and has been taking medication since.
The father states that his son's dose isn't high enough and you need to
raise it. He states that his son has been hearing things that don't exist.
You ask the young man what is going on and he tells you that his
father is just jealous because his sister talks only to him. His father
turns to him and says, "Son, you know your sister died 2 years ago!"
His son replies "Well, she still talks to me in my head all the time!"
Which best describes this patient's abnormality of perception?
A) Illusion
B) Hallucination
C) Fugue state. Answer: B) Hallucination
◉ A 26-year-old violinist comes to your clinic, complaining of
anxiety. He is a first chair violinist in the local symphony orchestra
and has started having symptoms during performances, such as
sweating, shaking, and hyperventilating. It has gotten so bad that he
has thought about giving up his first chair status so he does not have
to play the solo during one of the movements. He says that he never
has these symptoms during rehearsals or when he is practicing. He
denies having any of these symptoms at any other time. His past
medical history is unremarkable. He denies any tobacco use, drug use,
or alcohol abuse. His parents are both healthy. On examination you
see a young man who appears worried. His vital signs and physical
examination are unremarkable.
What type of anxiety disorder best describes his situation?
A) Panic disorder
B) Specific phobia
