Nr 511 Week 8 Final Exam Advanced Physical Assessment Chamberlain (NR511)

Exam (elaborations) Nr 511 Week 8 Final Exam Advanced Physical Assessment Chamberlain (NR511) Question1. The most cost-effective screening test for determining HIV status is which of the following? a. Western blot b. Enzyme-linked immunosorbent assay c. Venereal Disease Research Laboratory test d. Viral load Question2. Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? a. Erythrocyte sedimentation rate b. White blood cell count c. Polymorphonuclear cells d. C-reactive protein (CRP) Question3. Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? a. GABA b. Acetylcholine c. Dopamine d. Serotonin Question4. Mrs. Thomas was seen in the o ce complaining of pain ffice complaining of pain and point tenderness in the area of and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitiserentiates the diagnosis and is most consistent with lateral epicondylitis (tenniselbow)is: a. Ecchymosis,edema,anderythemaoverthelateralepicondyle b. Pain at the elbow with resisted movements at the wrist and forearm c. Inability to supinate and pronate the arm d. Inabilitytoflexorextendtheelbowagainstresistance Question5. Which of the following statements concerning the musculoskeletal examination is true? a. The uninvolved side should be examined initially and then compared to the involved side. b. The part of the body that is causing the patient pain should be examined first. c. When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain. d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. Question6. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? a. DecreasedC-reactiveprotein b. Hyperalbuminemia c. Morning stifferentiates the diagnosis and is most consistent with lateral epicondylitisness d. Weight gain Question7. Which causes the greatest percentage of mammalian bites? a. Dogs b. Cats c. Humans d. Rodents Question8. A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? a. Transvaginal ultrasound b. Endometrial biopsy c. MRI d. Abdominal computed tomography scan Question9. Adiabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? a. “Control of glucose will help postpone or delay complications.” b. “Regularly checking blood sugar will help establish a routine.” c. “Monitoring glucose will promote a sense of control.” d. All of the above Question10. A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? a. Serum calcium b. TSH c. Electrolytes d. Urine specific gravity Question11. Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? a. Insulin b. Metformin c. Glucotrol d. Precose Question12. During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? a. An enlarged rubbery gland b. A hard irregular gland c. A tender gland d. A boggy gland Question13. Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? a. Remove the insect with tweezers. b. Immobilize the insect with 2% lidocaine. c. Sedate Eddie with diazepam. d. Shine a light in the ear for the insect to “find its way out.” Question14. What is the most common cause of microcytic anemia? a. Anemia of chronic disease b. Sideroblastic anemia c. Iron-deficiency anemia d. Thalassemia Question15. An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? a. Benign prostatic hyperplasia (BPH) b. Parkinson’s disease c. Prostate cancer d. All of the above Question16. Early rheumatoid disease is characterized by: a. Pain and swelling in both small and large peripheral joints b. Rigid joints with diminished range of motion c. Joint swelling and immobility on rising d. A cardiac rub or pulmonary friction rub Question17. A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? a. Make an immediate referral for an orthopedic evaluation without further assessment. b. Tell her that it takes time for these bruises to improve, so she should be patient. c. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. d. Send her to the emergency room for reduction of this obvious wrist fracture. Question18. The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: a. 1 month b. 3 months c. 6 months d. 12 months Question19. A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? a. The scrotum will be dark. b. The scrotum will appear light pink or yellow. c. The scrotum will appear milky white. d. The internal structures will be clearly visible. Question20. According to Kübler-Ross, the stages of grief occur in which order? a. Anger, denial, depression, bargaining, acceptance b. Anger, denial, bargaining, acceptance, depression c. Denial, anger, depression, bargaining, acceptance d. Denial, anger, bargaining, depression, acceptance Question21. Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? a. A favorable prognostic trend b. Disease progression c. The need to be more aggressive with Reuben’s medications d. The eradication of the HIV Question22. The exanthem of Lyme disease is: a. Erythema infectiosum b. Laterothoracic exanthem c. Erythema migrans d. Morbilli exanthem Question23. You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: a. Articular b. Inflammatory c. Nonarticular d. A and B Question24. What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? a. 1,200 mg/day b. 1,000 mg/day c. 1,300 mg/day d. 1,500 mg/day Question25. When assessing a woman for infertility, which of the following tests should be done first? a. Analysis of partner’s sperm b. Magnetic resonance imaging (MRI) c. Hysterosalpingogram d. Estrogen level Question26. Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? a. Superficial burns b. Superficial partial-thickness burns c. Deep partial-thickness burns d. Full-thickness burns Question26. Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? a. Superficial burns b. Superficial partial-thickness burns c. Deep partial-thickness burns d. Full-thickness burns Question27. A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? a. Human papillomavirus (HPV) b. Endometrial hyperplasia c. Vagismus d. Polycystic ovarian syndrome Question28. As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? a. Two b. Three c. Four d. Five Question29. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. Morning stiffness and limited mobility of the lumbar spine b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate