Drexel NUR 550 2023 Final Exam Cumulative Review Questions With Answers (Graded A+)

Drexel NUR 550 2023 Final Exam Cumulative Review Questions With Answers (Graded A+) A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this? a). Occipital b). Tonsillar c). Submandibular d). Posterior cervical - Answer d). Posterior cervical A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient? a). Hair color b). Actinic lentigines c). Heavy sun exposure d). Age - Answer d). Age Is the following statement true or false? When assessing the patient's thought content, it is important to always follow specific questions to keep the patient on task. a). True b). False - Answer b). False Which of the following is true about hallucinations? a). Experiences may or may not be recognized by the person as false. b). Hallucinations may be auditory, visual, olfactory, gustatory, tactile, or somatic. c). Do not include false perceptions associated with dreaming and falling asleep. d). All of the above. - Answer d). All of the above. Coordination of muscle movement requires that four areas of the nervous system function in an integrated way. Coordinating eye, head, and body movements applies to which area of the nervous system? a). Motor system b). Cerebellar system c). Vestibular system d). Sensory system - Answer c). Vestibular system Which of the following statements regarding reinforcement when assessing reflexes is true? a). Used when reflexes are symmetrically hyperactive b). Technique involves isometric contraction of other muscles c). Supports the unsteady patient d). All of the above - Answer b). Technique involves isometric contraction of other muscles A patient presents to you with shoulder pain after falling during an ice storm. On examination, he exhibits localized shoulder pain when you preform the "crossover test" (arm moved across the chest toward the opposite side while extended at the elbow). Which of the following is the most likely site of injury? a). Rotator cuff b). Bicipital tendon c). Glenohumeral joint d). Acromioclavicular joint - Answer d). Acromioclavicular joint A patient who presents to the clinic complaining of hand pain says she was told by a friend that it is most likely carpal tunnel syndrome. Upon assessing the patient, you note the following. Which finding would be suggestive of carpal tunnel syndrome? a). Hand pain when holding both hands in acute extension b). Numbness and tingling when tapping over the course of the radial nerve c). Symptoms related to compression are evident in all fingers d). None of the above - Answer d). None of the above ---- b). MEDIAL NERVE is correct c). FIRST THREE FINGERS is correct You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or noninflammatory in nature. Which one of the following symptoms is consistent with an inflammatory process? a).Tenderness b).Ecchymosis c).Nodules d).Cool temperature - Answer a).Tenderness An 85-year-old retired housewife comes with her daughter to establish care. Her daughter is concerned because her mother has started to fall more. As part of her physical examination, you ask her to walk across the examination room. Which of the following is not part of the stance phase of gait? a). Heel strike b). Foot arched c). Push-off d). Mid-stance - Answer b). Foot arched A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states that he has numbness and tingling in the left leg. He wants to know if he needs to be off of work. What test should you perform to assess for a herniated disc? a). Phalen's test b). Straight-leg raise c). Leg-length test d). Tinel's test - Answer b). Straight-leg raise A high school soccer player "blew out his knee" when the opposing goalie's head and shoulder struck his flexed knee while the goalie was diving for the ball. All of the following structures were involved in some way in his injury, but which of the following is actually an extra-articular structure? a). Synovium b). Juxta-articular bone c). Joint capsule d). Tendons - Answer d). Tendons A 28-year-old book editor comes to your clinic, complaining of strange episodes. He states that about once a week for the last 3 months his left hand and arm will stiffen and then start jerking. He says that after a few seconds his whole left arm and then his left leg will also start to jerk. He denies any loss of consciousness or loss of bowel or bladder control. When the symptoms resolve, his arm and leg feel tired but otherwise he feels fine. His past medical history is significant for a cyst in his brain that was removed 6 months ago. He is married and has two children. His parents are both healthy. On examination you see a scar over the right side of his head but otherwise his neurologic examination is unremarkable. What type of seizure disorder is he most likely to have? a). Complex partial seizure b). Simple partial seizure (Jacksonian) c). Generalized tonic-clonic seizure d). Generalized absence seizure - Answer b). Simple partial seizure (Jacksonian) A 21-year-old engineering student comes to your office, complaining of leg and back pain and of tripping when he walks. He states this started 3 months ago with back and buttock pain but has since progressed to feeling weak in his left leg. He denies any bowel or bladder symptoms. He can think of no specific traumatic incidences but he was a defensive lineman in high school and junior college. His past medical history is unremarkable. He denies tobacco use or alcohol or drug abuse. His parents are both healthy. On examination he is tender over the lumbar spine and he has a positive straight-leg raise on the left. His Achilles tendon deep reflex is decreased on the left. While watching his gait you notice he has to pick his left foot up high in order not to trip. What abnormality of gait does he most likely have? a). Sensory ataxia b). Steppage gait c). Parkinsonian gait d). Spastic hemiparesis - Answer b). Steppage gait Steve has had a stroke and comes to you for follow-up today. On examination you find that he has increased muscle tone, some involuntary movements, an abnormal gait, and a slowness of response in movements. He most likely has involvement of which of the following? a). The corticospinal tract b). The cerebrum c). The basal ganglia d). The cerebellum - Answer c). The basal ganglia 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 seen a black van in his neighborhood at night and he is sure that it is full of computer tech workers stealing his work through special gamma waves. You ask him why he believes they are trying to steal his programs. He replies that the technicians have been telepathing their intents directly into his head. He says he hears these conversations at night so he knows this is happening. Todd's mother then tells you, "See, I told you . . . he's crazy. What do I do about it?" While arranging for a psychiatry consult, what psychotic disorder do you think Todd has? a). Psychotic disorder due to a medical illness b). Schizophrenia c). Substance-induced psychotic disorder d). Schizoaffective disorder - Answer b). 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 anxiety disorder do you think this young woman has? a). Acute stress disorder b). Generalized anxiety disorder c). Specific phobia d). Post-traumatic stress disorder - Answer d). Post-traumatic stress disorder A 72-year-old African-American male is brought to your clinic by his daughter for a follow-up visit after his recent hospitalization. He had been admitted to the local hospital for speech problems and weakness in his right arm and leg. On admission his MRI showed a small stroke. The patient was in rehab for 1 month following his initial presentation. He is now walking with a walker and has good use of his arm. His daughter complains, however, that everyone is still having trouble communicating with the patient. You ask the patient how he thinks he is doing. Although it is hard for you to make out his words you believe his answer is "well . . . fine . . . doing . . . okay." His prior medical history involved high blood pressure and coronary artery disease. He is a widower and retired handyman. He has three children who are healthy. He denies tobacco, alcohol, or drug use. He has no other current symptoms. On examination he is in no acute distress but does seem embarrassed when it takes him so long to answer. His blood pressure is 150/90 and his other vital signs are normal. Other than his weak right arm and leg his physical examination is unremarkable. What disorder of speech does he have? a). A. Dysarthria b). Broca's aphasia c). Wernicke's aphasia - Answer b). Broca's aphasia A young Hispanic mother brings in her 2-month-old son. She is upset because her neighbors have threatened to call the Child Protective Agency because they think his birthmark is a bruise. Her son was the product of an uneventful pregnancy and spontaneous vaginal delivery. On examination you see a large, smooth-bordered bluish mark on his buttock and lower back. Otherwise his examination is unremarkable. What form of birthmark is this likely to be? a). Café-au-lait spot b). Salmon patch c). Mongolian spot - Answer c). Mongolian spot You have been unable to hear normal S2 splitting in children up to this point. What technique will maximize your chances of hearing this phenomenon?