NSG6020 Final Exam – 2025 Summer Fall | Latest
Questions & Answers (Graded A) | South
University
A 23-year-old computer programmer comes to your office for an annual examination. She has recently
become sexually active and wants to be placed on birth control. Her only complaint is that the skin in
her armpits has become darker. She states it looks like dirt, and she scrubs her skin nightly with soap
and water but the color stays. Her past medical symptoms consist of acne and mild obesity. Her periods
have been irregular for 3 years. Her mother has type 2 diabetes, and her father has high blood pressure.
The patient denies using tobacco but has four to five drinks on Friday and Saturday nights. She denies
any illegal drug use. On examination, you see a mildly obese female who is breathing comfortably. Her
vital signs are unremarkable. Looking under her axilla, you see dark, velvet-like skin. Her annual
examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have?
Acanthosis nigricans
Which of the following is true of women who have had a unilateral mastectomy?
They should be examined carefully along the surgical scar for masses.
A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a
low-grade fever for about three days. He denies any nausea, vomiting, or diarrhea. The only unusual
thing he remembers eating is two bags of popcorn at the movies with his grandson, three days before
his symptoms began. He denies any other recent illnesses. His past medical history is significant for
coronary artery disease and high blood pressure. He has been married for over fifty years. He denies any
tobacco, alcohol, or drug use. His mother died of colon cancer and his father had a stroke. On
examination, he appears his stated age and is in no acute distress. His temperature is 100.9 degrees and
his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He
has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His
rectal examination is unremarkable and his fecal occult blood test is negative. His prostate is slightly
enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending.
What diagnosis for abdominal pain best describes his symptoms and signs?
Acute diverticulitis
,Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which
has been occurring for two days. He does note a dark, granular substance resembling the coffee left in
the filter after brewing. What do you suspect?
Bleeding from a peptic ulcer
A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal
pain for twelve hours. He began having a stomachache yesterday, with a decreased appetite, but today
the pain seems to be just on the lower right side. He has had some nausea and vomiting but no
constipation or diarrhea. His last bowel movement was the night before and was normal. He has had no
fever or chills. He denies any recent illnesses or injuries. His past medical history is unremarkable. He is
engaged. He denies any tobacco or drug use and drinks four to six beers per week. His mother has
breast cancer and his father has coronary artery disease. On examination, he appears ill and is lying on
his right side. His temperature is 100.4 degrees and his heart rate is 110. His bowel sounds are
decreased and he has rebound and involuntary guarding, one-third of the way between the anterior
superior iliac spine and the umbilicus in the right lower quadrant (RLQ). His rectal, inguinal, prostate,
penile, and testicular examinations are normal. What is the most likely cause of his pain?
Acute appendicitis
Josh is a 14-year-old boy who presents with a sore throat. On examination, you notice dullness in the
last intercostal space in the anterior axillary line on his left side with a deep breath. What does this
indicate?
His spleen is possibly enlarged and close attention should be paid to further examination.
Diminished radial pulses may be seen in patients with which of the following?
, Arterial emboli
A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months.
She has had no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any
recent illnesses or injuries. She denies any changes to her diet or exercise program. She is on no new
medications. During the review of systems (ROS), you note that she has felt fatigued, had some weight
gain, has irregular periods, and has cold intolerance. Her past medical history is significant for one
vaginal delivery and two cesarean sections. She is married, has three children, and owns a flower shop.
She denies tobacco, alcohol, or drug use. Her mother has type 2 diabetes and her father has coronary
artery disease. There is no family history of cancers. On examination, she appears her stated age. Her
vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her
cardiac, lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is
negative. Her deep tendon reflexes are delayed in response to a blow with the hammer, especially the
Achilles tendons. What is the best choice for the cause of her constipation?
Hypothyroidism
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked
two packs per day since the age of sixteen, but is otherwise healthy. You are concerned that he may
have peripheral vascular disease. Which of the following is part of common or concerning symptoms for
the peripheral vascular system?
Intermittent claudication
You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which
of the following locations would the patient's pain make you concerned for this disease process?
Calf
A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and
radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of
the following aspects of the physical are important to note when assessing the patient for peripheral
vascular disease in the arms?
Questions & Answers (Graded A) | South
University
A 23-year-old computer programmer comes to your office for an annual examination. She has recently
become sexually active and wants to be placed on birth control. Her only complaint is that the skin in
her armpits has become darker. She states it looks like dirt, and she scrubs her skin nightly with soap
and water but the color stays. Her past medical symptoms consist of acne and mild obesity. Her periods
have been irregular for 3 years. Her mother has type 2 diabetes, and her father has high blood pressure.
The patient denies using tobacco but has four to five drinks on Friday and Saturday nights. She denies
any illegal drug use. On examination, you see a mildly obese female who is breathing comfortably. Her
vital signs are unremarkable. Looking under her axilla, you see dark, velvet-like skin. Her annual
examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have?
Acanthosis nigricans
Which of the following is true of women who have had a unilateral mastectomy?
They should be examined carefully along the surgical scar for masses.
A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a
low-grade fever for about three days. He denies any nausea, vomiting, or diarrhea. The only unusual
thing he remembers eating is two bags of popcorn at the movies with his grandson, three days before
his symptoms began. He denies any other recent illnesses. His past medical history is significant for
coronary artery disease and high blood pressure. He has been married for over fifty years. He denies any
tobacco, alcohol, or drug use. His mother died of colon cancer and his father had a stroke. On
examination, he appears his stated age and is in no acute distress. His temperature is 100.9 degrees and
his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He
has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His
rectal examination is unremarkable and his fecal occult blood test is negative. His prostate is slightly
enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending.
What diagnosis for abdominal pain best describes his symptoms and signs?
Acute diverticulitis
,Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which
has been occurring for two days. He does note a dark, granular substance resembling the coffee left in
the filter after brewing. What do you suspect?
Bleeding from a peptic ulcer
A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal
pain for twelve hours. He began having a stomachache yesterday, with a decreased appetite, but today
the pain seems to be just on the lower right side. He has had some nausea and vomiting but no
constipation or diarrhea. His last bowel movement was the night before and was normal. He has had no
fever or chills. He denies any recent illnesses or injuries. His past medical history is unremarkable. He is
engaged. He denies any tobacco or drug use and drinks four to six beers per week. His mother has
breast cancer and his father has coronary artery disease. On examination, he appears ill and is lying on
his right side. His temperature is 100.4 degrees and his heart rate is 110. His bowel sounds are
decreased and he has rebound and involuntary guarding, one-third of the way between the anterior
superior iliac spine and the umbilicus in the right lower quadrant (RLQ). His rectal, inguinal, prostate,
penile, and testicular examinations are normal. What is the most likely cause of his pain?
Acute appendicitis
Josh is a 14-year-old boy who presents with a sore throat. On examination, you notice dullness in the
last intercostal space in the anterior axillary line on his left side with a deep breath. What does this
indicate?
His spleen is possibly enlarged and close attention should be paid to further examination.
Diminished radial pulses may be seen in patients with which of the following?
, Arterial emboli
A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months.
She has had no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any
recent illnesses or injuries. She denies any changes to her diet or exercise program. She is on no new
medications. During the review of systems (ROS), you note that she has felt fatigued, had some weight
gain, has irregular periods, and has cold intolerance. Her past medical history is significant for one
vaginal delivery and two cesarean sections. She is married, has three children, and owns a flower shop.
She denies tobacco, alcohol, or drug use. Her mother has type 2 diabetes and her father has coronary
artery disease. There is no family history of cancers. On examination, she appears her stated age. Her
vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her
cardiac, lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is
negative. Her deep tendon reflexes are delayed in response to a blow with the hammer, especially the
Achilles tendons. What is the best choice for the cause of her constipation?
Hypothyroidism
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked
two packs per day since the age of sixteen, but is otherwise healthy. You are concerned that he may
have peripheral vascular disease. Which of the following is part of common or concerning symptoms for
the peripheral vascular system?
Intermittent claudication
You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which
of the following locations would the patient's pain make you concerned for this disease process?
Calf
A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and
radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of
the following aspects of the physical are important to note when assessing the patient for peripheral
vascular disease in the arms?
