NSG6420 Midterm Exam Questions With Complete
Solutions
A 20-year-old engineering student complains of episodes of
abdominal discomfort, bloating, and episodes of diarrhea. The
symptoms usually occur after eating, and pain is frequently
relieved with bowel movement. She is on a "celiac diet" and the
episodic symptoms persist. Physical examination and diagnostic
tests are negative. Colonoscopy is negative for any
abnormalities. This is a history and physical consistent with:
Correct Answer b) Irritable bowel syndrome
A 22-year-old female comes to your office with complaints of
right lower quadrant abdominal pain, which has been worsening
over the last 24 hours. On examination of the abdomen, there is
a palpable mass and rebound tenderness over the right lower
quadrant. The clinician should recognize the importance of:
Correct Answer a) Digital rectal examination
b) Endoscopy
c) Pelvic examination d) Urinalysis
A 23-year-old patient who has had bronchiectasis since
childhood is likely to have which of the following Correct
Answer a) Barrel-shaped chest b) Clubbing
c) Pectus excavatum
d) Prolonged capillary refill
A 24-year-old patient presents to the emergency department
after sustaining multiple traumatic injuries after a motorcycle
accident. Upon examination, you note tachypnea, use of
intercostal muscles to breathe, asymmetric chest expansion, and
,no breath sounds over the left lower lobe. It is most important to
suspect: Correct Answer a) Pulmonary embolism b) Pleural
effusion
c) Pneumothorax
d) Fracture of ribs
A 26-year-old, non-smoker, male presented to your clinic with
SOB with exertion. This could be due to: Correct Answer c)
Alpha-1 deficiency
A 55-year-old post-menopausal woman with a history of
hypertension complains of jaw pain on heavy exertion. There
were no complaints of chest pain. Her ECG indicates normal
sinus rhythm without ST segment abnormalities. Your plan may
include: Correct Answer b) Exercise stress test
A 56-year-old male complains of anorexia, changes in bowel
habits, extreme fatigue, and unintentional weight loss. At times
he is constipated and other times he has episodes of diarrhea.
His physical examination is unremarkable. It is important for the
clinician to recognize the importance of: Correct Answer d)
Colonoscopy
A 59-year-old patient with history of alcohol abuse comes to
your office because of 'throwing up blood". On physical
examination, you note ascites and caput medusa. A likely cause
for the hematemesis is: Correct Answer a) Peptic ulcer disease
b) Barrett's esophagus c) Esophageal varices d) Pancreatitis
A 64-year-old male presents with erythema of the sclera,
tearing, and bilateral pruritus of the eyes. The symptoms occur
, intermittently throughout the year and he has associated clear
nasal discharge. Which of the following is most likely because
of the inflammation? Correct Answer a) Bacterium
b) Allergen
c) Virus
d) Fungi
A 66-year-old patient presents to the clinic complaining of
dyspnea and wheezing. The patient reports a smoking history of
2 packs of cigarettes per day since age 16. This would be
recorded in the chart as Correct Answer d) 100-pack history
A 72-year-old woman and her husband are on a cross-country
driving vacation. After a long day of driving, they stop for
dinner. Midway through the meal, the woman becomes very
short of breath, with chest pain and a feeling of panic. Which of
the following problems is most likely? Correct Answer c)
Pulmonary embolism
A 74-year-old obese female presents complaining of persistent
right upper quadrant pain. She reports that she has not had any
prior abdominal surgeries. Which of the following laboratory
studies would be most indicative of acute cholecystitis? Correct
Answer a) C-reactive protein level of 3 mg
b)White blood cell count of 11,000
c)Direct serum bilirubin level of 0.3 mg/dl d)Serum amylase
level of 145 U/L
A 75-year-old patient complains of pain and paresthesias in the
right foot that worsens with exercise and is relieved by rest. On
physical examination you note pallor of the right foot, capillary
Solutions
A 20-year-old engineering student complains of episodes of
abdominal discomfort, bloating, and episodes of diarrhea. The
symptoms usually occur after eating, and pain is frequently
relieved with bowel movement. She is on a "celiac diet" and the
episodic symptoms persist. Physical examination and diagnostic
tests are negative. Colonoscopy is negative for any
abnormalities. This is a history and physical consistent with:
Correct Answer b) Irritable bowel syndrome
A 22-year-old female comes to your office with complaints of
right lower quadrant abdominal pain, which has been worsening
over the last 24 hours. On examination of the abdomen, there is
a palpable mass and rebound tenderness over the right lower
quadrant. The clinician should recognize the importance of:
Correct Answer a) Digital rectal examination
b) Endoscopy
c) Pelvic examination d) Urinalysis
A 23-year-old patient who has had bronchiectasis since
childhood is likely to have which of the following Correct
Answer a) Barrel-shaped chest b) Clubbing
c) Pectus excavatum
d) Prolonged capillary refill
A 24-year-old patient presents to the emergency department
after sustaining multiple traumatic injuries after a motorcycle
accident. Upon examination, you note tachypnea, use of
intercostal muscles to breathe, asymmetric chest expansion, and
,no breath sounds over the left lower lobe. It is most important to
suspect: Correct Answer a) Pulmonary embolism b) Pleural
effusion
c) Pneumothorax
d) Fracture of ribs
A 26-year-old, non-smoker, male presented to your clinic with
SOB with exertion. This could be due to: Correct Answer c)
Alpha-1 deficiency
A 55-year-old post-menopausal woman with a history of
hypertension complains of jaw pain on heavy exertion. There
were no complaints of chest pain. Her ECG indicates normal
sinus rhythm without ST segment abnormalities. Your plan may
include: Correct Answer b) Exercise stress test
A 56-year-old male complains of anorexia, changes in bowel
habits, extreme fatigue, and unintentional weight loss. At times
he is constipated and other times he has episodes of diarrhea.
His physical examination is unremarkable. It is important for the
clinician to recognize the importance of: Correct Answer d)
Colonoscopy
A 59-year-old patient with history of alcohol abuse comes to
your office because of 'throwing up blood". On physical
examination, you note ascites and caput medusa. A likely cause
for the hematemesis is: Correct Answer a) Peptic ulcer disease
b) Barrett's esophagus c) Esophageal varices d) Pancreatitis
A 64-year-old male presents with erythema of the sclera,
tearing, and bilateral pruritus of the eyes. The symptoms occur
, intermittently throughout the year and he has associated clear
nasal discharge. Which of the following is most likely because
of the inflammation? Correct Answer a) Bacterium
b) Allergen
c) Virus
d) Fungi
A 66-year-old patient presents to the clinic complaining of
dyspnea and wheezing. The patient reports a smoking history of
2 packs of cigarettes per day since age 16. This would be
recorded in the chart as Correct Answer d) 100-pack history
A 72-year-old woman and her husband are on a cross-country
driving vacation. After a long day of driving, they stop for
dinner. Midway through the meal, the woman becomes very
short of breath, with chest pain and a feeling of panic. Which of
the following problems is most likely? Correct Answer c)
Pulmonary embolism
A 74-year-old obese female presents complaining of persistent
right upper quadrant pain. She reports that she has not had any
prior abdominal surgeries. Which of the following laboratory
studies would be most indicative of acute cholecystitis? Correct
Answer a) C-reactive protein level of 3 mg
b)White blood cell count of 11,000
c)Direct serum bilirubin level of 0.3 mg/dl d)Serum amylase
level of 145 U/L
A 75-year-old patient complains of pain and paresthesias in the
right foot that worsens with exercise and is relieved by rest. On
physical examination you note pallor of the right foot, capillary
