Advanced Health Assessment & Clinical Diagnosis in Primary Care (7th
Edition,2024) Joyce E. Dains over 100 questions with correct answers
PART A
All of the following are common in young adults with appendicitis except:
A. Pain in the RLQ
B. Rebound tenderness
C. Positive Obturator/Psoas Sign
D. Marked fever
D. Marked fever
A patient presents with appendicitis what would you expect on their CBC?
A. WBC: 4.5, 35% neutrophils, 2% bands, 45% lymphyocytes
B. WBC: 14, 55% neutrophils, 4% bands, 38% lymphyocytes
C. WBC: 16.5, 66% neutrophils, 8% bands, 22% lymphyocytes
D. WBC: 19, 55% neutrophils, 3% bands, 28% lymphyocytes
C. WBC: 16.5, 66% neutrophils, 8% bands, 22% lymphyocytes
You would expected an elevated WBC with a left shift - elevated neutrophils and bandemia (premature
neutrophils that are released during acute inflammation/infection)
A 48 year old woman comes in with sudden onset of RUQ pain which radiates to the shoulder, has
fevers, and chills. She has previously had less intense symptoms that were similar before. What is it?
A. Hepatoma
B. Acute cholycystitis
C. Acute hepatitis
D. Pancreatitis
B. Acute cholycystitis
,What is not a risk factor for gallstones?
A. Rapid weight loss
B. Male
C. Obesity
D. Native American ancestry
B. Male
Colon cancer is what number in terms of CA deaths in the US for men and women?
A. 1
B. 2
C. 9
D. 3
D. 3
PART B
1. A 19-year-old man comes to your clinic with a red, irritated right eye for 24-48 hours. He notes that
when he woke up, his eyelids were "stuck together". Physical exam findings: sclera is injected, vision is
normal, and EOM are intact, purulent discharge is noted. What is the most likely diagnosis?
A. Chemical exposure
B. Bacterial Conjunctivitis
C. Erythema nodosa
D. Trauma
B. Bacterial Conjunctivitis
2. An 18-year-old female presents to the ER with 1-day history of severe sore throat, malaise, and
headache. The patient reports no history of cough or rhinitis. V.S.: T 101F, P98, R22, BP 124/60. On skin
inspection, the NP notices a fine sandpaper rash on the chest. The throat examination reveals an
,inflamed uvula, pharynx, and tonsils with gray-white exudate on the right tonsil. Neck examination
reveals tender cervical lymphadenopathy. The most likely diagnosis is:
A. Hand-foot-and-mouth disease
B. Acute herpetic pharyngitis
C. Group A beta-hemolytic streptococcal infection
D. Acute diphtherial infection
C. Group A beta-hemolytic streptococcal infection
3. The purpose of the health history is to:
A. Gather subjective data about the patient
B. Obtain a genetic history to determine susceptibility to disease
C. Gather past and current objective and subjective data about the patient
D. Obtain a genealogic record of familial diseases
A. Gather subjective data about the patient
4. A 67-year-old man with a 40 pack-year smoking history complains of shortness of breath for the past
6 months and swelling in his legs. He often wakes up at night gasping for breath and feels most
comfortable sleeping on 3 pillows. He has no past medical history of COPD or CHF, but he has diabetes
and hypertension. What is the most likely diagnosis?
A. Congestive heart failure
B. Chronic obstructive pulmonary disease
C. Asthma
D. Lung cancer
A. Congestive heart failure
, 5. A 50-year-old woman comes to your office with a history of 2 episodes of coughing blood. The
quantity is estimated to be 2 to 3 tablespoons of bright blood on each occasion. She has mild shortness
of breath, but she feels comfortable at rest. She has never smoked, denies weight loss or fever, and has
no other medical problems. What would be the next step in her management?
A. Referral to a pulmonologist for bronchoscopy
B. Return to your clinic in the next several weeks to monitor her symptoms
C. Chest x-ray with an admission to the hospital for additional testing
D. Complete vital signs and physical examination
D. Complete vital signs and physical examination
6. During the central nervous system exam, the NP evaluates the patient's gait and determines the
patient is unable to perform a heel-walk. The differential diagnosis the NP is most concerned about is
damage to the:
A. Corticospinal tract
B. Spinocerebellar tract
C. Spinothalamic tract
D. Dorsal column-medial lemniscus tract
A. Corticospinal tract
7. What is the best way to begin asking about the past medical history?
A. Have you had measles, mumps, rubella, chicken pox, scarlet fever, or rheumatic fever?
B. Did you get all your shots growing up?
C. Were you hospitalized as a child?
D. How was your health as a child?
D. How was your health as a child?
Edition,2024) Joyce E. Dains over 100 questions with correct answers
PART A
All of the following are common in young adults with appendicitis except:
A. Pain in the RLQ
B. Rebound tenderness
C. Positive Obturator/Psoas Sign
D. Marked fever
D. Marked fever
A patient presents with appendicitis what would you expect on their CBC?
A. WBC: 4.5, 35% neutrophils, 2% bands, 45% lymphyocytes
B. WBC: 14, 55% neutrophils, 4% bands, 38% lymphyocytes
C. WBC: 16.5, 66% neutrophils, 8% bands, 22% lymphyocytes
D. WBC: 19, 55% neutrophils, 3% bands, 28% lymphyocytes
C. WBC: 16.5, 66% neutrophils, 8% bands, 22% lymphyocytes
You would expected an elevated WBC with a left shift - elevated neutrophils and bandemia (premature
neutrophils that are released during acute inflammation/infection)
A 48 year old woman comes in with sudden onset of RUQ pain which radiates to the shoulder, has
fevers, and chills. She has previously had less intense symptoms that were similar before. What is it?
A. Hepatoma
B. Acute cholycystitis
C. Acute hepatitis
D. Pancreatitis
B. Acute cholycystitis
,What is not a risk factor for gallstones?
A. Rapid weight loss
B. Male
C. Obesity
D. Native American ancestry
B. Male
Colon cancer is what number in terms of CA deaths in the US for men and women?
A. 1
B. 2
C. 9
D. 3
D. 3
PART B
1. A 19-year-old man comes to your clinic with a red, irritated right eye for 24-48 hours. He notes that
when he woke up, his eyelids were "stuck together". Physical exam findings: sclera is injected, vision is
normal, and EOM are intact, purulent discharge is noted. What is the most likely diagnosis?
A. Chemical exposure
B. Bacterial Conjunctivitis
C. Erythema nodosa
D. Trauma
B. Bacterial Conjunctivitis
2. An 18-year-old female presents to the ER with 1-day history of severe sore throat, malaise, and
headache. The patient reports no history of cough or rhinitis. V.S.: T 101F, P98, R22, BP 124/60. On skin
inspection, the NP notices a fine sandpaper rash on the chest. The throat examination reveals an
,inflamed uvula, pharynx, and tonsils with gray-white exudate on the right tonsil. Neck examination
reveals tender cervical lymphadenopathy. The most likely diagnosis is:
A. Hand-foot-and-mouth disease
B. Acute herpetic pharyngitis
C. Group A beta-hemolytic streptococcal infection
D. Acute diphtherial infection
C. Group A beta-hemolytic streptococcal infection
3. The purpose of the health history is to:
A. Gather subjective data about the patient
B. Obtain a genetic history to determine susceptibility to disease
C. Gather past and current objective and subjective data about the patient
D. Obtain a genealogic record of familial diseases
A. Gather subjective data about the patient
4. A 67-year-old man with a 40 pack-year smoking history complains of shortness of breath for the past
6 months and swelling in his legs. He often wakes up at night gasping for breath and feels most
comfortable sleeping on 3 pillows. He has no past medical history of COPD or CHF, but he has diabetes
and hypertension. What is the most likely diagnosis?
A. Congestive heart failure
B. Chronic obstructive pulmonary disease
C. Asthma
D. Lung cancer
A. Congestive heart failure
, 5. A 50-year-old woman comes to your office with a history of 2 episodes of coughing blood. The
quantity is estimated to be 2 to 3 tablespoons of bright blood on each occasion. She has mild shortness
of breath, but she feels comfortable at rest. She has never smoked, denies weight loss or fever, and has
no other medical problems. What would be the next step in her management?
A. Referral to a pulmonologist for bronchoscopy
B. Return to your clinic in the next several weeks to monitor her symptoms
C. Chest x-ray with an admission to the hospital for additional testing
D. Complete vital signs and physical examination
D. Complete vital signs and physical examination
6. During the central nervous system exam, the NP evaluates the patient's gait and determines the
patient is unable to perform a heel-walk. The differential diagnosis the NP is most concerned about is
damage to the:
A. Corticospinal tract
B. Spinocerebellar tract
C. Spinothalamic tract
D. Dorsal column-medial lemniscus tract
A. Corticospinal tract
7. What is the best way to begin asking about the past medical history?
A. Have you had measles, mumps, rubella, chicken pox, scarlet fever, or rheumatic fever?
B. Did you get all your shots growing up?
C. Were you hospitalized as a child?
D. How was your health as a child?
D. How was your health as a child?
