NR509 Week 4 Midterm Exam
Question 12
A 76-year-old male presents to the office for a routine physical examination. He has sun-exposed
skin and multiple, discrete, brown, stuck-on, non-indurated, verrucous lesions. What is the best
interpretation of these findings?
A. Actinic keratosis with suspicion for basal cell carcinoma
B. Tinea versicolor with associated post-inflammatory changes
C. Normal age-related changes and seborrheic keratoses
D. Lentigo maligna with associated melanoma risk
Correct Answer: C
Rationale: Seborrheic keratoses are benign, waxy, brown, "stuck-on" lesions commonly found in
older adults.
,Question 15
Proper positioning of the patient during the physical examination is fundamental to cardiac
assessment. What is the best position to place the patient when auscultating for S1, S2, and
murmurs?
A. Sitting upright and leaning forward
B. Left lateral decubitus position
C. Standing with arms raised overhead
D. Supine with the head of the bed elevated at 30–45 degrees
Correct Answer: D
Rationale: Standard position for routine cardiac auscultation.
,Question 24
A 12-year-old female complains of fullness as well as popping sensations in the ear and decreased
hearing. What medical condition is associated with these findings?
A. Tympanic membrane perforation
B. Purulent effusion
C. Retracted tympanic membrane
D. Serous effusion
Correct Answer: C
Rationale: Ear fullness and popping suggest Eustachian tube dysfunction causing TM retraction.
, Question 31
A 21-year-old male is experiencing dyspnea on exertion and palpitations. On cardiac auscultation,
you ... cardiac condition associated with this finding?
A. Aortic aneurysm
B. Pulmonic stenosisC. Tricuspid stenosis
D. Atrial septal defect
Correct Answer: D
Rationale: ASD classically presents with exertional dyspnea and a fixed split S2.
Question 12
A 76-year-old male presents to the office for a routine physical examination. He has sun-exposed
skin and multiple, discrete, brown, stuck-on, non-indurated, verrucous lesions. What is the best
interpretation of these findings?
A. Actinic keratosis with suspicion for basal cell carcinoma
B. Tinea versicolor with associated post-inflammatory changes
C. Normal age-related changes and seborrheic keratoses
D. Lentigo maligna with associated melanoma risk
Correct Answer: C
Rationale: Seborrheic keratoses are benign, waxy, brown, "stuck-on" lesions commonly found in
older adults.
,Question 15
Proper positioning of the patient during the physical examination is fundamental to cardiac
assessment. What is the best position to place the patient when auscultating for S1, S2, and
murmurs?
A. Sitting upright and leaning forward
B. Left lateral decubitus position
C. Standing with arms raised overhead
D. Supine with the head of the bed elevated at 30–45 degrees
Correct Answer: D
Rationale: Standard position for routine cardiac auscultation.
,Question 24
A 12-year-old female complains of fullness as well as popping sensations in the ear and decreased
hearing. What medical condition is associated with these findings?
A. Tympanic membrane perforation
B. Purulent effusion
C. Retracted tympanic membrane
D. Serous effusion
Correct Answer: C
Rationale: Ear fullness and popping suggest Eustachian tube dysfunction causing TM retraction.
, Question 31
A 21-year-old male is experiencing dyspnea on exertion and palpitations. On cardiac auscultation,
you ... cardiac condition associated with this finding?
A. Aortic aneurysm
B. Pulmonic stenosisC. Tricuspid stenosis
D. Atrial septal defect
Correct Answer: D
Rationale: ASD classically presents with exertional dyspnea and a fixed split S2.
