HOSMERIT
NU 650 MIDTERM EXAM QUESTION AND VERIFIED
ANSWERS LATEST AND COMPREHENSIVE VERSION
WITH INSTANT PDF DOWNLOAD
3 Dimensions of cultural humility - correct answer-1) Self-awareness: learn about your own
biases; we all have them.
2. Respectful communication: work to eliminate assumptions about what is "normal". Learn
directly from your patients; they are the experts on their culture and illness.
3. Collaborative partnerships: build your patient relationships on respect and mutually acceptable
plans.
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left
eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon
physical examination, there is a red raised area at the margin of the eyelid that is tender to
palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the
most likely diagnosis?
A. Dacryocystitis
B. Chalazion
C. Hordeolum
D. Xanthelasma - correct answer-CHordeolum - aka Stye
A 15 yo presents to the emergency room with his mother for eval of an area of blood in theleft
eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He denies
visual disturbances, eye pain, or discharge from the eye. On physical exam, the PERRL, with a
visual acuity of
20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the
lateral aspect of the base of the left eye. The cornea is clear. Based on this description, what is
the most likely diagnosis?
A. Conjunctivitis
B. Acute iritis
C. Corneal abrasion
D. Subconjunctival hemorrhage - correct answer-D
,A 15-year-old high school student presents to your clinic complaining of pain in his left ear. He
noticed that it occurred shortly after starting swimming lessons at the local YMCA. Upon
physical examination, you notice that the external canal is swollen and tender during insertion of
the speculum. What is your most likely diagnosis?
A. Otitis media
B. Serous otitis
C. Eustachian tube dysfunction
D. Otitis externa - correct answer-D
A 15-year-old member of the high school marching band comes to your office for evaluation of
hearing loss. He had multiple ear infections as an infant and toddler, and had to have
myringotomy tubes inserted in his ears. Additionally, he suffers from many allergies. His hearing
is diminished in the right ear. When you place a vibrating tuning fork on the top of his head, the
sound lateralizes to the right ear. The name of this test is:
A. Weber's test
B. Rinne's test
C. Whisper test
D. Romberg test - correct answer-A
A 17-year-old high school senior presents to your clinic in acute respiratory distress. Between
shallow breaths he states he was at home finishing his homework when he suddenly began
having right-sided chest pain and severe SOB. Denies any recent traumas or illnesses. PMH
unremarkable. On examination you see a tall, thin young man in obvious distress. He is
diaphoretic and RR 35. On auscultation you hear no breath sounds on the right side of his
superior chest wall. On percussion he is hyperresonant over RUL. Palpation: absent fremitus over
the RUL.
What disorder of the thorax or lung best describes his symptoms?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia - correct answer-A
A 19 yo construction worker presents for evaluation of a rash. He notes that it started on his back
with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat
more than before because being outdoors is part of his job. On physical examination, you note
dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more
prominently around the upper back, chest, neck, and upper arms aswell as under the arms. Based
on this description, what is your most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
,D. Atopic eczema - correct answer-B Tinea = fungal and promoted by moisture
A 2-week-old infant is brought into your clinic by his parents because they have noticed that their
child is having some difficulty with feeding and that there is something strange in his mouth.
You diagnose thrush. What is the most likely physical finding you will see upon examination of
his mouth?
A. Koplik's spots
B. White plaques
C. Erythematous plaques
D. Epstein's pearls - correct answer-B
A 21-year-old college senior presents to your clinic, complaining of SOB and a nonproductive
nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she
has felt this way continuously. She denies any other upper respiratory symptoms, CP, GI
symptoms, or urinary tract symptoms. PMH significant only forseasonal allergies. On exam she
is in no acute distress; temp is 98.6, BP is 120/80, her pulse is 80, and her RR is 20. On
auscultation of her chest, there is decreased air movement and a high-pitched whistling on
expiration in all lobes. Percussion reveals resonant lungs.
Which disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia - correct answer-C
A 22-year-old agricultural worker presents to your office for evaluation of coughing. She has had
this cough for 6 weeks; it is nonproductive and worst first thing in the morning. She denies fever,
chills, weight loss, or night sweats; she does have clear rhinorrhea and itchy, watery eyes. You
diagnose her with allergic rhinoconjunctivitis. On physical examination of the nasal mucosa,
what would you expect to find?
A. Erythematous, ulcerated mucosa
B. Pale to bluish, boggy mucosa
C. Pink mucosa
D. Ulcerated mucosa - correct answer-B
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right-sided
chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds,
taking his breath away. He states he feels like he has to breathe shallowly to keep it from
recurring. The only thing that makes it better is lying quietly on his right side. It is much worse
when he takes a deep breath. 2 weeks ago he had an upper respiratory infection with a severe
hacking cough. Exam: lying on his right side but appears quite comfortable. Temp, BP, pulse,
, and RR unremarkable. Normal breath sounds, percussion unremarkable. Ribs are nontender.
What disorder of the chest best describes his symptoms?
A. Pericarditis
B. Chest wall pain
C. Pleural pain
D. Angina pectoralis - correct answer-C
A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your
physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which
valve is most likely to be involved, based on the location of the murmur?
A. Mitral
B. Tricuspid
C. Aortic
D. Pulmonic - correct answer-A
A 25-year-old swim instructor presents to your clinic complaining of an itchy scalp. You diagnose
seborrheic dermatitis. What physical findings are most consistent with this diagnosis?
A. Erythema of the scalp
B. Pustules on the scalp
C. Dry, flaking areas on the scalp
D. Ecchymoses on the scalp - correct answer-C
A 26-year-old woman presents for evaluation of hair loss. She also has noticed increased weight
loss and diarrhea. You diagnose Graves' disease (hyperthyroidism). On physical examination of
the hair, what would you expect to find?
A. Fine texture
B. Coarse texture
C. Oily hair
D. Dry hair - correct answer-A
A 28 yo patient comes to the office for evaluation of a rash. At first there was only one large
patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On
examination, you note that the pattern of eruption is like a Christmas tree and that there area
variety of erythematous papules and macules on the cleavage lines of the back. Based on this
description, what is the most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
D. Atopic eczema - correct answer-A
A 28-year-old housewife presents to your office for a 6-week postpartum checkup. She
complains of fatigue greater than expected and palpitations. Her hair is falling out as well. She
NU 650 MIDTERM EXAM QUESTION AND VERIFIED
ANSWERS LATEST AND COMPREHENSIVE VERSION
WITH INSTANT PDF DOWNLOAD
3 Dimensions of cultural humility - correct answer-1) Self-awareness: learn about your own
biases; we all have them.
2. Respectful communication: work to eliminate assumptions about what is "normal". Learn
directly from your patients; they are the experts on their culture and illness.
3. Collaborative partnerships: build your patient relationships on respect and mutually acceptable
plans.
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left
eye. It started this morning. He denies any trauma or injury. There is no visual disturbance. Upon
physical examination, there is a red raised area at the margin of the eyelid that is tender to
palpation; no tearing occurs with palpation of the lesion. Based on this description, what is the
most likely diagnosis?
A. Dacryocystitis
B. Chalazion
C. Hordeolum
D. Xanthelasma - correct answer-CHordeolum - aka Stye
A 15 yo presents to the emergency room with his mother for eval of an area of blood in theleft
eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He denies
visual disturbances, eye pain, or discharge from the eye. On physical exam, the PERRL, with a
visual acuity of
20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area at the
lateral aspect of the base of the left eye. The cornea is clear. Based on this description, what is
the most likely diagnosis?
A. Conjunctivitis
B. Acute iritis
C. Corneal abrasion
D. Subconjunctival hemorrhage - correct answer-D
,A 15-year-old high school student presents to your clinic complaining of pain in his left ear. He
noticed that it occurred shortly after starting swimming lessons at the local YMCA. Upon
physical examination, you notice that the external canal is swollen and tender during insertion of
the speculum. What is your most likely diagnosis?
A. Otitis media
B. Serous otitis
C. Eustachian tube dysfunction
D. Otitis externa - correct answer-D
A 15-year-old member of the high school marching band comes to your office for evaluation of
hearing loss. He had multiple ear infections as an infant and toddler, and had to have
myringotomy tubes inserted in his ears. Additionally, he suffers from many allergies. His hearing
is diminished in the right ear. When you place a vibrating tuning fork on the top of his head, the
sound lateralizes to the right ear. The name of this test is:
A. Weber's test
B. Rinne's test
C. Whisper test
D. Romberg test - correct answer-A
A 17-year-old high school senior presents to your clinic in acute respiratory distress. Between
shallow breaths he states he was at home finishing his homework when he suddenly began
having right-sided chest pain and severe SOB. Denies any recent traumas or illnesses. PMH
unremarkable. On examination you see a tall, thin young man in obvious distress. He is
diaphoretic and RR 35. On auscultation you hear no breath sounds on the right side of his
superior chest wall. On percussion he is hyperresonant over RUL. Palpation: absent fremitus over
the RUL.
What disorder of the thorax or lung best describes his symptoms?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia - correct answer-A
A 19 yo construction worker presents for evaluation of a rash. He notes that it started on his back
with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat
more than before because being outdoors is part of his job. On physical examination, you note
dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more
prominently around the upper back, chest, neck, and upper arms aswell as under the arms. Based
on this description, what is your most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
,D. Atopic eczema - correct answer-B Tinea = fungal and promoted by moisture
A 2-week-old infant is brought into your clinic by his parents because they have noticed that their
child is having some difficulty with feeding and that there is something strange in his mouth.
You diagnose thrush. What is the most likely physical finding you will see upon examination of
his mouth?
A. Koplik's spots
B. White plaques
C. Erythematous plaques
D. Epstein's pearls - correct answer-B
A 21-year-old college senior presents to your clinic, complaining of SOB and a nonproductive
nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she
has felt this way continuously. She denies any other upper respiratory symptoms, CP, GI
symptoms, or urinary tract symptoms. PMH significant only forseasonal allergies. On exam she
is in no acute distress; temp is 98.6, BP is 120/80, her pulse is 80, and her RR is 20. On
auscultation of her chest, there is decreased air movement and a high-pitched whistling on
expiration in all lobes. Percussion reveals resonant lungs.
Which disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia - correct answer-C
A 22-year-old agricultural worker presents to your office for evaluation of coughing. She has had
this cough for 6 weeks; it is nonproductive and worst first thing in the morning. She denies fever,
chills, weight loss, or night sweats; she does have clear rhinorrhea and itchy, watery eyes. You
diagnose her with allergic rhinoconjunctivitis. On physical examination of the nasal mucosa,
what would you expect to find?
A. Erythematous, ulcerated mucosa
B. Pale to bluish, boggy mucosa
C. Pink mucosa
D. Ulcerated mucosa - correct answer-B
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right-sided
chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds,
taking his breath away. He states he feels like he has to breathe shallowly to keep it from
recurring. The only thing that makes it better is lying quietly on his right side. It is much worse
when he takes a deep breath. 2 weeks ago he had an upper respiratory infection with a severe
hacking cough. Exam: lying on his right side but appears quite comfortable. Temp, BP, pulse,
, and RR unremarkable. Normal breath sounds, percussion unremarkable. Ribs are nontender.
What disorder of the chest best describes his symptoms?
A. Pericarditis
B. Chest wall pain
C. Pleural pain
D. Angina pectoralis - correct answer-C
A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your
physical examination, you listen to her heart and hear a murmur only at the cardiac apex. Which
valve is most likely to be involved, based on the location of the murmur?
A. Mitral
B. Tricuspid
C. Aortic
D. Pulmonic - correct answer-A
A 25-year-old swim instructor presents to your clinic complaining of an itchy scalp. You diagnose
seborrheic dermatitis. What physical findings are most consistent with this diagnosis?
A. Erythema of the scalp
B. Pustules on the scalp
C. Dry, flaking areas on the scalp
D. Ecchymoses on the scalp - correct answer-C
A 26-year-old woman presents for evaluation of hair loss. She also has noticed increased weight
loss and diarrhea. You diagnose Graves' disease (hyperthyroidism). On physical examination of
the hair, what would you expect to find?
A. Fine texture
B. Coarse texture
C. Oily hair
D. Dry hair - correct answer-A
A 28 yo patient comes to the office for evaluation of a rash. At first there was only one large
patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On
examination, you note that the pattern of eruption is like a Christmas tree and that there area
variety of erythematous papules and macules on the cleavage lines of the back. Based on this
description, what is the most likely diagnosis?
A. Pityriasis rosea
B. Tinea versicolor
C. Psoriasis
D. Atopic eczema - correct answer-A
A 28-year-old housewife presents to your office for a 6-week postpartum checkup. She
complains of fatigue greater than expected and palpitations. Her hair is falling out as well. She
