AND ANSWERS RATED A+
✔✔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 - ✔✔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, -
✔✔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? -
✔✔Radial pulse, brachial pulse
✔✔Cody is a teenager with a history of leukemia and an enlarged spleen. Today he
presents with fairly significant left upper quadrant (LUQ) pain. On examination of this
area, a rough grating noise is heard. What is this sound? - ✔✔It is a splenic rub.
✔✔A 30-year-old woman with a history of mitral valve problems states that she has
been "very tired." She has started waking up at night and feels like her "heart is
pounding." During the assessment, the nurse practitioner palpates a thrill and lift at the
fifth left intercostal space midclavicular line. In the same area the nurse practitioner also
auscultates a blowing, swishing sound right after S1. These findings would be most
consistent with: - ✔✔mitral regurgitation.
✔✔A patient presents with excruciating headache pain on one side of his head,
especially around his eye, forehead, and cheek that lasts about 1/2 to 2 hours,
occurring once or twice each day. The nurse practitioner suspects: - ✔✔cluster
headaches
✔✔A patient complains that while studying for an examination he began to notice a
severe headache in the frontotemporal area of his head that is throbbing and is
somewhat relieved when he lies down. He tells the nurse practitioner that his mother
also had these headaches. The nurse practitioner suspects that he may be suffering
from: - ✔✔migraine headaches
✔✔A patient tells the nurse practitioner that he is very nervous, that he is nauseated,
and that he "feels hot." This type of data would be: - ✔✔subjective