1
NSG 6320 WEEK 8 QUIZ
1.
A 67-year-old patient presents to the adult-gerontology primary care clinic with
progressive difficulty climbing stairs and reports that the legs feel weaker than
they did six months ago. During the physical examination, the NP asks the patient
to move the lower extremities while the examiner applies resistance in the
opposite direction. Which aspect of the neurologic and musculoskeletal
examination is the NP primarily assessing?
A. Passive joint mobility
B. Muscle strength
C. Deep tendon reflexes
D. Joint stability
Answer: B
2.
A 58-year-old patient reports pain and stiffness in both knees that worsen after
prolonged activity. The patient denies fever, redness, or systemic symptoms.
Physical examination reveals crepitus and decreased range of motion. Which
condition is most consistent with this presentation?
A. Rheumatoid arthritis
B. Septic arthritis
C. Osteoarthritis
D. Gout
Answer: C
3.
A 72-year-old woman presents for evaluation after experiencing several months of
progressive height loss and chronic back discomfort. She has a history of
menopause and low dietary calcium intake. Which underlying process is most
likely contributing to her increased fracture risk?
,2
A. Increased bone resorption exceeding bone formation
B. Excessive cartilage formation within the joints
C. Acute inflammation of the periosteum
D. Increased deposition of uric acid within bone
Answer: A
4.
A 42-year-old patient presents with severe pain, warmth, erythema, and swelling
of the first metatarsophalangeal joint that developed overnight. The patient
reports similar episodes occurring twice during the previous year. Which
diagnostic study provides the strongest confirmation of gout during an acute
attack?
A. Serum calcium concentration
B. Plain radiography alone
C. Erythrocyte sedimentation rate
D. Synovial fluid examination using polarized-light microscopy
Answer: D
5.
A 35-year-old patient reports fatigue, headache, and an expanding circular
erythematous rash that developed after spending a weekend hiking in a wooded
area. The patient remembers removing a tick from the leg approximately one
week earlier. Which infectious organism is most strongly associated with this
clinical presentation?
A. Borrelia burgdorferi
B. Staphylococcus aureus
C. Epstein-Barr virus
D. Clostridium difficile
Answer: A
6.
,3
A 24-year-old athlete reports knee pain and a sensation that the knee occasionally
catches or locks after a twisting injury during a soccer game. The NP suspects
injury to the medial meniscus. Which physical examination maneuver is most
appropriate?
A. McMurray test
B. Romberg test
C. Babinski test
D. Phalen test
Answer: A
7.
A 30-year-old patient presents with anterior knee pain that worsens while
climbing stairs and after prolonged sitting. There is no major trauma, instability, or
joint effusion. Which diagnosis should the NP consider most strongly?
A. Septic arthritis
B. Patellofemoral pain syndrome
C. Achilles tendon rupture
D. Acute gout
Answer: B
8.
A 65-year-old patient with type 2 diabetes reports burning pain, tingling, and
decreased sensation in both feet. Examination demonstrates reduced vibration
and monofilament sensation bilaterally. Which complication is most consistent
with these findings?
A. Diabetic nephropathy
B. Diabetic retinopathy
C. Diabetic peripheral neuropathy
D. Diabetic ketoacidosis
Answer: C
, 4
9.
A patient with type 2 diabetes has a hemoglobin A1c of 9.4% despite reporting
adherence to medication. The patient states that meals are irregular and
frequently consist of refined carbohydrates. Which assessment is most important
before modifying the treatment plan?
A. Determine medication adherence, dietary patterns, activity level, and barriers
to glycemic control
B. Immediately discontinue all current diabetes medications
C. Assume the patient has type 1 diabetes
D. Recommend avoiding all carbohydrates permanently
Answer: A
10.
A 61-year-old patient with diabetes presents for routine primary care follow-up.
The patient reports no visual complaints and states that glucose readings have
generally been within the target range. Which preventive evaluation remains
important because diabetic retinal disease may progress without early symptoms?
A. Annual screening for hearing loss only
B. Routine ophthalmologic evaluation for diabetic retinopathy
C. Routine screening for acute appendicitis
D. Monthly bone marrow aspiration
Answer: B
11.
A 69-year-old patient with diabetes reports numbness of the feet and states that a
blister developed after wearing new shoes but was not noticed for several days.
Which intervention is most appropriate to reduce the risk of future diabetic foot
complications?
A. Encourage daily foot inspection and appropriate protective footwear
B. Recommend walking barefoot indoors to strengthen the feet
NSG 6320 WEEK 8 QUIZ
1.
A 67-year-old patient presents to the adult-gerontology primary care clinic with
progressive difficulty climbing stairs and reports that the legs feel weaker than
they did six months ago. During the physical examination, the NP asks the patient
to move the lower extremities while the examiner applies resistance in the
opposite direction. Which aspect of the neurologic and musculoskeletal
examination is the NP primarily assessing?
A. Passive joint mobility
B. Muscle strength
C. Deep tendon reflexes
D. Joint stability
Answer: B
2.
A 58-year-old patient reports pain and stiffness in both knees that worsen after
prolonged activity. The patient denies fever, redness, or systemic symptoms.
Physical examination reveals crepitus and decreased range of motion. Which
condition is most consistent with this presentation?
A. Rheumatoid arthritis
B. Septic arthritis
C. Osteoarthritis
D. Gout
Answer: C
3.
A 72-year-old woman presents for evaluation after experiencing several months of
progressive height loss and chronic back discomfort. She has a history of
menopause and low dietary calcium intake. Which underlying process is most
likely contributing to her increased fracture risk?
,2
A. Increased bone resorption exceeding bone formation
B. Excessive cartilage formation within the joints
C. Acute inflammation of the periosteum
D. Increased deposition of uric acid within bone
Answer: A
4.
A 42-year-old patient presents with severe pain, warmth, erythema, and swelling
of the first metatarsophalangeal joint that developed overnight. The patient
reports similar episodes occurring twice during the previous year. Which
diagnostic study provides the strongest confirmation of gout during an acute
attack?
A. Serum calcium concentration
B. Plain radiography alone
C. Erythrocyte sedimentation rate
D. Synovial fluid examination using polarized-light microscopy
Answer: D
5.
A 35-year-old patient reports fatigue, headache, and an expanding circular
erythematous rash that developed after spending a weekend hiking in a wooded
area. The patient remembers removing a tick from the leg approximately one
week earlier. Which infectious organism is most strongly associated with this
clinical presentation?
A. Borrelia burgdorferi
B. Staphylococcus aureus
C. Epstein-Barr virus
D. Clostridium difficile
Answer: A
6.
,3
A 24-year-old athlete reports knee pain and a sensation that the knee occasionally
catches or locks after a twisting injury during a soccer game. The NP suspects
injury to the medial meniscus. Which physical examination maneuver is most
appropriate?
A. McMurray test
B. Romberg test
C. Babinski test
D. Phalen test
Answer: A
7.
A 30-year-old patient presents with anterior knee pain that worsens while
climbing stairs and after prolonged sitting. There is no major trauma, instability, or
joint effusion. Which diagnosis should the NP consider most strongly?
A. Septic arthritis
B. Patellofemoral pain syndrome
C. Achilles tendon rupture
D. Acute gout
Answer: B
8.
A 65-year-old patient with type 2 diabetes reports burning pain, tingling, and
decreased sensation in both feet. Examination demonstrates reduced vibration
and monofilament sensation bilaterally. Which complication is most consistent
with these findings?
A. Diabetic nephropathy
B. Diabetic retinopathy
C. Diabetic peripheral neuropathy
D. Diabetic ketoacidosis
Answer: C
, 4
9.
A patient with type 2 diabetes has a hemoglobin A1c of 9.4% despite reporting
adherence to medication. The patient states that meals are irregular and
frequently consist of refined carbohydrates. Which assessment is most important
before modifying the treatment plan?
A. Determine medication adherence, dietary patterns, activity level, and barriers
to glycemic control
B. Immediately discontinue all current diabetes medications
C. Assume the patient has type 1 diabetes
D. Recommend avoiding all carbohydrates permanently
Answer: A
10.
A 61-year-old patient with diabetes presents for routine primary care follow-up.
The patient reports no visual complaints and states that glucose readings have
generally been within the target range. Which preventive evaluation remains
important because diabetic retinal disease may progress without early symptoms?
A. Annual screening for hearing loss only
B. Routine ophthalmologic evaluation for diabetic retinopathy
C. Routine screening for acute appendicitis
D. Monthly bone marrow aspiration
Answer: B
11.
A 69-year-old patient with diabetes reports numbness of the feet and states that a
blister developed after wearing new shoes but was not noticed for several days.
Which intervention is most appropriate to reduce the risk of future diabetic foot
complications?
A. Encourage daily foot inspection and appropriate protective footwear
B. Recommend walking barefoot indoors to strengthen the feet
