NU 518 Exam 2 Study Questions and Answers
Question 1.
A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing
sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started
a few hours ago, and she has noted nausea with sensitivity to light; she has had
headaches like this in the past, usually less than one per week, but not as severe. She
does not know of any inciting factors. There has been no change in the frequency of her
headaches. She usually takes an over the-counter analgesic, and this results in resolution
of the headache. Based on this description, what is the most likely diagnosis of the type of
headache? A) Tension B) Migraine C) Cluster D) Analgesic rebound
Correct Answer: B
Question 2.
A 29-year-old computer programmer comes to your office for evaluation of a headache.
The tightening sensation is located all over the head and is of moderate intensity. It used
to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea.
He spends several hours each day at a computer monitor/keyboard. He has tried
over-the-counter medication; it has dulled the pain but not taken it away. Based on this
description, what is your most likely diagnosis? A) Tension B) Migraine C) Cluster D)
Analgesic rebound
Correct Answer: A
Question 3.
Which of the following is a symptom involving the eye? A) Scotomas B) Tinnitus C)
Dysphagia D) Rhinorrhea
Correct Answer: A
Question 4.
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You
elicit the information that the dizziness is a spinning sensation of sudden onset, worse with
head position changes. The episodes last a few seconds and then go away, and they are
accompanied by intense nausea. She has vomited one time. She denies tinnitus. You
perform a physical examination of the head and neck and note that the patient's hearing is
intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this
description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular
neuronitis C) Ménière's disease D) Acoustic neuroma
Correct Answer: A
Question 5.
A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first
episode started suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with
vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½
,weeks. He does note some tinnitus that comes and goes. Upon physical examination, you
note that he has a normal gait. The Weber localizes to the right side and the air conduction
is equal to the bone conduction in the right ear. Nystagmus is present. Based on this
description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular
neuronitis C) Ménière's disease D) Acoustic neuroma
Correct Answer: C
Question 6.
A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not
on any medications and does not take herbs or supplements. She has no chronic medical
conditions. She does not smoke or drink alcohol. She walks into the examination room with
slow movements and shuffling steps. She has decreased facial mobility and a blunt
expression, without any changes in hair distribution on her face. Based on this description,
what is the most likely reason for the patient's symptoms? A) Cushing's syndrome B)
Nephrotic syndrome C) Myxedema D) Parkinson's disease
Correct Answer: D
Question 7.
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On
observation, the right eyeball appears to be protruding forward. Based on this description,
what is the most likely diagnosis? A) Ptosis B) Exophthalmos C) Ectropion D) Epicanthus
Correct Answer: B
Question 8.
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: C
Question 9.
A 15-year-old high school sophomore presents to the emergency room with his mother for
evaluation of an area of blood in the left 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 examination, the pupils are equal, round, and reactive
to light, 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
Question 10.
,A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history
of eye trauma. He denies any visual changes. You inspect his eyes and find a triangular
thickening of the bulbar conjunctiva across the outer surface of the cornea. He has a
normal pupillary reaction to light and accommodation. Based on this description, what is
the most likely diagnosis? A) Corneal arcus B) Cataracts C) Corneal scar D) Pterygium
Correct Answer: D
Question 11.
Which of the following is a "red flag" regarding patients presenting with headache? A)
Unilateral headache B) Pain over the sinuses C) Age over 50 D) Phonophobia and
photophobia
Correct Answer: C
Question 12.
A sudden, painless unilateral vision loss may be caused by which of the following? A)
Retinal detachment B) Corneal ulcer C) Acute glaucoma D) Uveitis
Correct Answer: A
Question 13.
Sudden, painful unilateral loss of vision may be caused by which of the following
conditions? A) Vitreous hemorrhage B) Central retinal artery occlusion C) Macular
degeneration D) Optic neuritis
Correct Answer: D
Question 14.
Diplopia, which is present with one eye covered, can be caused by which of the following
problems? A) Weakness of CN III B) Weakness of CN IV C) A lesion of the brainstem D) An
irregularity in the cornea or lens
Correct Answer: D
Question 15.
A patient complains of epistaxis. Which other cause should be considered? A) Intracranial
hemorrhage B) Hematemesis C) Intestinal hemorrhage D) Hematoma of the nasal septum
Correct Answer: B
Question 16.
Glaucoma is the leading cause of blindness in African Americans and the second leading
cause of blindness overall. What features would be noted on funduscopic examination? A)
Increased cup-to-disc ratio B) AV nicking C) Cotton wool spots D) Microaneurysms
Correct Answer: A
Question 17.
, Very sensitive methods for detecting hearing loss include which of the following? A) The
whisper test B) The finger rub test C) The tuning fork test D) Audiometric testing
Correct Answer: D
Question 18.
Which area of the fundus is the central focal point for incoming images? A) The fovea B)
The macula C) The optic disk D) The physiologic cup
Correct Answer: A
Question 19.
A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil
contracts as well, though it is not exposed to bright light. Which of the following terms
describes this latter phenomenon? A) Direct reaction B) Consensual reaction C) Near
reaction D) Accommodation
Correct Answer: B
Question 20.
A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is
true? A) She obtains a 20% correct score at 100 feet. B) She can accurately name 20% of
the letters at 20 feet. C) She can see at 20 feet what a normal person could see at 100
feet. D) She can see at 100 feet what a normal person could see at 20 feet.
Correct Answer: C
Question 21.
On visual confrontation testing, a stroke patient is unable to see your fingers on his entire
right side with either eye covered. Which of the following terms would describe this
finding? A) Bitemporal hemianopsia B) Right temporal hemianopsia C) Right homonymous
hemianopsia D) Binasal hemianopsia
Correct Answer: C
Question 22.
You note that a patient has anisocoria on examination. Pathologic causes of this include
which of the following? A) Horner's syndrome B) Benign anisocoria C) Differing light
intensities for each eye D) Eye prosthesis
Correct Answer: A
Question 23.
A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally.
Which of the following have you essentially excluded from your differential? A)
Retinoblastoma B) Cataract C) Artificial eye D) Hypertensive retinopathy
Correct Answer: D
Question 24.
Question 1.
A 38-year-old accountant comes to your clinic for evaluation of a headache. The throbbing
sensation is located in the right temporal region and is an 8 on a scale of 1 to 10. It started
a few hours ago, and she has noted nausea with sensitivity to light; she has had
headaches like this in the past, usually less than one per week, but not as severe. She
does not know of any inciting factors. There has been no change in the frequency of her
headaches. She usually takes an over the-counter analgesic, and this results in resolution
of the headache. Based on this description, what is the most likely diagnosis of the type of
headache? A) Tension B) Migraine C) Cluster D) Analgesic rebound
Correct Answer: B
Question 2.
A 29-year-old computer programmer comes to your office for evaluation of a headache.
The tightening sensation is located all over the head and is of moderate intensity. It used
to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea.
He spends several hours each day at a computer monitor/keyboard. He has tried
over-the-counter medication; it has dulled the pain but not taken it away. Based on this
description, what is your most likely diagnosis? A) Tension B) Migraine C) Cluster D)
Analgesic rebound
Correct Answer: A
Question 3.
Which of the following is a symptom involving the eye? A) Scotomas B) Tinnitus C)
Dysphagia D) Rhinorrhea
Correct Answer: A
Question 4.
A 49-year-old administrative assistant comes to your office for evaluation of dizziness. You
elicit the information that the dizziness is a spinning sensation of sudden onset, worse with
head position changes. The episodes last a few seconds and then go away, and they are
accompanied by intense nausea. She has vomited one time. She denies tinnitus. You
perform a physical examination of the head and neck and note that the patient's hearing is
intact to Weber and Rinne and that there is nystagmus. Her gait is normal. Based on this
description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular
neuronitis C) Ménière's disease D) Acoustic neuroma
Correct Answer: A
Question 5.
A 55-year-old bank teller comes to your office for persistent episodes of dizziness. The first
episode started suddenly and lasted 3 to 4 hours. He experienced a lot of nausea with
vomiting; the episode resolved spontaneously. He has had five episodes in the past 1½
,weeks. He does note some tinnitus that comes and goes. Upon physical examination, you
note that he has a normal gait. The Weber localizes to the right side and the air conduction
is equal to the bone conduction in the right ear. Nystagmus is present. Based on this
description, what is the most likely diagnosis? A) Benign positional vertigo B) Vestibular
neuronitis C) Ménière's disease D) Acoustic neuroma
Correct Answer: C
Question 6.
A 73-year-old nurse comes to your office for evaluation of new onset of tremors. She is not
on any medications and does not take herbs or supplements. She has no chronic medical
conditions. She does not smoke or drink alcohol. She walks into the examination room with
slow movements and shuffling steps. She has decreased facial mobility and a blunt
expression, without any changes in hair distribution on her face. Based on this description,
what is the most likely reason for the patient's symptoms? A) Cushing's syndrome B)
Nephrotic syndrome C) Myxedema D) Parkinson's disease
Correct Answer: D
Question 7.
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On
observation, the right eyeball appears to be protruding forward. Based on this description,
what is the most likely diagnosis? A) Ptosis B) Exophthalmos C) Ectropion D) Epicanthus
Correct Answer: B
Question 8.
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: C
Question 9.
A 15-year-old high school sophomore presents to the emergency room with his mother for
evaluation of an area of blood in the left 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 examination, the pupils are equal, round, and reactive
to light, 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
Question 10.
,A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history
of eye trauma. He denies any visual changes. You inspect his eyes and find a triangular
thickening of the bulbar conjunctiva across the outer surface of the cornea. He has a
normal pupillary reaction to light and accommodation. Based on this description, what is
the most likely diagnosis? A) Corneal arcus B) Cataracts C) Corneal scar D) Pterygium
Correct Answer: D
Question 11.
Which of the following is a "red flag" regarding patients presenting with headache? A)
Unilateral headache B) Pain over the sinuses C) Age over 50 D) Phonophobia and
photophobia
Correct Answer: C
Question 12.
A sudden, painless unilateral vision loss may be caused by which of the following? A)
Retinal detachment B) Corneal ulcer C) Acute glaucoma D) Uveitis
Correct Answer: A
Question 13.
Sudden, painful unilateral loss of vision may be caused by which of the following
conditions? A) Vitreous hemorrhage B) Central retinal artery occlusion C) Macular
degeneration D) Optic neuritis
Correct Answer: D
Question 14.
Diplopia, which is present with one eye covered, can be caused by which of the following
problems? A) Weakness of CN III B) Weakness of CN IV C) A lesion of the brainstem D) An
irregularity in the cornea or lens
Correct Answer: D
Question 15.
A patient complains of epistaxis. Which other cause should be considered? A) Intracranial
hemorrhage B) Hematemesis C) Intestinal hemorrhage D) Hematoma of the nasal septum
Correct Answer: B
Question 16.
Glaucoma is the leading cause of blindness in African Americans and the second leading
cause of blindness overall. What features would be noted on funduscopic examination? A)
Increased cup-to-disc ratio B) AV nicking C) Cotton wool spots D) Microaneurysms
Correct Answer: A
Question 17.
, Very sensitive methods for detecting hearing loss include which of the following? A) The
whisper test B) The finger rub test C) The tuning fork test D) Audiometric testing
Correct Answer: D
Question 18.
Which area of the fundus is the central focal point for incoming images? A) The fovea B)
The macula C) The optic disk D) The physiologic cup
Correct Answer: A
Question 19.
A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil
contracts as well, though it is not exposed to bright light. Which of the following terms
describes this latter phenomenon? A) Direct reaction B) Consensual reaction C) Near
reaction D) Accommodation
Correct Answer: B
Question 20.
A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is
true? A) She obtains a 20% correct score at 100 feet. B) She can accurately name 20% of
the letters at 20 feet. C) She can see at 20 feet what a normal person could see at 100
feet. D) She can see at 100 feet what a normal person could see at 20 feet.
Correct Answer: C
Question 21.
On visual confrontation testing, a stroke patient is unable to see your fingers on his entire
right side with either eye covered. Which of the following terms would describe this
finding? A) Bitemporal hemianopsia B) Right temporal hemianopsia C) Right homonymous
hemianopsia D) Binasal hemianopsia
Correct Answer: C
Question 22.
You note that a patient has anisocoria on examination. Pathologic causes of this include
which of the following? A) Horner's syndrome B) Benign anisocoria C) Differing light
intensities for each eye D) Eye prosthesis
Correct Answer: A
Question 23.
A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally.
Which of the following have you essentially excluded from your differential? A)
Retinoblastoma B) Cataract C) Artificial eye D) Hypertensive retinopathy
Correct Answer: D
Question 24.
