Midterm Exam: NUR634/ NUR 634 (New 2023/ 2024 Update) Advanced Health Assessment and Diagnostic Reasoning Exam | Questions and Verified Answers| 100% Correct| Graded A- GCU

Midterm Exam: NUR634/ NUR 634 (New 2023/ 2024 Update) Advanced Health Assessment and Diagnostic Reasoning Exam | Questions and Verified Answers| 100% Correct| Graded A- GCU Jacob, a 33-year-old construction worker, complains of a "lump on his back" over his scapula. It has been there for about a year and is getting larger. He says his wife has been able to squeeze out a cheesy-textured substance on occasion. He worries this may be cancer. When gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most likely? A. An enlarged lymph node B. A sebaceous cyst C. An actinic keratosis D. A malignant lesion Answer: B Feedback: This is a classic description of an epidermal inclusion cyst resulting from a blocked sebaceous gland. The fact that any lesion is enlarging is worrisome, but the other descriptors are so distinctive that cancer is highly unlikely. This would be an unusual location for a lymph node, and these do not usually drain to the skin. QUESTION A high school football player injured his wrist in a game. He is tender between the two tendons at the base of the thumb. Which of the following should be considered? A. DeQuervain's tenosynovitis B. Scaphoid fracture C. Wrist sprain D. Rheumatoid arthritis Answer: B Feedback: The "anatomic snuffbox" is found between the extensor and abductor tendons at the base of the thumb. Tenderness should make one think of a scaphoid fracture. Not only is this the most common carpal bone injury, but the poor blood supply puts the bone at risk for avascular necrosis when injured. This fracture is commonly missed on x-ray, so this is an important physical finding to support further or repeated studies. QUESTION During a musculoskeletal examination of the spine, what is the ac- tion(s) of the erector spinae muscle group? A. Extension of the spine B. Flexion of the spine C. Rotation of the spine D. Lateral bending of the spine Answer: A The erector spinae muscle group is one of the deep intrinsic muscle groups of the back that extends the spine. QUESTION A 13-year-old girl is brought by her mother to the clinic one day before the start of eighth grade because of a 3-day history of episodes of shortness of breath. When she gets the shortness of breath, she also notices tingling around her lips. She has no fever, cough, sputum production, or chest pain. She has no history of serious illness and takes no medications. Vital signs are within normal limits. Cardiac, lung, and extremity examinations show no abnormalities. Which of the following is the most likely diagnosis? a. Aspiration of a foreign body b. Anxiety c. Asthma d. Left-sided heart failure e. Pneumonia Answer: B QUESTION 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 Answer: C Feedback: A unilateral headache is often seen with migraines and may commonly be accompanied by phonophobia and photophobia. Pain over the sinuses from sinus congestion may also be unilateral and produce pain. Migraine and sinus headaches are common and generally benign. A new severe headache in someone over 50 can be associated with more serious etiologies for headache. Other red flags include acute onset, "the worst headache of my life"; very high blood pressure; rash or signs of infection; known presence of cancer, HIV, or pregnancy; vomiting; recent head trauma; and persistent neurologic problems QUESTION Adam is a very successful 15-year-old student and athlete. His mother brings him in today because he no longer studies, works out, or sees his friends. This has gone on for a month and a half. When you speak with him alone in the room, he states it "would be better if he were not here." What would you do next? A. Tell him that he has a very promising career in anything he chooses and soon he will feel better. B. Tell him that he needs an antidepressant and it will take about 4 weeks to work. C. Speak with his mother about getting him