NR 509 MIDTERM EXAM QUESTIONS AND ANSWERS WITH
RATIONALES 2024ALREADY GRADED A+
The components of the health history include all of the following except which one?
A) Review of systems
B) Thorax and lungs
C) Present illness
D) Personal and social items - B) Thorax and lungs
The thorax and lungs are part of the physical examination, not part of the health
history.
Is the following information subjective or objective?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with
activity
and relieved by rest.
A) Subjective
B) Objective - A) Subjective
This is information given by the patient about the circumstances of his chief
complaint. It does not represent an objective observation by the examiner.
Is the following information subjective or objective?
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
A) Subjective
B) Objective - B) Objective
This is a measurement obtained by the examiner, so it is considered objective data. The
patient is unlikely to be able to give this information to the examiner.
The following information is recorded in the health history: "The patient has had
abdominal
pain for 1 week. The pain lasts for 30 minutes at a time; it comes and goes. The severity
is 7 to 9
on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is located in the
mid-epigastric area."
Which of these categories does it belong to?
A) Chief complaint
B) Present illness
,C) Personal and social history
D) Review of systems - B) Present illness
This information describes the problem of abdominal pain, which is the present
illness. The interviewer has obtained the location, timing, severity, and associated
manifestations
of the pain. The interviewer will still need to obtain information concerning the quality of
the
pain, the setting in which it occurred, and the factors that aggravate and alleviate the
pain.
The following information is recorded in the health history: "The patient completed 8th
grade. He currently lives with his wife and two children. He works on old cars on the
weekend.
He works in a glass factory during the week."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - C) Personal and social history.
Personal and social history information includes educational level, family of origin,
current household status, personal interests, employment, religious beliefs, military
history, and
lifestyle (including diet and exercise habits; use of alcohol, tobacco, and/or drugs; and
sexual
preferences and history).
The following information is recorded in the health history: "I feel really tired."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - A) Chief complaint
The chief complaint is an attempt to quote the patient's own words. It is brief, like a
headline, and further details should be sought in the present illness section.
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea."
Which category does it belong to?
A) Chief complaint
B) Present illness
,C) Personal and social history
D) Review of systems - D) Review of systems
Review of systems documents the presence or absence of common symptoms related
to each major body system.
The following information is best placed in which category?
"The patient has had three cesarean sections."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - B) Surgeries
A cesarean section is a surgical procedure. Approximate dates or the age of the
patient at the time of the surgery should also be recorded.
The following information is best placed in which category?
"The patient had a stent placed in the left anterior descending artery (LAD) in 1999."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - A) Adult illnesses
The adult illnesses category is reserved for chronic illnesses, significant
hospitalizations, significant injuries, and significant procedures. A stent is a major
procedure but does not involve a surgery.
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall. Pleuritic
chest pain is also a sharp chest pain which increases with a deep breath. This type of
pain can
occur with inflammation of the pleura from pneumonia or other conditions and
pulmonary
embolus.
, A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - C) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
also result
in shortness of breath, such as anemia in the hematologic category, pregnancy in the
reproductive
category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine - C) Cardiac
The cardiac system can cause a cough if the patient has congestive heart failure. This
results in fluid buildup in the lungs, which in turn can cause a cough that produces pink,
frothy sputum. A foreign body in the ear may also cause a cough by stimulating Arnold's
branch of the vagus nerve, but this is less likely to be seen clinically than heart failure.
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new,
located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a
rash; she also denies recent travel or camping activities. She has a family history
significant for
rheumatoid arthritis. Based on this information, which of the following pathologic
processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic - B) Inflammatory
The description is most consistent with an inflammatory process, although all the other
etiologies should be considered. Lyme disease is an infection which commonly causes
RATIONALES 2024ALREADY GRADED A+
The components of the health history include all of the following except which one?
A) Review of systems
B) Thorax and lungs
C) Present illness
D) Personal and social items - B) Thorax and lungs
The thorax and lungs are part of the physical examination, not part of the health
history.
Is the following information subjective or objective?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with
activity
and relieved by rest.
A) Subjective
B) Objective - A) Subjective
This is information given by the patient about the circumstances of his chief
complaint. It does not represent an objective observation by the examiner.
Is the following information subjective or objective?
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
A) Subjective
B) Objective - B) Objective
This is a measurement obtained by the examiner, so it is considered objective data. The
patient is unlikely to be able to give this information to the examiner.
The following information is recorded in the health history: "The patient has had
abdominal
pain for 1 week. The pain lasts for 30 minutes at a time; it comes and goes. The severity
is 7 to 9
on a scale of 1 to 10. It is accompanied by nausea and vomiting. It is located in the
mid-epigastric area."
Which of these categories does it belong to?
A) Chief complaint
B) Present illness
,C) Personal and social history
D) Review of systems - B) Present illness
This information describes the problem of abdominal pain, which is the present
illness. The interviewer has obtained the location, timing, severity, and associated
manifestations
of the pain. The interviewer will still need to obtain information concerning the quality of
the
pain, the setting in which it occurred, and the factors that aggravate and alleviate the
pain.
The following information is recorded in the health history: "The patient completed 8th
grade. He currently lives with his wife and two children. He works on old cars on the
weekend.
He works in a glass factory during the week."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - C) Personal and social history.
Personal and social history information includes educational level, family of origin,
current household status, personal interests, employment, religious beliefs, military
history, and
lifestyle (including diet and exercise habits; use of alcohol, tobacco, and/or drugs; and
sexual
preferences and history).
The following information is recorded in the health history: "I feel really tired."
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems - A) Chief complaint
The chief complaint is an attempt to quote the patient's own words. It is brief, like a
headline, and further details should be sought in the present illness section.
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea."
Which category does it belong to?
A) Chief complaint
B) Present illness
,C) Personal and social history
D) Review of systems - D) Review of systems
Review of systems documents the presence or absence of common symptoms related
to each major body system.
The following information is best placed in which category?
"The patient has had three cesarean sections."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - B) Surgeries
A cesarean section is a surgical procedure. Approximate dates or the age of the
patient at the time of the surgery should also be recorded.
The following information is best placed in which category?
"The patient had a stent placed in the left anterior descending artery (LAD) in 1999."
A) Adult illnesses
B) Surgeries
C) Obstetrics/gynecology
D) Psychiatric - A) Adult illnesses
The adult illnesses category is reserved for chronic illnesses, significant
hospitalizations, significant injuries, and significant procedures. A stent is a major
procedure but does not involve a surgery.
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall. Pleuritic
chest pain is also a sharp chest pain which increases with a deep breath. This type of
pain can
occur with inflammation of the pleura from pneumonia or other conditions and
pulmonary
embolus.
, A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - C) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
also result
in shortness of breath, such as anemia in the hematologic category, pregnancy in the
reproductive
category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine - C) Cardiac
The cardiac system can cause a cough if the patient has congestive heart failure. This
results in fluid buildup in the lungs, which in turn can cause a cough that produces pink,
frothy sputum. A foreign body in the ear may also cause a cough by stimulating Arnold's
branch of the vagus nerve, but this is less likely to be seen clinically than heart failure.
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new,
located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a
rash; she also denies recent travel or camping activities. She has a family history
significant for
rheumatoid arthritis. Based on this information, which of the following pathologic
processes
would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic - B) Inflammatory
The description is most consistent with an inflammatory process, although all the other
etiologies should be considered. Lyme disease is an infection which commonly causes
