NSG6420 final Questions With Complete Solutions
A 20-year-old male construction worker is experiencing new
onset of knee pain. He complains of right knee pain when
kneeling, squatting, or walking up and down stairs. On physical
examination, there is swelling and crepitus of the right knee and
obvious pain with resisted range of motion of the knee. He is
unable to squat due to pain. Which of the following disorders
should be considered in the differential diagnosis? Correct
Answer all of the above
A 22-year-old female patient complains of excessive thirst,
feeling "shaky when she misses meals" and increased frequency
of urination. Family history is positive for cardiovascular
disease, cerebrovascular disease, and diabetes. The patient
denies use of tobacco, alcohol, or other drugs. She takes no
medication. Daily diet is fast food, and the patient does not
exercise regularly. On physical examination, there are no
significant findings except obesity, demonstrated by a BMI of
35 and blood pressure of 145/ 90. The signs and symptoms are
characteristic of: Correct Answer clinical depression
A 23-year-old patient who has had bronchiectasis since
childhood is likely to have which of the following Correct
Answer clubbing
A 33-year-old female reports general malaise, fatigue, stiffness,
and pain in multiple joints of the body. There is no history of
systemic disease and no history of trauma. On physical
examination, the patient has no swelling or decreased range of
motion in any of the joints. She indicates specific points on the
,neck and shoulders that are particularly affected. She complains
of tenderness upon palpation of the neck, both shoulders, hips,
and medial regions of the knees. The clinician should include
the following disorder in the list of potential diagnoses: Correct
Answer fibromyalgia
A 34-year-old female presents with fever, general malaise,
fatigue, arthralgias and rash for the last 2 weeks. On physical
examination, you note facial erythema across the nose and
cheeks. Serum diagnostic tests reveal positive antinuclear
antibodies, anti-DNA antibodies, elevated C-reactive protein and
erythrocyte sedimentation rate. The clinician should include the
following disorder in the list of potential problems: Correct
Answer Systemic lupus erythematosus
A 43-year-old female was in a bicycling accident and complains
of severe pain of the right foot. The patient limps into the
emergency room. On physical examination, there is no point
tenderness over the medial or lateral ankle malleolus. There is
no foot tenderness except at the base of the fifth metatarsal bone.
According to the Ottawa foot rules, should an X-ray of the feet
be ordered? Correct Answer A and C
A 43-year-old male patient complains of right-sided abdominal
and pain in the back in the right costovertebral angle region,
fever, chills, dysuria, and nausea. On physical examination,
there is 102 degree fever, tachycardia, and right costovertebral
angle tenderness to percussion. The most likely condition is:
Correct Answer pyelonephritis
, A 46-year-old female complains of fatigue, general malaise, and
pain and swelling in her hands that has gradually worsened over
the last few weeks. She reports that pain, stiffness, and swelling
of her hands are most severe in the morning. On physical
examination, you note swelling of the metacarpophalangeal
joints bilaterally. These are common signs of: Correct Answer
rheumatoid arthritis
A 55-year-old post-menopausal woman with a history of
hypertension complains of jaw pain on heavy exertion. There
were no complaints of chest pain. Her ECG indicates normal
sinus rhythm without ST segment abnormalities. Your plan may
include Correct Answer exercise stress test
A 59-year-old patient with history of alcohol abuse comes to
your office because of 'throwing up blood". On physical
examination, you note ascites and caput medusa. A likely cause
for the hematemesis is: Correct Answer Esophageal varices
A 62-year-old female complains of fatigue and lack of energy.
Constipation has increased and the patient has gained ten pounds
in the past 3 months. Depression is denied although the patient
reports a lack of interest in usual hobbies. Vital signs are within
normal limits and the patient's skin is dry and cool. Which of the
following must be included in the differential? Correct Answer
hypothyroidism
A 62-year-old woman presents with a recurrent urinary tract
infection. She now has a fever of 104°F and severe
costovertebral tenderness with pyuria. What is the appropriate
A 20-year-old male construction worker is experiencing new
onset of knee pain. He complains of right knee pain when
kneeling, squatting, or walking up and down stairs. On physical
examination, there is swelling and crepitus of the right knee and
obvious pain with resisted range of motion of the knee. He is
unable to squat due to pain. Which of the following disorders
should be considered in the differential diagnosis? Correct
Answer all of the above
A 22-year-old female patient complains of excessive thirst,
feeling "shaky when she misses meals" and increased frequency
of urination. Family history is positive for cardiovascular
disease, cerebrovascular disease, and diabetes. The patient
denies use of tobacco, alcohol, or other drugs. She takes no
medication. Daily diet is fast food, and the patient does not
exercise regularly. On physical examination, there are no
significant findings except obesity, demonstrated by a BMI of
35 and blood pressure of 145/ 90. The signs and symptoms are
characteristic of: Correct Answer clinical depression
A 23-year-old patient who has had bronchiectasis since
childhood is likely to have which of the following Correct
Answer clubbing
A 33-year-old female reports general malaise, fatigue, stiffness,
and pain in multiple joints of the body. There is no history of
systemic disease and no history of trauma. On physical
examination, the patient has no swelling or decreased range of
motion in any of the joints. She indicates specific points on the
,neck and shoulders that are particularly affected. She complains
of tenderness upon palpation of the neck, both shoulders, hips,
and medial regions of the knees. The clinician should include
the following disorder in the list of potential diagnoses: Correct
Answer fibromyalgia
A 34-year-old female presents with fever, general malaise,
fatigue, arthralgias and rash for the last 2 weeks. On physical
examination, you note facial erythema across the nose and
cheeks. Serum diagnostic tests reveal positive antinuclear
antibodies, anti-DNA antibodies, elevated C-reactive protein and
erythrocyte sedimentation rate. The clinician should include the
following disorder in the list of potential problems: Correct
Answer Systemic lupus erythematosus
A 43-year-old female was in a bicycling accident and complains
of severe pain of the right foot. The patient limps into the
emergency room. On physical examination, there is no point
tenderness over the medial or lateral ankle malleolus. There is
no foot tenderness except at the base of the fifth metatarsal bone.
According to the Ottawa foot rules, should an X-ray of the feet
be ordered? Correct Answer A and C
A 43-year-old male patient complains of right-sided abdominal
and pain in the back in the right costovertebral angle region,
fever, chills, dysuria, and nausea. On physical examination,
there is 102 degree fever, tachycardia, and right costovertebral
angle tenderness to percussion. The most likely condition is:
Correct Answer pyelonephritis
, A 46-year-old female complains of fatigue, general malaise, and
pain and swelling in her hands that has gradually worsened over
the last few weeks. She reports that pain, stiffness, and swelling
of her hands are most severe in the morning. On physical
examination, you note swelling of the metacarpophalangeal
joints bilaterally. These are common signs of: Correct Answer
rheumatoid arthritis
A 55-year-old post-menopausal woman with a history of
hypertension complains of jaw pain on heavy exertion. There
were no complaints of chest pain. Her ECG indicates normal
sinus rhythm without ST segment abnormalities. Your plan may
include Correct Answer exercise stress test
A 59-year-old patient with history of alcohol abuse comes to
your office because of 'throwing up blood". On physical
examination, you note ascites and caput medusa. A likely cause
for the hematemesis is: Correct Answer Esophageal varices
A 62-year-old female complains of fatigue and lack of energy.
Constipation has increased and the patient has gained ten pounds
in the past 3 months. Depression is denied although the patient
reports a lack of interest in usual hobbies. Vital signs are within
normal limits and the patient's skin is dry and cool. Which of the
following must be included in the differential? Correct Answer
hypothyroidism
A 62-year-old woman presents with a recurrent urinary tract
infection. She now has a fever of 104°F and severe
costovertebral tenderness with pyuria. What is the appropriate
