NSG6020 FINAL EXAM QUESTIONS WITH
100% CORRECT ANSWERS
Heberden'sWnodesWareWcommonlyWfoundWinWwhichWoneWofWtheWfollowingWdiseases?W-WcorrectWanswer-
DegenerativeWjointWdisease
YouWareWbeginningWtheWexaminationWofWtheWskinWonWaW25-year-
oldWteacher.WYouWhaveWpreviouslyWelicitedWthatWsheWcameWtoWtheWofficeWforWevaluationWofWfatigue,Wweig
htWgain,WandWhairWloss.WYouWstronglyWsuspectWthatWsheWhasWhypothyroidism.WWhatWisWtheWexpectedWmoi
stureWandWtextureWofWtheWskinWofWtheWpatientWwithWhypothyroidismW-WcorrectWanswer-dryWandWrough
YouWareWassessingWaWpatientWwithWjointWpainWandWareWtryingWtoWdecideWwhetherWitWisWinflammatoryWorW
noninflammatoryWinWnature.WWhichWoneWofWtheWfollowingWsymptomsWisWconsistentWwithWanWinflammato
ryWprocess?W-WcorrectWanswer-tenderness
AW68-year-
oldWretiredWfarmerWcomesWtoWyourWofficeWforWevaluationWofWaWskinWlesion.WOnWtheWrightWtemporalWarea
WofWtheWforehead,WyouWseeWaWflattenedWpapuleWtheWsameWcolorWasWhisWskin,WcoveredWbyWaWdryWscaleWth
atWisWroundWandWfeelsWhard.WHeWhasWseveralWmoreWofWtheseWscatteredWonWtheWforehead,WarmsWandWlegs
.WBasedWonWthisWdescription,WwhatWisWyourWmostWlikelyWdiagnosis?W-WcorrectWanswer-actinicWkeratosis
AW28-year-
oldWgraduateWstudentWcomesWtoWyourWclinicWforWevaluationWofWpainW"allWover."WWithWfurtherWquestionin
g,WsheWisWableWtoWrelateWthatWtheWpainWisWworseWinWtheWneck,Wshoulders,Whands,WlowWbackWandWknees.W
SheWdeniesWswellingWinWherWjoints.WSheWstatesWthatWtheWpainWisWworseWinWtheWmorning.WThereWisWnoWlim
itationWinWherWrangeWofWmotion.WOnWphysicalWexamination,WsheWhasWseveralWpointsWonWtheWmusclesWofW
theWneck,WshouldersWandWbackWthatWareWtenderWtoWpalpation.WMuscleWstrengthWandWrangeWofWmotionWa
reWnormal.WWhichWoneWofWtheWfollowingWisWlikelyWtheWcauseWofWherWpain?W-WcorrectWanswer-
fibromyalgia
AWnewWpatientWisWcomplainingWofWsevereWpruritusWthatWisWworseWatWnight.WSeveralWfamilyWmembersWals
oWhaveWtheWsameWsymptoms.WUponWexamination,WareasWofWexcoriatedWpapulesWareWnotedWonWsomeWof
WtheWinterdigitalWwebsWofWbothWhandsWandWonWtheWaxillae.WThisWfindingWisWmostWconsistentWwith:W-
WcorrectWanswer-Scabies
, AnWobeseW55-year-
oldWwomanWwentWthroughWmenarcheWatWageW16WandWmenopauseW2WyearsWago.WSheWisWconcernedWbeca
useWanWauntWhadWsevereWosteoporosis.WWhichWoneWofWtheWfollowingWisWaWriskWfactorWforWosteoporosis?
W-WcorrectWanswer-DelayedWmenarche
Ms.WWhitingWisWaW68-year-oldWfemaleWwhoWcomesWinWforWherWusualWfollow-
upWvisit.WYouWnoticeWaWfewWflatWredWandWpurpleWlesions,WaboutW6WcentimetersWinWdiameter,WonWtheWuln
arWaspectWofWherWforearmsWbutWnowhereWelse.WSheWdoesn'tWmentionWthem.WTheyWareWtenderWwhenWyo
uWexamineWthem.WWhatWshouldWyouWdo?W-WcorrectWanswer-AskWhowWsheWacquiredWthem.
AW58-year-
oldWmanWcomesWtoWyourWofficeWcomplainingWofWbilateralWbackWpainWthatWnowWawakensWhimWatWnight.WT
hisWhasWbeenWsteadilyWincreasingWforWtheWpastW2Wmonths.WWhichWoneWofWtheWfollowingWisWtheWmostWre
assuringWinWthisWpatientWwithWbackWpain?W-WcorrectWanswer-PainWthatWisWbilateral
TheWPhalen'sWtestWisWusedWtoWevaluate:W-WcorrectWanswer-inflammationWofWtheWmedianWnerve
WhichWofWtheWfollowingWwouldWleadWyouWtoWsuspectWaWhydroceleWversusWotherWcausesWofWscrotalWswelli
ng?W-WcorrectWanswer-AWpositiveWtransilluminationWtest
YouWareWexaminingWaWnewbornWandWnoteWthatWtheWrightWtesticleWisWnotWinWtheWscrotum.WWhatWshouldW
youWdoWnext?W-WcorrectWanswer-AttemptWtoWbringWdownWtheWtestisWfromWtheWinguinalWcanal
AW50-year-
oldWtruckWdriverWcomesWtoWyourWclinicWforWaWworkWphysical.WHeWhasWhadWnoWupperWrespiratory,Wcardiac,
Wpulmonary,Wgastrointestinal,Wurinary,WorWmusculoskeletalWsystemWcomplaints.WHisWpastWmedicalWhistory
WisWsignificantWforWmildWarthritisWandWpriorWkneeWsurgeryWinWcollege.WHeWisWmarriedWandWjustWchangedWj
obs,WworkingWforWaWdifferentWtruckingWcompany.WHeWsmokesWoneWpackWofWcigarettesWaWday,WdrinksWless
WthanWsixWbeersWaWweek,WandWdeniesWusingWanyWillegalWdrugs.WHisWmotherWhasWhighWbloodWpressureWan
dWarthritisWandWhisWfatherWdiedWofWlungWcancerWinWhisWsixties.WOnWexamination,WhisWbloodWpressureWisW1
30/80WandWhisWpulseWisW80.WHisWcardiac,Wlung,WandWabdominalWexaminationsWareWnormal.WHeWhasWnoWin
guinalWhernia,WbutWonWhisWdigitalWrectalWexaminationWyouWpalpateWaWsoft,Wsmooth,WandWnontenderWped
unculatedWmassWonWtheWposteriorWwallWofWtheWrectum.WWhatWanal,Wrectal,WorWprostateWdisorderWbestWfi
tsWhisWpresentation?W-WcorrectWanswer-RectalWpolyp
AW15-year-
oldWhighWschoolWfootballWplayerWisWbroughtWtoWyourWofficeWbyWhisWmother.WHeWisWcomplainingWofWsevere
100% CORRECT ANSWERS
Heberden'sWnodesWareWcommonlyWfoundWinWwhichWoneWofWtheWfollowingWdiseases?W-WcorrectWanswer-
DegenerativeWjointWdisease
YouWareWbeginningWtheWexaminationWofWtheWskinWonWaW25-year-
oldWteacher.WYouWhaveWpreviouslyWelicitedWthatWsheWcameWtoWtheWofficeWforWevaluationWofWfatigue,Wweig
htWgain,WandWhairWloss.WYouWstronglyWsuspectWthatWsheWhasWhypothyroidism.WWhatWisWtheWexpectedWmoi
stureWandWtextureWofWtheWskinWofWtheWpatientWwithWhypothyroidismW-WcorrectWanswer-dryWandWrough
YouWareWassessingWaWpatientWwithWjointWpainWandWareWtryingWtoWdecideWwhetherWitWisWinflammatoryWorW
noninflammatoryWinWnature.WWhichWoneWofWtheWfollowingWsymptomsWisWconsistentWwithWanWinflammato
ryWprocess?W-WcorrectWanswer-tenderness
AW68-year-
oldWretiredWfarmerWcomesWtoWyourWofficeWforWevaluationWofWaWskinWlesion.WOnWtheWrightWtemporalWarea
WofWtheWforehead,WyouWseeWaWflattenedWpapuleWtheWsameWcolorWasWhisWskin,WcoveredWbyWaWdryWscaleWth
atWisWroundWandWfeelsWhard.WHeWhasWseveralWmoreWofWtheseWscatteredWonWtheWforehead,WarmsWandWlegs
.WBasedWonWthisWdescription,WwhatWisWyourWmostWlikelyWdiagnosis?W-WcorrectWanswer-actinicWkeratosis
AW28-year-
oldWgraduateWstudentWcomesWtoWyourWclinicWforWevaluationWofWpainW"allWover."WWithWfurtherWquestionin
g,WsheWisWableWtoWrelateWthatWtheWpainWisWworseWinWtheWneck,Wshoulders,Whands,WlowWbackWandWknees.W
SheWdeniesWswellingWinWherWjoints.WSheWstatesWthatWtheWpainWisWworseWinWtheWmorning.WThereWisWnoWlim
itationWinWherWrangeWofWmotion.WOnWphysicalWexamination,WsheWhasWseveralWpointsWonWtheWmusclesWofW
theWneck,WshouldersWandWbackWthatWareWtenderWtoWpalpation.WMuscleWstrengthWandWrangeWofWmotionWa
reWnormal.WWhichWoneWofWtheWfollowingWisWlikelyWtheWcauseWofWherWpain?W-WcorrectWanswer-
fibromyalgia
AWnewWpatientWisWcomplainingWofWsevereWpruritusWthatWisWworseWatWnight.WSeveralWfamilyWmembersWals
oWhaveWtheWsameWsymptoms.WUponWexamination,WareasWofWexcoriatedWpapulesWareWnotedWonWsomeWof
WtheWinterdigitalWwebsWofWbothWhandsWandWonWtheWaxillae.WThisWfindingWisWmostWconsistentWwith:W-
WcorrectWanswer-Scabies
, AnWobeseW55-year-
oldWwomanWwentWthroughWmenarcheWatWageW16WandWmenopauseW2WyearsWago.WSheWisWconcernedWbeca
useWanWauntWhadWsevereWosteoporosis.WWhichWoneWofWtheWfollowingWisWaWriskWfactorWforWosteoporosis?
W-WcorrectWanswer-DelayedWmenarche
Ms.WWhitingWisWaW68-year-oldWfemaleWwhoWcomesWinWforWherWusualWfollow-
upWvisit.WYouWnoticeWaWfewWflatWredWandWpurpleWlesions,WaboutW6WcentimetersWinWdiameter,WonWtheWuln
arWaspectWofWherWforearmsWbutWnowhereWelse.WSheWdoesn'tWmentionWthem.WTheyWareWtenderWwhenWyo
uWexamineWthem.WWhatWshouldWyouWdo?W-WcorrectWanswer-AskWhowWsheWacquiredWthem.
AW58-year-
oldWmanWcomesWtoWyourWofficeWcomplainingWofWbilateralWbackWpainWthatWnowWawakensWhimWatWnight.WT
hisWhasWbeenWsteadilyWincreasingWforWtheWpastW2Wmonths.WWhichWoneWofWtheWfollowingWisWtheWmostWre
assuringWinWthisWpatientWwithWbackWpain?W-WcorrectWanswer-PainWthatWisWbilateral
TheWPhalen'sWtestWisWusedWtoWevaluate:W-WcorrectWanswer-inflammationWofWtheWmedianWnerve
WhichWofWtheWfollowingWwouldWleadWyouWtoWsuspectWaWhydroceleWversusWotherWcausesWofWscrotalWswelli
ng?W-WcorrectWanswer-AWpositiveWtransilluminationWtest
YouWareWexaminingWaWnewbornWandWnoteWthatWtheWrightWtesticleWisWnotWinWtheWscrotum.WWhatWshouldW
youWdoWnext?W-WcorrectWanswer-AttemptWtoWbringWdownWtheWtestisWfromWtheWinguinalWcanal
AW50-year-
oldWtruckWdriverWcomesWtoWyourWclinicWforWaWworkWphysical.WHeWhasWhadWnoWupperWrespiratory,Wcardiac,
Wpulmonary,Wgastrointestinal,Wurinary,WorWmusculoskeletalWsystemWcomplaints.WHisWpastWmedicalWhistory
WisWsignificantWforWmildWarthritisWandWpriorWkneeWsurgeryWinWcollege.WHeWisWmarriedWandWjustWchangedWj
obs,WworkingWforWaWdifferentWtruckingWcompany.WHeWsmokesWoneWpackWofWcigarettesWaWday,WdrinksWless
WthanWsixWbeersWaWweek,WandWdeniesWusingWanyWillegalWdrugs.WHisWmotherWhasWhighWbloodWpressureWan
dWarthritisWandWhisWfatherWdiedWofWlungWcancerWinWhisWsixties.WOnWexamination,WhisWbloodWpressureWisW1
30/80WandWhisWpulseWisW80.WHisWcardiac,Wlung,WandWabdominalWexaminationsWareWnormal.WHeWhasWnoWin
guinalWhernia,WbutWonWhisWdigitalWrectalWexaminationWyouWpalpateWaWsoft,Wsmooth,WandWnontenderWped
unculatedWmassWonWtheWposteriorWwallWofWtheWrectum.WWhatWanal,Wrectal,WorWprostateWdisorderWbestWfi
tsWhisWpresentation?W-WcorrectWanswer-RectalWpolyp
AW15-year-
oldWhighWschoolWfootballWplayerWisWbroughtWtoWyourWofficeWbyWhisWmother.WHeWisWcomplainingWofWsevere