NSG 6420 Midterm Exam Questions And
Verified Correct Answers.
1. Your patient has been using chewing tobacco for 10 years. On physical examination, you
observe a white ulceration surrounded by an erythematous base on the side of his tongue. The
clinician should recognize that very often this is:
a) Malignant melanoma
b) Squamous cell carcinoma
c) Aphthous ulceration
d) Behcet's syndrome - Answer b) Squamous cell carcinoma
2. Which of the following would be considered a "red flag" that requires more investigation in a
patient assessment?
a) Colon cancer in family member at age 70
b) Breast cancer in family member at age 75
c) Myocardial infarction in family member at age 35
d) All the above - Answer c) Myocardial infarction in family member at age 35
3. The pathophysiological hallmark of ACD is:
a) Depleted iron stores
b) Impaired ability to use iron stores
c) Chronic uncorrectable bleeding
e) Reduced intestinal absorption of iron - Answer b) Impaired ability to use iron stores
4. It is important to not dilate the eye if ____ is suspected.
a) Cataract
b) Macular degeneration
c) Acute closed-angle glaucoma
d) Chronic open-angle glaucoma - Answer c) Acute closed-angle glaucoma
5. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The
patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be
, d) 100-pack history - Answer b) 100-pack years
6. When teaching a group of older adults regarding prevention of gastroesophageal reflux
disease symptoms, the nurse practitioner will include which of the following instructions?
a) Raise the head of the bed with pillows at night and chew peppermints when symptoms of
heartburn begins.
b) Raise the head of the bed on blocks and take the proton pump inhibitor medication at
bedtime.
c) Sit up for an hour after taking any medication and restrict fluid intake.
d) Avoid food intolerances, raise head of bed on blocks, and take a proton pump inhibitor before
a meal. - Answer d) Avoid food intolerances, raise head of bed on blocks, and take a proton
pump inhibitor before a meal.
7. A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and
unintentional weight loss. At times he is constipated and other times he has episodes of
diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize
the importance of:
a) CBC with differential
b) Stool culture and sensitivity
c) Abdominal X-ray
d) Colonoscopy - Answer d) Colonoscopy
8. Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest
pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is
characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago,
intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is
retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is
worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal
heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be
most likely?
a) Musculoskeletal chest wall syndrome with radiation
b) Esophageal motor disorder with radiation
c) Acute cholecystitis with cholelithiasis
d) Coronary artery disease with angina pectoris - Answer d) Coronary artery disease with
angina pectoris
Verified Correct Answers.
1. Your patient has been using chewing tobacco for 10 years. On physical examination, you
observe a white ulceration surrounded by an erythematous base on the side of his tongue. The
clinician should recognize that very often this is:
a) Malignant melanoma
b) Squamous cell carcinoma
c) Aphthous ulceration
d) Behcet's syndrome - Answer b) Squamous cell carcinoma
2. Which of the following would be considered a "red flag" that requires more investigation in a
patient assessment?
a) Colon cancer in family member at age 70
b) Breast cancer in family member at age 75
c) Myocardial infarction in family member at age 35
d) All the above - Answer c) Myocardial infarction in family member at age 35
3. The pathophysiological hallmark of ACD is:
a) Depleted iron stores
b) Impaired ability to use iron stores
c) Chronic uncorrectable bleeding
e) Reduced intestinal absorption of iron - Answer b) Impaired ability to use iron stores
4. It is important to not dilate the eye if ____ is suspected.
a) Cataract
b) Macular degeneration
c) Acute closed-angle glaucoma
d) Chronic open-angle glaucoma - Answer c) Acute closed-angle glaucoma
5. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The
patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be
, d) 100-pack history - Answer b) 100-pack years
6. When teaching a group of older adults regarding prevention of gastroesophageal reflux
disease symptoms, the nurse practitioner will include which of the following instructions?
a) Raise the head of the bed with pillows at night and chew peppermints when symptoms of
heartburn begins.
b) Raise the head of the bed on blocks and take the proton pump inhibitor medication at
bedtime.
c) Sit up for an hour after taking any medication and restrict fluid intake.
d) Avoid food intolerances, raise head of bed on blocks, and take a proton pump inhibitor before
a meal. - Answer d) Avoid food intolerances, raise head of bed on blocks, and take a proton
pump inhibitor before a meal.
7. A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and
unintentional weight loss. At times he is constipated and other times he has episodes of
diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize
the importance of:
a) CBC with differential
b) Stool culture and sensitivity
c) Abdominal X-ray
d) Colonoscopy - Answer d) Colonoscopy
8. Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest
pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is
characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago,
intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is
retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is
worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal
heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be
most likely?
a) Musculoskeletal chest wall syndrome with radiation
b) Esophageal motor disorder with radiation
c) Acute cholecystitis with cholelithiasis
d) Coronary artery disease with angina pectoris - Answer d) Coronary artery disease with
angina pectoris
