NUR631 Exam 3 -
neuro,musculoskeletal,mental health
Questions With Complete Solutions
A 17-year-old high school student is brought in to
your emergency room in a comatose state. His
friends have accompanied him and tell you that
they have been shooting up heroin tonight and
they think their friend may have had too much. The
patient is unconscious and cannot protect his
airway, so he is intubated. His heart rate is 60 and
he is breathing through the ventilator. He is not
posturing and he does not respond to a sternal rub.
Preparing to finish the neurologic examination, you
get a penlight.
What size pupils do you expect to see in this
comatose patient?
A) Pinpoint pupils
B) Large pupils
C) Asymmetric pupils
D) Irregularly shaped pupils Correct Answers A)
Pinpoint pupils
A 19-year-old college sophomore comes to the
clinic for evaluation of joint pains. The student has
been back from spring break for 2 weeks; during
her holiday, she went camping. She notes that she
had a red spot, shaped like a target, but then it
started spreading, and then the joint pains started.
She used insect repellant but was in an area known
,to have ticks. She has never been sick and takes
no medications routinely; she has never been
sexually active. What is the most likely cause of
her joint pain?
A) Trauma
B) Gonococcal arthritis
C) Psoriatic arthritis
D) Lyme disease Correct Answers D) Lyme
disease
A 19-year-old college student, Todd, is brought to
your clinic by his mother. She is concerned that
there is something seriously wrong with him. She
states for the past 6 months his behavior has
become peculiar and he has flunked out of college.
Todd denies any recent illness or injuries. His past
medical history is remarkable only for a broken
foot. His parents are both healthy. He has a
paternal uncle who had similar symptoms in
college. The patient admits to smoking cigarettes
and drinking alcohol. He also admits to marijuana
use but none in the last week. He denies using any
other substances. He denies any feelings of
depression or anxiety. While speaking with Todd
and his mother you do a complete physical
examination, which is essentially normal. When
you question him on how he is feeling, he says that
he is very worried that Microsoft has stolen his
software for creating a better browser. He tells you
he has se Correct Answers D) Schizophrenia
,A 21-year-old engineering student comes to your
office, complaining of leg and back pain and of
tripping when he walks. He states this started 3
months ago with back and buttock pain but has
since progressed to feeling weak in his left leg. He
denies any bowel or bladder symptoms. He can
think of no specific traumatic incidences but he
was a defensive lineman in high school and junior
college. His past medical history is unremarkable.
He denies tobacco use or alcohol or drug abuse.
His parents are both healthy. On examination he is
tender over the lumbar spine and he has a positive
straight-leg raise on the left. His Achilles tendon
deep reflex is decreased on the left. While
watching his gait you notice he has to pick his left
foot up high in order not to trip.
What abnormality of gait does he most likely have?
A) Sensory ataxia
B) Parkinsonian gait
C) Steppage gait
D) Spastic hemiparesis Correct Answers C)
Steppage gait
A 22-year-old man is brought to your office by his
father to discuss his son's mental health disorder.
The patient was diagnosed with schizophrenia 6
months ago and has been taking medication since.
The father states that his son's dose isn't high
enough and you need to raise it. He states that his
, son has been hearing things that don't exist. You
ask the young man what is going on and he tells
you that his father is just jealous because his sister
talks only to him. His father turns to him and says,
"Son, you know your sister died 2 years ago!" His
son replies "Well, she still talks to me in my head
all the time!"
Which best describes this patient's abnormality of
perception?
A) Illusion
B) Hallucination
C) Fugue state Correct Answers B) Hallucination
A 23-year-old ticket agent is brought in by her
husband because he is concerned about her recent
behavior. He states that for the last 2 weeks she
has been completely out of control. He says that
she hasn't showered in days, stays awake most of
the night cleaning their apartment, and has run up
over $1,000 on their credit cards. While he is
talking, the patient interrupts him frequently and
declares this is all untrue and she has never been
so happy and fulfilled in her whole life. She speaks
very quickly, changing the subject often. After a
longer than normal interview you find out she has
had no recent illnesses or injuries. Her past
medical history is unremarkable. Both her parents
are healthy but the husband has heard rumors
about an aunt with similar symptoms. She and her
husband have no children. She smokes one pack of
neuro,musculoskeletal,mental health
Questions With Complete Solutions
A 17-year-old high school student is brought in to
your emergency room in a comatose state. His
friends have accompanied him and tell you that
they have been shooting up heroin tonight and
they think their friend may have had too much. The
patient is unconscious and cannot protect his
airway, so he is intubated. His heart rate is 60 and
he is breathing through the ventilator. He is not
posturing and he does not respond to a sternal rub.
Preparing to finish the neurologic examination, you
get a penlight.
What size pupils do you expect to see in this
comatose patient?
A) Pinpoint pupils
B) Large pupils
C) Asymmetric pupils
D) Irregularly shaped pupils Correct Answers A)
Pinpoint pupils
A 19-year-old college sophomore comes to the
clinic for evaluation of joint pains. The student has
been back from spring break for 2 weeks; during
her holiday, she went camping. She notes that she
had a red spot, shaped like a target, but then it
started spreading, and then the joint pains started.
She used insect repellant but was in an area known
,to have ticks. She has never been sick and takes
no medications routinely; she has never been
sexually active. What is the most likely cause of
her joint pain?
A) Trauma
B) Gonococcal arthritis
C) Psoriatic arthritis
D) Lyme disease Correct Answers D) Lyme
disease
A 19-year-old college student, Todd, is brought to
your clinic by his mother. She is concerned that
there is something seriously wrong with him. She
states for the past 6 months his behavior has
become peculiar and he has flunked out of college.
Todd denies any recent illness or injuries. His past
medical history is remarkable only for a broken
foot. His parents are both healthy. He has a
paternal uncle who had similar symptoms in
college. The patient admits to smoking cigarettes
and drinking alcohol. He also admits to marijuana
use but none in the last week. He denies using any
other substances. He denies any feelings of
depression or anxiety. While speaking with Todd
and his mother you do a complete physical
examination, which is essentially normal. When
you question him on how he is feeling, he says that
he is very worried that Microsoft has stolen his
software for creating a better browser. He tells you
he has se Correct Answers D) Schizophrenia
,A 21-year-old engineering student comes to your
office, complaining of leg and back pain and of
tripping when he walks. He states this started 3
months ago with back and buttock pain but has
since progressed to feeling weak in his left leg. He
denies any bowel or bladder symptoms. He can
think of no specific traumatic incidences but he
was a defensive lineman in high school and junior
college. His past medical history is unremarkable.
He denies tobacco use or alcohol or drug abuse.
His parents are both healthy. On examination he is
tender over the lumbar spine and he has a positive
straight-leg raise on the left. His Achilles tendon
deep reflex is decreased on the left. While
watching his gait you notice he has to pick his left
foot up high in order not to trip.
What abnormality of gait does he most likely have?
A) Sensory ataxia
B) Parkinsonian gait
C) Steppage gait
D) Spastic hemiparesis Correct Answers C)
Steppage gait
A 22-year-old man is brought to your office by his
father to discuss his son's mental health disorder.
The patient was diagnosed with schizophrenia 6
months ago and has been taking medication since.
The father states that his son's dose isn't high
enough and you need to raise it. He states that his
, son has been hearing things that don't exist. You
ask the young man what is going on and he tells
you that his father is just jealous because his sister
talks only to him. His father turns to him and says,
"Son, you know your sister died 2 years ago!" His
son replies "Well, she still talks to me in my head
all the time!"
Which best describes this patient's abnormality of
perception?
A) Illusion
B) Hallucination
C) Fugue state Correct Answers B) Hallucination
A 23-year-old ticket agent is brought in by her
husband because he is concerned about her recent
behavior. He states that for the last 2 weeks she
has been completely out of control. He says that
she hasn't showered in days, stays awake most of
the night cleaning their apartment, and has run up
over $1,000 on their credit cards. While he is
talking, the patient interrupts him frequently and
declares this is all untrue and she has never been
so happy and fulfilled in her whole life. She speaks
very quickly, changing the subject often. After a
longer than normal interview you find out she has
had no recent illnesses or injuries. Her past
medical history is unremarkable. Both her parents
are healthy but the husband has heard rumors
about an aunt with similar symptoms. She and her
husband have no children. She smokes one pack of
