NSG6020 Final examQuestions/Answers
2025/2026Graded A+
A 12-year-old is brought to your clinic by his father. He was taught in his health class at school to do monthly
testicular self-examinations. Yesterday, when he felt his left testicle, it was enlarged and tender. He isn't sure if he
has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough,
and runny nose for the last three days. His past medical history is significant for a tonsillectomy as a small child. His
father has high blood pressure and his mother is healthy. On examination, you see a child in no acute distress. His
temperature is 100.8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is
uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on
the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An
examin - ✔✔✔Acute orchitis
A 14-year-old junior high school student is brought in by his mother and father because he seems to be developing
breasts. The mother is upset because she read on the Internet that smoking marijuana leads to breast enlargement
in males. The young man adamantly denies using any tobacco, alcohol, or drugs. He has recently noticed changes
in his penis, testicles, and pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are
both in good health. He has two older brothers who never had this problem. On examination, you see a mildly
overweight teenager with enlarged breast tissue that is slightly tender on both sides. Otherwise, his examination is
normal. He is agreeable to taking a drug test. What is the most likely cause of his gynecomastia? - ✔✔✔Imbalance
of hormones of puberty
A 15-year-old high school football player is brought to your office by his mother. He is complaining of severe
testicular pain since exactly 8:00 this morning. He denies any sexual activity and states that he hurts so bad he
can't even urinate. He is nauseated and is throwing up. He denies any recent illness or fever. His past medical
history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. On
examination, you see a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps
shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24. On visualization of
the penis, he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense
and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is
unremarkable. His - ✔✔✔Torsion of the spermatic cord
A 23-year-old computer programmer comes to your office for an annual examination. She has recently become
sexually active and wants to be placed on birth control. Her only complaint is that the skin in her armpits has
become darker. She states it looks like dirt, and she scrubs her skin nightly with soap and water but the color stays.
Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her
mother has type 2 diabetes, and her father has high blood pressure. The patient denies using tobacco but has four
to five drinks on Friday and Saturday nights. She denies any illegal drug use. On examination, you see a mildly
obese female who is breathing comfortably. Her vital signs are unremarkable. Looking under her axilla, you see
dark, velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is
she most likely to have? - ✔✔✔Acanthosis nigricans
, A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal pain for
twelve hours. He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to
be just on the lower right side. He has had some nausea and vomiting but no constipation or diarrhea. His last
bowel movement was the night before and was normal. He has had no fever or chills. He denies any recent
illnesses or injuries. His past medical history is unremarkable. He is engaged. He denies any tobacco or drug use
and drinks four to six beers per week. His mother has breast cancer and his father has coronary artery disease. On
examination, he appears ill and is lying on his right side. His temperature is 100.4 degrees and his heart rate is 110.
His bowel sounds are decreased and he has rebound and involuntary guarding, one-third of the way between the
anterior superior iliac spine and the - ✔✔✔Acute appendicitis
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With further questioning, she
is able to relate that the pain is worse in the neck, shoulders, hands, low back and knees. She denies swelling in her
joints. She states that the pain is worse in the morning. There is no limitation in her range of motion. On physical
examination, she has several points on the muscles of the neck, shoulders and back that are tender to palpation.
Muscle strength and range of motion are normal. Which one of the following is likely the cause of her pain? -
✔✔✔fibromyalgia
A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of
breast cancer in his first-degree relatives. What is the most likely diagnosis? - ✔✔✔Breast tissue
A 30-year-old woman with a history of mitral valve problems states that she has been "very tired." She has started
waking up at night and feels like her "heart is pounding." During the assessment, the nurse practitioner palpates a
thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also
auscultates a blowing, swishing sound right after S1. These findings would be most consistent with: - ✔✔✔mitral
regurgitation.
A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months. She has had
no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any recent illnesses or injuries.
She denies any changes to her diet or exercise program. She is on no new medications. During the review of
systems (ROS), you note that she has felt fatigued, had some weight gain, has irregular periods, and has cold
intolerance. Her past medical history is significant for one vaginal delivery and two cesarean sections. She is
married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother has
type 2 diabetes and her father has coronary artery disease. There is no family history of cancers. On examination,
she appears her stated age. Her vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations
are normal. Her cardiac, lung, - ✔✔✔Hypothyroidism
A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac,
pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant
for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different
trucking company. He smokes one pack of cigarettes a day, drinks less than six beers a week, and denies using any
illegal drugs. His mother has high blood pressure and arthritis and his father died of lung cancer in his sixties. On
examination, his blood pressure is 130/80 and his pulse is 80. His cardiac, lung, and abdominal examinations are
2025/2026Graded A+
A 12-year-old is brought to your clinic by his father. He was taught in his health class at school to do monthly
testicular self-examinations. Yesterday, when he felt his left testicle, it was enlarged and tender. He isn't sure if he
has had burning with urination and he says he has never had sexual intercourse. He has had a sore throat, cough,
and runny nose for the last three days. His past medical history is significant for a tonsillectomy as a small child. His
father has high blood pressure and his mother is healthy. On examination, you see a child in no acute distress. His
temperature is 100.8 and his blood pressure and pulse are unremarkable. On visualization of his penis, he is
uncircumcised and has no lesions or discharge. His scrotum is red and tense on the left and normal appearing on
the right. Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An
examin - ✔✔✔Acute orchitis
A 14-year-old junior high school student is brought in by his mother and father because he seems to be developing
breasts. The mother is upset because she read on the Internet that smoking marijuana leads to breast enlargement
in males. The young man adamantly denies using any tobacco, alcohol, or drugs. He has recently noticed changes
in his penis, testicles, and pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are
both in good health. He has two older brothers who never had this problem. On examination, you see a mildly
overweight teenager with enlarged breast tissue that is slightly tender on both sides. Otherwise, his examination is
normal. He is agreeable to taking a drug test. What is the most likely cause of his gynecomastia? - ✔✔✔Imbalance
of hormones of puberty
A 15-year-old high school football player is brought to your office by his mother. He is complaining of severe
testicular pain since exactly 8:00 this morning. He denies any sexual activity and states that he hurts so bad he
can't even urinate. He is nauseated and is throwing up. He denies any recent illness or fever. His past medical
history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents are both in good health. On
examination, you see a young teenager lying on the bed with an emesis basin. He is very uncomfortable and keeps
shifting his position. His blood pressure is 150/100, his pulse is 110, and his respirations are 24. On visualization of
the penis, he is circumcised and there are no lesions and no discharge from the meatus. His scrotal skin is tense
and red. Palpation of the left testicle causes severe pain and the patient begins to cry. His prostate examination is
unremarkable. His - ✔✔✔Torsion of the spermatic cord
A 23-year-old computer programmer comes to your office for an annual examination. She has recently become
sexually active and wants to be placed on birth control. Her only complaint is that the skin in her armpits has
become darker. She states it looks like dirt, and she scrubs her skin nightly with soap and water but the color stays.
Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her
mother has type 2 diabetes, and her father has high blood pressure. The patient denies using tobacco but has four
to five drinks on Friday and Saturday nights. She denies any illegal drug use. On examination, you see a mildly
obese female who is breathing comfortably. Her vital signs are unremarkable. Looking under her axilla, you see
dark, velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is
she most likely to have? - ✔✔✔Acanthosis nigricans
, A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal pain for
twelve hours. He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to
be just on the lower right side. He has had some nausea and vomiting but no constipation or diarrhea. His last
bowel movement was the night before and was normal. He has had no fever or chills. He denies any recent
illnesses or injuries. His past medical history is unremarkable. He is engaged. He denies any tobacco or drug use
and drinks four to six beers per week. His mother has breast cancer and his father has coronary artery disease. On
examination, he appears ill and is lying on his right side. His temperature is 100.4 degrees and his heart rate is 110.
His bowel sounds are decreased and he has rebound and involuntary guarding, one-third of the way between the
anterior superior iliac spine and the - ✔✔✔Acute appendicitis
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With further questioning, she
is able to relate that the pain is worse in the neck, shoulders, hands, low back and knees. She denies swelling in her
joints. She states that the pain is worse in the morning. There is no limitation in her range of motion. On physical
examination, she has several points on the muscles of the neck, shoulders and back that are tender to palpation.
Muscle strength and range of motion are normal. Which one of the following is likely the cause of her pain? -
✔✔✔fibromyalgia
A 30-year-old man notices a firm, 2-cm mass under his areola. He has no other symptoms and no diagnosis of
breast cancer in his first-degree relatives. What is the most likely diagnosis? - ✔✔✔Breast tissue
A 30-year-old woman with a history of mitral valve problems states that she has been "very tired." She has started
waking up at night and feels like her "heart is pounding." During the assessment, the nurse practitioner palpates a
thrill and lift at the fifth left intercostal space midclavicular line. In the same area the nurse practitioner also
auscultates a blowing, swishing sound right after S1. These findings would be most consistent with: - ✔✔✔mitral
regurgitation.
A 42-year-old florist comes to your office, complaining of chronic constipation for the last six months. She has had
no nausea, vomiting, or diarrhea, and no abdominal pain or cramping. She denies any recent illnesses or injuries.
She denies any changes to her diet or exercise program. She is on no new medications. During the review of
systems (ROS), you note that she has felt fatigued, had some weight gain, has irregular periods, and has cold
intolerance. Her past medical history is significant for one vaginal delivery and two cesarean sections. She is
married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug use. Her mother has
type 2 diabetes and her father has coronary artery disease. There is no family history of cancers. On examination,
she appears her stated age. Her vital signs are normal. Her head, eyes, ears, nose, throat, and neck examinations
are normal. Her cardiac, lung, - ✔✔✔Hypothyroidism
A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac,
pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant
for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different
trucking company. He smokes one pack of cigarettes a day, drinks less than six beers a week, and denies using any
illegal drugs. His mother has high blood pressure and arthritis and his father died of lung cancer in his sixties. On
examination, his blood pressure is 130/80 and his pulse is 80. His cardiac, lung, and abdominal examinations are
