NSG 6020 3P EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES.
Heberden's nodes are commonly found in which one of the following diseases?
~CORRECT ANSWER~Degenerative joint disease
You are beginning the examination of the skin on a 25-year-old teacher. You
have previously elicited that she came to the office for evaluation of fatigue,
weight gain, and hair loss. You strongly suspect that she has hypothyroidism.
What is the expected moisture and texture of the skin of the patient with
hypothyroidism ~CORRECT ANSWER~dry and rough
You are assessing a patient with joint pain and are trying to decide whether
it is inflammatory or noninflammatory in nature. Which one of the following
symptoms is consistent with an inflammatory process? ~CORRECT
ANSWER~tenderness
A 68-year-old retired farmer comes to your office for evaluation of a skin
lesion. On the right temporal area of the forehead, you see a flattened papule
the same color as his skin, covered by a dry scale that is round and feels hard.
He has several more of these scattered on the forehead, arms and legs. Based
on this description, what is your most likely diagnosis? ~CORRECT
ANSWER~actinic keratosis
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? ~CORRECT
ANSWER~fibromyalgia
A new patient is complaining of severe pruritus that is worse at night.
Several family members also have the same symptoms. Upon examination,
areas of excoriated papules are noted on some of the interdigital webs of both
hands and on the axillae. This finding is most consistent with: ~CORRECT
ANSWER~Scabies
An obese 55-year-old woman went through menarche at age 16 and
menopause 2 years ago. She is concerned because an aunt had severe
osteoporosis. Which one of the following is a risk factor for osteoporosis?
~CORRECT ANSWER~Delayed menarche
Ms. Whiting is a 68-year-old female who comes in for her usual follow-up
visit. You notice a few flat red and purple lesions, about 6 centimeters in
diameter, on the ulnar aspect of her forearms but nowhere else. She doesn't
mention them. They are tender when you examine them. What should you
do? ~CORRECT ANSWER~Ask how she acquired them.
A 58-year-old man comes to your office complaining of bilateral back pain
that now awakens him at night. This has been steadily increasing for the
past 2 months. Which one of the following is the most reassuring in this
patient with back pain? ~CORRECT ANSWER~Pain that is bilateral
The Phalen's test is used to evaluate: ~CORRECT ANSWER~inflammation
of the median nerve
, Which of the following would lead you to suspect a hydrocele versus other
causes of scrotal swelling? ~CORRECT ANSWER~A positive
transillumination test
You are examining a newborn and note that the right testicle is not in the
scrotum. What should you do next? ~CORRECT ANSWER~Attempt to bring
down the testis from the inguinal canal
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 normal. He has no inguinal hernia, but on his digital rectal examination
you palpate a soft, smooth, and nontender pedunculated mass on the
posterior wall of the rectum. What anal, rectal, or prostate disorder best fits
his presentation? ~CORRECT ANSWER~Rectal polyp
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
DETAILED ANSWERS WITH RATIONALES.
Heberden's nodes are commonly found in which one of the following diseases?
~CORRECT ANSWER~Degenerative joint disease
You are beginning the examination of the skin on a 25-year-old teacher. You
have previously elicited that she came to the office for evaluation of fatigue,
weight gain, and hair loss. You strongly suspect that she has hypothyroidism.
What is the expected moisture and texture of the skin of the patient with
hypothyroidism ~CORRECT ANSWER~dry and rough
You are assessing a patient with joint pain and are trying to decide whether
it is inflammatory or noninflammatory in nature. Which one of the following
symptoms is consistent with an inflammatory process? ~CORRECT
ANSWER~tenderness
A 68-year-old retired farmer comes to your office for evaluation of a skin
lesion. On the right temporal area of the forehead, you see a flattened papule
the same color as his skin, covered by a dry scale that is round and feels hard.
He has several more of these scattered on the forehead, arms and legs. Based
on this description, what is your most likely diagnosis? ~CORRECT
ANSWER~actinic keratosis
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? ~CORRECT
ANSWER~fibromyalgia
A new patient is complaining of severe pruritus that is worse at night.
Several family members also have the same symptoms. Upon examination,
areas of excoriated papules are noted on some of the interdigital webs of both
hands and on the axillae. This finding is most consistent with: ~CORRECT
ANSWER~Scabies
An obese 55-year-old woman went through menarche at age 16 and
menopause 2 years ago. She is concerned because an aunt had severe
osteoporosis. Which one of the following is a risk factor for osteoporosis?
~CORRECT ANSWER~Delayed menarche
Ms. Whiting is a 68-year-old female who comes in for her usual follow-up
visit. You notice a few flat red and purple lesions, about 6 centimeters in
diameter, on the ulnar aspect of her forearms but nowhere else. She doesn't
mention them. They are tender when you examine them. What should you
do? ~CORRECT ANSWER~Ask how she acquired them.
A 58-year-old man comes to your office complaining of bilateral back pain
that now awakens him at night. This has been steadily increasing for the
past 2 months. Which one of the following is the most reassuring in this
patient with back pain? ~CORRECT ANSWER~Pain that is bilateral
The Phalen's test is used to evaluate: ~CORRECT ANSWER~inflammation
of the median nerve
, Which of the following would lead you to suspect a hydrocele versus other
causes of scrotal swelling? ~CORRECT ANSWER~A positive
transillumination test
You are examining a newborn and note that the right testicle is not in the
scrotum. What should you do next? ~CORRECT ANSWER~Attempt to bring
down the testis from the inguinal canal
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 normal. He has no inguinal hernia, but on his digital rectal examination
you palpate a soft, smooth, and nontender pedunculated mass on the
posterior wall of the rectum. What anal, rectal, or prostate disorder best fits
his presentation? ~CORRECT ANSWER~Rectal polyp
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
