NUR631 Exam 3 -
neuro,musculoskeletal,mental
health with all correct answers
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 seen a black van in his neighborhood at night
and he is sure that it is full of computer tech workers stealing his work
through special gamma waves. You ask him why he believes they are trying
to steal his programs. He replies that the technicians have been telepathing
their intents directly into his head. He says he hears these conversations at
night so he knows this is happening. Todd's mother then tells you, "See, I told
you . . . he's crazy. What do I do about it?"
While arranging for a psychiatry consult, what psychotic disorder do you
think Todd has?
A) Schizoaffective disorder
B) Psychotic disorder due to a medical illness
C) Substance-induced psychotic disorder
D) Schizophrenia
D) Schizophrenia
,Mrs. Fletcher complains of numbness of her right hand. On examination,
sensation of the volar aspect of the web of the thumb and index finger and
the pulp of the middle finger are normal. The pulp of the index finger has
decreased sensation. Which of the following is affected?
A) Median nerve
B) Ulnar nerve
C) Radial nerve
A) Median nerve
A 50-year-old woman presents with "left hip pain" of several weeks duration.
There is marked tenderness when you press over her proximal lateral thigh.
What do you think she has?
A) Osteoarthritis
B) Rheumatoid arthritis
C) Sciatica
D) Trochanteric bursitis
D) Trochanteric bursitis
Sarah presents with left lateral knee pain and has some locking in full
extension. There is tenderness over the medial joint line. When the knee is
extended with the foot externally rotated and some valgus stress is applied,
a click is noted. What is the most likely diagnosis?
A) Torn anterior cruciate ligament
B) Torn posterior cruciate ligament
C) Torn medial meniscus
D) Torn lateral meniscus
C) Torn medial meniscus
,A 24-year-old secretary comes to your clinic, complaining of difficulty
sleeping, severe nightmares, and irritability. She states it all began 6 months
ago when she went to a fast food restaurant at midnight. While she was
waiting in her car a man entered through the passenger door and put a gun
to her head. He had her drive to a remote area, where he took her money
and threatened to kill her. When the gun jammed he panicked and ran off.
Ever since this occurred the patient has been having these symptoms. She
states she jumps at every noise and refuses to drive at night. She states her
anxiety has had such a marked influence on her job performance she is
afraid she will be fired. She denies any recent illnesses or injuries. Her past
medical history is unremarkable. On examination you find a nervous woman
appearing her stated age. Her physical examination is unremarkable. You
recommend medication and counseling.
What anxiety disorder to you think this young woman has?
A) Specific phobia
B) Acute stress disorder
C) Post-traumatic stress disorder
D) Generalized anxiety disorder
C) Post-traumatic stress disorder
A 75-year-old homemaker brings her 76-year-old husband to your clinic. She
states that 4 months ago he had a stroke and ever since she has been
frustrated with his problems with communication. They were at a restaurant
after church one Sunday when he suddenly became quiet. When she realized
something was wrong he was taken to the hospital by EMS. He spent 2
, weeks in the hospital with right-sided weakness and difficulty speaking. After
hospitalization he was in a rehab center, where he regained the ability to
walk and most of the use of his right hand. He also began to speak more, but
she says that much of the time "he doesn't make any sense." She gives an
example that when she reminded him the car needed to be serviced he told
her "I will change the Kool-Aid out of the sink myself with the ludrip." She
says that these sayings are becoming frustrating. She wants you to tell her
what is wrong and what you can do about it. While you write up a consult to
neurology, you describe the syndrome to her.
What type of aphasia does he have?
A) Wernicke's aphasia
B) Broca's aphasia
C) Dysarthria
A) Wernicke's aphasia
A 32-year-old white female comes to your clinic, complaining of
overwhelming sadness. She says for the past 2 months she has had crying
episodes, difficulty sleeping, and problems with overeating. She says she
used to go out with her friends from work but now she just wants to go home
and be by herself. She also thinks that her work productivity has been
dropping because she just is too tired to care or concentrate. She denies any
feelings of guilt or any suicidal ideation. She states that she has never felt
this way in the past. She denies any recent illness or injuries. Her past
medical history consists of an appendectomy when she was a teenager;
otherwise, she has been healthy. She is single and works as a clerk in a
medical office. She denies tobacco, alcohol, or illegal drug use. Her mother
has high blood pressure and her father has had a history of mental illness.
On examination you see a woman appearing her stated age who seems quite
sad. Her facial expression does not change while you talk to her and she
makes little eye contact. She speaks so softly you cannot always understand
her. Her thought processes and content seem unremarkable.
What type of mood disorder do you think she has?
A) Dysthymic disorder
neuro,musculoskeletal,mental
health with all correct answers
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 seen a black van in his neighborhood at night
and he is sure that it is full of computer tech workers stealing his work
through special gamma waves. You ask him why he believes they are trying
to steal his programs. He replies that the technicians have been telepathing
their intents directly into his head. He says he hears these conversations at
night so he knows this is happening. Todd's mother then tells you, "See, I told
you . . . he's crazy. What do I do about it?"
While arranging for a psychiatry consult, what psychotic disorder do you
think Todd has?
A) Schizoaffective disorder
B) Psychotic disorder due to a medical illness
C) Substance-induced psychotic disorder
D) Schizophrenia
D) Schizophrenia
,Mrs. Fletcher complains of numbness of her right hand. On examination,
sensation of the volar aspect of the web of the thumb and index finger and
the pulp of the middle finger are normal. The pulp of the index finger has
decreased sensation. Which of the following is affected?
A) Median nerve
B) Ulnar nerve
C) Radial nerve
A) Median nerve
A 50-year-old woman presents with "left hip pain" of several weeks duration.
There is marked tenderness when you press over her proximal lateral thigh.
What do you think she has?
A) Osteoarthritis
B) Rheumatoid arthritis
C) Sciatica
D) Trochanteric bursitis
D) Trochanteric bursitis
Sarah presents with left lateral knee pain and has some locking in full
extension. There is tenderness over the medial joint line. When the knee is
extended with the foot externally rotated and some valgus stress is applied,
a click is noted. What is the most likely diagnosis?
A) Torn anterior cruciate ligament
B) Torn posterior cruciate ligament
C) Torn medial meniscus
D) Torn lateral meniscus
C) Torn medial meniscus
,A 24-year-old secretary comes to your clinic, complaining of difficulty
sleeping, severe nightmares, and irritability. She states it all began 6 months
ago when she went to a fast food restaurant at midnight. While she was
waiting in her car a man entered through the passenger door and put a gun
to her head. He had her drive to a remote area, where he took her money
and threatened to kill her. When the gun jammed he panicked and ran off.
Ever since this occurred the patient has been having these symptoms. She
states she jumps at every noise and refuses to drive at night. She states her
anxiety has had such a marked influence on her job performance she is
afraid she will be fired. She denies any recent illnesses or injuries. Her past
medical history is unremarkable. On examination you find a nervous woman
appearing her stated age. Her physical examination is unremarkable. You
recommend medication and counseling.
What anxiety disorder to you think this young woman has?
A) Specific phobia
B) Acute stress disorder
C) Post-traumatic stress disorder
D) Generalized anxiety disorder
C) Post-traumatic stress disorder
A 75-year-old homemaker brings her 76-year-old husband to your clinic. She
states that 4 months ago he had a stroke and ever since she has been
frustrated with his problems with communication. They were at a restaurant
after church one Sunday when he suddenly became quiet. When she realized
something was wrong he was taken to the hospital by EMS. He spent 2
, weeks in the hospital with right-sided weakness and difficulty speaking. After
hospitalization he was in a rehab center, where he regained the ability to
walk and most of the use of his right hand. He also began to speak more, but
she says that much of the time "he doesn't make any sense." She gives an
example that when she reminded him the car needed to be serviced he told
her "I will change the Kool-Aid out of the sink myself with the ludrip." She
says that these sayings are becoming frustrating. She wants you to tell her
what is wrong and what you can do about it. While you write up a consult to
neurology, you describe the syndrome to her.
What type of aphasia does he have?
A) Wernicke's aphasia
B) Broca's aphasia
C) Dysarthria
A) Wernicke's aphasia
A 32-year-old white female comes to your clinic, complaining of
overwhelming sadness. She says for the past 2 months she has had crying
episodes, difficulty sleeping, and problems with overeating. She says she
used to go out with her friends from work but now she just wants to go home
and be by herself. She also thinks that her work productivity has been
dropping because she just is too tired to care or concentrate. She denies any
feelings of guilt or any suicidal ideation. She states that she has never felt
this way in the past. She denies any recent illness or injuries. Her past
medical history consists of an appendectomy when she was a teenager;
otherwise, she has been healthy. She is single and works as a clerk in a
medical office. She denies tobacco, alcohol, or illegal drug use. Her mother
has high blood pressure and her father has had a history of mental illness.
On examination you see a woman appearing her stated age who seems quite
sad. Her facial expression does not change while you talk to her and she
makes little eye contact. She speaks so softly you cannot always understand
her. Her thought processes and content seem unremarkable.
What type of mood disorder do you think she has?
A) Dysthymic disorder
