NU 650 through Midterm Questions With Complete
Solutions
3 Dimensions of cultural humility Correct Answer 1) Self-
awareness: learn about your own biases; we all have them.
2) Respectful communication: work to eliminate assumptions
about what is "normal". Learn directly from your patients; they
are the experts on their culture and illness.
3) Collaborative partnerships: build your patient relationships on
respect and mutually acceptable plans.
A 12-year-old presents to the clinic with his father for evaluation
of a painful lump in the left eye. It started this morning. He
denies any trauma or injury. There is no visual disturbance.
Upon physical examination, there is a red raised area at the
margin of the eyelid that is tender to palpation; no tearing occurs
with palpation of the lesion. Based on this description, what is
the most likely diagnosis?
A) Dacryocystitis
B) Chalazion
C) Hordeolum
D) Xanthelasma Correct Answer C
Hordeolum - aka Stye
A 15 yo presents to the emergency room with his mother for
eval of an area of blood in the left eye. He denies trauma or
injury but has been coughing forcefully with a recent cold. He
denies visual disturbances, eye pain, or discharge from the eye.
On physical exam, the PERRL, with a visual acuity of
20/20 in each eye and 20/20 bilaterally. There is a
homogeneous, sharply demarcated area at the lateral aspect of
,the base of the left eye. The cornea is clear. Based on this
description, what is the most likely diagnosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage Correct Answer D
A 15-year-old high school student presents to your clinic
complaining of pain in his left ear. He noticed that it occurred
shortly after starting swimming lessons at the local YMCA.
Upon physical examination, you notice that the external canal is
swollen and tender during insertion of the speculum. What is
your most likely diagnosis?
(A) Otitis media
(B) Serous otitis
(C) Eustachian tube dysfunction
(D) Otitis externa Correct Answer D
A 15-year-old member of the high school marching band comes
to your office for evaluation of hearing loss. He had multiple ear
infections as an infant and toddler, and had to have
myringotomy tubes inserted in his ears. Additionally, he suffers
from many allergies. His hearing is diminished in the right ear.
When you place a vibrating tuning fork on the top of his head,
the sound lateralizes to the right ear. The name of this test is:
(A) Weber's test
(B) Rinne's test
(C) Whisper test
(D) Romberg test Correct Answer A
,A 17-year-old high school senior presents to your clinic in acute
respiratory distress. Between shallow breaths he states he was at
home finishing his homework when he suddenly began having
right-sided chest pain and severe SOB. Denies any recent
traumas or illnesses. PMH unremarkable. On examination you
see a tall, thin young man in obvious distress. He is diaphoretic
and RR 35. On auscultation you hear no breath sounds on the
right side of his superior chest wall. On percussion he is
hyperresonant over RUL. Palpation: absent fremitus over the
RUL.
What disorder of the thorax or lung best describes his
symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia Correct Answer A
A 19 yo construction worker presents for evaluation of a rash.
He notes that it started on his back with a multitude of spots and
is also on his arms, chest, and neck. It itches a lot. He does sweat
more than before because being outdoors is part of his job. On
physical examination, you note dark tan patches with a reddish
cast that has sharp borders and fine scales, scattered more
prominently around the upper back, chest, neck, and upper arms
as well as under the arms. Based on this description, what is
your most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema Correct Answer B
Tinea = fungal and promoted by moisture
, A 2-week-old infant is brought into your clinic by his parents
because they have noticed that their child is having some
difficulty with feeding and that there is something strange in his
mouth. You diagnose thrush. What is the most likely physical
finding you will see upon examination of his mouth?
(A) Koplik's spots
(B) White plaques
(C) Erythematous plaques
(D) Epstein's pearls Correct Answer B
A 21-year-old college senior presents to your clinic,
complaining of SOB and a nonproductive nocturnal cough. She
states she used to feel this way only with extreme exercise, but
lately she has felt this way continuously. She denies any other
upper respiratory symptoms, CP, GI symptoms, or urinary tract
symptoms. PMH significant only for seasonal allergies. On
exam she is in no acute distress; temp is 98.6, BP is 120/80, her
pulse is 80, and her RR is 20. On auscultation of her chest, there
is decreased air movement and a high-pitched whistling on
expiration in all lobes. Percussion reveals resonant lungs. Which
disorder of the thorax or lung does this best describe?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia Correct Answer C
A 22-year-old agricultural worker presents to your office for
evaluation of coughing. She has had this cough for 6 weeks; it is
nonproductive and worst first thing in the morning. She denies
fever, chills, weight loss, or night sweats; she does have clear
Solutions
3 Dimensions of cultural humility Correct Answer 1) Self-
awareness: learn about your own biases; we all have them.
2) Respectful communication: work to eliminate assumptions
about what is "normal". Learn directly from your patients; they
are the experts on their culture and illness.
3) Collaborative partnerships: build your patient relationships on
respect and mutually acceptable plans.
A 12-year-old presents to the clinic with his father for evaluation
of a painful lump in the left eye. It started this morning. He
denies any trauma or injury. There is no visual disturbance.
Upon physical examination, there is a red raised area at the
margin of the eyelid that is tender to palpation; no tearing occurs
with palpation of the lesion. Based on this description, what is
the most likely diagnosis?
A) Dacryocystitis
B) Chalazion
C) Hordeolum
D) Xanthelasma Correct Answer C
Hordeolum - aka Stye
A 15 yo presents to the emergency room with his mother for
eval of an area of blood in the left eye. He denies trauma or
injury but has been coughing forcefully with a recent cold. He
denies visual disturbances, eye pain, or discharge from the eye.
On physical exam, the PERRL, with a visual acuity of
20/20 in each eye and 20/20 bilaterally. There is a
homogeneous, sharply demarcated area at the lateral aspect of
,the base of the left eye. The cornea is clear. Based on this
description, what is the most likely diagnosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage Correct Answer D
A 15-year-old high school student presents to your clinic
complaining of pain in his left ear. He noticed that it occurred
shortly after starting swimming lessons at the local YMCA.
Upon physical examination, you notice that the external canal is
swollen and tender during insertion of the speculum. What is
your most likely diagnosis?
(A) Otitis media
(B) Serous otitis
(C) Eustachian tube dysfunction
(D) Otitis externa Correct Answer D
A 15-year-old member of the high school marching band comes
to your office for evaluation of hearing loss. He had multiple ear
infections as an infant and toddler, and had to have
myringotomy tubes inserted in his ears. Additionally, he suffers
from many allergies. His hearing is diminished in the right ear.
When you place a vibrating tuning fork on the top of his head,
the sound lateralizes to the right ear. The name of this test is:
(A) Weber's test
(B) Rinne's test
(C) Whisper test
(D) Romberg test Correct Answer A
,A 17-year-old high school senior presents to your clinic in acute
respiratory distress. Between shallow breaths he states he was at
home finishing his homework when he suddenly began having
right-sided chest pain and severe SOB. Denies any recent
traumas or illnesses. PMH unremarkable. On examination you
see a tall, thin young man in obvious distress. He is diaphoretic
and RR 35. On auscultation you hear no breath sounds on the
right side of his superior chest wall. On percussion he is
hyperresonant over RUL. Palpation: absent fremitus over the
RUL.
What disorder of the thorax or lung best describes his
symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia Correct Answer A
A 19 yo construction worker presents for evaluation of a rash.
He notes that it started on his back with a multitude of spots and
is also on his arms, chest, and neck. It itches a lot. He does sweat
more than before because being outdoors is part of his job. On
physical examination, you note dark tan patches with a reddish
cast that has sharp borders and fine scales, scattered more
prominently around the upper back, chest, neck, and upper arms
as well as under the arms. Based on this description, what is
your most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema Correct Answer B
Tinea = fungal and promoted by moisture
, A 2-week-old infant is brought into your clinic by his parents
because they have noticed that their child is having some
difficulty with feeding and that there is something strange in his
mouth. You diagnose thrush. What is the most likely physical
finding you will see upon examination of his mouth?
(A) Koplik's spots
(B) White plaques
(C) Erythematous plaques
(D) Epstein's pearls Correct Answer B
A 21-year-old college senior presents to your clinic,
complaining of SOB and a nonproductive nocturnal cough. She
states she used to feel this way only with extreme exercise, but
lately she has felt this way continuously. She denies any other
upper respiratory symptoms, CP, GI symptoms, or urinary tract
symptoms. PMH significant only for seasonal allergies. On
exam she is in no acute distress; temp is 98.6, BP is 120/80, her
pulse is 80, and her RR is 20. On auscultation of her chest, there
is decreased air movement and a high-pitched whistling on
expiration in all lobes. Percussion reveals resonant lungs. Which
disorder of the thorax or lung does this best describe?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia Correct Answer C
A 22-year-old agricultural worker presents to your office for
evaluation of coughing. She has had this cough for 6 weeks; it is
nonproductive and worst first thing in the morning. She denies
fever, chills, weight loss, or night sweats; she does have clear
