1|Page
NR 509 BATES MIDTERM EXAM|| ACCURATE AND FREQUENTLY
TESTED QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES|| LATEST AND COMPLETE UPDATE WITH EXPERT VERIFIED
SOLUTIONS
A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - ANSWER: C) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may also
result in shortness of breath, such as anemia in the hematologic category, pregnancy in
the reproductive category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine - ANSWER: C) Cardiac
The cardiac system can cause a cough if the patient has congestive heart failure. This
results in fluid buildup in the lungs, which in turn can cause a cough that produces
pink, frothy sputum. A foreign body in the ear may also cause a cough by stimulating
Arnold's branch of the vagus nerve, but this is less likely to be seen clinically than
heart failure.
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A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - ANSWER: A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall.
Pleuritic chest pain is also a sharp chest pain which increases with a deep breath. This
type of pain can occur with inflammation of the pleura from pneumonia or other
conditions and pulmonary embolus.
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new, located in the wrists and fingers bilaterally, with some subjective fever. The
patient denies a rash; she also denies recent travel or camping activities. She has a
family history significant for rheumatoid arthritis. Based on this information, which of
the following pathologic processes would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic - ANSWER: B) Inflammatory
The description is most consistent with an inflammatory process, although all the
other etiologies should be considered. Lyme disease is an infection which commonly
causes arthritis, hemophilia is a hematologic condition which can cause bleeding in
the joints, and trauma can obviously cause joint pain.
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A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications to
ease the pain, but this time they haven't worked as well and he still has discomfort. He
recently wallpapered the entire second floor in his house, which caused him great
discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory
symptoms, trauma, or injury to the neck. Based on this description, what is the most
likely pathologic process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic - ANSWER: C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The patient
has had intermittent symptoms and the questions asked to elicit pertinent negative
and positive findings are negative for infectious, traumatic, or neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3- week
history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular - ANSWER: C) Allergic
This description is most consistent with allergic rhinitis.
A 19-year old-college student presents to the emergency room with fever, headache,
and neck pain/stiffness. She is concerned about the possibility of meningococcal
meningitis. Several of her dorm mates have been vaccinated, but
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she hasn't been. Which of the following physical examination descriptions is most
consistent with meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full
range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with full range of motion - ANSWER: C) Head is normocephalic and
atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to
perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and lack of
range of motion are consistent with neck stiffness, which in this scenario is likely to be
caused by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.
A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal
pain. The pain is associated with nausea and vomiting and occurs 1 to 2 hours after
eating greasy foods. Which one of the following physical examination descriptions
would be most consistent with the diagnosis of cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or
masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without
rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding. - ANSWER: C) Abdomen is soft and tender to palpation in
NR 509 BATES MIDTERM EXAM|| ACCURATE AND FREQUENTLY
TESTED QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES|| LATEST AND COMPLETE UPDATE WITH EXPERT VERIFIED
SOLUTIONS
A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - ANSWER: C) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may also
result in shortness of breath, such as anemia in the hematologic category, pregnancy in
the reproductive category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine - ANSWER: C) Cardiac
The cardiac system can cause a cough if the patient has congestive heart failure. This
results in fluid buildup in the lungs, which in turn can cause a cough that produces
pink, frothy sputum. A foreign body in the ear may also cause a cough by stimulating
Arnold's branch of the vagus nerve, but this is less likely to be seen clinically than
heart failure.
,2|Page
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - ANSWER: A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall.
Pleuritic chest pain is also a sharp chest pain which increases with a deep breath. This
type of pain can occur with inflammation of the pleura from pneumonia or other
conditions and pulmonary embolus.
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new, located in the wrists and fingers bilaterally, with some subjective fever. The
patient denies a rash; she also denies recent travel or camping activities. She has a
family history significant for rheumatoid arthritis. Based on this information, which of
the following pathologic processes would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic - ANSWER: B) Inflammatory
The description is most consistent with an inflammatory process, although all the
other etiologies should be considered. Lyme disease is an infection which commonly
causes arthritis, hemophilia is a hematologic condition which can cause bleeding in
the joints, and trauma can obviously cause joint pain.
,3|Page
A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications to
ease the pain, but this time they haven't worked as well and he still has discomfort. He
recently wallpapered the entire second floor in his house, which caused him great
discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory
symptoms, trauma, or injury to the neck. Based on this description, what is the most
likely pathologic process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic - ANSWER: C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The patient
has had intermittent symptoms and the questions asked to elicit pertinent negative
and positive findings are negative for infectious, traumatic, or neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3- week
history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular - ANSWER: C) Allergic
This description is most consistent with allergic rhinitis.
A 19-year old-college student presents to the emergency room with fever, headache,
and neck pain/stiffness. She is concerned about the possibility of meningococcal
meningitis. Several of her dorm mates have been vaccinated, but
, 4|Page
she hasn't been. Which of the following physical examination descriptions is most
consistent with meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full
range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with full range of motion - ANSWER: C) Head is normocephalic and
atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to
perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and lack of
range of motion are consistent with neck stiffness, which in this scenario is likely to be
caused by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.
A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal
pain. The pain is associated with nausea and vomiting and occurs 1 to 2 hours after
eating greasy foods. Which one of the following physical examination descriptions
would be most consistent with the diagnosis of cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or
masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without
rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding. - ANSWER: C) Abdomen is soft and tender to palpation in
