NR 509 Midterm Exam
NR 509 Midterm EXAM NR 509 Midterm EXAM
NR 509 Midterm EXAM NR 509 Midterm EXAM
A blood pressure of 142/92 mmHg is best classified as:A. Answer: D
Normal Rationale: Stage 2 hypertension is defined as systolic ≥140 mmHg or diastolic
B. Elevated ≥90 mmHg.
C. Stage 1 hypertension
D. Stage 2 hypertension
Which of the following is considered subjective data Answer: B
during a patient assessment?A. Blood pressure reading Rationale: Subjective data is what the patient reports; objective data includes
B. Patient states, "I feel dizzy" measurable or observable findings.
C. Temperature of 101.2°F
D. Physician notes "rales in lungs"
What is the first step in forming a differential diagnosis Answer: C
(DDx)? Rationale: A thorough history is foundational and guides the formation of an
A. Creating a list of possible diagnoses accurate differential diagnosis.
B. Ordering diagnostic tests
C. Taking a thorough patient history
D. Initiating treatment
Which of the following speech patterns is associated with Answer: B
expressive aphasia? Rationale: Expressive (Broca's) aphasia is characterized by difficulty initiating or
A. Fluent speech with no meaning forming words, despite understanding language.
B. Difficulty initiating speech
C. Slurred but understandable speech
D. Inability to recognize objects
Which of the following best describes the purpose of the Answer: C
FIFE model in patient interviewing? Rationale: The FIFE model (Feelings, Ideas, Function, Expectations) helps
A. A tool for assessing a patient's physical exam findings clinicians understand the patient's perspective regarding their illness.
B. A framework for documenting patient symptoms
C. A method for understanding the patient's perspective
D. A classification system for disease staging
Which lesion type is most commonly associated with Answer: B
herpes zoster? Rationale: Herpes zoster presents with grouped vesicles on an erythematous
A. Papules base, typically following a dermatomal pattern.
B. Vesicles
C. Pustules
D. Macules
Damage to which cranial nerve can result in impaired Answer: B
extraocular movements? Rationale: Cranial nerve III (oculomotor) is responsible for most eye movements,
A. CN II including opening the eyelid and pupil constriction
B. CN III
C. CN V
D. CN VIII
A patient complains of dizziness triggered by head Answer: C
movement, without hearing loss. Which is the most likely Rationale: BPPV typically presents with vertigo precipitated by changes in head
diagnosis? position, without hearing loss or tinnitus.
A. Otitis media
B. Labyrinthitis
C. Benign paroxysmal positional vertigo (BPPV)
D. Acoustic neuroma
Which lung condition is characterized by hyperresonant Answer: D
percussion and decreased breath sounds? Rationale: Emphysema leads to hyperinflated lungs, causing hyperresonant
A. Pneumonia percussion and decreased breath sounds.
B. Asthma
C. Pleural effusion
D. Emphysema
, NR 509 Midterm Exam
Which of the following is a classic auscultatory finding in Answer: B
congestive heart failure (CHF)? Rationale: An S3 gallop is often heard in CHF and indicates increased ventricular
A. Systolic ejection click filling pressures.
B. S3 gallop
C. Opening snap
D. Continuous murmur
Which finding is most consistent with chronic venous Answer: D
insufficiency? Rationale: Chronic venous insufficiency causes increased venous pressure and
A. Cold, pale extremity hemosiderin deposition, leading to brownish discoloration.
B. Pulsatile mass in abdomen
C. Leg pain relieved by rest
D. Brownish discoloration around ankles
The term "general survey" in physical examination refers Answer: C
to: Rationale: The general survey includes observations such as gait, hygiene, body
A. A comprehensive review of systems habitus, and affect.
B. Observations made at the end of the exam
C. Initial impressions of the patient's appearance and
behavior
D. Vital signs and BMI alone
Which symptom is least likely to be found in a patient Answer: D
with COPD? Rationale: Night sweats are more associated with infections like tuberculosis
A. Chronic cough than with COPD.
B. Barrel chest
C. Clubbing
D. Night sweats
A thyroid nodule that is hard, fixed, and non-tender is Answer: B
most concerning for: Rationale: Hard, fixed thyroid nodules are suspicious for malignancy.
A. Hashimoto's thyroiditis
B. Thyroid cancer
C. Thyroid cyst
D. Graves' disease
Which feature best differentiates delirium from Answer: D
dementia? Rationale: Delirium is acute and fluctuating in nature, whereas dementia has a
A. Memory loss gradual, progressive course
B. Gradual onset
C. Hallucinations
D. Fluctuating consciousness
In otitis externa, which finding is most likely present? Answer: B
A. Middle ear effusion Rationale: Pain on pulling the auricle is classic for otitis externa.
B. Pain with movement of the pinna
C. Sensorineural hearing loss
D. Tympanic membrane rupture
Which examination finding is most indicative of Answer: B
pneumonia? Rationale: Consolidation in pneumonia increases tactile fremitus and bronchial
A. Hyperresonant percussion breath sounds.
B. Increased tactile fremitus
C. Decreased breath sounds bilaterally
D. Expiratory wheezing
A bounding carotid pulse may be seen in: Answer: C
A. Aortic stenosis Rationale: Aortic regurgitation leads to a bounding pulse due to wide pulse
B. Hypovolemia pressure.
C. Aortic regurgitation
D. Cardiac tamponade
In a patient with acute arterial occlusion, which symptom Answer: D
is not expected? Rationale: Acute arterial occlusion typically causes the 6 Ps (pain, pallor,
A. Pain pulselessness, paresthesia, poikilothermia, paralysis); pitting edema is not
B. Pallor characteristic
C. Paresthesia
D. Pitting edema
, NR 509 Midterm Exam
When grading tonsils, a score of 3+ indicates: Answer: C
A. Tonsils are visible only with tongue blade Rationale: 3+ tonsils extend to and touch the uvula, suggesting significant
B. Tonsils are halfway between tonsillar pillars and uvula enlargement
C. Tonsils touch the uvula
D. Tonsils are hidden behind the pillars
Which cranial nerve is responsible for the sense of Answer: A
smell? Rationale: Cranial nerve I (olfactory) transmits smell information from the nose to
A. CN I the brain.
B. CN II
C. CN V
D. CN X
A positive Phalen's test is indicative of: Answer: C
A. De Quervain's tenosynovitis Rationale: Phalen's test reproduces symptoms of median nerve compression in
B. Lateral epicondylitis carpal tunnel syndrome
C. Carpal tunnel syndrome
D. Rheumatoid arthritis
Which heart sound is commonly heard in uncontrolled Answer: D
hypertension? Rationale: S4 is associated with stiff ventricles and is often heard in long-
A. S1 standing hypertension.
B. S2
C. S3
D. S4
Which is an example of an open-ended question? Answer: C
A. Do you have chest pain? Rationale: Open-ended questions encourage the patient to elaborate.
B. Is the pain sharp or dull?
C. Can you describe what you are feeling?
D. Is it worse with exertion?
When assessing the carotid pulse, where should the Answer: B
examiner place their fingers? Rationale: The carotid pulse is best felt just lateral to the trachea.
A. At the angle of the mandible
B. Lateral to the trachea at the level of the thyroid
cartilage
C. Over the sternocleidomastoid muscle
D. At the suprasternal notch
Which finding is consistent with a benign lymph node? Answer: B
A. Hard and fixed Rationale: Benign lymph nodes are usually mobile, soft to firm, and not fixed.
B. Firm and mobile
C. Tender and fixed
D. Rubber-like and non-mobile
Which skin lesion is most characteristic of basal cell Answer: B
carcinoma? Rationale: Basal cell carcinoma often appears as a pearly papule with visible
A. Scaly red patch surface blood vessels
B. Pearly papule with telangiectasia
C. Firm nodule with central ulcer
D. Brownish plaque with irregular border
A patient with myxedema will most likely present with: Answer: B
A. Protruding eyeballs Rationale: Myxedema is a manifestation of severe hypothyroidism and causes a
B. Puffy face and coarse features puffy appearance.
C. Warm, moist skin
D. Tachycardia
The Weber test is used to: Answer: B
A. Compare bone and air conduction Rationale: The Weber test checks for sound lateralization in cases of hearing
B. Detect lateralization of sound loss.
C. Assess hearing loss in infants
D. Test auditory acuity
Which of the following is characteristic of macular Answer: C
degeneration? Rationale: Macular degeneration primarily affects the central visual field.
A. Peripheral vision loss
B. Halos around lights
C. Central vision loss
D. Tunnel vision
NR 509 Midterm EXAM NR 509 Midterm EXAM
NR 509 Midterm EXAM NR 509 Midterm EXAM
A blood pressure of 142/92 mmHg is best classified as:A. Answer: D
Normal Rationale: Stage 2 hypertension is defined as systolic ≥140 mmHg or diastolic
B. Elevated ≥90 mmHg.
C. Stage 1 hypertension
D. Stage 2 hypertension
Which of the following is considered subjective data Answer: B
during a patient assessment?A. Blood pressure reading Rationale: Subjective data is what the patient reports; objective data includes
B. Patient states, "I feel dizzy" measurable or observable findings.
C. Temperature of 101.2°F
D. Physician notes "rales in lungs"
What is the first step in forming a differential diagnosis Answer: C
(DDx)? Rationale: A thorough history is foundational and guides the formation of an
A. Creating a list of possible diagnoses accurate differential diagnosis.
B. Ordering diagnostic tests
C. Taking a thorough patient history
D. Initiating treatment
Which of the following speech patterns is associated with Answer: B
expressive aphasia? Rationale: Expressive (Broca's) aphasia is characterized by difficulty initiating or
A. Fluent speech with no meaning forming words, despite understanding language.
B. Difficulty initiating speech
C. Slurred but understandable speech
D. Inability to recognize objects
Which of the following best describes the purpose of the Answer: C
FIFE model in patient interviewing? Rationale: The FIFE model (Feelings, Ideas, Function, Expectations) helps
A. A tool for assessing a patient's physical exam findings clinicians understand the patient's perspective regarding their illness.
B. A framework for documenting patient symptoms
C. A method for understanding the patient's perspective
D. A classification system for disease staging
Which lesion type is most commonly associated with Answer: B
herpes zoster? Rationale: Herpes zoster presents with grouped vesicles on an erythematous
A. Papules base, typically following a dermatomal pattern.
B. Vesicles
C. Pustules
D. Macules
Damage to which cranial nerve can result in impaired Answer: B
extraocular movements? Rationale: Cranial nerve III (oculomotor) is responsible for most eye movements,
A. CN II including opening the eyelid and pupil constriction
B. CN III
C. CN V
D. CN VIII
A patient complains of dizziness triggered by head Answer: C
movement, without hearing loss. Which is the most likely Rationale: BPPV typically presents with vertigo precipitated by changes in head
diagnosis? position, without hearing loss or tinnitus.
A. Otitis media
B. Labyrinthitis
C. Benign paroxysmal positional vertigo (BPPV)
D. Acoustic neuroma
Which lung condition is characterized by hyperresonant Answer: D
percussion and decreased breath sounds? Rationale: Emphysema leads to hyperinflated lungs, causing hyperresonant
A. Pneumonia percussion and decreased breath sounds.
B. Asthma
C. Pleural effusion
D. Emphysema
, NR 509 Midterm Exam
Which of the following is a classic auscultatory finding in Answer: B
congestive heart failure (CHF)? Rationale: An S3 gallop is often heard in CHF and indicates increased ventricular
A. Systolic ejection click filling pressures.
B. S3 gallop
C. Opening snap
D. Continuous murmur
Which finding is most consistent with chronic venous Answer: D
insufficiency? Rationale: Chronic venous insufficiency causes increased venous pressure and
A. Cold, pale extremity hemosiderin deposition, leading to brownish discoloration.
B. Pulsatile mass in abdomen
C. Leg pain relieved by rest
D. Brownish discoloration around ankles
The term "general survey" in physical examination refers Answer: C
to: Rationale: The general survey includes observations such as gait, hygiene, body
A. A comprehensive review of systems habitus, and affect.
B. Observations made at the end of the exam
C. Initial impressions of the patient's appearance and
behavior
D. Vital signs and BMI alone
Which symptom is least likely to be found in a patient Answer: D
with COPD? Rationale: Night sweats are more associated with infections like tuberculosis
A. Chronic cough than with COPD.
B. Barrel chest
C. Clubbing
D. Night sweats
A thyroid nodule that is hard, fixed, and non-tender is Answer: B
most concerning for: Rationale: Hard, fixed thyroid nodules are suspicious for malignancy.
A. Hashimoto's thyroiditis
B. Thyroid cancer
C. Thyroid cyst
D. Graves' disease
Which feature best differentiates delirium from Answer: D
dementia? Rationale: Delirium is acute and fluctuating in nature, whereas dementia has a
A. Memory loss gradual, progressive course
B. Gradual onset
C. Hallucinations
D. Fluctuating consciousness
In otitis externa, which finding is most likely present? Answer: B
A. Middle ear effusion Rationale: Pain on pulling the auricle is classic for otitis externa.
B. Pain with movement of the pinna
C. Sensorineural hearing loss
D. Tympanic membrane rupture
Which examination finding is most indicative of Answer: B
pneumonia? Rationale: Consolidation in pneumonia increases tactile fremitus and bronchial
A. Hyperresonant percussion breath sounds.
B. Increased tactile fremitus
C. Decreased breath sounds bilaterally
D. Expiratory wheezing
A bounding carotid pulse may be seen in: Answer: C
A. Aortic stenosis Rationale: Aortic regurgitation leads to a bounding pulse due to wide pulse
B. Hypovolemia pressure.
C. Aortic regurgitation
D. Cardiac tamponade
In a patient with acute arterial occlusion, which symptom Answer: D
is not expected? Rationale: Acute arterial occlusion typically causes the 6 Ps (pain, pallor,
A. Pain pulselessness, paresthesia, poikilothermia, paralysis); pitting edema is not
B. Pallor characteristic
C. Paresthesia
D. Pitting edema
, NR 509 Midterm Exam
When grading tonsils, a score of 3+ indicates: Answer: C
A. Tonsils are visible only with tongue blade Rationale: 3+ tonsils extend to and touch the uvula, suggesting significant
B. Tonsils are halfway between tonsillar pillars and uvula enlargement
C. Tonsils touch the uvula
D. Tonsils are hidden behind the pillars
Which cranial nerve is responsible for the sense of Answer: A
smell? Rationale: Cranial nerve I (olfactory) transmits smell information from the nose to
A. CN I the brain.
B. CN II
C. CN V
D. CN X
A positive Phalen's test is indicative of: Answer: C
A. De Quervain's tenosynovitis Rationale: Phalen's test reproduces symptoms of median nerve compression in
B. Lateral epicondylitis carpal tunnel syndrome
C. Carpal tunnel syndrome
D. Rheumatoid arthritis
Which heart sound is commonly heard in uncontrolled Answer: D
hypertension? Rationale: S4 is associated with stiff ventricles and is often heard in long-
A. S1 standing hypertension.
B. S2
C. S3
D. S4
Which is an example of an open-ended question? Answer: C
A. Do you have chest pain? Rationale: Open-ended questions encourage the patient to elaborate.
B. Is the pain sharp or dull?
C. Can you describe what you are feeling?
D. Is it worse with exertion?
When assessing the carotid pulse, where should the Answer: B
examiner place their fingers? Rationale: The carotid pulse is best felt just lateral to the trachea.
A. At the angle of the mandible
B. Lateral to the trachea at the level of the thyroid
cartilage
C. Over the sternocleidomastoid muscle
D. At the suprasternal notch
Which finding is consistent with a benign lymph node? Answer: B
A. Hard and fixed Rationale: Benign lymph nodes are usually mobile, soft to firm, and not fixed.
B. Firm and mobile
C. Tender and fixed
D. Rubber-like and non-mobile
Which skin lesion is most characteristic of basal cell Answer: B
carcinoma? Rationale: Basal cell carcinoma often appears as a pearly papule with visible
A. Scaly red patch surface blood vessels
B. Pearly papule with telangiectasia
C. Firm nodule with central ulcer
D. Brownish plaque with irregular border
A patient with myxedema will most likely present with: Answer: B
A. Protruding eyeballs Rationale: Myxedema is a manifestation of severe hypothyroidism and causes a
B. Puffy face and coarse features puffy appearance.
C. Warm, moist skin
D. Tachycardia
The Weber test is used to: Answer: B
A. Compare bone and air conduction Rationale: The Weber test checks for sound lateralization in cases of hearing
B. Detect lateralization of sound loss.
C. Assess hearing loss in infants
D. Test auditory acuity
Which of the following is characteristic of macular Answer: C
degeneration? Rationale: Macular degeneration primarily affects the central visual field.
A. Peripheral vision loss
B. Halos around lights
C. Central vision loss
D. Tunnel vision
