,Herzing NU 623 Quiz 5 | Adult Healthcare (2026)
Q&A
1. Which laboratory test result is diagnostic for hypoglycemia?
A) A1c 7.0%
B) Fasting blood sugar of 75 mg/dL
C) Glucose level of 43 mg/dL
D) Random glucose level of 64 mg/dL
Correct Answer: C) Glucose level of 43 mg/dL
Rationale: A serum glucose level below 70 mg/dL is diagnostic for hypoglycemia. A level of
43 mg/dL is significantly below this threshold and confirms the diagnosis. An A1c of 7.0%
indicates poor glycemic control over time, not acute hypoglycemia. Fasting and random
glucose levels within or near normal range do not confirm hypoglycemia.
2. Which of the following statements concerning the musculoskeletal examination is true?
A) The part of the body that is causing the patient pain should be examined first
B) Radiographs should always be obtained prior to examination
C) When possible, the patient should not be asked to perform active ROM exercises to avoid
causing pain
D) The uninvolved side should be examined initially and then compared to the involved side
Correct Answer: D) The uninvolved side should be examined initially and then compared to
the involved side
Rationale: The uninvolved side should always be examined first to establish a baseline for
normal findings, which allows for accurate comparison and identification of abnormalities on
the involved side. Examining the painful area first can cause unnecessary discomfort and may
limit the patient's cooperation for the remainder of the exam.
,3. A patient presents with pain, tenderness, erythema, and swelling of the left great toe. The
clinician suspects acute gout. Which of the following is the most appropriate initial diagnostic
test?
A) Serum uric acid level
B) Synovial fluid analysis for urate crystals
C) X-ray of the foot
D) Complete blood count
Correct Answer: B) Synovial fluid analysis for urate crystals
Rationale: The gold standard for diagnosing acute gout is the identification of monosodium
urate crystals in synovial fluid obtained from the affected joint. While serum uric acid may be
elevated during a flare, it can also be normal, making it less definitive. X-rays may show
chronic changes but are not diagnostic in the acute setting.
4. A 55-year-old patient presents with a 3-month history of gradually worsening low back
pain that radiates down the right leg. The pain is exacerbated by sitting and relieved by
standing or walking. Which of the following is the most likely diagnosis?
A) Lumbar spinal stenosis
B) Herniated lumbar disc
C) Sacroiliac joint dysfunction
D) Osteoarthritis of the lumbar spine
Correct Answer: A) Lumbar spinal stenosis
Rationale: Lumbar spinal stenosis typically presents with neurogenic claudication—pain that
worsens with sitting (flexion) and improves with standing or walking (extension). This
contrasts with vascular claudication, which improves with rest. A herniated disc typically
causes pain that worsens with sitting and improves with standing, but it is often more acute.
5. A 62-year-old patient with type 2 diabetes mellitus presents with a 2-day history of
progressive confusion, lethargy, and polyuria. The patient's blood glucose is 920 mg/dL,
, serum osmolality is 340 mOsm/kg, and there are no ketones in the urine. Which of the
following is the most likely diagnosis?
A) Diabetic ketoacidosis (DKA)
B) Hyperglycemic hyperosmolar state (HHS)
C) Hypoglycemia
D) Lactic acidosis
Correct Answer: B) Hyperglycemic hyperosmolar state (HHS)
Rationale: HHS is characterized by severe hyperglycemia (>600 mg/dL), hyperosmolality
(>320 mOsm/kg), and the absence of significant ketosis. It typically occurs in older adults
with type 2 diabetes and presents with gradual onset of confusion and lethargy. DKA presents
with ketones and acidosis, hypoglycemia presents with low glucose, and lactic acidosis is
associated with tissue hypoperfusion.
6. A 45-year-old male presents with a painful, swollen right knee following a twisting injury
during a basketball game. On examination, there is joint effusion and instability. Which of the
following is the most likely diagnosis?
A) Osteoarthritis
B) Gout
C) Anterior cruciate ligament (ACL) tear
D) Rheumatoid arthritis
Correct Answer: C) Anterior cruciate ligament (ACL) tear
Rationale: ACL tears are common sports injuries, particularly in activities involving sudden
stops or direction changes. They present with acute pain, swelling, and joint instability.
Osteoarthritis is a degenerative condition, gout is typically acute but associated with
metabolic factors, and rheumatoid arthritis is a chronic inflammatory condition.
7. A 68-year-old female presents with bilateral knee pain that is worse with activity and
improves with rest. She reports morning stiffness lasting less than 30 minutes. Which of the
following is the most likely diagnosis?
Q&A
1. Which laboratory test result is diagnostic for hypoglycemia?
A) A1c 7.0%
B) Fasting blood sugar of 75 mg/dL
C) Glucose level of 43 mg/dL
D) Random glucose level of 64 mg/dL
Correct Answer: C) Glucose level of 43 mg/dL
Rationale: A serum glucose level below 70 mg/dL is diagnostic for hypoglycemia. A level of
43 mg/dL is significantly below this threshold and confirms the diagnosis. An A1c of 7.0%
indicates poor glycemic control over time, not acute hypoglycemia. Fasting and random
glucose levels within or near normal range do not confirm hypoglycemia.
2. Which of the following statements concerning the musculoskeletal examination is true?
A) The part of the body that is causing the patient pain should be examined first
B) Radiographs should always be obtained prior to examination
C) When possible, the patient should not be asked to perform active ROM exercises to avoid
causing pain
D) The uninvolved side should be examined initially and then compared to the involved side
Correct Answer: D) The uninvolved side should be examined initially and then compared to
the involved side
Rationale: The uninvolved side should always be examined first to establish a baseline for
normal findings, which allows for accurate comparison and identification of abnormalities on
the involved side. Examining the painful area first can cause unnecessary discomfort and may
limit the patient's cooperation for the remainder of the exam.
,3. A patient presents with pain, tenderness, erythema, and swelling of the left great toe. The
clinician suspects acute gout. Which of the following is the most appropriate initial diagnostic
test?
A) Serum uric acid level
B) Synovial fluid analysis for urate crystals
C) X-ray of the foot
D) Complete blood count
Correct Answer: B) Synovial fluid analysis for urate crystals
Rationale: The gold standard for diagnosing acute gout is the identification of monosodium
urate crystals in synovial fluid obtained from the affected joint. While serum uric acid may be
elevated during a flare, it can also be normal, making it less definitive. X-rays may show
chronic changes but are not diagnostic in the acute setting.
4. A 55-year-old patient presents with a 3-month history of gradually worsening low back
pain that radiates down the right leg. The pain is exacerbated by sitting and relieved by
standing or walking. Which of the following is the most likely diagnosis?
A) Lumbar spinal stenosis
B) Herniated lumbar disc
C) Sacroiliac joint dysfunction
D) Osteoarthritis of the lumbar spine
Correct Answer: A) Lumbar spinal stenosis
Rationale: Lumbar spinal stenosis typically presents with neurogenic claudication—pain that
worsens with sitting (flexion) and improves with standing or walking (extension). This
contrasts with vascular claudication, which improves with rest. A herniated disc typically
causes pain that worsens with sitting and improves with standing, but it is often more acute.
5. A 62-year-old patient with type 2 diabetes mellitus presents with a 2-day history of
progressive confusion, lethargy, and polyuria. The patient's blood glucose is 920 mg/dL,
, serum osmolality is 340 mOsm/kg, and there are no ketones in the urine. Which of the
following is the most likely diagnosis?
A) Diabetic ketoacidosis (DKA)
B) Hyperglycemic hyperosmolar state (HHS)
C) Hypoglycemia
D) Lactic acidosis
Correct Answer: B) Hyperglycemic hyperosmolar state (HHS)
Rationale: HHS is characterized by severe hyperglycemia (>600 mg/dL), hyperosmolality
(>320 mOsm/kg), and the absence of significant ketosis. It typically occurs in older adults
with type 2 diabetes and presents with gradual onset of confusion and lethargy. DKA presents
with ketones and acidosis, hypoglycemia presents with low glucose, and lactic acidosis is
associated with tissue hypoperfusion.
6. A 45-year-old male presents with a painful, swollen right knee following a twisting injury
during a basketball game. On examination, there is joint effusion and instability. Which of the
following is the most likely diagnosis?
A) Osteoarthritis
B) Gout
C) Anterior cruciate ligament (ACL) tear
D) Rheumatoid arthritis
Correct Answer: C) Anterior cruciate ligament (ACL) tear
Rationale: ACL tears are common sports injuries, particularly in activities involving sudden
stops or direction changes. They present with acute pain, swelling, and joint instability.
Osteoarthritis is a degenerative condition, gout is typically acute but associated with
metabolic factors, and rheumatoid arthritis is a chronic inflammatory condition.
7. A 68-year-old female presents with bilateral knee pain that is worse with activity and
improves with rest. She reports morning stiffness lasting less than 30 minutes. Which of the
following is the most likely diagnosis?
