NR_511_FINAL EXAM UPDATE

NR_511_FINAL EXAM UPDATED 1: which test is used to confirm a diagnosis of epididymitis? Answer: Ultrasound of the scrotum. 2: Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? Answer; High fiber diet 3: Reuben, age 24 years old has HIV & just had a routine viral load test done. The results show a falling viral load. What does this indicates? Answer: A favorable diagnostic trend 4: The patient with gastro esophageal reflux disease (GERD) should be instructed to eliminate which of these activities? Answer: Weight lifting 5: you have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion with both active & passive movement. These findings suggest that the origin of the musculoskeletal complaint is Answer: Articular 6: A 25 years old patient presents to the clinic with fatigue, cold intolerance, weight gain & constipation for the past 3 months. On physical exam, the clinician notice a sinus bradycardia, muscular stiffness, coarse, dry hair, & a delay in relaxation in deep tendon reflexes (DTRs). Which of the following test should be ordered next? Answer: Thyroid Stimulating Hormone (TSH) 7: Sam is a 25years old man who has been diagnosis with low back stain based on his history of localized low back pain & muscle spasm along with a normal numerological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Answer: Unilateral radicular pain symptoms that extend below the knee & are equal to or greater than the back pain. 8: Which of the following data is indication of testicular torsion? Answer: Asecnt cremasteric reflex 9: What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Answer: 1500mg /day 10: A 14 years old is seen with complaint of severe testicular pain. The clinician suspect testicular torsion. Which of the following is the appropriate action? Answer: Send the patient to the emergency room 11: Which of the following data are indicative of testicular torsion? Answer: Absent cremasteric reflex 12: A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, & diaphoresis, in addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? Answer: Pancreatitis, peptic ulcer disease, diverticulitis, All of the above 13: The patient is seen in the office complaining flank pain. The clinician should assess this patient for which risk factor for kidney stones? Answer: Hypertension 14: A 76 years old man is seen in the office for complaint of urinary incontinence. The clinician should suspect which causes of incontinence in men? Answer; Urinary Tract Infection (UTI) 14: Harvey has a rubbery smooth, round mass on his chest which is compressible & has a soft to to very firm texture. What do you diagnose this as? Answer: Lipoma 15: The patient is prescribed radioactive iodine (RA) & asks the clinician how this drug works. The clinician’s response should include which of the following data? Answer: RAI destroys thyroid tissue. 16: Most nosocomial pneumonias are caused by Answer: Gram-negative bacteria 17: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Answer: Morning stiffness. 18: A patient presents to the clinician with a sore throat, fever, of 100.7f & tender anterior cervical lymphadenopathy. The clinician suspect strep throat & performed a rapid strep test that is negative. What would the nest step be? Answer: A throat culture should be performed to confirm the result of the rapid strep test. 19:Most Nosocomial pneumonias are caused by……. Answer: ? 20: A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? Answer: Metrinidazole. 21: Which causes the greatest percentage of mammalian bites? Answer: Dog 22: One of the initial steps in assessing patient with musculoskeletal complaints is to determine whether the complaint is articular or non-articular in origin. Which of the following is an example of an articular structure? Answer: Synovium 23: Cat bites are commonly associated with which of the following pathogens? Answer: Pasteurella Multocida 24:Which of the following should be considered in a patient presenting with erectile dysfunction? Answer: DM, HTN, Atherosclerosis All of the above 25: Tori is on systemic antifungals for a tines infect. You underst& that serum labs monitored for Answer: Hepatotoxicity 26:Fluctuation & reductions in estrogen may be a contributing factor in which type of rhinitis? Answer: Vasomotor rhinitis 27: Severe pain associated with acute otitis media signifies perforation of the tympanic membrane Answer: False 28: The Patient is diagnosed with overactive bladder (OAB).Which of the following instructions should be given to the woman? Answer: Eliminate caffeine from your diet 29: Sally aged 25, present with impetigo that has been diagnosed as infected with staphylococcus. The clinical presentation in pruritic, tender, red vesicles surrounded y erythema with a rash that is ulcerating. Which types of impetigo is this? Answer: Ecthyma 30: Which of the following instructions should be given to the patient with nephrolithiasis? Answer: Take Ibuprofen 600mg every 8 hours 31: A 63 years old man is seen in the clinic with a chief complaint of nocturia . Which of the following should be included in the differential diagnosis? Answer: Benign prostatic hypertrophy 32: Which of the following are predisposing factors for pyelonephritis? Answer: Pregnancy 33: Which of the following statements is true regarding the treatment of carpal tunnel syndrome? Answer: All of the above ===34: A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? Answer: ? 35; Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than Answer: 12 weeks 36: A patient is seen in the clinic with right upper quadrant (RUQ) pain that is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician should expect which of the following laboratory findings? Answer; Elevated alkaline phosphatase 37: SNAPPS is pneumonic used to described a technique in orally presenting a patient Answer; True 38; The clinician is caring for Diane a 22 years old woman who presents with an injured ankle. Diane asks the clinician if she will need an X-ray. The clinician explains to Diane that X-ray is not always necessary for an injured ankle & that the decision to obtain radiographs is dependent on the exam & Diane’s description of her injury. Which of the following clues in Diane’s exam or history would alert the clinician to the need for obtaining radiography? Answer; All of above 39; The 56 years old man with chronic prostatitis should be treated with trimethoprim 80mg sulfamethoxazole 400mg (TMPSMX. Actrim) for how long? Answer: 6-12 weeks 40; A 23 years old sexually active man is seen in the clinic with unilateral painful testicular swelling & diagnosed with epididymitis in order to prescribe the correct drug the clinician underst&s that which of these is the most common causative organism? Answer: Chlamydia trachomatis 41; A 30 years old patient presents with pain on urination. The urine microscopy of unspun urine showed greater than leukocytes/ml & a dipstick was positive for nitrites What is probable diagnosis? Answer; Lower urinary tract infection 42: Acute angl-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure? Answer: 8 to 21mmHg 43: Joyce is taking a long-acting beta agonist for moderate persistent asthma. Which additional medication should she be taking? Answer; Inhaled corticosteroid (ie Flovent). 44: A patient is seen in the clinic with a chief complaint of hematuria. Which of the following data should be collected in order to make a differential diagnosis? Answer; What medications are you currently taking? 45; Which information should be included when you are teaching your patient about the use of nicotine gum? Answer; the gum must be correctly chewed to a softened state & then place in the buccal mucosa 46; Parkinson’s disease is a progressive neurological disorder that is associated with which type of tremor Answer; Resting tremor 47; If your preceptor is out ill on a day that you are scheduled to be in the clinical setting, another preceptor can supervise you as long as they are willing to take you on as a student & they meet the minimum preceptor qualifications Answer; False 48; A 42 years old woman is seen in the clinic with fever, chills vomiting, & severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be manged? Answer; Hospitalization 49; The “B” in the ABCDE’s of assessing skin cancer represents Answer; Border irregularity 50; Janet is a 30-year-old woman who has been recently with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equine compression. Which of the following is a sign or symptom of cauda equine compression? Answer; Paresthesia of the perineum & buttocks 51; A 34 year old patient was treated for a urinary tract infection (UTI) & has not responded to antibiotic therapy. Which of the following actions should be taken next? Answer; Send a urine specimen for microscopy looking for fungal colonies 52; Answer; Blood in urine & frequency 53: A patient is diagnosed with gastroesophageal reflux disease (GERD), & his endoscopic report reveals the presence of Barretts epithelium. Which of the following information should the clinician include in the explanation of the pathology Answer; This is a premalignant tissue, This tissue is resistant to gastric acid, This tissue supports healing of the esophagus: All of the above 54; Ian age 62 presents with a wide diffuse area of erythematous skin on his left lower leg that is warm & tender to palpation. There is some edema involved. You suspect Answer; Cellulitis 55; A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease? Answer; Sinus bradycardia 56; As diabetic retinopathy progress, the presence of “cotton wool” spots can be detected Cotton Wool spots refers to Answer; Nerve fiber layer infarction 57; which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD) Answer; Eliminate coffee 58; which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? Answer; Erysipelas 59; The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptom of pain & discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain? Answer; You should start with the lowest dose that is effective in managing your pain because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers & hemorrhage 60; Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria? Answer; Clostridium perfringens 61; The most common precancerous skin lesion found in CaucasiAnswer is Answer; Actinic Keratosis 62; The patient is seen complaining of “leaking urine when I sneeze” Which of the following action actions should the clinician take first? Answer; Instruct the patient on Kegel exercises 63; John is a 16 year old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee & then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred & has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? Answer; McMurray circumduction test 64; A 27 years old female presents with a chief complaint of burning & pain on urination. She has no previous history of urinary tracy infection(UTI) What are some additional symptoms consistent with a diagnosis of lower UTI? Answer: blood in urine & frequency 65; The patient is seen complaining of leaking urine when I sneeze ‘Which of the following actions should the clinician take first? Answer: Instruct the patient on kegel exercises. 66;Which obstructive lung diseases is classified as reversible? Answer: Asthma 67; Which of the following are risk factors associated with obesity? Answer: Diabetes, Skin infection, Arthritis: All of the above 68; The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following should the clinician order on the initial visit? Answer: Thyroid stimulating hormone (TSH) & free T4 69; The most common offending agents for medication- induced resting tremor are Answer: Anti-psychotics 70;the patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication? Answer: Closed angle Glaucoma 71;The pt presents with costovertebral angle (CVA) tenderness & a sveral day history of high fever & chills & dysuria. Which of the following diagnosis is most likely given the above information? Answer:Pyelonephritis 72; After 6 months of synthroid therapy, the clinician should expect which of the following in the repeated thyroid studies? Answer: Normal TSH 73; Which of the following pt are at risk for developing urinary tract cancer? All of the above. 74;The pt has acute pancreatitis with 7 of the diagnostic criteria from RAnsweron’s Criteria in order to plan care, the clinician underst&s that this criteria score has which of the following meanings? Answer: A high mortality rate 75; Mrs Gray is a 55-year-old woman who presents with lightness, pain & limited movement in her right shoulder. She denies any history of trauma. Her exam reveals a 75% reduction in both active & passive range of motion of the right shoulder. Mrs Gray is also experiencing tenderness with motion & pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus & hypertension. Her social history reveals that she is a secretary & that she is right-h&ed. Based on her exam & medical history you suspect adhesive capsulitis or: frozen shoulder” Which clue in Mrs. Gray’s history supports this diagnosis Answer: His history of diabetes mellitus 76; which of the following type of tremor is characterized by an increase in amplitude when the patient attempts voluntary movement Answer: Intention Tremor 77; Jennifer is an 18 years old girl who comes to the emergency room after a fall during a soccer games. Jennifer explains that she fell on her left side & kept her arm out straight to break her fall. She has been experiencing severe pain & limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? Answer: There is a risk of neurovascular & neurosensory trauma so the clinician should check for distal pulses. 78;The patient is diagnosed with urge incontinence. Before prescribing Detrol XL the provider should question the patient about which of these contraindications to this medication? Answer: ? 79; the A” in SNAPPS st&s for assessment Answer: False 80; the most cost effective screening test to determine HIV status is which of the following? Answer: Enzyme-linked immunosorbent assay (ELISA). 81; The clinician see a patient who is 5 feet tall & weighs 150 pounds (BMI 29.3). How would the clinician classify this patient? Answer: Overweight 82; The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? Answer HIV 83;Nathan a 32 years old policeman has a 15-pack year history of smoking & continue to smoke heavily. He gets irate during every visit when you try to talk to him about quitting. What should you do? Answer: Continue to ask him at every visit if he is ready yet. 84; which of the following test is considered the “gold st&ard” for definitively diagnosis osteoporosis? Answer: Bone mass density measurement by densitometry 85; You are performing muscle strength testing on a patient presenting with musculoskeletal pain & find that the patient has complete ange of motion with gravity eliminated. Which numeric grade of muscle strength would you give this patient? Answer: 2 86; Preceptors must always see the patients that the student sees in the clinical setting Answer: True 87;Jason; age 62 has obstructive sleep apnea. What do you think is one of his contributing factors? Answer: His collar size is 19inches 88; Treatment for epididymis includes which of the following? Answer: Scrotal elevation 89; Joyce is seen in the clinic complaining of vague symptoms of feeling nervous & irritable & that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat & brisk reflexes. The differential diagnosis should include which of the following conditions? Answer: Thyrotoxicosis 90; A 22 years old male is seen in the clinic because he found a hard lump in his testicle during a testicular self-exam (TSE). Which of the following should be included in the differential diagnosis? Answer: All of the above 91; All student are subject to review of clinical logs to ensure that they have received a well-rounded experience Answer True 92; Josh, aged 22 has tinea vesicolor. Which description is the most likely for this condition? Answer: There are round hypo pigmented macules on his back 93; A pt present with the following signs & symptoms gradual onset of low-grade fever, marked fatgue, severe score throat, & posterior cervical lymphadenopathy. Based on the signs & symptoms alone which patient the following conditions are most likely the cause? Answer: Mononucleosis 94; Cydney was just diagnosed with mild, intermittent asthma. Which is the most appropriate medication foe her? Answer: Short acting beta-agonist as needed 95; which is the differentiating symptom between labyrinthitis & vestibular neuritis? Answer: Hearing loss may be associated with labyrinthitis. But not with vestibular neuritis 96; An 86 years old woman is seen in the clinic for recurrent hematuria. The provider suspect bladder cancer. Which of the following information from the history would be considered a risk factor for this type of cancer? Answer: 65 years old smoking history 97; which of the following statement is true concerning the musculoskeletal exam? Answer: The uninvolved side should be examined initially & compared to the involved 98; The differential diagnosis for vertigo can be classified into which of the following categories Answer: Peripheral vestibular disease, CNC disorders, Systemic Disorders. All of the Above 99; Which statement about HIV post-exposure prophylaxis (PEP) for health-care workers is most accurate? Answer: PEP should be stated within hours after the exposure 100;Your patient has decided to give Chantix a try to quit smoking. You are discussing his quit date & he will begin taking the medication starting tomorrow. When should he plan to quit smoking? Answer: His quit date should be in 1 week. 101; An 82 years old man is seen in the primary care office with complaints of dribbling urine & difficulty starting his stream. Which of the following should be included in the list of differentials? Answer: All of the above 102;A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? Answer: Very early 103;In which of the following situations would referral to a specialist be needed for sinusitis? Answer All of the above