"Instability in interpersonal relations, self-image, and affective regulation; impulsivity" describes which personality
disorder?
A. Borderline
B. Histrionic
C. Antisocial
D. Narcissistic - Correct Answer A. Borderline
A 21-year-old carwash attendant sustained a laceration to the ulnar aspect of his mid-forearm while at work last
week. He did not have it evaluated at that time and is now noticing purulent discharge and increasing pain from
the wound along with fever and chills. In which lymph nodes would the advanced practice registered nurse (APRN)
expect to find
the first signs of lymphadenopathy?
A. Lateral axillary
B. Cervical chain
C. Infraclavicular
D. Epitrochlear - Correct Answer D. Epitrochlear
First nodes in drainage region from ulnar surface of forearm and hand and some fingers
All other options are distal to this area and would show secondary lymphadenopathy
A 25-year old male presents for his annual exam. His BMI is 22.0, but he is concerned about his weight. What is the
most appropriate response?
A. Reassure the patient his weight is normal.
B. Refer the patient to a nutritionist because he is anorexic.
C. Provide the patient with information about weight loss because he is overweight.
D. Refer the patient to a nutritionist because he is obese. - Correct Answer A. Reassure the patient his weight is
normal.
Normal BMI range 18.5-24.5.
A 26-year old female presents to the office with unilateral pain during chewing which is chronic. She does not have
facial tenderness or tenderness of the scalp The APRN suspects:
A. trigeminal neuralgia
B. TMJ syndrome
C. temporal arteritis
D. tumor of mandible - Correct Answer B. TMJ syndrome
Review Bates P. 645
A 27-year-old professional tennis player presents to the office with left shoulder pain after playing in a
tournament this weekend. The patient has supraspinatus weakness on abduction, infraspinatus weakness during
external rotation, a positive impingement sign and a positive drop-arm test. The advanced practice registered
nurse suspects:
A. Bicipital tendinitis
B. Adhesive tendinitis
C. Acromioclavicular arthritis
D. Rotator cuff tear - Correct Answer D. Rotator cuff tear
, A 29-year-old football player presents with right knee pain after a game. The patient relates hyperextending his
knee and then receiving a direct blow to the knee with a tackle. On examination of the right knee, the advanced
practice registered nurse (APRN) notes a forward jerk showing the contours of the upper tibia when testing the
anterior drawer sign, and significant forward excursion with a Lachman Test. The APRN suspects a tear in the:
A.PCL
B. ACL
C. MCL
D. LCL - Correct Answer B. Anterior cruciate ligment (ACL)
Review P. 689-690
A 31-year-old day care worker presents with a worsening stiff, painful neck. On inspection, the patient's head is
laterally deviated toward the shoulder and rotated. At this point of the examination, what is the most likely
diagnosis?
A. Osteoarthritis
B. Spondylolisthesis
C. Ankylosing spondylitis
D. Torticollis - Correct Answer D. Torticollis
Characteristic signs are head rotation and lateral deviation
B - slippage between vertebrae
C/D - do not cause lateral deviation
A 33-year-old female presents with a history of weight gain, decreased energy, and menorrhagia over the past
several months. Review of her family history reveals Hashimoto thyroiditis and hypothyroidism in four female
first-degree relatives (her mother and three sisters). Which of the following skin findings best supports a
diagnosis of clinical hypothyroidism?
A. Dry skin, myxedem, alopecia of eyebrows, brittle nails
B. Thickened, taut skin with sclerodactyly and teangiectasia
C. Warm moist skin, hyperpigmentation, and pretibial myxedema
D. Discoid rash, alopecia, oral ulcers, and Raynaud phenomenon - Correct Answer A. Dry skin, myxedema, alopecia
of eyebrows and brittle nails
D - SLE
C - hyperthyroid
B - CREST syndrome
A 45-year-old female presents acutely with respiratory distress, and the advanced practice registered nurse
(APRN) intends to draw an arterial blood gas (ABG). Prior to drawing the ABG, the APRN will perform which test
to ensure the patency of the ulnar artery prior to puncturing the radial artery?
A. Trendelenberg test
B. Allen test
C. Tinel's test
D. Phalen's test - Correct Answer B. Allen test
Review P. 529-530
A 48-year-old female presents to the clinic with the chief complaint of her head being "stuck" to one side. She
says that today she was doing her normal routine when it suddenly felt like her head was being moved to her left
and then it just stuck that way. She says it is somewhat painful because she cannot get it moved back to normal.
She denies any recent neck trauma. Her past medical history consists of type 2 diabetes and gastroparesis. She
is on oral medications for each. On examination the advanced practice registered nurse (APRN) notes the
patient's head is twisted grotesquely to the left but otherwise her examination is normal. The APRN should
document what form of involuntary movement for this patient?
A. Athetosis
B. Chorea