Midterm Exam: NR509 / NR 509 (Latest
Version ) Advanced Physical
Assessment | Questions & Correct Answers |
100% Correct | Grade A - Chamberlain
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 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.
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.
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 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?
Version ) Advanced Physical
Assessment | Questions & Correct Answers |
100% Correct | Grade A - Chamberlain
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 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.
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.
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 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?
