NR 511 Week 8 Exam
Question 1. The most cost-e?ective screening test for determining HIV status is which of the following?
Western blot
Enzyme-linked immunosorbent assay
Venereal Disease Research Laboratory test
Viral load
Question 2. Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?
Erythrocyte sedimentation rate
White blood cell count Polymorphonuclear cells
C-reactive protein (CRP)
Question 3. Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?
GABA Acetylcholine Dopamine Serotonin
Question 4. Mrs. Thomas was seen in the o?ce complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that di?erentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:
Ecchymosis, edema, and erythema over the
lateral epicondyle
Pain at the elbow with resisted movements at the wrist and forearm
Inability to supinate and pronate the arm
Inability to flex or extend the elbow against resistance
Question 5. Which of the following statements concerning the musculoskeletal examination is true?
The uninvolved side should be examined initially and then compared to the involved side.
The part of the body that is causing the patient pain should be examined first.
When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.
Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
Question 6. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
Decreased C-reactive protein
Hyperalbuminemia Morning sti?ness Weight gain
Question 7. Which causes the greatest percentage of mammalian bites?
Dogs Cats
Humans Rodents
Question 8. A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first?
Transvaginal ultrasound
Endometrial biopsy MRI
Abdominal computed tomography scan
Question 9. A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?
"Control of glucose will help postpone or delay
complications."
"Regularly checking blood sugar will help establish a routine."
"Monitoring glucose will promote a sense of control." All of the above
Question 10. A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular sti?ness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?
Serum calcium TSH Electrolytes
Urine specific gravity
Question 11. Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?
Insulin Metformin Glucotrol Precose
Question 12. During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
An enlarged rubbery gland
A hard irregular gland A tender gland
A boggy gland
Question 13. Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step?
Remove the insect with tweezers.
Immobilize the insect with 2% lidocaine. Sedate Eddie with diazepam.
Shine a light in the ear for the insect to "find its way out."
Question 14. What is the most common cause of microcytic anemia?
Anemia of chronic disease
Sideroblastic anemia Iron-deficiency anemia Thalassemia
Question 15. An 82-year-old man is seen in the primary care o?ce with complaints of dribbling urine and di?culty starting his stream. Which of the following should be included in the list of di?erential diagnoses?
Benign prostatic hyperplasia (BPH)
Parkinson's disease Prostate cancer
All of the above
Question 16. Early rheumatoid disease is characterized by:
Pain and swelling in both small and large
peripheral joints
Rigid joints with diminished range of motion Joint swelling and immobility on rising
A cardiac rub or pulmonary friction rub
Question 17. A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity.
Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do?
Make an immediate referral for an orthopaedic evaluation without further assessment.
Tell her that it takes time for these bruises to improve, so she should be patient.
Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.
Send her to the emergency room for reduction of this obvious wrist fracture.
Question 18. The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:
1 month 3
months 6 months
12 months
Question 19. A 60-year-old man presents with an enlarged scrotum. The
clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?
The scrotum will be dark.
The scrotum will appear light pink or yellow. The scrotum will appear milky white.
The internal structures will be clearly visible.
Question 20. According to Kübler-Ross, the stages of grief occur in which order?
Anger, denial, depression, bargaining, acceptance
Anger, denial, bargaining, acceptance, depression Denial, anger, depression, bargaining, acceptance Denial, anger, bargaining, depression, acceptance
Question 21. Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?
A favorable prognostic trend
Disease progression
The need to be more aggressive with Reuben's medications
The eradication of the HIV
Question 22. The exanthem of Lyme disease is: Erythema infectiosum
Laterothoracic exanthem Erythema migrans Morbilli exanthem
Question 23. You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:
Articular Inflammatory Nonarticular A and B
Question 24. What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?
1,200 mg/day 1,000
mg/day 1,300 mg/day
1,500
mg/day
Question 25. When assessing a woman for infertility, which of the following tests should be done first?
Analysis of partner's sperm
Magnetic resonance imaging (MRI) Hysterosalpingogram
Estrogen level
Question 26. Which type of burn injury results in destruction of the
epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
Superficial burns
Superficial partial-thickness burns Deep partial-thickness burns
Full-thickness burns
Question 27. A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?
Human papillomavirus (HPV)
Endometrial hyperplasia Vagismus
Polycystic ovarian syndrome
Question 28. As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?
Two Three Four Five
Question 29. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological 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?
Morning sti?ness and limited mobility of the lumbar spine
Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
Fever, chills, and elevated erythrocyte sedimentation rate
Pathologic fractures, severe night pain, weight loss, and fatigue
Question 30. A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?
Testosterone level Prostate-specific antigen
Nocturnal penile tumescence and rigidity Prolactin level
Question 31. The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been e?ective?
"I'll take my pill at least 30 minutes before breakfast."
"I'll take my Glucotrol before bedtime."
"It is important to take my medication right after I eat." "Since I only like to eat two meals a day, I can take the pill
between my meals."
Question 32. In the United States, what is the second most common connective tissue disease and the most destructive to the joints?
Osteoarthritis
Systemic lupus erythematosus (SLE) Rheumatoid arthritis Sjögren's
syndrome
Question 33. The e?ectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?
Acetylcholine
Gamma-aminobutyric acid (GABA) Dopamine
Serotonin
Question 34. A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?
Refer to a urologist immediately.
Obtain a computed tomography (CT) scan. Instruct the patient to elevate the scrotum. Prescribe ibuprofen.
Question 35. Which of the following medications can cause hyperglycemia?
Prednisone Metformin Synthroid Cephalexin
Question 36. During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?
IV
Abdomen
Upper lateral thigh Deltoid
Question 37. It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?
Before the initiation of treatment
1 to 2 weeks after the initiation of treatment When switching to a di?erent medication
1 to 2 weeks after tapering o? medications
Question 38. What is the most common cause of secondary amenorrhea?
Pregnancy
Pituitary dysfunction Inadequate estrogen levels Genetic disorders
Question 39. Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?
Sertraline Fluoxetine Citoprolam Imipramine
Question 40. The goals of the 15-minute hour approach include: Enhance self-esteem, expand behavioral repertoire,
prevent dire consequences, and reestablish premorbid
levels of functioning
Emerge with a higher level of functioning and commitment to long-term psychotherapy Accept need for antidepressant therapy and
psychiatric referral; share concerns with primary care clinician
Improve family functioning and sexual performance as well as accept need for antidepressant medication
Question 41. 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 and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and 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?
Valgus stress test
McMurray circumduction test Lachman test
Varus stress test
Question 42. The cardinal subjective symptom of sickle cell crisis is which of the following?
Pain Nausea
Light-headedness Palpitations
Question 43. A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea?
Pelvic inflammatory disease
Endometriosis
Sexually transmitted infections Ovarian cyst
Question 44. Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue?
Tick
Brown recluse spider Wasp
Stinging caterpillar
Question 45. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?
Gastrocnemius weakness
A reduced or absent ankle reflex Numbness in the lateral foot
Paresthesia of the perineum and buttocks
Question 46. A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive?
Pregnancy test
Complete blood cell count Thyroid-stimulating hormone Urine dip for protein
Question 47. A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?
Ketoacidosis Cirrhosis
Hypoglycemic episodes All of the above
Question 48. The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?
SSRIs are more e?ective than TCAs.
SSRIs take less time to work than TCAs.
SSRIs have a more favorable side-e?ect profile than TCAs.
SSRIs are not lethal in overdose.
Question 49. Which type of bone marrow transplant is obtained from an identical twin?
Autogenic Autologous Allogeneic Syngeneic
Question 50. Pink, cherry red tissues and skin may result from which type of poisoning?
Arsenic Lead
Carbon monoxide Strychnine
Question 51. Basic human needs are identified as: Autonomy and feeling valued by others
Exhilaration and productivity Spirituality
Career success and material rewards
Question 52. The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?
Overweight Mild obesity
Moderate obesity Morbid obesity
53. A 22-year-old male is seen in the clinic because he found a
hard lump in his testicle when performing testicular self-
examination (TSE). Which of the following should be included in the list of di?erential diagnoses?
Testicular cancer Inguinal hernia Varicocele
All of the above
