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NR511 FINAL EXAM ACTUAL EXAM COMPLETE
QUESTIONS ND DETAILED ANSWERS|ALREADY
GRADED
...responded to antibiotic therapy. Which of the following actions should be taken next? a. send a urine specimen for microscopy looking for fungal colonies b. increase the dose of the antibiotic c. order a cystoscopy d. order a different antibiotic Correct Ans- a. send a urine specimen for microscopy looking for fungal colonies A 14 year old is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? a. obtain a scrotal ultrasound b. obtain a computed tomography scan (CT) c. instruct the patient to elevate the scrotum d. send the patient to the Emergency room Correct Ans- c. instruct the patient to elevate the scrotum d. send the patient to the Emergency room
A 22 year 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 shoud be included in the differential diagnosis. a. testicular cancer b.. inguinal hernia c. varicocele d. all of the above Correct Ans- d. all of the above A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? a. very early b 3-4 hours after perforation c. late in inflammation d. appendicitis never presents with vague pain Correct Ans- a. very early A 23 year old sexually active man is seen in the clinic with unilateral painful testicular swelling and diagnosed with epididymitis. In order to prescribe the correct drub, the clinician understands that which of these is them most common causative organism? a. escheichia coli b. staphylococcus aureus
A 28 year old patient is seen in the office with colicky abdominal pain, particularly with meals. She has frequent constipation, flatulence and abdominal distention. Which of the data makes a diagnosis of diverticulitis unlikely? a. her age b. frequent constipation c. flatulence d. colicky abdominal pain Correct Ans- a. her age A 28 year old patient is seen with complaints of diarrhea. Which of the following questions would help the clinician establish the diagnosis of irratible bowel syndrome? a. Feels relief after a bowel movement b. sometimes is constipated c. does not defecate in the middle of the night d. all of the above Correct Ans- d. all of the above A 30 year old patient presents with pain on urination. The urine microscopy of unspun urine showed greater than 10 leukocytes/ml and a dipstick was possible for nitrates. What is the probable diagnosis? a. lower urinary tract infection b. chlamydia infection
c. candidiasis d. pyelonephritis Correct Ans- b. chlamydia infection A 42 year old woman is seen in the clinic with fever, chills, vomiting and severe dysuria. She is diagnosed with acute pyelonepritis. How should this patient be managed? a. 3 day course of oral antibiotics b. hospitalization Correct Ans- b. hospitalization A 63 year old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis? a. Psychogenic nocturia b. Urethral polyp c. Irritative posterior urethral lesion d. Benign prostatic hypertrophy Correct Ans- d. Benign prostatic hypertrophy A 76 year old man is seen in the office for complaints of urinary incontinence. The clinican should suspect which of these causes of incontinence in men? a. urethral polyps
A patient is diagnosed with Giardia after backpacking trip in the mountains. Which of the following would be the appropriate treatement? a. Vancomycin b. Penicillin c. Metronidazole d. Bactrim Correct Ans- c. Metronidazole A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinican expect as a manifestation of the disease? a. sinus bradycardia b. atrial fibrillation c. supraventricular tachycardia d. U-waves Correct Ans- a. sinus bradycardia A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that may cause hematuria a. NSAIDS b. Beets c. Vitamin A d. Red meat Correct Ans- a. NSAIDS
A patient is seen in the clinic with right upper quadrant pain (RUQ) that is radiating to the middle of the back. The clinical suspects acute cholelithasis. The clinician should expect with of the following laboratory findings? a. Decreased alanine anminotransferase (ALT) and aspartate aminotransferase (AST) b. elevated alkaline phosphatase c. elevated indirect biliruben d. decreased white blood cell (WBC) count Correct Ans- b. elevated alkaline phosphatase A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting and diaphoresis. In addition to nephrolithasis, which of the following should be added to the list of differential diagnosis a. Pancreatitis' b. peptic ulcer disease c. diverticulitis d all of the above Correct Ans- d all of the above A patient presents with the following signs and symptoms: gradual onset of low grade fever, marked fatigue, severe sore throat and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause?
All students are subject to review of clinical logs to ensure that they have received a well-rounded experience a. true b. false Correct Ans- a. true An 82 year old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differentials? a. BPH b. Prostate cancer c. UTI d. all of the above Correct Ans- d. all of the above As diabetic retinopathy progresses, the presence of "cotton wool" spots can be detected. Cotton wool spots refer to: a) Venous beading. b) Retinal hemorrhage. c) Nerve fiber layer infarctions. d) Blood vessel proliferation Correct Ans- c) Nerve fiber layer infarctions. Cat bites are commonly associated with which of the following pathogens?
a. pasteurella multocida b. vibri vulnificus c. group B streptococcus d. Group A beta hemolytic streptococcus Correct Ans- a. pasteurella multocida Cydney was just diagnosed with mild, intermittant asthma. Which if the most appropriate medication for her? a. short acting beta-agonist as needed b. short acting beta-agonist twice a day c. long acting beta agonist as needed d. long acting beta agonist twice a day Correct Ans- a. short acting beta-agonist as needed Endoscopic report reveals the presents of Barrett's epithelium. Which of the following information should the clinician include in the explaination of the pathology report? a. this is a premalignant tissue b. this tissue is resistant to gastric acid c. this tissue supports healing of the esophagus d. all of the above Correct Ans- d. all of the above
Ian, age 62, presents with a wide, diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect: a. Necrotizing fasciitis. b. Kaposi's sarcoma. c. Cellulitis. d. A diabetic ulcer. Correct Ans- c. Cellulitis. 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 and they meet the minimum preceptor qualifications. a. true a. false Correct Ans- a. false In which of the following situations would referral to a specialist be needed for sinusitis a. recurrent sinusitis b. allergic sinusitis c. sinusitis that is refractory to antibiotic therapy d. all of the above Correct Ans- d. all of the above
Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspician of cauda equna compression. Which of the following is a sign or symptom of cauda equina compression? a. gastrocnemius weakness b. reduced or absent ankle refles c. numbness of the lateral foot d. paresthesia of the perineum and buttocks Correct Ans- d. paresthesia of the perineum and buttocks Jason, aged 62, has obstructive sleep apnea. What do you think is one of his contributing factors? a. He is a recovering alcoholic of 6 years. b. His collar size is 19 inches. c. He is the only person in his family who has this. d. He is extremely thin. Correct Ans- b. His collar size is 19 inches. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and 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?
a. valgus stress test b. McMurray circumduction test c. Lachman's test d. Varus stress test Correct Ans- b. McMurray circumduction test Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition? a. there are round hypopigmented macules on his back b. there are red papules on his face c. there are crusted placques in Josh's groin area d. there are white streaks on his neck Correct Ans- a. there are round hypopigmented macules on his back Joyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable, and that her hair will not hold a curl anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis could be which of the following?
- Myxedema
- Cushing's Syndrome
- Pan-hypopituitism
- Thyrotoxicosis Correct Ans- • Thyrotoxicosis
Joyce is taking a long-acting beta agonist for her moderate persistent asthma. What additional medication should she be taking? a. Inhaled corticosteroid (Flovent) b. Leukotriene receptor antagonist c. Systemic corticosteroid (Prednisone) d. Methyl xanthenes (Theophylline Correct Ans- a. Inhaled corticosteroid (Flovent) Most nosocomial pneumonias are caused by: a. Fungi. b. Viruses c. Gram-negative bacteria. d. Pneumococcal pneumonia. Correct Ans- c. Gram-negative bacteria. Mrs. Gary is a 55 year old woman who presents with tightness, pain and limited movement in her right shoulder. She denies any history of trauma. Her exam reveals a 75% reduction in both active and passive range of motion of the right shoulder. Mrs. Gray is also experiencing tenderness with motion and pain at the deltoid insertion. HEr medical history is significant for type 1 DMm and HTN. HEr social history reveals that she is a secretary ant that she is right handed. Based on her exam and medical history, you suspect adhesive capulitis or "frozen shoulder" Which clue in Mrs. Grays history supports the diagnosis? a. history of hypertension b. her affected shoulder is also her dominant hand
d. medication induced tremor Correct Ans- a. resting tremor Preceptors must always see the patients that the students see in the clinical setting a. true b. false Correct Ans- a. true 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. a favorable diagnostic trend b. disease progression c. the need to be more aggressive with Reuben's medications d. the eradication of the HIV Correct Ans- a. a favorable diagnostic trend Sally, aged 25, presents with impetigo that has been diagnosed as infected with staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. She has not been adequately treated recently. Which type of impetigo is this? a. Bullous impetigo b. Staphylococcal scalded skin syndrome (SSSS) c. Nonbullous impetigo d. Ecthyma Correct Ans- d. Ecthyma
Sam is a 25-year-old man 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? a. morning stiffness and limited mobility of the lumbar spine b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. pathologic fractures, severe night pain, weight loss and fatigue Correct Ans- b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Severe pain associated with acute otitis media signifies perforation of the tympanic membrane. a. true b. false Correct Ans- b. false Sinusitis is considered when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater then:
