NUSING PATHO EXAM QUESTIONS WITH ANSWERS 2024 LATEST UPDATES WITH ASSURED SUCCESS, Exams of Pathophysiology

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NUSING PATHO EXAM QUESTIONS WITH ANSWERS

2024 LATEST UPDATES WITH ASSURED SUCCESS

Question 1

An 18-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis? Pityriasis rosea Psoriasis Atopic eczema Tinea versicolor

Question 2

A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis? Psoriasis Tinea versicolor Atopic eczema Pityriasis rosea

Question 3

You are examining a child with severe cerebral palsy. When you suddenly move his foot dorsally, a sustained “beating” of the foot against your hand ensues. What does this represent? Clonus Reinforcement A focal seizure Extinction

Question 4

A patient presents with a daily headache which has worsened over the past several months. On funduscopic examination, you notice that the disk edge is indistinct and the veins do not pulsate. Which is most likely? Detached retina Glaucoma Migraine Increased intracranial pressure

Question 5

A patient complains of epistaxis. Which other cause should be considered? Hematemesis

Hematoma of the nasal septum Intestinal hemorrhage Intracranial hemorrhage

Question 6

A patient complains of shortness of breath for the past few days. On examination, you note late inspiratory crackles in the lower third of the chest that were not present a week ago. What is the most likely explanation for these? Heart failure Asthma Bronchiectasis COPD

Question 7

You are excited about a positive test finding you have just noticed on physical examination of your patient. You go on to do more examination, laboratory work, and diagnostic tests, only to find that there is no sign of the disease you thought would correlate with the finding. This same experience happens several times. What should you conclude? Continue using the test, perhaps doing less laboratory work and diagnostics. Omit this test from future examinations.

Consider not doing this test routinely. Use this test when you have a higher suspicion for a certain correlating condition.

Question 8

A 50-year-old woman presents with a new complaint of headache. The patient states, “this is worst headache of my life”. Her concurrent conditions includes hypertension. Her history includes habitual ER visits for various complaints and panic attacks. Her most recent ER visit was last week. Today her BP is 200/110 with a HR of 95. Of the following diagnoses, which etiology has the highest priority? Migraine Subarachnoid hemorrhage Cluster Panic disorder

Question 9

A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his palms and notice that every few seconds his palms suddenly move toward the floor. What does this indicate? Metabolic problems Stroke Severe fatigue and weakness

Carpal tunnel syndrome

Question 10

A 29-year-old computer programmer comes to your office for evaluation of a headache. The tightening sensation is located all over the head and is of moderate intensity. It used to last minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He spends several hours each day at a computer monitor/keyboard. He has tried over-the-counter medication; it has dulled the pain but not taken it away. Based on this description, what is your most likely diagnosis? Analgesic rebound Migraine Cluster Tension

Question 11

A 62-year-old smoker complains of “coughing up small amounts of blood,” so you consider hemoptysis. Which other diagnoses should also be considered as an etiology for the complaint? Bruising of the tongue Intestinal bleeding Hematoma of the nasal septum Epistaxis

Question 12

You ask a patient to hold her arms up, with her palms up, and then to close her eyes. The right arm begins to move downward after a few seconds and her thumb rotates upward. This is most likely a problem with which part of the nervous system? Thalamus Dorsal root ganglion Spinothalamic tract Corticospinal tract

Question 13

When assessing for mitral stenosis, you should place the patient in what position? right lateral decubitus position squatting tripod position to enhance cardiac circulation left lateral decubitus position supine with head of bed elevated 30 degrees

Question 14

A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is normal. What diagnosis would you assign this patient? Perforation of the tympanum

Otitis externa Malignant otitis media Otitis media

Question 15

When assessing for nystagmus the nurse practitioner instructs the patient to: fix their gaze on a nearby object within 3-6 inches fix their gaze on an object located in the distance fix their gaze downward and quickly look up fix their gaze in the right and left peripheral fields

Question 16

A 58-year-old teacher presents to your clinic with a complaint of breathlessness with activity. The patient has no chronic conditions and does not take any medications, herbs, or supplements. Which of the following symptoms is appropriate to ask about in the cardiovascular review of systems? Hematochezia Abdominal pain Orthopnea

Question 18

0 / 2 pts

Wheezing

Question 17

Which is true of examination of the olfactory nerve? Allergies are unrelated to testing of this nerve. It is not tested for laterality. Diminished responses may be seen in otherwise normal elderly. The smell must be identified to declare a normal response. Loss of smell occurs in sinus conditions, head trauma, smoking, normal aging, use of cocaine, and Parkinson disease (p. 736). During the physical examination, which is the best position to place the patient when auscultating for S1, S2, and murmurs? Lying with the head of the bed elevated Leaning forward with the foot elevated Lying Supine Sitting

Question 19

For which of the following patients would a comprehensive health history be appropriate? A new patient with the chief complaint of “I sprained my ankle” A new patient with the chief complaint of “I am here to establish care” A new patient with the chief complaint of “I cut my hand” An established patient with the chief complaint of “I have an upper respiratory infection”

Question 20

Identify the abnormal assessment findings in this image. AV nicking

Vitreous floaters Cotton-wool patches Papilledema

Question 21

A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema and her father has high blood pressure. She is an only child. She denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. She is a junior in finance at a local university and she has recently started a job as a bartender in town. On examination she is in no acute distress and her temperature is 98.6. Her blood pressure is 120/80, her pulse is 80, and her respirations are

20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs. Which disorder of the thorax or lung does this best describe? Asthma Spontaneous pneumothorax Pneumonia Chronic obstructive pulmonary disease (COPD)

Question 22

A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true?

She can accurately name 20% of the letters at 20 feet. She can see at 100 feet what a normal person could see at 20 feet. She obtains a 20% correct score at 100 feet. She can see at 20 feet what a normal person could see at 100 feet.

Question 23

While examining a 43-year-old Hispanic female patient, you discover skin findings as represented in this image. She denies history of any known or diagnosed adult illnesses or medical conditions. What associated concurrent medical condition should you suspect?

Sjogren's syndrome Diabetes mellitus Systemic lupus erythematosus (SLE) Berger's disease

Question 24

Glaucoma is the leading cause of blindness in African-Americans and the second leading cause of blindness overall. What features would be noted on funduscopic examination? Cotton wool spots Increased cup-to-disc ratio Microaneurysms AV nicking

Question 25

A patient is examined with the ophthalmoscope and found to have red reflexes bilaterally. Which of the following diagnoses is still a potential concern? Cataract Detached retina Retinoblastoma

Question 26

Hypertensive retinopathy Absence of a red reflex suggests an opacity of the lens (cataract) or, possibly, the vitreous (or even an artificial eye). Less commonly, a detached retina or, in children, a retinoblastoma may obscure this reflex (p. 239). A 7-year-old boy is performing poorly in school. His teacher is frustrated because he is frequently seen “staring off into space” and not paying attention. If this is a seizure, it most likely represents which type? Absence Tonic–clonic seizure Pseudoseizure Myoclonus

Question 27

You have just asked a patient how he feels about his emphysema. He becomes silent, folds his arms across his chest and leans back in his chair, and then replies, “It is what it is.” How should you respond? “Okay, let's move on to your other problems.” “Next, I would like to talk with you about your smoking habit.” “You seem bothered by this question.”

“You have adopted a practical attitude toward your problem.”

Question 28

A college student presents with a sore throat, fever, and fatigue for several days. You notice exudates on her enlarged tonsils. You do a careful lymphatic examination and notice some scattered small, mobile lymph nodes just behind her sternocleidomastoid muscles bilaterally. What group of nodes is this? Submandibular Occipital Tonsillar Posterior cervical

Question 29

A 55–year-old smoker complains of chest pain and gestures with a closed fist over her sternum to describe it. Which of the following diagnoses should you consider because of her gesture? Angina pectoris Costochondritis Pericarditis Bronchitis

Question 30

A 65-year-old woman presents to the clinic with an eye complaint. The medical assistant documents the visual acuity: Corrected right 20/40; Corrected left 20/60; Bilateral 20/60. The nurse practitioner surmises the following: 20/60 represents the patient's actual visual acuity 20/60 represents normal vision for a 65 year old The patient sees in 60 feet what a person with normal vision would see in 20 feet The patient could read the 20/60 line with the left eye with glasses

Question 31

The following information is best placed in which category? “The patient has had three cesarean sections.” Psychiatric Surgeries Obstetrics/gynecology Adult illnesses

Question 32

A 17-year-old high school student is brought in to your emergency room in a comatose state. His friends have accompanied him and tell you that they have been shooting up heroin tonight and they think their friend may have had too much. The patient is unconscious and cannot protect his airway, so he is intubated. His heart rate is 60 and he is breathing through the ventilator. He is not posturing and he does not respond to a sternal rub. Preparing to finish the neurologic examination, you get a penlight. What size pupils do you expect to see in this comatose patient?

Irregularly shaped pupils Asymmetric pupils Dilated pupils Pinpoint pupils

Question 33

Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her regular provider is on vacation and she wanted to be seen. You have heard about her many times from your colleague and are aware that she is a very talkative person. Which of the following is a helpful technique to improve the quality of the interview for both the provider and the patient? Allow your impatience to show so that the patient picks up on your nonverbal cue that the appointment needs to end. Allow the patient to speak uninterrupted for the duration of the appointment. Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on one aspect of what she told you. Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of the interview.

Question 34

When using an interpreter to facilitate an interview, where should the interpreter be positioned? Between you and the patient so all parties can make the necessary observations

Behind you, the examiner, so that the lips of the patient and the patient's nonverbal cues can be seen Next to the patient, so the examiner can maintain eye contact and observe the nonverbal cues of the patient In a corner of the room so as to provide minimal distraction to the interview

Question 35

The following information is best placed in which category? “The patient was treated for an asthma exacerbation in the hospital last year; the patient has never been intubated.” Psychiatric Adult illnesses Obstetrics/gynecology Surgeries

Question 36

Suzanne, a 25 year old, comes to your clinic to establish care. You are the student preparing to go into the examination room to interview her. Which of the following is the most logical sequence for the patient–provider interview? Negotiate a plan, establish an agenda, invite the patient's story, and establish rapport. Invite the patient's story, negotiate a plan, establish the agenda, and establish rapport.

Greet the patient, establish rapport, invite the patient's story, establish the agenda, expand and clarify the patient's story, and negotiate a plan. Establish the agenda, negotiate a plan, establish rapport, and invite the patient's story.

Question 37

Which cranial nerve is being assessed by the examiner in this image? IX XI XII X

Question 38

A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a sudden onset of pain after lifting a set of boxes that were heavier than usual. He also states that he has numbness and tingling in the left leg. He wants to know if he needs to be off of work. What test should you perform to assess for a herniated disc? Heel-to-shin test Leg-length test Straight-leg raise Phalen's test

Question 39

When you enter your patient's examination room, his wife is waiting there with him. Which of the following is most appropriate? Ask if it's okay to carry out the visit with both people in the room. Ask his wife to leave the room for reasons of confidentiality. Carry on as you would ordinarily. The permission is implied because his wife is in the room with him. First ask his wife what she thinks is going on.

Question 40

You are testing the biceps strength in a young man following a spinal trauma from a motor vehicle accident. He cannot lift his hand upward, but if the arm is supported by the examiner and abducted to 90 degrees, he can then move his forearm side to side. This would represent which muscle strength grading?

Question 41

Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes, and it seems to be worse a couple of hours after eating. She has noticed that it starts after eating greasy foods, so she has cut down on these as much as she can. Initially it occurred once a week, but now it is occurring every other day. Nothing makes it better. From this description, which of the seven attributes of a symptom has been omitted? Associated manifestations Timing Quality Setting in which the symptom occurs

Question 42

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? Inflammation

Vascular Infection Allergic

Question 43

What is responsible for the inspiratory splitting of S2? Closure of aortic, then pulmonic valves Closure of aortic, then tricuspid valves Closure of mitral, then pulmonic valves Closure of mitral, then tricuspid valves

Question 44

A 19-year-old college sophomore comes to the clinic for evaluation of joint pains. The student has been back from spring break for 2 weeks; during her holiday, she went camping. She notes that she had a red spot, shaped like a target, but then it started spreading, and then the joint pains started. She used insect repellant but was in an area known to have ticks. She has never been sick and takes no medications routinely; she has never been sexually active. What is the most likely cause of her joint pain? Lyme disease Gonococcal arthritis

Psoriatic arthritis Rocky Mountain Spotted Fever

Question 45

You are performing a cranial nerve assessment of a 28-year-old female. She denies history of head injury or trauma. However, she has been treated in the past year for Lyme disease. Damage or inflammation of which of the following cranial nerves is demonstrated in this image? 6 CN IV CN VI

CN V

CN III

Question 46

The components of the health history include all of the following except which one? Personal and social items Thorax and lungs Present illness Review of systems

Question 47

Sudden, painful unilateral loss of vision may be caused by which of the following conditions? Central retinal artery occlusion Macular degeneration Optic neuritis Vitreous hemorrhage

Question 48

Mark is a contractor who recently injured his back. He was told he had a “bulging disc” to account for the burning pain down his right leg and slight foot drop. The vertebral bodies of the spine involve which type of joint? Cartilaginous Fibrous Synostosis Synovial

Question 49

You are interviewing an elderly woman in the ambulatory setting and trying to get more information about her urinary symptoms. Which of the following techniques is not a component of adaptive questioning? Asking her to tell you exactly what she means when she states that she has a urinary tract infection Directed questioning: starting with the general and proceeding to the specific in a manner that does not make the patient give a yes/no answer Offering the patient multiple choices in order to clarify the character of the urinary symptoms that she is experiencing Reassuring the patient that the urinary symptoms are benign and that she doesn't need to worry about it being a sign of cancer

Question 50

Which of the following anatomic landmark associations is correct?

Sternal angle marks the 4th rib 5th intercostal space for chest tube insertion T6 for lower margin of endotracheal tube 2nd intercostal space for needle insertion in tension pneumothorax

Question 51

Common or concerning symptoms to inquire about in the Constituitional portion of the Review of Symptoms include all of the following except: Hemoptysis Fever and chills Fatigue and weakness Changes in weight

Question 52

You are conducting a mental status examination and note impairment of speech and judgement, but the rest of your examination is intact. Where is the most likely location of the problem? Cerebellum Basal ganglia Cerebrum