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Identifying Oral Lesions and Interpreting Medical Exam Findings, Exams of Nursing

A range of medical exam questions and scenarios, including the identification of oral lesions, interpretation of family medical history, recognition of common auscultatory findings in congestive heart failure, and the appropriate imaging studies for evaluating abdominal pain. The questions test the reader's clinical knowledge and decision-making skills across various medical specialties, such as gastroenterology, cardiology, and ophthalmology. By studying this document, students can develop a deeper understanding of the diagnostic process, the importance of a thorough patient history, and the integration of physical exam findings with laboratory and imaging results to arrive at the correct diagnosis and management plan. The diverse range of topics and clinical scenarios presented in this document make it a valuable resource for medical students, nursing students, and healthcare professionals seeking to enhance their clinical reasoning and problem-solving abilities.

Typology: Exams

2024/2025

Available from 09/19/2024

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NSG 6420 Midterm Exam Questions and Answers 2024
Question 1.
1. Your patient has been using chewing tobacco for 10 years. On physical examination, you
observe a white ulceration surrounded by
erythematous base on the side of his tongue. The clinician should recognize that very often
this is: (Points : 2)
Malignant melanoma
Squamous cell carcinoma
Aphthous ulceration
Behcet’s syndrome
Question 2.
2. Which of the following would be considered a “red flag” that requires more investigation
in a patient assessment? (Points : 2)
Colon cancer in family member at age 70
Breast cancer in family member at age 75
Myocardial infarction in family member at age 35
All of the above
Question 3.
3. The pathophysiological hallmark of ACD is: (Points : 2)
Depleted iron stores
Impaired ability to use iron stores
Chronic uncorrectable bleeding
Reduced intestinal absorption of iron
Question 4.
4. It is important to not dilate the eye if is suspected. (Points
: 2) Cataract
Macular degeneration
Acute closed-angle glaucoma
Chronic open-angle glaucoma
Question 5.
5. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The
patient reports a smoking history of 2 packs of
cigarettes per day since age 16. This would be recorded in the chart as: (Points : 2)
50 x 2-pack years
100-pack years
50-year, 2-pack history
100-pack history
Question 6.
6. When teaching a group
of older adults regarding
prevention of
gastroesophageal reflux
pf3
pf4
pf5
pf8
pf9
pfa

Partial preview of the text

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NSG 6420 Midterm Exam Questions and Answers 2024

Question 1.

  1. Your patient has been using chewing tobacco for 10 years. On physical examination, you

observe a white ulceration surrounded by

erythematous base on the side of his tongue. The clinician should recognize that very often

this is: (Points : 2)

Malignant melanoma

Squamous cell carcinoma

Aphthous ulceration

Behcet’s syndrome

Question 2.

  1. Which of the following would be considered a “red flag” that requires more investigation

in a patient assessment? (Points : 2)

Colon cancer in family member at age 70

Breast cancer in family member at age 75

Myocardial infarction in family member at age 35

All of the above

Question 3.

  1. The pathophysiological hallmark of ACD is: (Points : 2)

Depleted iron stores

Impaired ability to use iron stores

Chronic uncorrectable bleeding

Reduced intestinal absorption of iron

Question 4.

  1. It is important to not dilate the eye if is suspected. (Points

: 2) Cataract

Macular degeneration

Acute closed-angle glaucoma

Chronic open-angle glaucoma

Question 5.

  1. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The

patient reports a smoking history of 2 packs of

cigarettes per day since age 16. This would be recorded in the chart as: (Points : 2)

50 x 2-pack years

100-pack years

50-year, 2-pack history

100-pack history

Question 6.

  1. When teaching a group

of older adults regarding

prevention of

gastroesophageal reflux

disease symptoms, the nurse practitioner will include

which of the following instructions? (Points : 2)

Raise the head of the bed with pillows at night and chew peppermints when symptoms

of heartburn begins.

Raise the head of the bed on blocks and take the proton pump inhibitor medication at

bedtime.

Sit up for an hour after taking any medication and restrict fluid intake.

Avoid food intolerances, raise head of bed on blocks, and take a proton pump inhibitor

before a meal.

Question 7.

  1. A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue,

and unintentional weight loss. At times he is constipated

and other times he has episodes of diarrhea. His physical examination is unremarkable.

It is important for the clinician to recognize the

importance of: (Points : 2)

CBC with differential

Stool culture and sensitivity

Abdominal X-ray

Colonoscopy

Question 8.

  1. Dan G., a 65-year-old man, presents to your primary care office for the evaluation of

chest pain and left-sided shoulder pain. Pain begins

after strenuous activity, including walking. Pain is characterized as dull, aching; 8/

during activity, otherwise 0/10. Began a few months ago,

intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain

is retrosternal, radiating to left shoulder, definitely

affects quality of life by limiting activity. Pain is worse today; did not go away after he

stopped walking. BP 120/80. Pulse 72 and regular. Normal

heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses

would be most likely? (Points : 2)

Musculoskeletal chest wall syndrome with radiation

Esophageal motor disorder with radiation

Acute cholecystitis with cholelithiasis

Coronary artery disease with angina pectoris

Question 9.

  1. A common auscultatory finding in advanced CHF is: (Points : 2)

Systolic ejection murmur

S3 gallop rhythm

Friction rub

Bradycardia

Question 10.

  1. Which of

the following

symptoms is

common with

acute otitis

media? (Points :

Question 15.

  1. Helicobacter pylori is implicated as a causative agent in the development of duodenal or

gastric ulcers. What teaching should the nurse

practitioner plan for a patient who has a positive Helicobacter pylori test? (Points : 2)

It is highly contagious and a mask should be worn at home.

Treatment regimen is multiple lifetime medications.

Treatment regimen is multiple medications taken daily for a few weeks.

Treatment regimen is complicated and is not indicated unless the patient is

symptomatic.

Question 16.

  1. The best evidence rating drugs to consider in a post myocardial infarction

patient include: (Points : 2)

ASA, ACE/ARB, beta-blocker, aldosterone blockade

ACE, ARB, Calcium channel blocker, ASA

Long-acting nitrates, warfarin, ACE, and ARB

ASA, clopidogrel, nitrates

Question 17.

  1. The most common cause of eye redness is:

(PointsConjunctivitis : 2)

Acute glaucoma

Head trauma

Corneal abrasion

Question 18.

  1. A specific exam used to evaluate the gall bladder is: (Points : 2)

Psoas sign

Obturator sign

Cullens sign

Murphy’s sign

Question 19.

  1. An 82-year-old female presents to the emergency department with epigastric pain and

weakness. She admits to having dark, tarry

stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-

medicates daily with ibuprofen, naprosyn, and

aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor.

Fecal occult blood test is positive. A likely etiology

of the patient’s problem is: (Points : 2)

Mallory-Weiss tear

Esophageal varices

Gastric ulcer

Colon cancer

Question 20.

  1. Which of the following is not a contributing factor to the development of esophagitis in

older adults? (Points : 2)

Increased gastric emptying time

Regular ingestion of NSAIDs

Decreased salivation

Fungal infections such as

Candida

Question 21.

  1. Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary

care practice for evaluation of a persistent,

daily cough with increased sputum production, worse in the morning, occurring over the

past three months. She tells you, “I have the

same thing, year after year.” Which of the following choices would you consider strongly

in your critical thinking process? (Points : 2)

Seasonal

allergies Acute

bronchitis

Bronchial asthma

Chronic bronchitis

Question 22.

  1. A 59-year-old patient with history of alcohol abuse comes to your office because of

‘throwing up blood”. On physical examination, you note

ascites and caput medusa. A likely cause for the hematemesis is: (Points : 2)

Peptic ulcer disease

Barrett’s esophagus

Esophageal varices

Pancreatitis

Question 23.

  1. Which disease process typically causes episodic right upper quadrant pain, epigastric

pain or chest pain that can last 4- 6 hours or less,

often radiates to the back (classically under the right shoulder blade) and is often

accompanied by nausea or vomiting and often follows a

heavy, fatty meal. (Points : 2)

Acute pancreatitis

Duodenal ulcer

Biliary colic

Cholecystitis

Question 24.

  1. Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to his

back. He was mowing his lawn. He reports the pain

When all lab work is returned within normal limits, what is the most practical imaging study

to order, considering cost, availability, and sensitivity?

(Points : 2)

Abdominal upright and flat plate x-ray

Abdominal MRI

Abdominal CT scan with contrast

Abdominal ultrasound

Question 29.

  1. Emphysematous changes in the lungs produce the following characteristic in COPD

patients? (Points : 2)

Asymmetric chest expansion

Increased lateral diameter

Increased anterior-posterior diameter

Pectus excavatum

Question 30.

  1. (*There are multiple questions on this exam related to the following scenario. Be sure to

read the whole way through to the question.)

Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an

appendectomy, presenting with an acute onset

of significant right upper-quadrant abdominal pain and vomiting. His pain began after

a large meal, was unrelieved by a proton-pump inhibitor,

was unlike his previous episodes of heartburn, but upon questioning, reports

milder, prodromal episodes of similar post-prandial pain. His pain

seems to radiate to his back. Despite a family history of cardiac disease, he reports

no classic anginal signs or chest pain. He furthermore

denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight

loss. Finally, there are no dermatologic signs, nor

genitourinary symptoms.

The chosen imaging study reveals: “GB normal in size without wall-thickening, but with

5- 6 stones with shadowing. Common bile duct not

dilated. Liver is homogenous and normal in size. Pancreas and kidneys are normal.” What

is the most effective therapeutic/management

option at this point? (Points : 2)

Trial of ursodiol

‘Watchful waiting’

Surgical consult

HIDA scan

Question 31.

  1. A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This

could be due to: (Points : 2)

Exercise-induced cough

Bronchiectasis

Alpha- 1 deficiency

Pericarditis

Question 32.

  1. (*There are multiple questions on this exam related to this scenario. Be sure to read the

whole way through to the question.)

Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an

appendectomy, presenting with an acute onset

of significant right upper-quadrant abdominal pain and vomiting. His pain began after

a large meal, was unrelieved by a proton-pump inhibitor,

was unlike his previous episodes of heartburn, but upon questioning, reports

milder, prodromal episodes of similar post-prandial pain. His

pain seems to radiate to his back. Despite a family history of cardiac disease, he reports

no classic anginal signs or chest pain. He furthermore

denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight

loss. Finally, there are no dermatologic signs, nor

genitourinary symptoms.

Of the following lab studies, which would provide little help in determining

your differential diagnosis? (Points : 2)

Abdominal plain

films Liver function

tests Amylase/lipase

Urinalysis

Question 33.

  1. A 22-year-old female comes to your office with complaints of right lower quadrant

abdominal pain, which has been worsening over the

last 24 hours. On examination of the abdomen, there is a palpable mass and rebound

tenderness over the right lower quadrant. The clinician

should recognize the importance of: (Points : 2)

Digital rectal examination

Endoscopy

Pelvic examination

Urinalysis

Question 34.

  1. A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple

air-fluid levels in the bowel. This is a diagnostic

finding found in: (Points : 2)

Appendicitis

Cholecystitis

Bowel Obstruction

Diverticulitis

Hemoglobin <12 g/dl, MCV decreased, MCH decreased

Hemoglobin >12 g/dl, MCV increased, MCH increased

Hemoglobin <12 g/dl, MCV normal, MCH normal

Hemoglobin >12 g/dl, MCV decreased, MCH increased

NSG 6420

Midterm

Exam

Questions and

Answers 2024