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NR 509 Final Exam Questions With Accurate Answers, Exams of Medicine

NR 509 Final Exam Questions With Accurate Answers

Typology: Exams

2024/2025

Available from 07/06/2025

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NR 509 Final Exam Questions With Accurate Answers
Cause of saddle numbness and urinary retention - accurate answers-Cauda
equina syndrome
Presentation of retinal detachment - accurate answers-If sudden visual loss is
unilateral and painless,
Obtunded - accurate answers-patient opens the eyes and looks at you but
responds slowly and is somewhat confused. Alertness and interest in the
environment are decreased.
Cranial nerve for lateral gaze - accurate answers-CN6: Abducens
Adult Illnesses - accurate answers-Medical: Illnesses such as diabetes,
hypertension, hepatitis, asthma, and human immunodeficiency virus (HIV);
hospitalizations; number and gender of sexual partners; and risk-taking sexual
practices
Surgical: Dates, indications, and types of operations
Obstetric/Gynecologic: Obstetric history, menstrual history, methods of
contraception, and sexual function
Psychiatric: Illness and time frame, diagnoses, hospitalizations, and treatments
Present Illness - accurate answers-chronologic description of the problems
prompting the patient's visit, including the onset of the problem, the setting in
which it developed, its manifestations, and any treatments to date.Each
problem/symptom needs: (1) location; (2) quality; (3) quantity or severity; (4)
timing, including onset, duration, and frequency; (5) the setting in which it
occurs; (6) factors that have aggravated
-meds, allergies, tobacco use, ETOH and drug use
Absence of red reflex - accurate answers-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.
S/S of seasonal allergies - accurate answers-Itching, watery eyes, sneezing, ear
congestion, postnasal drainage
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NR 509 Final Exam Questions With Accurate Answers

Cause of saddle numbness and urinary retention - accurate answers-Cauda equina syndrome Presentation of retinal detachment - accurate answers-If sudden visual loss is unilateral and painless, Obtunded - accurate answers-patient opens the eyes and looks at you but responds slowly and is somewhat confused. Alertness and interest in the environment are decreased. Cranial nerve for lateral gaze - accurate answers-CN6: Abducens Adult Illnesses - accurate answers-Medical: Illnesses such as diabetes, hypertension, hepatitis, asthma, and human immunodeficiency virus (HIV); hospitalizations; number and gender of sexual partners; and risk-taking sexual practices ■ Surgical: Dates, indications, and types of operations ■ Obstetric/Gynecologic: Obstetric history, menstrual history, methods of contraception, and sexual function ■ Psychiatric: Illness and time frame, diagnoses, hospitalizations, and treatments Present Illness - accurate answers-chronologic description of the problems prompting the patient's visit, including the onset of the problem, the setting in which it developed, its manifestations, and any treatments to date.Each problem/symptom needs: (1) location; (2) quality; (3) quantity or severity; (4) timing, including onset, duration, and frequency; (5) the setting in which it occurs; (6) factors that have aggravated -meds, allergies, tobacco use, ETOH and drug use Absence of red reflex - accurate answers-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. S/S of seasonal allergies - accurate answers-Itching, watery eyes, sneezing, ear congestion, postnasal drainage

Presentation of optic neuritis - accurate answers-Enlarged blind spot, vision loss in 1 eye, loss of color vision, hole in center of vision, trouble seeing to the side, eye pain pityriasis rosea - accurate answers-Multiple round to oval scaling violaceous plaques on abdomen and back Acromion - accurate answers-tip of shoulder What to do for + finding on physical exam, but - workup - accurate answers- continue using test, but less lab and diagnostics Cause of falsely high BP - accurate answers--too small of a BP cuff

  • if the brachial artery is below heart level
  • loose cuff
  • bladder that balloons outside the cuff Check for nystagmus - accurate answers--involuntary jerking movement of the eyes with quick and slow components.
  • It is named for the direction of the quick component
  • seen in cerebellar disease and vestibular disorders and in internuclear ophthalmoplegia Jaundice - accurate answers-yellow sclera how do get a patient to open up when upset - accurate answers-effective reassurance is simply identifying and acknowledging the patient's feelings. -Partnering -Summarizing -Transitions
  • Empowering the pt s/s of degenerative pain - accurate answers--Slowly progressive, with temporary exacerbations after periods of overuse -usually insidious
  • flexion and deviation deformities How otosclerosis presents with Weber and Rinne test - accurate answers-- Weber: Sound lateralizes to impaired ear. Room noise not well heard, so detection of vibrations improves

Acute RA - accurate answers-Tender, painful, stiff joints in RA, usually with symmetric involvement on both sides of the body. The distal interphalangeal (DIP), metacarpophalangeal (MCP), and wrist joints are the most frequently affected. Note the fusiform or spindle-shaped swelling of the PIP joints in acute disease. Chronic RA - accurate answers-swelling and thickening of the MCP and PIP joints. Range of motion becomes limited, and fingers may deviate toward the ulnar side. The interosseous muscles atrophy. The fingers may show "swan neck" deformities (hyperextension of the PIP joints with fixed flexion of the distal interphalangeal [DIP] joints). Less common is a boutonnière deformity (persistent flexion of the PIP joint with hyperextension of the DIP joint). Rheumatoid nodules are seen in the acute or the chronic stage. subjective data - accurate answers-- Symptoms

  • What pt tells you -goes under ROS sources of joint pain - accurate answers--If age <60 years, consider repetitive strain or overuse syndromes like tendinitis or bursitis, crystalline arthritis (gout; crystalline pyrophosphate deposition disease [CPPD]) (males), rheumatoid arthritis (RA), psoriatic arthritis and reactive (Reiter) arthritis (in inflammatory bowel disease [IBD]), and infectious arthritis from gonorrhea, Lyme disease, or viral or bacterial infections.
  • If age >60 years, look for OA, gout and pseudogout, polymyalgia rheumatica (PMR), osteoporotic fracture, and septic bacterial arthritis.
  • congenital, inflammatory or infectious, immunologic, neoplastic, metabolic, nutritional, degenerative, vascular, traumatic, and toxic? CN 1-6 - accurate answers-1) Olfactory- smell 2)Optic- visual acuity with eye chart & pupil response 3)Oculomotor- conjugate gaze with EOM 4)Trochlear- conjugate gaze with EOM
  1. Trigeminal- palpate masseter & touch face and have pt identify where
  2. Abducens- Conjugate gaze with EOM CN 7-12 - accurate answers-7)Facial- Blow cheeks out, smile, frown, pucker lips 8)Vestibulocochlear (Acoustic)- Whisper test
  3. Glossopharyngeal- Gag reflex 10)Vagus- say "ahhh". soft palate and uvula rise symmetrically
  1. Accessory- shrug shoulders
  2. Hypoglossal- Stick out tongue and move left to right epistaxis causes - accurate answers-nosebleed
  • cause: trauma, inflammation, drying and crusting of the mucosa, tumors and foreign bodies Vesicular lung sounds - accurate answers-soft and low pitched. They are heard throughout inspiration, continue without pause through expiration, and then fade away about one third of the way through expiration. Bronchovesicular sounds - accurate answers-with inspiratory and expiratory sounds about equal in length, at times separated by a silent interval. Detecting differences in pitch and intensity is often easier during expiration. Bronchial - accurate answers-or louder, harsher and higher in pitch, with a short silence be-tween inspiratory and expiratory sounds. Expiratory sounds last longer than inspiratory sounds. tracheal sounds - accurate answers-Loud, harsh sounds heard over the trachea in the neck Wheezes - accurate answers-high pitched, shrill quality -means narrowed airway, COPD, bronchitis, asthma Rhonchi - accurate answers-- Low pitched -sound from secretions in the large airways that may change with coughing crackles - accurate answers--intermittent, nonmusical, brief
  • Come from abnormalities of the lung parenchyma (pneumonia, interstitial lung disease, pulmonary fibrosis, atelectasis, heart failure) or of the airways (bronchitis, bronchiectasis -can be indicative of heart failure Acromion - accurate answers- Risks for Melanoma - accurate answers-Personal or family history of previous melanoma ● ≥50 common moles ● Atypical or large moles, especially if dysplastic

Signs of increased ICP - accurate answers-Papilledema ( pink, hyperemic, loss of venous pulsations, disc more visible, disc swollen with blurred margins, physiologic cup not visible) signs of respiratory distress - accurate answers-Tachypnea, cyanosis or pallor, audible whistling during inspiration over neck or lungs, stridor, use of accessory muscles, objective information - accurate answers-Vitals, info you detect during examination, physical exam findings Signs of otitis externa - accurate answers--After swimming

  • inflammation of the ear canal -pain, itching, redness, swelling, hearing loss Symptoms of pneumonia - accurate answers-- fever -may have normal VS
  • dim lung sounds or crackles
  • dull percussion -tachypnea -nasal flaring signs of meningitis - accurate answers-neck stiffness with resistance to flexion signs of asthma - accurate answers-wheezes absent breath sounds & abnormal retraction (severe asthma) hyperresonance Acanthosis nigricans - accurate answers-deeply pigmented, velvety axillary skin in the axilla -associated with diabetes, obesity, PCOS, and rarely malignant paraneoplastic disorders Labs for vitiligo - accurate answers-thyroid (hyperthyroidism) interpreter in the room - accurate answers-you have eye contact with patient. Speak to pt. have interpreter sit close to the patient, or even behind you, so you don't have to turn your head back and forth

constitutional ROS - accurate answers-fatigue, weakness, fever, chills, night sweats, weight changes, pain Dim response of olfactory nerve in elderly - accurate answers-Normal finding C-section should be listed under surgeries - accurate answers- psoriasis presentation - accurate answers--Scattered erythematous round drop- like, flat-topped well-circumscribed scaling papules and plaques on trunk (guttate psoriasis) -Scattered erythematous to bright pink well-circumscribed flat-topped plaques on extensor knees and elbows, with overlying silvery scale; plaque psoriasis vasovagal syncope - accurate answers--neurocardiogenic (also called neutrally mediated vasodepressor syncope or vasovagal syncope) and of cardiac origin from arrhythmias in only ∼20% of cases Angina pectoris - accurate answers-Consider this as a differential diagnosis for chest pain subconjunctival hemorrhage - accurate answers--no pain -vision not affected

  • no eye discharge -pupil not affected -clear cornea
  • benign, spontaneous, doesn't need treatment. Sternocleidomastoid lymph nodes - accurate answers-Considered posterior cervical Tension Pneumo - accurate answers-Use 2nd intercostal space for needle insertion listening to the heart - accurate answers-Patient must lay down to listen for S1, S2, and murmurs Heroin overdose - accurate answers-pinpoint pupils Lymph nodes - accurate answers-Small, discrete, mobile mass