NR 511 / NR511 FINAL EXAM 2

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 si ...

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 d. paresthesia of the perineum and buttocks The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In order to plan care, the clinician understands that this criteria score has which of the following meanings? a. a high mortality rate b. an increased chance of recurrence c. 7% chance of the disease becoming chronic d. all of the above a. a high mortality rate 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 a. a favorable diagnostic trend Which is the differentiating symptom mbetween labyrinthitis and vestibular neuritis? a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the onet is more gradual b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular neuritis the onset is more gradual d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis.d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. A 27 year old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection. what are some additional symptoms consistant with a diagnosis of lower UTI? a. back and abdominal pain b. fever, chills, costovertebral angle (CVA) tenderness c. blood in urine and frequency d. foul-smelling discharge, perineal itch c. blood in urine and frequency The differential diagnosis for vertigo can be classified into which of the following categories: a. peripheral vestibular disease b. CNS disorders c. Systemic disorders d. all of the above d. all of the above 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 b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Preceptors must always see the patients that the students see in the clinical setting a. true b. false 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 d. all of the above Which causes the greatest percentage of mammalian bites? a. dogs b. cats c. humans d. rodents a. dogs 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 d. all of the above Which of the following data are indicative of testicular torsion? a. absent cremasteric reflux b. pain relived on testicular elevation c. testicle very low in the scrotum d. swollen scrotum with a red dot sign a. absent cremasteric reflux Most nosocomial pneumonias are caused by: a. Fungi. b. Viruses c. Gram-negative bacteria. d. Pneumococcal pneumonia. c. Gram-negative bacteria. A family practice office for all 5 of your clinical rotations will guarantee that you will gain the required pediatric exposurea. true b. false b. false The most common precancerous skin lesion found in Caucasians is a. skin tags b. actinic keratosis c. melanoma d. basal skin lesion b. actinic keratosis Which obstructive lung disease is classified as reversible? a. Asthma b. Chronic bronchitis c. Emphysema d. COPD a. Asthma Which of the following is an example of an articular structure a. bone b. synovium c. tendons d. fascia b. synovium 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. posterior dislocations are more common than anterior dislocations b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses Which of the following statements is true concerning the management of the client with a herniated disc? a. muscle relaxants and narcotics can be used to control moderate pain but should bediscontinued after 3 weeks of use b. an epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred. c. intolerable pain for more than 3 months is an indication for surgical intervention d. all of the above c. intolerable pain for more than 3 months is an indication for surgical intervention After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. elevated TSH b. normal TSH c. low TSH d. undetectable TSH b. normal TSH The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? a. thryoid stimulating hormone (TSH) and free T4 b. TSH and thyrotoxin antibodies •High sensitivity thyroid stimulating hormone TSH and free T4 • Free T4 and serum calcium a. thryoid stimulating hormone (TSH) and free T4 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 a. pasteurella multocida The 56 year old man with chronic prostatitis should be treated with trimethoprim 80mgsulfamethoxazole 400 (TMP-SMX, Bactrim) for how long? a. 3-7 days b. 14-21 days c. 3-6 weeks d 6-12 weeks d 6-12 weeksThe A in SNAPPS stands for Assessment a. true b. false b. false 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 c. Metronidazole The most cost effective screening test to determine HIV status is which of the following? a. western blot b. enzyme-linked immunosorbent assay (ELISA) c. venereal disease research laboratory test (VDRL) d. Viral load b. enzyme-linked immunosorbent assay (ELISA) The clinician sees a patient who is 5 feet tall and weighs 150 pounds (:BMI 29.3). How would the clinician classify this patient? a. overweight b. Mild Obesity c. Moderate Obesity d. morbid obesity b. Mild Obesity One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular srtucture? A. Fascia B. Bone C. Synovium D. Tendons C. Synovium 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 herfall. 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. posterior dislocations are more common than anterior dislocations b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses Which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? a. necrotizing fascitis b. periorbital cellulitis c. erysipelas d. flesh eating bacteria c. erysipelas 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 b,. urinary tract infection (UTI) c. anticholinergic medications d. all of the above d. all of the above 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