NR509 BATES TEST BANK – MIDTERM
UPDATE 2026 2027 QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT
walk again, but after 100 yards these same symptoms recur. Which of the following
would suggest spinal stenosis as a cause of this pain?
A) Coldness and pallor of the legs
B) Relief of the pain with bending at the waist
C) Color changes of the skin
D) Swelling with tenderness of the skin - CORRECT ANSWES -- B) Relief of the pain
with bending at the waist
?
A) Lower calf/superficial femoral
B) Erectile dysfunction/iliac or pudendal
C) Buttock/common femoral
D) Upper calf/tibial or peroneal - CORRECT ANSWES -- B) Erectile dysfunction/iliac or
pudendal
The ankle-brachial index (ABI) is calculated by dividing the systolic BP at the dorsalis
pedis by the systolic BP at the brachial artery. Which of the following values would be
consistent with mild peripheral arterial disease? Which of the following pairs of ischemic
symptoms versus vascular supply is correct
A) 1.1
B) 0.85
C) 0.65
D) 0.35 - CORRECT ANSWES -- B) 0.85
The mild disease is represented by an ABI of 0.71 to 0.9. Any value above 0.9 is
normal. Moderate disease is defined as between 0.7 and 0.41, and severe disease is
defined as
0.4 or less. Patients in the "severe" category have a 20% to 25% annual risk of death.
Asymmetric BPs are seen in which of the following conditions?
A) Coronary artery disease
B) Congenital narrowing of the aorta
,C) Diffuse atherosclerosis
D) Vasculitis, as seen in systemic lupus erythematosus - CORRECT ANSWES -- B)
Congenital narrowing of the aorta
Diminished radial pulses may be seen in patients with which of the following?
A) Aortic insufficiency
B) Hyperthyroidism
C) Arterial emboli
D) Early "warm" septic shock - CORRECT ANSWES -- C) Arterial emboli
Arterial emboli would decrease flow to a region, and therefore pulses would decrease
as well. The other conditions actually cause bounding pulses.
When assessing temperature of the skin, which portion of your hand should be used?
A) Fingertips
B) Palms
C) Backs of fingers
D) Ulnar aspect of the hand - CORRECT ANSWES -- C) Backs of fingers
The backs of the fingers are thought to be the most temperature sensitive, perhaps
because the skin is thinnest there.
A patient presents with claudication symptoms and diminished pulses. Which of the
following is consistent with chronic arterial insufficiency?
A) Pallor of the foot when raised to 60 degrees for one minute
B) Return of color to the skin within 5 seconds of allowing legs to dangle
C) Filling of the veins of the ankles within 10 seconds of allowing the legs to dangle
D) Hyperpigmentation of the skin - CORRECT ANSWES -- A) Pallor of the foot when
raised to 60 degrees for one minute
You note a painful ulcerative lesion near the medial malleolus, with accompanying
hyperpigmentation. Which of the following etiologies is most likely?
A) Arterial insufficiency
B) Neuropathic ulcer
C) Venous insufficiency
D) Trauma - CORRECT ANSWES -- C) Venous insufficiency
These features are most consistent with venous insufficiency. You may also see
scaling, redness, varicosities, and other findings. Arterial insufficiency usually affects
distal or traumatized areas.
,You are assessing a patient with joint pain and are trying to decide whether it is
inflammatory or noninflammatory in nature. Which one of the following symptoms is
consistent with an inflammatory process?
A) Tenderness
B) Cool temperature
C) Ecchymosis
D) Nodules - CORRECT ANSWES -- A) Tenderness
You are assessing a patient with diffuse joint pains and want to make sure that only the
joints are the problem, and that the pain is not related to other diseases. Which of the
following is
a systemic cause of joint pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis - CORRECT ANSWES -- C) Lupus
Lupus is a systemic disease, one symptom of which may be joint pain. It is
important to consider the presence of a systemic illness when a patient presents with
arthritis.
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?
A) Trauma
B) Gonococcal arthritis
C) Psoriatic arthritis
D) Lyme disease - CORRECT ANSWES -- D) Lyme disease
Lyme disease is characterized by a target-shaped red spot at the site of the bite, which
disappears, then reappears and starts spreading (erythema migrans). Lyme disease
can also
result in joint pain as well as cardiac and neurologic manifestations.
An 85-year-old retired housewife comes with her daughter to establish care. Her
daughter is
concerned because her mother has started to fall more. As part of her physical
examination, you
ask her to walk across the examination room. Which of the following is not part of the
stance
, phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off - CORRECT ANSWES -- A) Foot arched
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?
A) Leg-length test
B) Straight-leg raise
C) Tinel's test
D) Phalen's test - CORRECT ANSWES -- B) Straight-leg raise
The straight-leg raise involves having the patient lie supine with the examiner
raising the leg. If the patient experiences a sharp pain radiating from the back down the
leg in an
L5 or S1 distribution, that suggests the presence of a herniated disc.
A 33-year-old construction worker comes for evaluation and treatment of acute onset of
low
back pain. He notes that the pain is an aching located in the lumbosacral area. It has
been present intermittently for several years; there is no known trauma or injury. He
points to the left lower
back. The pain does not radiate and there is no numbness or tingling in the legs or
incontinence. He was moving furniture for a friend over the weekend. On physical
examination, you note
muscle spasm, with normal deep tendon reflexes and muscle strength. What is the most
likely
cause of this patient's low back pain?
A) Herniated disc
B) Compression fracture
C) Mechanical low back pain
D) Ankylosing spondylitis - CORRECT ANSWES -- ) Mechanical low back pain
The case is an example of mechanical low back pain; in a large percentage of cases
there is no known underlying cause. The pain is often precipitated by moving, lifting, or
twisting motions and relieved by rest.
UPDATE 2026 2027 QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT
walk again, but after 100 yards these same symptoms recur. Which of the following
would suggest spinal stenosis as a cause of this pain?
A) Coldness and pallor of the legs
B) Relief of the pain with bending at the waist
C) Color changes of the skin
D) Swelling with tenderness of the skin - CORRECT ANSWES -- B) Relief of the pain
with bending at the waist
?
A) Lower calf/superficial femoral
B) Erectile dysfunction/iliac or pudendal
C) Buttock/common femoral
D) Upper calf/tibial or peroneal - CORRECT ANSWES -- B) Erectile dysfunction/iliac or
pudendal
The ankle-brachial index (ABI) is calculated by dividing the systolic BP at the dorsalis
pedis by the systolic BP at the brachial artery. Which of the following values would be
consistent with mild peripheral arterial disease? Which of the following pairs of ischemic
symptoms versus vascular supply is correct
A) 1.1
B) 0.85
C) 0.65
D) 0.35 - CORRECT ANSWES -- B) 0.85
The mild disease is represented by an ABI of 0.71 to 0.9. Any value above 0.9 is
normal. Moderate disease is defined as between 0.7 and 0.41, and severe disease is
defined as
0.4 or less. Patients in the "severe" category have a 20% to 25% annual risk of death.
Asymmetric BPs are seen in which of the following conditions?
A) Coronary artery disease
B) Congenital narrowing of the aorta
,C) Diffuse atherosclerosis
D) Vasculitis, as seen in systemic lupus erythematosus - CORRECT ANSWES -- B)
Congenital narrowing of the aorta
Diminished radial pulses may be seen in patients with which of the following?
A) Aortic insufficiency
B) Hyperthyroidism
C) Arterial emboli
D) Early "warm" septic shock - CORRECT ANSWES -- C) Arterial emboli
Arterial emboli would decrease flow to a region, and therefore pulses would decrease
as well. The other conditions actually cause bounding pulses.
When assessing temperature of the skin, which portion of your hand should be used?
A) Fingertips
B) Palms
C) Backs of fingers
D) Ulnar aspect of the hand - CORRECT ANSWES -- C) Backs of fingers
The backs of the fingers are thought to be the most temperature sensitive, perhaps
because the skin is thinnest there.
A patient presents with claudication symptoms and diminished pulses. Which of the
following is consistent with chronic arterial insufficiency?
A) Pallor of the foot when raised to 60 degrees for one minute
B) Return of color to the skin within 5 seconds of allowing legs to dangle
C) Filling of the veins of the ankles within 10 seconds of allowing the legs to dangle
D) Hyperpigmentation of the skin - CORRECT ANSWES -- A) Pallor of the foot when
raised to 60 degrees for one minute
You note a painful ulcerative lesion near the medial malleolus, with accompanying
hyperpigmentation. Which of the following etiologies is most likely?
A) Arterial insufficiency
B) Neuropathic ulcer
C) Venous insufficiency
D) Trauma - CORRECT ANSWES -- C) Venous insufficiency
These features are most consistent with venous insufficiency. You may also see
scaling, redness, varicosities, and other findings. Arterial insufficiency usually affects
distal or traumatized areas.
,You are assessing a patient with joint pain and are trying to decide whether it is
inflammatory or noninflammatory in nature. Which one of the following symptoms is
consistent with an inflammatory process?
A) Tenderness
B) Cool temperature
C) Ecchymosis
D) Nodules - CORRECT ANSWES -- A) Tenderness
You are assessing a patient with diffuse joint pains and want to make sure that only the
joints are the problem, and that the pain is not related to other diseases. Which of the
following is
a systemic cause of joint pain?
A) Gout
B) Osteoarthritis
C) Lupus
D) Spondylosis - CORRECT ANSWES -- C) Lupus
Lupus is a systemic disease, one symptom of which may be joint pain. It is
important to consider the presence of a systemic illness when a patient presents with
arthritis.
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?
A) Trauma
B) Gonococcal arthritis
C) Psoriatic arthritis
D) Lyme disease - CORRECT ANSWES -- D) Lyme disease
Lyme disease is characterized by a target-shaped red spot at the site of the bite, which
disappears, then reappears and starts spreading (erythema migrans). Lyme disease
can also
result in joint pain as well as cardiac and neurologic manifestations.
An 85-year-old retired housewife comes with her daughter to establish care. Her
daughter is
concerned because her mother has started to fall more. As part of her physical
examination, you
ask her to walk across the examination room. Which of the following is not part of the
stance
, phase of gait?
A) Foot arched
B) Heel strike
C) Mid-stance
D) Push-off - CORRECT ANSWES -- A) Foot arched
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?
A) Leg-length test
B) Straight-leg raise
C) Tinel's test
D) Phalen's test - CORRECT ANSWES -- B) Straight-leg raise
The straight-leg raise involves having the patient lie supine with the examiner
raising the leg. If the patient experiences a sharp pain radiating from the back down the
leg in an
L5 or S1 distribution, that suggests the presence of a herniated disc.
A 33-year-old construction worker comes for evaluation and treatment of acute onset of
low
back pain. He notes that the pain is an aching located in the lumbosacral area. It has
been present intermittently for several years; there is no known trauma or injury. He
points to the left lower
back. The pain does not radiate and there is no numbness or tingling in the legs or
incontinence. He was moving furniture for a friend over the weekend. On physical
examination, you note
muscle spasm, with normal deep tendon reflexes and muscle strength. What is the most
likely
cause of this patient's low back pain?
A) Herniated disc
B) Compression fracture
C) Mechanical low back pain
D) Ankylosing spondylitis - CORRECT ANSWES -- ) Mechanical low back pain
The case is an example of mechanical low back pain; in a large percentage of cases
there is no known underlying cause. The pain is often precipitated by moving, lifting, or
twisting motions and relieved by rest.
