NUR 679: Primary Care Immersion 4 Internal Medicine
Final Exam, MCQ Questions With Complete Solutions
A definitive diagnosis of acute leukemia typically requires?
Peripheral blood smear and bone marrow aspiration
What is the main application of flow cytometry in the diagnostic
process of leukemia?
To identify cell surface markers and classify leukemia subtypes
A 60-year-old man presents with bone pain, fatigue, and
recurrent infections. Laboratory tests reveal elevated calcium
and abnormal plasma cells in the bone marrow. Which condition
is most likely?
Multiple myeloma
A 65-year-old patient presents with bone pain, anemia,
hypercalcemia, and renal impairment. Which disease are these
features most commonly associated with?
Multiple myeloma
In a patient with newly-diagnosed multiple myeloma, which
laboratory abnormality most often results in symptoms like
constipation, nausea, or mental confusion?
,Hypercalcemia
A patient with multiple myeloma presents with elevated
creatinine levels. What primary underlying problem often causes
kidney dysfunction in these patients?
Deposition of light-chain proteins
Which mutation typically causes sickle cell anemia and leads to
abnormal hemoglobin in red blood cells?
Point mutation in the beta-globin gene
Which statement best describes Hemoglobin S in sickle cell
anemia patients?
It results from a mutation GLU → VAL at the sixth position of
the beta-globin gene.
What is a key treatment to reduce sickling episodes and stroke
incidence for patients with sickle cell anemia?
Hydroxyurea therapy
Which statement best describes the real-life use of hydroxyurea
in managing sickle cell anemia?
,It increases fetal hemoglobin production to prevent painful
crises.
What is the main reason regular vaccinations are part of sickle
cell anemia management?
Vaccinations protect against infections due to loss of spleen
function.
Hospital protocols for tuberculosis control focus primarily on
what population-level practice?
Early diagnosis and airborne isolation
A patient presents with fever of unknown origin. Which of the
following is the best initial step in the management?
Thorough history and physical examination
When approaching a patient with an unknown cause of fever,
what should you do first after taking a thorough history and
physical exam?
Establish basic laboratory investigations such as CBC and urine
analysis
Which of the following patients presenting with fever should be
considered high-risk and require urgent evaluation?
, A 70-year-old with diabetes and chronic kidney disease
Which set of signs would most suggest the onset of sepsis in a
patient presenting with fever?
Confusion, hypotension, and rapid heart rate
A patient presents with fever that spikes every evening and
returns to normal by morning. Which fever pattern does this
most likely represent?
Intermittent fever
When managing a patient with fever, which principle is most
important in the therapeutic framework?
Identify and address the underlying etiology
Which of the following patients most likely requires an
antibiotic as part of treatment for a common upper respiratory
tract problem?
Adult with sudden onset fever, tender anterior cervical lymph
nodes, and exudative pharyngitis
A patient presents with sore throat, fever, and tender anterior
cervical lymphadenopathy. Which physical finding would most
likely suggest a bacterial rather than viral cause?
Final Exam, MCQ Questions With Complete Solutions
A definitive diagnosis of acute leukemia typically requires?
Peripheral blood smear and bone marrow aspiration
What is the main application of flow cytometry in the diagnostic
process of leukemia?
To identify cell surface markers and classify leukemia subtypes
A 60-year-old man presents with bone pain, fatigue, and
recurrent infections. Laboratory tests reveal elevated calcium
and abnormal plasma cells in the bone marrow. Which condition
is most likely?
Multiple myeloma
A 65-year-old patient presents with bone pain, anemia,
hypercalcemia, and renal impairment. Which disease are these
features most commonly associated with?
Multiple myeloma
In a patient with newly-diagnosed multiple myeloma, which
laboratory abnormality most often results in symptoms like
constipation, nausea, or mental confusion?
,Hypercalcemia
A patient with multiple myeloma presents with elevated
creatinine levels. What primary underlying problem often causes
kidney dysfunction in these patients?
Deposition of light-chain proteins
Which mutation typically causes sickle cell anemia and leads to
abnormal hemoglobin in red blood cells?
Point mutation in the beta-globin gene
Which statement best describes Hemoglobin S in sickle cell
anemia patients?
It results from a mutation GLU → VAL at the sixth position of
the beta-globin gene.
What is a key treatment to reduce sickling episodes and stroke
incidence for patients with sickle cell anemia?
Hydroxyurea therapy
Which statement best describes the real-life use of hydroxyurea
in managing sickle cell anemia?
,It increases fetal hemoglobin production to prevent painful
crises.
What is the main reason regular vaccinations are part of sickle
cell anemia management?
Vaccinations protect against infections due to loss of spleen
function.
Hospital protocols for tuberculosis control focus primarily on
what population-level practice?
Early diagnosis and airborne isolation
A patient presents with fever of unknown origin. Which of the
following is the best initial step in the management?
Thorough history and physical examination
When approaching a patient with an unknown cause of fever,
what should you do first after taking a thorough history and
physical exam?
Establish basic laboratory investigations such as CBC and urine
analysis
Which of the following patients presenting with fever should be
considered high-risk and require urgent evaluation?
, A 70-year-old with diabetes and chronic kidney disease
Which set of signs would most suggest the onset of sepsis in a
patient presenting with fever?
Confusion, hypotension, and rapid heart rate
A patient presents with fever that spikes every evening and
returns to normal by morning. Which fever pattern does this
most likely represent?
Intermittent fever
When managing a patient with fever, which principle is most
important in the therapeutic framework?
Identify and address the underlying etiology
Which of the following patients most likely requires an
antibiotic as part of treatment for a common upper respiratory
tract problem?
Adult with sudden onset fever, tender anterior cervical lymph
nodes, and exudative pharyngitis
A patient presents with sore throat, fever, and tender anterior
cervical lymphadenopathy. Which physical finding would most
likely suggest a bacterial rather than viral cause?
