WITH CORRECT ANSWERS GRADED A+
◍ 11. The following information is best placed in which category?"The patient
was treated for an asthma exacerbation in the hospital last year; the patient
has never been intubated."A) Adult illnessesB) SurgeriesC)
Obstetrics/gynecologyD) Psychiatric.
Answer: A) adult illnesses
◍ Geriatric Skin Changes.
Answer: Less subq fat, less collagen, less sweat glands, less hair
folliclesXerosis: dryness of skinStasis dermatitisRosaceaBenign skin tumors
such as seborrheic keratosis (waxy stuck on lesions)- very common in
elderlySkin tags: acrochordon
◍ A 70-year-old retired auto mechanic comes to your office because his
neighbor is concerned about his memory. The patient himself admits to
misplacing his keys more often and forgets what he is supposed to buy from
the grocery store and where he has parked the car. He denies getting lost in
familiar places. Upon further questioning, he states that his wife of 40 years
died 8 months ago; his three children live in three different states; and he
has limited his activities because the people he interacted with were "his
wife's friends, not his." He drinks a six-pack of beer daily; he does not
smoke or use illicit drugs. You perform a mini-mental state examination and
obtain a total score of 24 out of 28. Based on this information, what is your
most likely diagnosis?A) Benign forgetfulnessB) DementiaC) MeningitisD)
Depression.
Answer: D) Depression
◍ A 58-year-old gardener comes to your office for evaluation of a new lesion
on her upper chest. The lesion appears to be "stuck on" and is oval, brown,
, and slightly elevated with a flat surface. It has a rough, wartlike texture on
palpation. Based on this description, what is your most likely diagnosis?A)
Actinic keratosisB) Seborrheic keratosisC) Basal cell carcinomaD)
Squamous cell carcinoma.
Answer: B) seborrheic keratosis "stuck on"
◍ Which of the following questions is part of the screening for physical
disability?A) Are you able to go shopping for groceries or clothes?B) Are
you able to walk one block?C) Are you able to pass the driver's license
test?D) Are you able to perform light dusting and pick up after yourself
around the house?.
Answer: A) Are you able to go shopping for groceries or clothes?
◍ Pneumatic otoscopy.
Answer: should be used to determine whether the TM is mobile.Immobility
of the TM indicates fluid in the middle ear
◍ Mrs. R. is a 92-year-old retired teacher who comes to your clinic
accompanied by her daughter. You ask Mrs. R. why she came to your clinic
today. She looks at her daughter and doesn't say anything in response to
your question. This is an example of which type of challenging patient?A)
Talkative patientB) Angry patientC) Silent patientD) Hearing-impaired
patient.
Answer: C) silent patient
◍ Ms. Whiting is a 68 year old who comes in for her usual follow-up visit.
You notice a few flat red and purple lesions, about 6 centimeters in
diameter, on the ulnar aspect of her forearms but nowhere else. She doesn't
mention them. They are tender when you examine them. What should you
do?A) Conclude that these are lesions she has had for a long time.B) Wait
for her to mention them before asking further questions.C) Ask how she
acquired them.D) Conduct the visit as usual for the patient..
Answer: C) ask how she acquired them abuse??
◍ You have just asked a patient how he feels about his emphysema. He
becomes silent, folds his arms across his chest and leans back in his chair,
, and then replies, "It is what it is." How should you respond?A) "You seem
bothered by this question."B) "Next, I would like to talk with you about
your smoking habit."C) "Okay, let's move on to your other problems."D)
"You have adopted a practical attitude toward your problem.".
Answer: A) you seem bothered by this question
◍ a 56 year old truck drive presents with a new nodular, opaque lesion with
non distinct borders on his left forearm. This most likely represents:a.
actinic keratosis b. squamous cell carcinoma c. basal cell carcinoma d.
malignant melanoma.
Answer: b. squamous cell carcinoma remember NO SUN
◍ warts.
Answer: growths on your skin caused by an infection with human papilloma
virus, or HPV
◍ Mrs. Glynn is 90 years old and lives alone. She is able to bathe, dress,
prepare her food, and transfer from bed to chair independently. She has
children in the area who help her with her medications and transportation
needs. Which of the following is considered an instrumental activity of daily
living?A) BathingB) DressingC) Preparing foodD) Transferring from bed to
chair.
Answer: C) Preparing food
◍ Mrs. Anderson presents with an itchy rash which is raised and appears and
disappears in various locations. Each lesion lasts for many minutes. What
most likely accounts for this rash?A) Insect bitesB) Urticaria, or hivesC)
PsoriasisD) Purpura.
Answer: B) urticaria/hives "comes and goes"
◍ A 37-year-old nurse comes for evaluation of colicky right upper quadrant
abdominal pain. The pain is associated with nausea and vomiting and occurs
1 to 2 hours after eating greasy foods. Which one of the following physical
examination descriptions would be most consistent with the diagnosis of
cholecystitis?A) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.B) Abdomen is soft and tender to palpation
, in the right lower quadrant, without rebound or guarding.C) Abdomen is soft
and tender to palpation in the right upper quadrant with inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.D)
Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding..
Answer: C) tender to palpation in RUQ
◍ 9. The following information is best placed in which category?"The patient
has had three cesarean sections."A) Adult illnessesB) SurgeriesC)
Obstetrics/gynecologyD) Psychiatric.
Answer: B) surgeries
◍ You are performing a young woman's first pelvic examination. You make
sure to tell her verbally what is coming next and what to expect. Then you
carry out each maneuver of the examination. You let her know at the outset
that if she needs a break or wants to stop, this is possible. You ask several
times during the examination, "How are you doing, Brittney?" What are you
accomplishing with these techniques?A) Increasing the patient's sense of
controlB) Increasing the patient's trust in you as a caregiverC) Decreasing
her sense of vulnerabilityD) All of the above.
Answer: D) all of the above
◍ a 78 year old resident of a long term care facility complains of generalized
itchiness at night that disturbs her sleep. Her examination is consistent with
scabies. Which of the following do you expect to find on examination?a.
excoriated papule on the interdigital areab. annular lesions over the buttocks
c. vesicular lesions in a linear pattern d. honey-colored crusted lesions that
began as vesicles.
Answer: a. excoriated (from itching) papule on the interdigital area
◍ A 72-year-old retired truck driver comes to the clinic with his wife for
evaluation of hearing loss. He has noticed some decreased ability to hear
what his wife and grandchildren are saying to him. He admits to lip-reading
more. He has a history of noise exposure in his young adult years: He
worked as a sound engineer at a local arena and had to attend a lot of