NUR 509 FINAL EXAM QUESTIONS AND ANSWERS
A 31-year-old female presents to the clinic with a worsening stiff, painful neck. On
inspection, the patients head is laterally deviated toward the shoulder and rotated.
Given this specific physical assessment finding, what condition should the NP suspect
as a differential diagnosis?
A-torticollis
B-ankylosing spondylitis
C-osteoarthritis (OA)
D-spondylolisthesis
E-thoracic kyphosis - Answers - A
Torticollis
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the
following are expected assessment findings consistent with the diagnosis?
A-Swelling of the synovial tissue in joints and tendon sheaths
B-The first metatarsophalangeal joint is frequently involved.
C-Asymmetrical joint distribution.
D-Tophi present in the subcutaneous tissue
E-Stiffness follows joint activity. - Answers - A
Swelling of the synovial tissue in joints and tendon sheaths
A 66-year-old female presents to the office for a focused visit to discuss hypertension
management strategies. During the interview, the patient asks the MP if she could be
screened today for cervical cancer/HPV. Review of her medical record reveals she was
screened at ages 57, 60, and 63, with no abnormal findings, and no history of cancer.
What is the best action the NP should take regarding the patients request for
screening?
A-Deny her request, inform her that she is past due for cervical cancer/HPV screening,
and
schedule another visit in 6 months.
B-Honor her request, perform the screening today, and reschedule the appointment to
discuss
hypertension management strategies.
C-Deny her request, inform the patient that she has had three negative screenings in
the last 10 years
and no longer requires screening, and focus on the reason
,for the visit.
D-Deny her request, inform the patient she is not due to - Answers - C
Deny her request, inform the patient that she has had three negative screenings in the
last 10 years
and no longer requires screening, and focus on the reason
for the visit.
A 45-year-old female presents to the primary care clinic. She complains of recently
experiencing a change in the patterns of her bowel movements. Her PMH is significant
for bleeding ulcers as well as Crohns disease. Her family medical history includes a
maternal aunt who died of colon cancer at age 49 years. Which of the following
historical elements would be most concerning for colon cancer in this patient?
A-recent onset of small-caliber stools
B-new-onset anal fissures
C-recent history of black, tarry stools
D-long-term history of hemorrhoids
E-remote history of anal pruritus - Answers - A
recent onset of small-caliber stools
Which of the following physical assessment finding is most suggestive of peritonitis
secondary to a ruptured appendix?
A pain with internal rotation of the right hip
B abdominal pain that increases with hip flexion
C localized pain over McBurney point, which lies 2 inches from the anterior superior iliac
spinous process
on a line drawn from the umbilicus
D pressing down onto the abdomen firmly and quickly withdraws the hand produces
pain
E voluntary contraction of the abdominal wall that persists over several examinations -
Answers - D
pressing down onto the abdomen firmly and quickly withdraws the hand produces pain
A-21year -old female presents for her first annual exam. She reports concern because
her female partner was recently diagnosed with condyloma acuminata and wonders if
she could also be infected. If true what physical assessment findings would the NP
expect to find during the speculum examination
,A several shallow ulcers with a red base
B translucent nodules
C bright red, soft lesions arising from the cervical canal
D small red granular spots or petechiae on the cervix
E - raised friable or lobed lesions - Answers - E
raised friable or lobed lesions
A 35-year-old female with a history of migraines presents to the clinic with worsening
symptoms for the past few weeks. She reports waking up at night with headaches and
nausea. Her only medication history is oral contraceptive pills (OPs). Otherwise, she
states she is
healthy. Which of the following actions if taken by the NP is the best next step?
A Reassure her that this is a common pattern with migraines
B Evaluate her for possible sinus infection.
C Order studies to evaluate potential transient ischemic attacks (TIAs) because she is
on OCPs.
D Take a further history and perform a very careful neurological examination.
E Prescribe a strong medication for her migraines. - Answers - D
Take a further history and perform a very careful neurological examination.
The NP is observing a full-term infant male. He can pull to a stand, use "mama" or
"dada" specifically, and indicates his wants by vocalization and pointing. Based on your
observations, determine his developmental age
A 12 months
B 4 months
C 8 months
D 10 months
E 6 months - Answers - A
12 MONTHS
During an evaluation of an athletic 30-year-old female, the NP conducts an active range
of motion evaluation at the neck. All of the following muscles are being assessed when
the
patient is asked to extend, flex, and rotate the neck, EXCEPT?
A sacrospinalis
, B sternocleidomastoid (SCM)
C trapezius
D splenius capitis
E splenius cervicis - Answers - A
sacrospinalis
What structure in the spine is primarily responsible for supporting the bodys weight?
A spinous process
B vertebral body
C transverse process
D vertebral arch
E intervertebral disk - Answers - B
vertebral body
Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-lower
quadrant (LLQ) then quickly withdrawing your fingers indicates what positive
assessment
A psoas sign
B Murphy sign
C Blumberg sign
D Roving sign
E McBurney sign - Answers - C
Blumberg sign
Cervical motion tenderness and/or adnexal tenderness are hallmarks of all the following
conditions, EXCEPT?
A pelvic inflammatory disease
B bacterial vaginosis
C endometriosis
D ectopic pregnancy
E appendicitis - Answers - B
Bacterial Vaginosis
The NP is conducting a physical assessment on a woman in her 26th week of
pregnancy. Which of the examination finding is worrisome for a potential, emergent
condition?
A facial edema
B nosebleeds
A 31-year-old female presents to the clinic with a worsening stiff, painful neck. On
inspection, the patients head is laterally deviated toward the shoulder and rotated.
Given this specific physical assessment finding, what condition should the NP suspect
as a differential diagnosis?
A-torticollis
B-ankylosing spondylitis
C-osteoarthritis (OA)
D-spondylolisthesis
E-thoracic kyphosis - Answers - A
Torticollis
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the
following are expected assessment findings consistent with the diagnosis?
A-Swelling of the synovial tissue in joints and tendon sheaths
B-The first metatarsophalangeal joint is frequently involved.
C-Asymmetrical joint distribution.
D-Tophi present in the subcutaneous tissue
E-Stiffness follows joint activity. - Answers - A
Swelling of the synovial tissue in joints and tendon sheaths
A 66-year-old female presents to the office for a focused visit to discuss hypertension
management strategies. During the interview, the patient asks the MP if she could be
screened today for cervical cancer/HPV. Review of her medical record reveals she was
screened at ages 57, 60, and 63, with no abnormal findings, and no history of cancer.
What is the best action the NP should take regarding the patients request for
screening?
A-Deny her request, inform her that she is past due for cervical cancer/HPV screening,
and
schedule another visit in 6 months.
B-Honor her request, perform the screening today, and reschedule the appointment to
discuss
hypertension management strategies.
C-Deny her request, inform the patient that she has had three negative screenings in
the last 10 years
and no longer requires screening, and focus on the reason
,for the visit.
D-Deny her request, inform the patient she is not due to - Answers - C
Deny her request, inform the patient that she has had three negative screenings in the
last 10 years
and no longer requires screening, and focus on the reason
for the visit.
A 45-year-old female presents to the primary care clinic. She complains of recently
experiencing a change in the patterns of her bowel movements. Her PMH is significant
for bleeding ulcers as well as Crohns disease. Her family medical history includes a
maternal aunt who died of colon cancer at age 49 years. Which of the following
historical elements would be most concerning for colon cancer in this patient?
A-recent onset of small-caliber stools
B-new-onset anal fissures
C-recent history of black, tarry stools
D-long-term history of hemorrhoids
E-remote history of anal pruritus - Answers - A
recent onset of small-caliber stools
Which of the following physical assessment finding is most suggestive of peritonitis
secondary to a ruptured appendix?
A pain with internal rotation of the right hip
B abdominal pain that increases with hip flexion
C localized pain over McBurney point, which lies 2 inches from the anterior superior iliac
spinous process
on a line drawn from the umbilicus
D pressing down onto the abdomen firmly and quickly withdraws the hand produces
pain
E voluntary contraction of the abdominal wall that persists over several examinations -
Answers - D
pressing down onto the abdomen firmly and quickly withdraws the hand produces pain
A-21year -old female presents for her first annual exam. She reports concern because
her female partner was recently diagnosed with condyloma acuminata and wonders if
she could also be infected. If true what physical assessment findings would the NP
expect to find during the speculum examination
,A several shallow ulcers with a red base
B translucent nodules
C bright red, soft lesions arising from the cervical canal
D small red granular spots or petechiae on the cervix
E - raised friable or lobed lesions - Answers - E
raised friable or lobed lesions
A 35-year-old female with a history of migraines presents to the clinic with worsening
symptoms for the past few weeks. She reports waking up at night with headaches and
nausea. Her only medication history is oral contraceptive pills (OPs). Otherwise, she
states she is
healthy. Which of the following actions if taken by the NP is the best next step?
A Reassure her that this is a common pattern with migraines
B Evaluate her for possible sinus infection.
C Order studies to evaluate potential transient ischemic attacks (TIAs) because she is
on OCPs.
D Take a further history and perform a very careful neurological examination.
E Prescribe a strong medication for her migraines. - Answers - D
Take a further history and perform a very careful neurological examination.
The NP is observing a full-term infant male. He can pull to a stand, use "mama" or
"dada" specifically, and indicates his wants by vocalization and pointing. Based on your
observations, determine his developmental age
A 12 months
B 4 months
C 8 months
D 10 months
E 6 months - Answers - A
12 MONTHS
During an evaluation of an athletic 30-year-old female, the NP conducts an active range
of motion evaluation at the neck. All of the following muscles are being assessed when
the
patient is asked to extend, flex, and rotate the neck, EXCEPT?
A sacrospinalis
, B sternocleidomastoid (SCM)
C trapezius
D splenius capitis
E splenius cervicis - Answers - A
sacrospinalis
What structure in the spine is primarily responsible for supporting the bodys weight?
A spinous process
B vertebral body
C transverse process
D vertebral arch
E intervertebral disk - Answers - B
vertebral body
Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-lower
quadrant (LLQ) then quickly withdrawing your fingers indicates what positive
assessment
A psoas sign
B Murphy sign
C Blumberg sign
D Roving sign
E McBurney sign - Answers - C
Blumberg sign
Cervical motion tenderness and/or adnexal tenderness are hallmarks of all the following
conditions, EXCEPT?
A pelvic inflammatory disease
B bacterial vaginosis
C endometriosis
D ectopic pregnancy
E appendicitis - Answers - B
Bacterial Vaginosis
The NP is conducting a physical assessment on a woman in her 26th week of
pregnancy. Which of the examination finding is worrisome for a potential, emergent
condition?
A facial edema
B nosebleeds
