NR 509 midterm | Questions and
Answers | Study Set | A+ Verified
Content
• Challenging patients -✓✓Silent, talkative, confusing narrative, emotional liability,
angry/aggressive, flirtatious, discriminatory, hearing loss, nonadherence
• Focus vs comprehensive assessment -✓✓Comprehensive for initial assessment,
focused for returning pt with chief compliant with an established baseline.
• Health history -✓✓Use quotation, age, gender, source of info, 1-2 sentences
• PMH -✓✓Medical illnesses, sx, psych, obgyn
• Problem list and differential diagnoses -✓✓Problem list summarizes all related
problems to support diff dx.
diff dx- list of all poss dx with pertinent + (abnormal findings that support dx) and
pertinent- (normal findings that do not support dx)
• white coat HTN -✓✓Htn in office
• Masked HTN -✓✓htn at home but not in clinic
• Hallucinations -✓✓No external stimulation, can hear, see, smell, or feeling sensations
that are not there. Delirium, dementia, ptsd, schizo
• Illusions -✓✓misinterpretations of real external stimuli. "Magic show". Delirium, grief
reaction, acute ptsd, schizo
• Depression screening -✓✓Use PHQ2 first and if any questions are answered "yes"
proceed with PHQ9. Can tax for depression based off of PHQ9.
• retinal detachment -✓✓Vision loss, unilateral, painless, treatment is supportive. Sx to
reattach
• Red reflex absences indicates what? -✓✓Cataracts, vitreous, detached retina,
retinoblastoma (in kids).
refer to ophthalmologist
• nystagmus -✓✓Involuntary rapid eye movements
, could indicate cerebellum dz with gait ataxia, dysarthria (increase in retinal fixation),
vestibular disorder(decreases with retinal fixation)
• Optic neuritis -✓✓Painful, unilateral inflammation of the optic nerve
seen in pts with MS
• increased ICP -✓✓Papilledema of optic disc (optic disc is pink, blurred margins, edges
defined)
• Cotton wool patches result from what -✓✓Htn or dm
• subconjunctival hemorrhage -✓✓On sclera, benign and resolves in about 2wks. Can
be caused by trauma, sudden increase in BP
• CN I -✓✓Olfactory nerve: smell
age, head trauma, cigarettes, cocaine and Parkinson's can impact it
• CN XI -✓✓spinal accessory: shoulder shrug used to test it. Can indicate a peripheral
nerve disorder
• Acanthosis nigricans -✓✓Darkening skin folds on the back of neck. Can indicate
insulin resistance and uncontrolled DM
• Pityriasis Rosea -✓✓Xmas tree rash. MaculAr and papular lesions. Resolves on its
own. Benign.
• Psoriasis -✓✓Papullar rash with plaques
• Lyme disease -✓✓Bulls eye pattern rash. Can have symptoms of rash, flu like, fever,
headaches, fatigue
• Mongolian spots -✓✓Birth marks on buttocks, lower lumbar regions. Lessen or
disappear with age.
• Vitiligo -✓✓Hypopigmentation. Need to check thyroid function (TSH, FT3,FT4, cbc).
Increase chance of autoimmune dz
• Melanoma -✓✓ABCDE rule. Full body skin exams at 50 or above. Suggest a
dermatologist so they are established once they are 50.
• CN X -✓✓Vagus nerve. Test by opening pts mouth and having them say 'Ahh'. Uvula
and soft palate should rise in symmetry.
Answers | Study Set | A+ Verified
Content
• Challenging patients -✓✓Silent, talkative, confusing narrative, emotional liability,
angry/aggressive, flirtatious, discriminatory, hearing loss, nonadherence
• Focus vs comprehensive assessment -✓✓Comprehensive for initial assessment,
focused for returning pt with chief compliant with an established baseline.
• Health history -✓✓Use quotation, age, gender, source of info, 1-2 sentences
• PMH -✓✓Medical illnesses, sx, psych, obgyn
• Problem list and differential diagnoses -✓✓Problem list summarizes all related
problems to support diff dx.
diff dx- list of all poss dx with pertinent + (abnormal findings that support dx) and
pertinent- (normal findings that do not support dx)
• white coat HTN -✓✓Htn in office
• Masked HTN -✓✓htn at home but not in clinic
• Hallucinations -✓✓No external stimulation, can hear, see, smell, or feeling sensations
that are not there. Delirium, dementia, ptsd, schizo
• Illusions -✓✓misinterpretations of real external stimuli. "Magic show". Delirium, grief
reaction, acute ptsd, schizo
• Depression screening -✓✓Use PHQ2 first and if any questions are answered "yes"
proceed with PHQ9. Can tax for depression based off of PHQ9.
• retinal detachment -✓✓Vision loss, unilateral, painless, treatment is supportive. Sx to
reattach
• Red reflex absences indicates what? -✓✓Cataracts, vitreous, detached retina,
retinoblastoma (in kids).
refer to ophthalmologist
• nystagmus -✓✓Involuntary rapid eye movements
, could indicate cerebellum dz with gait ataxia, dysarthria (increase in retinal fixation),
vestibular disorder(decreases with retinal fixation)
• Optic neuritis -✓✓Painful, unilateral inflammation of the optic nerve
seen in pts with MS
• increased ICP -✓✓Papilledema of optic disc (optic disc is pink, blurred margins, edges
defined)
• Cotton wool patches result from what -✓✓Htn or dm
• subconjunctival hemorrhage -✓✓On sclera, benign and resolves in about 2wks. Can
be caused by trauma, sudden increase in BP
• CN I -✓✓Olfactory nerve: smell
age, head trauma, cigarettes, cocaine and Parkinson's can impact it
• CN XI -✓✓spinal accessory: shoulder shrug used to test it. Can indicate a peripheral
nerve disorder
• Acanthosis nigricans -✓✓Darkening skin folds on the back of neck. Can indicate
insulin resistance and uncontrolled DM
• Pityriasis Rosea -✓✓Xmas tree rash. MaculAr and papular lesions. Resolves on its
own. Benign.
• Psoriasis -✓✓Papullar rash with plaques
• Lyme disease -✓✓Bulls eye pattern rash. Can have symptoms of rash, flu like, fever,
headaches, fatigue
• Mongolian spots -✓✓Birth marks on buttocks, lower lumbar regions. Lessen or
disappear with age.
• Vitiligo -✓✓Hypopigmentation. Need to check thyroid function (TSH, FT3,FT4, cbc).
Increase chance of autoimmune dz
• Melanoma -✓✓ABCDE rule. Full body skin exams at 50 or above. Suggest a
dermatologist so they are established once they are 50.
• CN X -✓✓Vagus nerve. Test by opening pts mouth and having them say 'Ahh'. Uvula
and soft palate should rise in symmetry.
