NR509 Week 4 Midterm Exam Complete Actual
Exam Questions 1- 100 | NR-509 Advanced
Physical Assessment Midterm Exam
Question 1
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine
Answer: A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall.
Pleuritic chest pain is also a sharp chest pain which increases with a deep breath.
This type of pain can occur with inflammation of the pleura from pneumonia or
other conditions and pulmonary embolus.
Question 2
A patient comes to the emergency room for evaluation of shortness of breath. To
which anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic
Answer: C) Cardiac
,Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
also result in shortness of breath, such as anemia in the hematologic category,
pregnancy in the reproductive category, or sepsis with UTI in the urinary category.
Question 3
A patient presents for evaluation of a cough. Which of the following anatomic
regions can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine
Answer: C) Cardiac
The cardiac system can cause a cough if the patient has congestive heart failure.
This results in fluid buildup in the lungs, which in turn can cause a cough that
produces pink, frothy sputum. A foreign body in the ear may also cause a cough by
stimulating Arnold's branch of the vagus nerve, but this is less likely to be seen
clinically than heart failure.
Question 4
A 22-year-old advertising copywriter presents for evaluation of joint pain. The
pain is new, located in the wrists and fingers bilaterally, with some subjective
fever. The patient denies a rash; she also denies recent travel or camping activities.
She has a family history significant for rheumatoid arthritis. Based on this
information, which of the following pathologic processes would be the most
correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
,Answer: B) Inflammatory
The description is most consistent with an inflammatory process, although all the
other etiologies should be considered. Lyme disease is an infection which
commonly causes arthritis, hemophilia is a hematologic condition which can cause
bleeding in the joints, and trauma can obviously cause joint pain.
Question 5
A 58-year-old male with a history of hypertension presents with sudden onset of
severe headache described as "thunderclap." He states it is the worst headache of
his life. Which of the following is the most concerning diagnosis?
A) Migraine headache
B) Tension headache
C) Subarachnoid hemorrhage
D) Sinusitis
Answer: C) Subarachnoid hemorrhage
A thunderclap headache that reaches maximal intensity within seconds to minutes
is highly concerning for subarachnoid hemorrhage. Other causes include sentinel
bleed from an aneurysm, reversible cerebral vasoconstriction syndrome, or
pituitary apoplexy. Migraine and tension headaches typically have gradual onset.
Question 6
A 45-year-old female presents with fatigue, weight gain, cold intolerance, and dry
skin. On examination, you note bradycardia and delayed relaxation of deep tendon
reflexes. Which endocrine disorder is most likely?
A) Hyperthyroidism
B) Hypothyroidism
C) Cushing's syndrome
D) Diabetes mellitus
Answer: B) Hypothyroidism
, The combination of fatigue, weight gain, cold intolerance, dry skin, bradycardia,
and delayed reflex relaxation is classic for hypothyroidism. Hyperthyroidism
would present with weight loss, heat intolerance, and tachycardia. Cushing's
syndrome presents with weight gain but also striae, moon facies, and hypertension.
Question 7
A 72-year-old male presents with acute onset of right-sided weakness and
difficulty speaking. His symptoms began 2 hours ago. On examination, he has right
facial droop, right arm drift, and slurred speech. What is the most appropriate next
step?
A) Order an outpatient MRI
B) Administer aspirin and schedule follow-up
C) Activate stroke protocol and obtain emergent CT head
D) Prescribe physical therapy
Answer: C) Activate stroke protocol and obtain emergent CT head
This patient presents with acute onset of focal neurological deficits consistent with
stroke. Time is critical, and the patient is within the window for possible
thrombolytic therapy. Emergent CT head is required to rule out hemorrhagic stroke
before considering thrombolytics.
Question 8
A 35-year-old pregnant female at 28 weeks gestation presents with a chief
complaint of "seeing spots" and a headache. Her blood pressure is 165/105 mmHg.
Urinalysis shows 3+ protein. What is the most likely diagnosis?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Migraine with aura
Answer: B) Preeclampsia
Exam Questions 1- 100 | NR-509 Advanced
Physical Assessment Midterm Exam
Question 1
A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine
Answer: A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest wall.
Pleuritic chest pain is also a sharp chest pain which increases with a deep breath.
This type of pain can occur with inflammation of the pleura from pneumonia or
other conditions and pulmonary embolus.
Question 2
A patient comes to the emergency room for evaluation of shortness of breath. To
which anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic
Answer: C) Cardiac
,Cardiac disorders such as congestive heart failure are the most likely on this list to
result in shortness of breath. There are cases within the other categories which may
also result in shortness of breath, such as anemia in the hematologic category,
pregnancy in the reproductive category, or sepsis with UTI in the urinary category.
Question 3
A patient presents for evaluation of a cough. Which of the following anatomic
regions can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine
Answer: C) Cardiac
The cardiac system can cause a cough if the patient has congestive heart failure.
This results in fluid buildup in the lungs, which in turn can cause a cough that
produces pink, frothy sputum. A foreign body in the ear may also cause a cough by
stimulating Arnold's branch of the vagus nerve, but this is less likely to be seen
clinically than heart failure.
Question 4
A 22-year-old advertising copywriter presents for evaluation of joint pain. The
pain is new, located in the wrists and fingers bilaterally, with some subjective
fever. The patient denies a rash; she also denies recent travel or camping activities.
She has a family history significant for rheumatoid arthritis. Based on this
information, which of the following pathologic processes would be the most
correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
,Answer: B) Inflammatory
The description is most consistent with an inflammatory process, although all the
other etiologies should be considered. Lyme disease is an infection which
commonly causes arthritis, hemophilia is a hematologic condition which can cause
bleeding in the joints, and trauma can obviously cause joint pain.
Question 5
A 58-year-old male with a history of hypertension presents with sudden onset of
severe headache described as "thunderclap." He states it is the worst headache of
his life. Which of the following is the most concerning diagnosis?
A) Migraine headache
B) Tension headache
C) Subarachnoid hemorrhage
D) Sinusitis
Answer: C) Subarachnoid hemorrhage
A thunderclap headache that reaches maximal intensity within seconds to minutes
is highly concerning for subarachnoid hemorrhage. Other causes include sentinel
bleed from an aneurysm, reversible cerebral vasoconstriction syndrome, or
pituitary apoplexy. Migraine and tension headaches typically have gradual onset.
Question 6
A 45-year-old female presents with fatigue, weight gain, cold intolerance, and dry
skin. On examination, you note bradycardia and delayed relaxation of deep tendon
reflexes. Which endocrine disorder is most likely?
A) Hyperthyroidism
B) Hypothyroidism
C) Cushing's syndrome
D) Diabetes mellitus
Answer: B) Hypothyroidism
, The combination of fatigue, weight gain, cold intolerance, dry skin, bradycardia,
and delayed reflex relaxation is classic for hypothyroidism. Hyperthyroidism
would present with weight loss, heat intolerance, and tachycardia. Cushing's
syndrome presents with weight gain but also striae, moon facies, and hypertension.
Question 7
A 72-year-old male presents with acute onset of right-sided weakness and
difficulty speaking. His symptoms began 2 hours ago. On examination, he has right
facial droop, right arm drift, and slurred speech. What is the most appropriate next
step?
A) Order an outpatient MRI
B) Administer aspirin and schedule follow-up
C) Activate stroke protocol and obtain emergent CT head
D) Prescribe physical therapy
Answer: C) Activate stroke protocol and obtain emergent CT head
This patient presents with acute onset of focal neurological deficits consistent with
stroke. Time is critical, and the patient is within the window for possible
thrombolytic therapy. Emergent CT head is required to rule out hemorrhagic stroke
before considering thrombolytics.
Question 8
A 35-year-old pregnant female at 28 weeks gestation presents with a chief
complaint of "seeing spots" and a headache. Her blood pressure is 165/105 mmHg.
Urinalysis shows 3+ protein. What is the most likely diagnosis?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Migraine with aura
Answer: B) Preeclampsia
