NR 511 (CHAMBERLAIN UNIV) FINAL EXAM 1
DIAGNOSES & PRIMARY CARE PRACTICUM
Q&A
2024
1. A 45-year-old male patient presents with a history of chronic low back
pain that radiates to his right leg. He has tried over-the-counter analgesics
and physical therapy, but they have not helped. He also reports difficulty
sleeping and feeling depressed. What is the most likely diagnosis for this
patient?
a) Lumbar disc herniation
b) Lumbar spinal stenosis
c) Lumbar spondylolisthesis
d) Lumbar radiculopathy*
Rationale: Lumbar radiculopathy is a condition where the nerve roots in the
lower spine are compressed or irritated, causing pain, numbness, tingling,
or weakness in the lower back and leg. The pain may be worse with certain
movements or positions, such as bending, twisting, or sitting. Lumbar disc
herniation, spinal stenosis, and spondylolisthesis are possible causes of
lumbar radiculopathy, but they are not the diagnosis itself.
2. A 60-year-old female patient comes to the clinic for a routine check-up.
She has a history of hypertension, diabetes, and hyperlipidemia. She takes
metformin, lisinopril, and atorvastatin. Her blood pressure is 150/90
mmHg, her fasting blood glucose is 180 mg/dL, and her LDL cholesterol is
160 mg/dL. What is the best course of action for this patient?
,a) Increase the dose of metformin
b) Add a diuretic to her antihypertensive regimen*
c) Switch from atorvastatin to rosuvastatin
d) Refer her to a cardiologist
Rationale: This patient has poorly controlled hypertension, diabetes, and
hyperlipidemia, which increase her risk of cardiovascular complications.
Adding a diuretic to her antihypertensive regimen may help lower her
blood pressure and reduce fluid retention. Increasing the dose of metformin
may lower her blood glucose, but it may also cause gastrointestinal side
effects or lactic acidosis. Switching from atorvastatin to rosuvastatin may
lower her LDL cholesterol, but it may also increase her risk of myopathy or
liver toxicity. Referring her to a cardiologist may be appropriate, but it is not
the first-line option.
3. A 35-year-old female patient complains of recurrent episodes of
palpitations, sweating, trembling, shortness of breath, chest pain, nausea,
dizziness, and fear of losing control or dying. She says these episodes occur
unpredictably and last for about 10 minutes. She avoids going to crowded
places or traveling alone because of these attacks. What is the most likely
diagnosis for this patient?
a) Generalized anxiety disorder
b) Panic disorder*
c) Post-traumatic stress disorder
d) Social anxiety disorder
Rationale: Panic disorder is characterized by recurrent and unexpected panic
attacks that cause intense fear and physical symptoms. The attacks are
followed by persistent worry about having another attack or its
consequences, or a change in behavior to avoid situations that may trigger an
attack. Generalized anxiety disorder involves excessive and uncontrollable
,worry about various aspects of life that lasts for at least six months. Post-
traumatic stress disorder involves re-experiencing a traumatic event through
intrusive memories, nightmares, flashbacks, or emotional distress, as well as
avoiding reminders of the event, having negative thoughts and feelings, and
being hyperaroused or easily startled. Social anxiety disorder involves
marked fear or anxiety about social situations where one may be scrutinized
or judged by others.
1. A patient presents to the primary care clinic with a persistent cough,
shortness of breath, and occasional wheezing. The primary care provider
suspects a respiratory condition. Which diagnostic tool would be most
appropriate for confirming the diagnosis?
a. Pulmonary function test
b. Electrocardiogram
c. Urinalysis
d. Chest X-ray
Answer: a. Pulmonary function test
Rationale: A pulmonary function test measures lung capacity and airflow,
helping to diagnose and monitor respiratory conditions such as asthma or
chronic obstructive pulmonary disease (COPD).
2. A patient visits the primary care clinic with symptoms of excessive thirst,
increased urination, and unexplained weight loss. The primary care
provider suspects diabetes mellitus. What laboratory test is typically used to
, confirm the diagnosis?
a. Complete blood count (CBC)
b. Fasting plasma glucose (FPG)
c. Thyroid-stimulating hormone (TSH)
d. Liver function test (LFT)
Answer: b. Fasting plasma glucose (FPG)
Rationale: Fasting plasma glucose is the most common screening test for
diabetes mellitus. A level above 126 mg/dL (7.0 mmol/L) on two separate
occasions confirms the diagnosis.
3. A patient presents to the primary care clinic with a circular, red rash with
a clear center and red edges. The primary care provider suspects Lyme
disease. Which laboratory test would be most appropriate for confirming
the diagnosis?
a. Complete blood count (CBC)
b. Rheumatoid factor (RF)
c. Urinalysis
d. Enzyme immunoassay (EIA) for Borrelia burgdorferi antibodies
Answer: d. Enzyme immunoassay (EIA) for Borrelia burgdorferi antibodies
Rationale: EIA is a reliable test for detecting antibodies against Borrelia
burgdorferi, the bacterium causing Lyme disease, in the blood. Positive
DIAGNOSES & PRIMARY CARE PRACTICUM
Q&A
2024
1. A 45-year-old male patient presents with a history of chronic low back
pain that radiates to his right leg. He has tried over-the-counter analgesics
and physical therapy, but they have not helped. He also reports difficulty
sleeping and feeling depressed. What is the most likely diagnosis for this
patient?
a) Lumbar disc herniation
b) Lumbar spinal stenosis
c) Lumbar spondylolisthesis
d) Lumbar radiculopathy*
Rationale: Lumbar radiculopathy is a condition where the nerve roots in the
lower spine are compressed or irritated, causing pain, numbness, tingling,
or weakness in the lower back and leg. The pain may be worse with certain
movements or positions, such as bending, twisting, or sitting. Lumbar disc
herniation, spinal stenosis, and spondylolisthesis are possible causes of
lumbar radiculopathy, but they are not the diagnosis itself.
2. A 60-year-old female patient comes to the clinic for a routine check-up.
She has a history of hypertension, diabetes, and hyperlipidemia. She takes
metformin, lisinopril, and atorvastatin. Her blood pressure is 150/90
mmHg, her fasting blood glucose is 180 mg/dL, and her LDL cholesterol is
160 mg/dL. What is the best course of action for this patient?
,a) Increase the dose of metformin
b) Add a diuretic to her antihypertensive regimen*
c) Switch from atorvastatin to rosuvastatin
d) Refer her to a cardiologist
Rationale: This patient has poorly controlled hypertension, diabetes, and
hyperlipidemia, which increase her risk of cardiovascular complications.
Adding a diuretic to her antihypertensive regimen may help lower her
blood pressure and reduce fluid retention. Increasing the dose of metformin
may lower her blood glucose, but it may also cause gastrointestinal side
effects or lactic acidosis. Switching from atorvastatin to rosuvastatin may
lower her LDL cholesterol, but it may also increase her risk of myopathy or
liver toxicity. Referring her to a cardiologist may be appropriate, but it is not
the first-line option.
3. A 35-year-old female patient complains of recurrent episodes of
palpitations, sweating, trembling, shortness of breath, chest pain, nausea,
dizziness, and fear of losing control or dying. She says these episodes occur
unpredictably and last for about 10 minutes. She avoids going to crowded
places or traveling alone because of these attacks. What is the most likely
diagnosis for this patient?
a) Generalized anxiety disorder
b) Panic disorder*
c) Post-traumatic stress disorder
d) Social anxiety disorder
Rationale: Panic disorder is characterized by recurrent and unexpected panic
attacks that cause intense fear and physical symptoms. The attacks are
followed by persistent worry about having another attack or its
consequences, or a change in behavior to avoid situations that may trigger an
attack. Generalized anxiety disorder involves excessive and uncontrollable
,worry about various aspects of life that lasts for at least six months. Post-
traumatic stress disorder involves re-experiencing a traumatic event through
intrusive memories, nightmares, flashbacks, or emotional distress, as well as
avoiding reminders of the event, having negative thoughts and feelings, and
being hyperaroused or easily startled. Social anxiety disorder involves
marked fear or anxiety about social situations where one may be scrutinized
or judged by others.
1. A patient presents to the primary care clinic with a persistent cough,
shortness of breath, and occasional wheezing. The primary care provider
suspects a respiratory condition. Which diagnostic tool would be most
appropriate for confirming the diagnosis?
a. Pulmonary function test
b. Electrocardiogram
c. Urinalysis
d. Chest X-ray
Answer: a. Pulmonary function test
Rationale: A pulmonary function test measures lung capacity and airflow,
helping to diagnose and monitor respiratory conditions such as asthma or
chronic obstructive pulmonary disease (COPD).
2. A patient visits the primary care clinic with symptoms of excessive thirst,
increased urination, and unexplained weight loss. The primary care
provider suspects diabetes mellitus. What laboratory test is typically used to
, confirm the diagnosis?
a. Complete blood count (CBC)
b. Fasting plasma glucose (FPG)
c. Thyroid-stimulating hormone (TSH)
d. Liver function test (LFT)
Answer: b. Fasting plasma glucose (FPG)
Rationale: Fasting plasma glucose is the most common screening test for
diabetes mellitus. A level above 126 mg/dL (7.0 mmol/L) on two separate
occasions confirms the diagnosis.
3. A patient presents to the primary care clinic with a circular, red rash with
a clear center and red edges. The primary care provider suspects Lyme
disease. Which laboratory test would be most appropriate for confirming
the diagnosis?
a. Complete blood count (CBC)
b. Rheumatoid factor (RF)
c. Urinalysis
d. Enzyme immunoassay (EIA) for Borrelia burgdorferi antibodies
Answer: d. Enzyme immunoassay (EIA) for Borrelia burgdorferi antibodies
Rationale: EIA is a reliable test for detecting antibodies against Borrelia
burgdorferi, the bacterium causing Lyme disease, in the blood. Positive
