NR 509 MIDTERM EXAM QBANK | 250 QUESTIONS
AND ANSWERS (100% CORRECT)/A+ GRADE ASSURED
A patient presents for evaluation of a sharp, aching chest pain which increases
with breathing. Which anatomic area would you localize the symptom to?
• Musculoskeletal
• Reproductive
• Urinary
• Endocrine Correct Ans ➡ A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such ascostochondritis 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 conditionsand
pulmonary embolus.
A patient comes to the emergency room for evaluation of shortness of breath.
To which anatomic region would you assign the symptom?
• Reproductive
• Urinary
• Cardiac
• Hematologic Correct Ans ➡ 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.
,A patient presents for evaluation of a cough. Which of the following anatomic
regions can be responsible for a cough?
• Ophthalmologic
• Auditory
• Cardiac
• Endocrine Correct Ans ➡ C) Cardiac
2
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.
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 familyhistory significant for rheumatoid arthritis. Based on this
information, which of the following pathologic processes would be the most
correct?
• Infectious
• Inflammatory
• Hematologic
• Traumatic Correct Ans ➡ 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 inthe joints, and trauma can obviously cause joint pain.
A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications
to ease the pain, but this time they haven't worked as well and he still has
discomfort. He recently wallpapered the entire second floor in his house, which
caused him great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this
description, what is the most likely pathologic process?
• Infectious
• Neoplastic
• Degenerative
• Traumatic Correct Ans ➡ C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The
patient has had intermittent symptoms and the questions asked to elicit pertinent
negative and positive findings are negative for infectious, traumatic, or
neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-
week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
• Infection
• Inflammation
• Allergic
• Vascular Correct Ans ➡ C) Allergic
This description is most consistent with allergic rhinitis.
, A 19-year old-college student presents to the emergency room with fever,
headache, and neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis. Several of her dorm mates have been vaccinated, but
she hasn't been.Which of the following
physical examination descriptions is most consistent with meningitis?
• Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range of motion
• Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous
muscle spasm and limited range of motion to the right
• Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck tender to
palpation, unable to perform range of motion
• Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck supple with
full range of motion Correct Ans ➡ C) Head is normocephalic and atraumatic,
fundi with blurred disc margins, neck tender to
palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and
lack of range of motion are consistent with neck stiffness, which in this scenario
is likely to be caused
by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.
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?
AND ANSWERS (100% CORRECT)/A+ GRADE ASSURED
A patient presents for evaluation of a sharp, aching chest pain which increases
with breathing. Which anatomic area would you localize the symptom to?
• Musculoskeletal
• Reproductive
• Urinary
• Endocrine Correct Ans ➡ A) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such ascostochondritis 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 conditionsand
pulmonary embolus.
A patient comes to the emergency room for evaluation of shortness of breath.
To which anatomic region would you assign the symptom?
• Reproductive
• Urinary
• Cardiac
• Hematologic Correct Ans ➡ 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.
,A patient presents for evaluation of a cough. Which of the following anatomic
regions can be responsible for a cough?
• Ophthalmologic
• Auditory
• Cardiac
• Endocrine Correct Ans ➡ C) Cardiac
2
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.
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 familyhistory significant for rheumatoid arthritis. Based on this
information, which of the following pathologic processes would be the most
correct?
• Infectious
• Inflammatory
• Hematologic
• Traumatic Correct Ans ➡ 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 inthe joints, and trauma can obviously cause joint pain.
A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications
to ease the pain, but this time they haven't worked as well and he still has
discomfort. He recently wallpapered the entire second floor in his house, which
caused him great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this
description, what is the most likely pathologic process?
• Infectious
• Neoplastic
• Degenerative
• Traumatic Correct Ans ➡ C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The
patient has had intermittent symptoms and the questions asked to elicit pertinent
negative and positive findings are negative for infectious, traumatic, or
neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-
week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
• Infection
• Inflammation
• Allergic
• Vascular Correct Ans ➡ C) Allergic
This description is most consistent with allergic rhinitis.
, A 19-year old-college student presents to the emergency room with fever,
headache, and neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis. Several of her dorm mates have been vaccinated, but
she hasn't been.Which of the following
physical examination descriptions is most consistent with meningitis?
• Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range of motion
• Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous
muscle spasm and limited range of motion to the right
• Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck tender to
palpation, unable to perform range of motion
• Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck supple with
full range of motion Correct Ans ➡ C) Head is normocephalic and atraumatic,
fundi with blurred disc margins, neck tender to
palpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and
lack of range of motion are consistent with neck stiffness, which in this scenario
is likely to be caused
by meningeal inflammation. Kernig's and Brudzinski's signs are also helpful in
testing for meningeal irritation on exam.
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?
