NR 509 BATES TEST BANK - MIDTERM ACTUAL
UPDATED QUESTIONS AND ANSWERS WITH
RATIONALE 2024/2025 SOLVED 100% OVER 250 Q&A.
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
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.
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
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?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine
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.
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
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.
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?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
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?
,A) Infection
B) Inflammation
C) Allergic
D) Vascular
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?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with
full range of motion
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?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly
or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without
, rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration,
to the
point of stopping inspiration, and there is no rebound or guarding.
In cholecystitis, the pain, which originates from the gallbladder, is located in the
right upper quadrant. Severity of pain with inspiration that is sufficient to stop further
inhalation
is also known as Murphy's sign, which, if present, is further indicative of inflammation of
the
gallbladder.
A 55-year-old data entry operator comes to the clinic to establish care. She has
the following
symptoms: headache, neck pain, sinus congestion, sore throat, ringing in ears,
sharp brief chest
pains at rest, burning abdominal pain with spicy foods, constipation, urinary
frequency that is worse with coughing and sneezing, and swelling in legs. This
cluster of symptoms is explained
by:
A) One disease process
B) More than one disease process
B) More than one disease process
The patient appears to have several possible conditions: allergic rhinitis, arthritis,
conductive hearing loss, pleuritic chest pains, heartburn, stress urinary incontinence,
and venous stasis, among other conditions. Although we always try, it is very difficult to
assign all of these
symptoms to one cohesive diagnosis.
A 62-year-old teacher presents to the clinic for evaluation of the following
symptoms: fever, headache, sinus congestion, sore throat, green nasal
discharge, and cough. This cluster of symptoms is best explained by:
A) One disease process
B) More than one disease process
A) One disease process
This cluster of symptoms is most consistent with sinusitis. The chance that all of these
UPDATED QUESTIONS AND ANSWERS WITH
RATIONALE 2024/2025 SOLVED 100% OVER 250 Q&A.
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
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.
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
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?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine
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.
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
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.
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?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
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?
,A) Infection
B) Inflammation
C) Allergic
D) Vascular
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?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range
of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous
muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to
palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with
full range of motion
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?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly
or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without
, rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration,
to the
point of stopping inspiration, and there is no rebound or guarding.
In cholecystitis, the pain, which originates from the gallbladder, is located in the
right upper quadrant. Severity of pain with inspiration that is sufficient to stop further
inhalation
is also known as Murphy's sign, which, if present, is further indicative of inflammation of
the
gallbladder.
A 55-year-old data entry operator comes to the clinic to establish care. She has
the following
symptoms: headache, neck pain, sinus congestion, sore throat, ringing in ears,
sharp brief chest
pains at rest, burning abdominal pain with spicy foods, constipation, urinary
frequency that is worse with coughing and sneezing, and swelling in legs. This
cluster of symptoms is explained
by:
A) One disease process
B) More than one disease process
B) More than one disease process
The patient appears to have several possible conditions: allergic rhinitis, arthritis,
conductive hearing loss, pleuritic chest pains, heartburn, stress urinary incontinence,
and venous stasis, among other conditions. Although we always try, it is very difficult to
assign all of these
symptoms to one cohesive diagnosis.
A 62-year-old teacher presents to the clinic for evaluation of the following
symptoms: fever, headache, sinus congestion, sore throat, green nasal
discharge, and cough. This cluster of symptoms is best explained by:
A) One disease process
B) More than one disease process
A) One disease process
This cluster of symptoms is most consistent with sinusitis. The chance that all of these
