NURS 6614 Final Questions With Complete Solutions
36 year old male presents with complaints of pain and swelling
in his left knee with associated knee instability and occasional
"locking" when walking. He reports playing tennis last week and
felt a tearing, popping sensation that caused him to fall to the
ground. He denies any bruising. He has self treated with
Ibuprofen and wearing a knee brace with partial resolution.
Based on this history your differentials should include all of the
following except: Correct Answer Trochanteric bursitis
A 25 year old male presents with complaints of daily back pain
localized to his lower back after lifting a heavy box at work 3
days ago. The symptoms interfere with his ability to participate
in his bowling league. He denies incontinence, gait instability or
radicular symptoms. On examination, you note normal
musculature, FROM of the spine with moderate paravertibral
tenderness throughout the lubrosacaral spine without spasm. The
client complains of posterior thigh pain when his right leg is
elevated 75 degrees. His remaining examination is
unremarkable. Your diagnosis is: Correct Answer Lumbar
Strain
A 28 year old female presents with complaints of chronic aching
pain and stiffness, frequently involving the entire body but with
prominence of pain around the neck, shoulders, low back, and
hips. She reports frequent headaches and trouble sleeping at
least three nights per week and reports that even minor exertion
aggravates pain and increases fatigue. Physical examination is
normal except for "trigger points" of pain produced by palpation
of various areas such as the trapezius, the medial fat pad of the
,knee, and the lateral epicondyle of the elbow. Your most likely
diagnosis would be: Correct Answer Fibromyalgia
A 33-year-old female patient presents to your clinic with a 2 day
history of dysuria, urinary frequency, and incontinence. She has
been afebrile and denies sexual intercourse in the past two
months. This is the first such episode and she has no history of
previous hospitalization or antibiotic use for any reason in the
past 3 months. She has no known allergies to any medications.
She has no pertinent positive exam findings. The urinalysis is
positive for RBCs, protein, and nitrites. What is your diagnosis
for this patient? Correct Answer Lower urinary tract infection
A 33-year-old female patient presents to your clinic with a 2 day
history of dysuria, urinary frequency, and incontinence. She has
been afebrile and denies sexual intercourse in the past two
months. This is the first such episode and she has no history of
previous hospitalization or antibiotic use for any reason in the
past 3 months. She has no known allergies to any medications.
The urinalysis is positive for blood and pyuria. Your patient
does not have insurance and has financial constraints. There is
no known antibiotic resistance in your area. What do you decide
to order for your patient today? Correct Answer
Trimethoprim-sulfamethoxazole
A 33-year-old female patient presents to your clinic with a 2 day
history of dysuria, urinary frequency, and incontinence. She has
been afebrile and denies sexual intercourse in the past two
months. This is the first such episode and she has no history of
previous hospitalization or antibiotic use for any reason in the
past 3 months. She has no known allergies to any medications.
, What is most likely to be the best option for your initial
diagnostic work-up today? Correct Answer Clean-catch, mid-
stream urine for urinalysis
A 36 year old male presents with acute onset of unilateral
inflammation, pain, and erythema of the first
metatarsophanlangeal (MTP) joint. Differential diagnoses that
should be considered include: Correct Answer Cellulitis,
arthritis, and gout
A 36-year-old afebrile woman without health problems presents
with dysuria and frequency of urination. Her urinalysis findings
include results positive for leukocyte esterase. Nitrites are
negative. You understand that possible reasons for these
findings include all of the following except: Correct Answer
Her differential diagnosis excludes UTI
A 44-year-old woman presents with pyelonephritis. The report
of her urinalysis is least likely to include: Correct Answer 3+
protein
A 48 year old female patient presents to clinic with the
following history: "Feeling blue" "No desire to attend sewing
group these days" "I go to sleep at night but I wake up at 3 am
and cannot go back to sleep." "I just have trouble getting out of
bed in the morning and I feel tired all day." "I'm just not a good
wife any more." When asked how long she has been feeling this
way she recalls at least 3 weeks, maybe more. Based on the
following history, your patient Correct Answer Meets the
DSM-IV diagnostic criteria for major depression in adults
36 year old male presents with complaints of pain and swelling
in his left knee with associated knee instability and occasional
"locking" when walking. He reports playing tennis last week and
felt a tearing, popping sensation that caused him to fall to the
ground. He denies any bruising. He has self treated with
Ibuprofen and wearing a knee brace with partial resolution.
Based on this history your differentials should include all of the
following except: Correct Answer Trochanteric bursitis
A 25 year old male presents with complaints of daily back pain
localized to his lower back after lifting a heavy box at work 3
days ago. The symptoms interfere with his ability to participate
in his bowling league. He denies incontinence, gait instability or
radicular symptoms. On examination, you note normal
musculature, FROM of the spine with moderate paravertibral
tenderness throughout the lubrosacaral spine without spasm. The
client complains of posterior thigh pain when his right leg is
elevated 75 degrees. His remaining examination is
unremarkable. Your diagnosis is: Correct Answer Lumbar
Strain
A 28 year old female presents with complaints of chronic aching
pain and stiffness, frequently involving the entire body but with
prominence of pain around the neck, shoulders, low back, and
hips. She reports frequent headaches and trouble sleeping at
least three nights per week and reports that even minor exertion
aggravates pain and increases fatigue. Physical examination is
normal except for "trigger points" of pain produced by palpation
of various areas such as the trapezius, the medial fat pad of the
,knee, and the lateral epicondyle of the elbow. Your most likely
diagnosis would be: Correct Answer Fibromyalgia
A 33-year-old female patient presents to your clinic with a 2 day
history of dysuria, urinary frequency, and incontinence. She has
been afebrile and denies sexual intercourse in the past two
months. This is the first such episode and she has no history of
previous hospitalization or antibiotic use for any reason in the
past 3 months. She has no known allergies to any medications.
She has no pertinent positive exam findings. The urinalysis is
positive for RBCs, protein, and nitrites. What is your diagnosis
for this patient? Correct Answer Lower urinary tract infection
A 33-year-old female patient presents to your clinic with a 2 day
history of dysuria, urinary frequency, and incontinence. She has
been afebrile and denies sexual intercourse in the past two
months. This is the first such episode and she has no history of
previous hospitalization or antibiotic use for any reason in the
past 3 months. She has no known allergies to any medications.
The urinalysis is positive for blood and pyuria. Your patient
does not have insurance and has financial constraints. There is
no known antibiotic resistance in your area. What do you decide
to order for your patient today? Correct Answer
Trimethoprim-sulfamethoxazole
A 33-year-old female patient presents to your clinic with a 2 day
history of dysuria, urinary frequency, and incontinence. She has
been afebrile and denies sexual intercourse in the past two
months. This is the first such episode and she has no history of
previous hospitalization or antibiotic use for any reason in the
past 3 months. She has no known allergies to any medications.
, What is most likely to be the best option for your initial
diagnostic work-up today? Correct Answer Clean-catch, mid-
stream urine for urinalysis
A 36 year old male presents with acute onset of unilateral
inflammation, pain, and erythema of the first
metatarsophanlangeal (MTP) joint. Differential diagnoses that
should be considered include: Correct Answer Cellulitis,
arthritis, and gout
A 36-year-old afebrile woman without health problems presents
with dysuria and frequency of urination. Her urinalysis findings
include results positive for leukocyte esterase. Nitrites are
negative. You understand that possible reasons for these
findings include all of the following except: Correct Answer
Her differential diagnosis excludes UTI
A 44-year-old woman presents with pyelonephritis. The report
of her urinalysis is least likely to include: Correct Answer 3+
protein
A 48 year old female patient presents to clinic with the
following history: "Feeling blue" "No desire to attend sewing
group these days" "I go to sleep at night but I wake up at 3 am
and cannot go back to sleep." "I just have trouble getting out of
bed in the morning and I feel tired all day." "I'm just not a good
wife any more." When asked how long she has been feeling this
way she recalls at least 3 weeks, maybe more. Based on the
following history, your patient Correct Answer Meets the
DSM-IV diagnostic criteria for major depression in adults
