NSG 6020 FINAL EXAM
1. 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
2. A 35-year-old archaeologist comes to your office (located in Phoenix,
Arizona) for a regular skin check-up. She has just returned from her annual
dig site in Greece. She has fair skin and reddish-blonde hair. She has a
family history of melanoma. She has many freckles scattered across her skin.
From this description, which of the following is not a risk factor for
melanoma in this patient?
A) Age
B) Hair color
C) Actinic lentigines
D) Heavy sun exposure
3. A 15-year-old high school sophomore and her mother come to your clinic
because the mother is concerned about her daughter's weight. You measure
her daughter's height and weight and obtain a BMI of 19.5 kg/m2. Based on
this information, which of the following is appropriate?
A) Refer the patient to a nutritionist and a psychologist because the patient is
anorexic.
B) Reassure the mother that this is a normal body weight.
C) Give the patient information about exercise because the patient is obese.
D) Give the patient information concerning reduction of fat and cholesterol
in her diet because she is obese.
, 4. A middle-aged man comes in because he has noticed multiple small,
blood-red, raised lesions over his anterior chest and abdomen for the past
several months. They are not painful and he has not noted any bleeding or
bruising. He is concerned this may be consistent with a dangerous condition.
What should you do?
A) Reassure him that there is nothing to worry about.
B) Do laboratory work to check for platelet problems.
C) Obtain an extensive history regarding blood problems and bleeding
disorders.
D) Do a skin biopsy in the office.
5. Jacob, a 33-year-old construction worker, complains of a "lump on his
back" over his scapula. It has been there for about a year and is getting
larger. He says his wife has been able to squeeze out a cheesy-textured
substance on occasion. He worries this may be cancer. When gently pinched
from the side, a prominent dimple forms in the middle of the mass. What is
most likely?
A) An enlarged lymph node
B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion
6. A patient comes to you for the appearance of red patches on his forearms
that have been present for several months. They remain for several weeks.
He denies a history of trauma. Which of the following is likely?
A) Actinic keratoses
B) Pseudoscars
C) Actinic purpura
D) Cherry angiomas
7. 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
1. 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
2. A 35-year-old archaeologist comes to your office (located in Phoenix,
Arizona) for a regular skin check-up. She has just returned from her annual
dig site in Greece. She has fair skin and reddish-blonde hair. She has a
family history of melanoma. She has many freckles scattered across her skin.
From this description, which of the following is not a risk factor for
melanoma in this patient?
A) Age
B) Hair color
C) Actinic lentigines
D) Heavy sun exposure
3. A 15-year-old high school sophomore and her mother come to your clinic
because the mother is concerned about her daughter's weight. You measure
her daughter's height and weight and obtain a BMI of 19.5 kg/m2. Based on
this information, which of the following is appropriate?
A) Refer the patient to a nutritionist and a psychologist because the patient is
anorexic.
B) Reassure the mother that this is a normal body weight.
C) Give the patient information about exercise because the patient is obese.
D) Give the patient information concerning reduction of fat and cholesterol
in her diet because she is obese.
, 4. A middle-aged man comes in because he has noticed multiple small,
blood-red, raised lesions over his anterior chest and abdomen for the past
several months. They are not painful and he has not noted any bleeding or
bruising. He is concerned this may be consistent with a dangerous condition.
What should you do?
A) Reassure him that there is nothing to worry about.
B) Do laboratory work to check for platelet problems.
C) Obtain an extensive history regarding blood problems and bleeding
disorders.
D) Do a skin biopsy in the office.
5. Jacob, a 33-year-old construction worker, complains of a "lump on his
back" over his scapula. It has been there for about a year and is getting
larger. He says his wife has been able to squeeze out a cheesy-textured
substance on occasion. He worries this may be cancer. When gently pinched
from the side, a prominent dimple forms in the middle of the mass. What is
most likely?
A) An enlarged lymph node
B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion
6. A patient comes to you for the appearance of red patches on his forearms
that have been present for several months. They remain for several weeks.
He denies a history of trauma. Which of the following is likely?
A) Actinic keratoses
B) Pseudoscars
C) Actinic purpura
D) Cherry angiomas
7. 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
