2021 nur 634 final exam test preparation gcu nur 634 final test prep nur 634final exam test preparation advanced healt
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NUR-634 Final Exam Test Prep
You are examining an elderly man and notice the following: Decreased
vibration sense in the feet and ankles, diminished gag reflex, right patellar reflex
less than the left, and diminished abdominal reflexes. Which of these is
abnormal?
Decreased vibration sense
Diminished gag reflex
Diminished right patellar reflex compared to the left
Diminished abdominal reflexes
Question Points: 1..0
A 68-year-old retired farmer presents to your office for evaluation of a skin lesion.
On the right temporal area of the forehead, you see a flattened papule the same
color as his skin, covered by a dry scale that is round and feels hard. He has
several more of these scattered on the forehead, arms, and legs. Based on this
description, what is your most likely diagnosis?
Actinic keratosis
Seborrheic keratosis
Basal cell carcinoma
Squamous cell carcinoma
Question Points: 1..0
A 14-year-old junior high school student is brought in by his mother and
father because he seems to be developing breasts. The mother is upset because
she read on the Internet that smoking marijuana leads to breast enlargement in
males. The young man adamantly denies using any tobacco, alcohol, or drugs.
He has recently noticed changes in his penis, testicles, and pubic hair pattern.
Otherwise, his past medical history is unremarkable. His parents are both in good
health. He has two older brothers who never had this problem. On examination,
you see a mildly overweight teenager with enlarged breast tissue that is slightly
tender on both sides. Otherwise his examination is normal. He is agreeable to
taking a drug test.
What is the most likely cause of his gynecomastia?
Breast cancer
Imbalance of hormones of puberty
Drug use
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Alcohol use
Question Points: 1..0
A 17-year-old female presents to your office, complaining of a clear discharge
from her right breast for 2 months. She states that she noticed it when she and
her boyfriend were “messing around” and he squeezed her nipple. She continues
to have this discharge anytime she squeezes that nipple. She denies any trauma
to her breasts. Her past medical history is unremarkable. She denies any
pregnancies. Both of her parents are healthy. She denies using tobacco or illegal
drugs and drinks three to four beers a week. On examination, her breasts are
symmetric with no skin changes. You are able to express clear discharge from
her right nipple. You feel no discrete masses and her axillae are normal. The
remainder of her heart, lung, abdominal, and pelvic examinations are
unremarkable. A urine pregnancy test is negative.
What cause of nipple discharge is the most likely in her circumstance?
Benign breast abnormality
Breast cancer
Nonpuerperal galactorrhea
Pagets disease
Question Points: 1..0
A 26-year-old flight attendant presents in for a third trimester prenatal visit.
She has had prenatal care since her sixth week of pregnancy. She has no
complaints today and her prenatal course has been unremarkable. Today her
blood pressure and weight gain are appropriate, and her urine is unremarkable.
You have a first-year medical student shadowing you, so you ask the student to
get Doptones and measure the patient's uterus in centimeters. The nurse
practitioner student promptly reports fetal heart tones of 140, but he is having
difficulty obtaining the correct measurement. He knows one end of the tape goes
over the uterine fundus.
From what inferior anatomic position should the tape be placed?
Vagina
Clitoris
Pubic symphysis
Umbilicus
Question Points: 1..0
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A 58-year-old gardener presents to your office for evaluation of a new lesion
on her upper chest. The lesion appears to be “stuck on” and is oval, brown, and
slightly elevated with a flat surface. It has a rough, wart like texture on palpation.
Based on this description, what is your most likely diagnosis?
Actinic keratosis
Seborrheic keratosis
Basal cell carcinoma
Squamous cell carcinoma
Question Points: 0..0
Which of the following represents age-related changes in the lungs?
Decrease in chest wall compliance
Speed of expiration increases
Increase in respiratory muscle strength
Increased elastic recoil of lung tissue
Question Points: 1..0
A 15-month-old is brought to you for a fever of 38.6 degrees Celsius and
fussiness. The ear examination is as follows: external ear, normal appearance
and no tenderness with manipulation; canal, normal diameter without
evidence of inflammation; tympanic membrane, bulging, erythematous, and
opaque. Insufflation is deferred due to pain. What is the most likely condition
here?
Otitis externa
Cholesteatoma
Ruptured tympanic membrane
Otitis media
Question Points: 1..0
A 28-year-old musician presents to your clinic, complaining of a “spot” on his
penis. He states his partner noticed it 2 days ago and it hasn't gone away. He
says it doesn't hurt. He has had no burning with urination and no pain during
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intercourse. He has had several partners in the last year and uses condoms
occasionally. His past medical history consists of nongonococcal urethritis from
Chlamydia and prostatitis. He denies any surgeries. He smokes two packs of
cigarettes a day, drinks a case of beer a week, and smokes marijuana and
occasionally crack. He has injected IV drugs before but not in the last few years.
He is single and currently unemployed. His mother has rheumatoid arthritis, and
he doesn't know anything about his father. On examination, you see a young
man appearing deconditioned but pleasant. His vital signs are unremarkable. On
visualization of his penis, there is a 6-mm red, oval ulcer with an indurated base
just proximal to the corona. There is no prepuce because of neonatal
circumcision. On palpation, the ulcer is nontender. In the inguinal region, there is
nontender lymphadenopathy.
What disorder of the penis is most likely the diagnosis?
Condylomata acuminata
Genital herpes
Syphilitic chancre
Penile carcinoma
Question Points: 1..0
A 22-year-old law student presents to your office complaining of severe
abdominal pain radiating to his back. He states it began last night after hours of
heavy drinking. He has had abdominal pain and vomiting in the past after
drinking but never as bad as this. He cannot keep any food or water down, and
these symptoms have been going on for almost 12 hours. He has had no recent
illnesses or injuries. His past medical history is unremarkable. He denies smoking
or using illegal drugs but admits to drinking 6 to 10 beers per weekend night. He
admits that last night he drank something like 14 drinks. On examination you
find a young male appearing his stated age in some distress. He is leaning over
on the examination table and holding his abdomen with his arms. His blood
pressure is 90/60 and his pulse is 120. He is afebrile. His abdominal examination
reveals normal bowel sounds, but he is very tender in the left upper quadrant
and epigastric area. He has no Murphy's sign or tenderness in the right lower
quadrant. The remainder of his abdominal examination is normal. His rectal,
prostate, penile, and testicular examinations are normal. He has no inguinal
hernias or tenderness with that examination. Blood work is pending.
What etiology of abdominal pain is most likely causing his symptoms?
Peptic ulcer disease
Biliary colic
Acute cholecystitis
Acute pancreatitis
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