NR 509 MIDTERM ASSESSMENT QIUZ
QUESTIONS WITH COMPLETE
ANSWERS
FIFE model - Answer-Feelings, ideas, functional effects, expectations
Challenging patients - Answer-Silent, talkative, confusing narrative, emotional liability,
angry/aggressive, flirtatious, discriminatory, hearing loss, nonadherence
Focus vs comprehensive assessment - Answer-Comprehensive for initial assessment,
focused for returning pt with chief compliant with an established baseline.
Health history - Answer-Use quotation, age, gender, source of info, 1-2 sentences
PMH - Answer-Medical illnesses, sx, psych, obgyn
Problem list and differential diagnoses - Answer-Problem list summarizes all related
problems to support diff dx.
diff dx- list of all poss dx with pertinent + (abnormal findings that support dx) and
pertinent- (normal findings that do not support dx)
white coat HTN - Answer-Htn in office
Masked HTN - Answer-htn at home but not in clinic
Hallucinations - Answer-No external stimulation, can hear, see, smell, or feeling
sensations that are not there. Delirium, dementia, ptsd, schizo
Illusions - Answer-misinterpretations of real external stimuli. "Magic show". Delirium,
grief reaction, acute ptsd, schizo
Depression screening - Answer-Use PHQ2 first and if any questions are answered "yes"
proceed with PHQ9. Can tax for depression based off of PHQ9.
retinal detachment - Answer-Vision loss, unilateral, painless, treatment is supportive. Sx
to reattach
Red reflex absences indicates what? - Answer-Cataracts, vitreous, detached retina,
retinoblastoma (in kids).
refer to ophthalmologist
nystagmus - Answer-Involuntary rapid eye movements
, could indicate cerebellum dz with gait ataxia, dysarthria (increase in retinal fixation),
vestibular disorder(decreases with retinal fixation)
Optic neuritis - Answer-Painful, unilateral inflammation of the optic nerve
seen in pts with MS
increased ICP - Answer-Papilledema of optic disc (optic disc is pink, blurred margins,
edges defined)
Cotton wool patches result from what - Answer-Htn or dm
subconjunctival hemorrhage - Answer-On sclera, benign and resolves in about 2wks.
Can be caused by trauma, sudden increase in BP
CN I - Answer-Olfactory nerve: smell
age, head trauma, cigarettes, cocaine and Parkinson's can impact it
CN XI - Answer-spinal accessory: shoulder shrug used to test it. Can indicate a
peripheral nerve disorder
Acanthosis nigricans - Answer-Darkening skin folds on the back of neck. Can indicate
insulin resistance and uncontrolled DM
Pityriasis Rosea - Answer-Xmas tree rash. MaculAr and papular lesions. Resolves on
its own. Benign.
Psoriasis - Answer-Papullar rash with plaques
Lyme disease - Answer-Bulls eye pattern rash. Can have symptoms of rash, flu like,
fever, headaches, fatigue
Mongolian spots - Answer-Birth marks on buttocks, lower lumbar regions. Lessen or
disappear with age.
Vitiligo - Answer-Hypopigmentation. Need to check thyroid function (TSH, FT3,FT4,
cbc). Increase chance of autoimmune dz
Melanoma - Answer-ABCDE rule. Full body skin exams at 50 or above. Suggest a
dermatologist so they are established once they are 50.
CN X - Answer-Vagus nerve. Test by opening pts mouth and having them say 'Ahh'.
Uvula and soft palate should rise in symmetry.
Vasovagal syncope - Answer-Sympathetic tone and increase in vagal tone causing a
decrease in BP