readiness assessment-patho
A 24-year-old man presents with a 3-month history of upper abdominal pain. He
describes it as an intermittent, centrally located burning feeling in his upper abdomen,
most often occuring 2-3 hours after meals. His presentation is most consistent with the
clinical presentation of:
-acute gastritis
-gastric ulcer
-duodenal ulcer
-cholecystitis - ANS - Duodenal ulcer
Feedback: The pain associated with duodenal ulcers typically improves immediately
following meals and returns several hours after a meal.
A 68-year-old female with heart failure presents with tachycardia, S3 heart sound, and
basilar crackles bilaterally. blood pressure is 90/68, BUN is 58 mg/dL, creatinine is 2.4
mg/dL. This clinical presentation is most consistent with:
-prerenal azotemia
-acute glomerulonephritis
-tubular necrosis
-postrenal azotemia - ANS - prerenal azotemia
Feedback: Prerenal azotemia refers to elevations in BUN and creatinine levels resulting
from problems in the systemic circulation that decrease flow to the kidneys.
A 78-year-old man presents with fatigue and difficulty with bladder emptying.
Examination reveals a distended bladder but is otherwise unremarkable. The BUN is
88mg/dL; the creatinine is 2.8 mg/dL. This clinical assessment is most consistent with:
-prerenal azotemia
-acute glomerulonephritis
-acute tubular necrosis
-postrenal azotemia - ANS - postrenal azotemia
Feedback: Postrenal azotemia refers to elevations in BUN and creatinine levels
resulting from obstruction in the collecting system
,A woman has sustained a traumatic brain injury. She is able to follow simple commands
and can manipulate objects. Which term describes this state?
-Coma
-Persistent vegetative state
-Minimally conscious
-Locked-in syndrome - ANS - Minimally conscious
Feedback: When responses to the environment are seen, the patient is said to be in a
minimally conscious state
A young adult female patient presents to the clinic with complaints of nervousness,
tremulousness, palpitations, heat intolerance, fatigue, weight loss, and polyphagia. After
a complete history and physical, along with thyroid function tests, the FNP makes the
diagnosis of hyperthyroidism, recognizing that the most common cause of this condition
is:
-Thyroid cancer
-Graves' disease
-Pituitary adenoma
-Postpartum thyroiditis - ANS - Graves' Disease
Feedback: Graves' disease, an autoimmune condition also known as "diffuse toxic
goiter" is the most common cause of hyperthyroidism in this age group.
Age and the admission of the Glasgow Coma Scale (GCS) are important diagnostic
factors in TBI. Which GCS score describes a severe TBI?
13-15
12-13
9-12
3-8 - ANS - 3-8
Feedback: The GCS is scored between 3 and 15, 3 being the worst and 15 the best.
An adult patient with pernicious anemia may present with which signs and symptoms?
-Peripheral neuropathy, ataxia, lethargy, and fatigue
-Hepatomegaly, jaundice, and RUQ pain
-Hypertension, angina, and peripheral edema
-Blurred vision, diplopia, and decreased vibratory sensation - ANS - Peripheral
neuropathy, ataxia, lethargy, and fatigue
, Feedback: Vitamin B12 deficiency may result in neurologic signs and symptoms
including peripheral neuropathy, paresthesias, unsteady gait, loss of proprioception,
decreased vibratory sensation, lethargy and fatigue. In later stage, spasticity,
hyperactive reflexes and the presence of Romberg's sign are noted because of the
formation of a demyelinating lesion of the neurons of the spinal cord and cerebral cortex
and the presence of a beefy red tongue. These findings are specific to pernicious
anemia and must be assessed in all patient who present with anemia.
An older adult is diagnosed with renal failure. Lipid panel is noted to be within normal
limits, as is the patient's glycosylated hemoglobin. Which one of the following is most
likely the cause of his renal failure?
-History of MI with severe hypotensive crisis
-Advanced prostatic hypertrophy with hematuria
-Renal vascular changes secondary to long history of diabetes
-Exposure to carbon tetrachloride at the job site - ANS - Advanced prostatic
hypertrophy with hematuria
Feedback: Postrenal azotemia results from development of an obstructive problem
distal to the kidney, as seen in advanced prostatic hypertrophy with hematuria, bladder
tumor, or pelvic mass.
An older adult patient has a diagnosis of left-sided heart failure. The FNP would identify
what common condition associated with heart failure?
-Peripheral vascular disease
-Untreated hypertension
-Ventricular dysrhythmias
-COPD - ANS - Untreated hypertension
Feedback: Untreated HTN causes significant increased work of the the LV, eventually
causing left-sided HF.
An older adult patient is diagnosed with leukemia and has constitutional symptoms of
night sweats, unintentional weight loss, and fatigue with painless lymphadenopathy.
What type of leukemia does this patient have?
-Acute lymphocytic leukemia
-Chronic lymphocytic leukemia
-Acute myelogenous leukemia
-Chronic myelogenous leukemia - ANS - Chronic lymphocytic leukemia
