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NU 650 through Midterm Questions and answers
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NU 650 through Midterm Questions and answers
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NU 650 through Midterm3 Dimensions of cultural humility - correct answer-1) Self-awareness: learn about your own
biases; we all have them.
2) Respectful communication: work to eliminate assumptions about what is "normal". Learn
directly from your patients; they are the experts on their culture and illness.
3) Collaborative partnerships: build your patient relationships on respect and mutually
acceptable plans.
A 12-year-old presents to the clinic with his father for evaluation of a painful lump in the left
eye. It started this morning. He denies any trauma or injury. There is no visual disturbance.
Upon physical examination, there is a red raised area at the margin of the eyelid that is
tender to palpation; no tearing occurs with palpation of the lesion. Based on this description,
what is the most likely diagnosis?
A) Dacryocystitis
B) Chalazion
C) Hordeolum
D) Xanthelasma - correct answer-C
Hordeolum - aka Stye
A 15 yo presents to the emergency room with his mother for eval of an area of blood in the
left eye. He denies trauma or injury but has been coughing forcefully with a recent cold. He
denies visual disturbances, eye pain, or discharge from the eye. On physical exam, the
PERRL, with a visual acuity of
20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated area
at the lateral aspect of the base of the left eye. The cornea is clear. Based on this
description, what is the most likely diagnosis?
A) Conjunctivitis
B) Acute iritis
C) Corneal abrasion
D) Subconjunctival hemorrhage - correct answer-D
A 15-year-old high school student presents to your clinic complaining of pain in his left ear.
He noticed that it occurred shortly after starting swimming lessons at the local YMCA. Upon
physical examination, you notice that the external canal is swollen and tender during
insertion of the speculum. What is your most likely diagnosis?
(A) Otitis media
(B) Serous otitis
(C) Eustachian tube dysfunction
(D) Otitis externa - correct answer-D
A 15-year-old member of the high school marching band comes to your office for evaluation
of hearing loss. He had multiple ear infections as an infant and toddler, and had to have
myringotomy tubes inserted in his ears. Additionally, he suffers from many allergies. His
hearing is diminished in the right ear. When you place a vibrating tuning fork on the top of his
head, the sound lateralizes to the right ear. The name of this test is:
,(A) Weber's test
(B) Rinne's test
(C) Whisper test
(D) Romberg test - correct answer-A
A 17-year-old high school senior presents to your clinic in acute respiratory distress.
Between shallow breaths he states he was at home finishing his homework when he
suddenly began having right-sided chest pain and severe SOB. Denies any recent traumas
or illnesses. PMH unremarkable. On examination you see a tall, thin young man in obvious
distress. He is diaphoretic and RR 35. On auscultation you hear no breath sounds on the
right side of his superior chest wall. On percussion he is hyperresonant over RUL. Palpation:
absent fremitus over the RUL.
What disorder of the thorax or lung best describes his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - correct answer-A
A 19 yo construction worker presents for evaluation of a rash. He notes that it started on his
back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He
does sweat more than before because being outdoors is part of his job. On physical
examination, you note dark tan patches with a reddish cast that has sharp borders and fine
scales, scattered more prominently around the upper back, chest, neck, and upper arms as
well as under the arms. Based on this description, what is your most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema - correct answer-B
Tinea = fungal and promoted by moisture
A 2-week-old infant is brought into your clinic by his parents because they have noticed that
their child is having some difficulty with feeding and that there is something strange in his
mouth. You diagnose thrush. What is the most likely physical finding you will see upon
examination of his mouth?
(A) Koplik's spots
(B) White plaques
(C) Erythematous plaques
(D) Epstein's pearls - correct answer-B
A 21-year-old college senior presents to your clinic, complaining of SOB and a
nonproductive nocturnal cough. She states she used to feel this way only with extreme
exercise, but lately she has felt this way continuously. She denies any other upper
respiratory symptoms, CP, GI symptoms, or urinary tract symptoms. PMH significant only for
seasonal allergies. On exam she is in no acute distress; temp is 98.6, BP is 120/80, her
pulse is 80, and her RR is 20. On auscultation of her chest, there is decreased air movement
and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.
Which disorder of the thorax or lung does this best describe?
A) Spontaneous pneumothorax
,B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - correct answer-C
A 22-year-old agricultural worker presents to your office for evaluation of coughing. She has
had this cough for 6 weeks; it is nonproductive and worst first thing in the morning. She
denies fever, chills, weight loss, or night sweats; she does have clear rhinorrhea and itchy,
watery eyes. You diagnose her with allergic rhinoconjunctivitis. On physical examination of
the nasal mucosa, what would you expect to find?
(A) Erythematous, ulcerated mucosa
(B) Pale to bluish, boggy mucosa
(C) Pink mucosa
(D) Ulcerated mucosa - correct answer-B
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right-sided
chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5
seconds, taking his breath away. He states he feels like he has to breathe shallowly to keep
it from recurring. The only thing that makes it better is lying quietly on his right side. It is
much worse when he takes a deep breath. 2 weeks ago he had an upper respiratory
infection with a severe hacking cough. Exam: lying on his right side but appears quite
comfortable. Temp, BP, pulse, and RR unremarkable. Normal breath sounds, percussion
unremarkable. Ribs are nontender. What disorder of the chest best describes his symptoms?
A) Pericarditis
B) Chest wall pain
C) Pleural pain
D) Angina pectoralis - correct answer-C
A 25-year-old optical technician comes to your clinic for evaluation of fatigue. As part of your
physical examination, you listen to her heart and hear a murmur only at the cardiac apex.
Which valve is most likely to be involved, based on the location of the murmur?
A) Mitral
B) Tricuspid
C) Aortic
D) Pulmonic - correct answer-A
A 25-year-old swim instructor presents to your clinic complaining of an itchy scalp. You
diagnose seborrheic dermatitis. What physical findings are most consistent with this
diagnosis?
(A) Erythema of the scalp
(B) Pustules on the scalp
(C) Dry, flaking areas on the scalp
(D) Ecchymoses on the scalp - correct answer-C
A 26-year-old woman presents for evaluation of hair loss. She also has noticed increased
weight loss and diarrhea. You diagnose Graves' disease (hyperthyroidism). On physical
examination of the hair, what would you expect to find?
(A) Fine texture
(B) Coarse texture
, (C) Oily hair
(D) Dry hair - correct answer-A
A 28 yo patient comes to the office for evaluation of a rash. At first there was only one large
patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On
examination, you note that the pattern of eruption is like a Christmas tree and that there are
a variety of erythematous papules and macules on the cleavage lines of the back. Based on
this description, what is the most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema - correct answer-A
A 28-year-old housewife presents to your office for a 6-week postpartum checkup. She
complains of fatigue greater than expected and palpitations. Her hair is falling out as well.
She denies sadness or depression symptoms. Before this, she had not had any medical
problems. She is breastfeeding her child and is not on any birth control. She had her first
period since giving birth last week. A pregnancy test done in the office is negative. What is
your most likely diagnosis?
(A) Thyroiditis
(B) Iron-deficiency anemia
(C) Addison's disease
(D) Sheehan's syndrome - correct answer-A
A 29-year-old computer programmer comes to your office for evaluation of a headache. The
tightening sensation is located all over the head and is of moderate intensity. It used to last
minutes, but this time it has lasted for 5 days. He denies photophobia and nausea. He
spends several hours each day at a computer monitor/keyboard. He has tried
over-the-counter medication; it has dulled the pain but not taken it away. Based on this
description, what is your most likely diagnosis?
A) Tension
B) Migraine
C) Cluster
D) Analgesic rebound - correct answer-A
A 29-year-old physical therapist presents for evaluation of an eyelid problem. On
observation, the right eyeball appears to be protruding forward. Based on this description,
what is the most likely diagnosis?
A) Ptosis
B) Exophthalmos
C) Ectropion
D) Epicanthus - correct answer-B
May suggest Grave"s
A 3-year-old boy is brought to your office by his mother for evaluation of fever, loss of
appetite, and emesis. The symptoms have been present for 2 days; the fever is only
temporarily relieved with antipyretics. You perform a physical examination and diagnose
otitis media. What is your most likely physical finding on otoscopic examination?
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