2024 NR509 BATES TEST BANK
MIDTERM EXAM WITH CORRECT
ANSWERS
A patient comes to you because she is experiencing a tremor only when she
reaches for things. This becomes worse as she nears the "target." When you
ask her to hold out her hands, no tremor is apparent. What type of tremor
does this most likely represent?
A) Intention tremor
B) Postural tremor
C) Resting tremor
D) Nervous tremor - CORRECT-ANSWERSA) Intention tremor
A patient presents for evaluation of a sharp, aching chest pain which
increases with breathing. Which anatomic area would you localize the
symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine - CORRECT-ANSWERSA) Musculoskeletal
Chest pain may be due to a musculoskeletal condition, such as
costochondritis or
intercostal muscle cramp. This would be worsened by motion of the chest
wall. Pleuritic chest pain is also a sharp chest pain which increases with a
deep breath. This type of pain can
occur with inflammation of the pleura from pneumonia or other conditions
and pulmonary
embolus.
A young woman comes in with brief, rapid, jerky, irregular movements. They
can occur
at rest or during other intentional movements and involve mostly her face,
head, lower arms, and
hands. How would you describe these movements?
A) Tics
B) Dystonia
C) Athetosis
,D) Chorea - CORRECT-ANSWERSD) Chorea
These represent chorea because they are brief, rapid, unpredictable, and
irregular. Tics are irregular but tend to be stereotyped and can be vocal
(throat-clearing), facial
expressions, or shoulder shrugging. Athetosis is a slow, squirming motion
usually affecting the
face and distal extremities. Dystonia is similar to athetosis but the
movements are more coarse
and can involve twisted postural changes.
Which of the following changes are expected in vision as part of the normal
aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision - CORRECT-ANSWERSD) Blurring of near vision
The lens loses its elasticity over time as part of the normal aging process,
and the eye is less able to accommodate and focus on near objects;
therefore, the patient will be expected to have blurring of near vision.
A 72-year-old retired truck driver comes to the clinic with his wife for
evaluation of hearing loss. He has noticed some decreased ability to hear
what his wife and grandchildren are saying to him. He admits to lip-reading
more. He has a history of noise exposure in his young adult years: He worked
as a sound engineer at a local arena and had to attend a lot of concerts.
Based on this
information, what is the most likely finding regarding his hearing acuity?
A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds
C) Loss of acuity for high-range sounds
D) Increase of acuity for high-range sounds - CORRECT-ANSWERSA) Loss of
acuity for middle-range sounds
A 79-year-old retired banker comes to your office for evaluation of difficulty
with urination; he gets up five to six times per night to urinate and has to go
at least that often in the daytime. He does not feel as if his bladder empties
completely; the strength of the urinary stream is
diminished. He denies dysuria or hematuria. This problem has been present
for several years but
has worsened over the last 8 months. You palpate his prostate. What is your
expected physical
examination finding, based on this description?
,A) Normal size, smooth
B) Normal size, boggy
C) Enlarged size, smooth
D) Enlarged size, boggy - CORRECT-ANSWERSC) Enlarged size, smooth
A patient comes to the emergency room for evaluation of shortness of
breath. To which anatomic region would you assign the symptom?
A) Reproductive
B) Urinary
C) Cardiac
D) Hematologic - CORRECT-ANSWERSC) Cardiac
Cardiac disorders such as congestive heart failure are the most likely on this
list to result in shortness of breath. There are cases within the other
categories which may also result
in shortness of breath, such as anemia in the hematologic category,
pregnancy in the reproductive
category, or sepsis with UTI in the urinary category.
A patient presents for evaluation of a cough. Which of the following anatomic
regions can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine - CORRECT-ANSWERSC) Cardiac
The cardiac system can cause a cough if the patient has congestive heart
failure. This results in fluid buildup in the lungs, which in turn can cause a
cough that produces pink,
frothy sputum. A foreign body in the ear may also cause a cough by
stimulating Arnold's branch of the vagus nerve, but this is less likely to be
seen clinically than heart failure.
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 - CORRECT-ANSWERSB) Inflammatory
The description is most consistent with an inflammatory process, although all
the other etiologies should be considered. Lyme disease is an infection which
commonly causes
arthritis, hemophilia is a hematologic condition which can cause bleeding in
the joints, and trauma can obviously cause joint pain.
A 47-year-old contractor presents for evaluation of neck pain, which has
been intermittent for several years. He normally takes over-the-counter
medications to ease the pain, but this time they haven't worked as well and
he still has discomfort. He recently wallpapered the entire second floor in his
house, which caused him great discomfort. The pain resolved with rest. He
denies fever, chills, rash, upper respiratory symptoms, trauma, or injury to
the neck. Based on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic - CORRECT-ANSWERSC) Degenerative
The description is most consistent with degenerative arthritis in the neck.
The
patient has had intermittent symptoms and the questions asked to elicit
pertinent negative and
positive findings are negative for infectious, traumatic, or neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a
3-week history
of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which
is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular - CORRECT-ANSWERSC) Allergic
This description is most consistent with allergic rhinitis.