NSG6020 Final exam
Heberden's nodes are commonly found in which one of the following diseases? ans: Degenerative joint disease
You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight g...
Heberden's nodes are commonly found in which one of the following diseases? ans: Degenerative joint
disease
You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited
that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that
she has hypothyroidism. What is the expected moisture and texture of the skin of the patient with
hypothyroidism ans: dry and rough
You are assessing a patient with joint pain and are trying to decide whether it is inflammatory or
noninflammatory in nature. Which one of the following symptoms is consistent with an inflammatory
process? ans: tenderness
A 68-year-old retired farmer comes 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? ans: actinic keratosis
A 28-year-old graduate student comes to your clinic for evaluation of pain "all over." With further
questioning, she is able to relate that the pain is worse in the neck, shoulders, hands, low back and
knees. She denies swelling in her joints. She states that the pain is worse in the morning. There is no
limitation in her range of motion. On physical examination, she has several points on the muscles of the
neck, shoulders and back that are tender to palpation. Muscle strength and range of motion are normal.
Which one of the following is likely the cause of her pain? ans: fibromyalgia
A new patient is complaining of severe pruritus that is worse at night. Several family members also have
the same symptoms. Upon examination, areas of excoriated papules are noted on some of the
interdigital webs of both hands and on the axillae. This finding is most consistent with: ans: Scabies
An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is
concerned because an aunt had severe osteoporosis. Which one of the following is a risk factor for
osteoporosis? ans: Delayed menarche
Ms. Whiting is a 68-year-old female who comes in for her usual follow-up visit. You notice a few flat red
and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere
else. She doesn't mention them. They are tender when you examine them. What should you do? ans:
Ask how she acquired them.
A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at
night. This has been steadily increasing for the past 2 months. Which one of the following is the most
reassuring in this patient with back pain? ans: Pain that is bilateral
The Phalen's test is used to evaluate: ans: inflammation of the median nerve
, Which of the following would lead you to suspect a hydrocele versus other causes of scrotal swelling?
ans: A positive transillumination test
You are examining a newborn and note that the right testicle is not in the scrotum. What should you do
next? ans: Attempt to bring down the testis from the inguinal canal
A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory,
cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical
history is significant for mild arthritis and prior knee surgery in college. He is married and just changed
jobs, working for a different trucking company. He smokes one pack of cigarettes a day, drinks less than
six beers a week, and denies using any illegal drugs. His mother has high blood pressure and arthritis and
his father died of lung cancer in his sixties. On examination, his blood pressure is 130/80 and his pulse is
80. His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his
digital rectal examination you palpate a soft, smooth, and nontender pedunculated mass on the
posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation? ans:
Rectal polyp
A 15-year-old high school football player is brought to your office by his mother. He is complaining of
severe testicular pain since exactly 8:00 this morning. He denies any sexual activity and states that he
hurts so bad he can't even urinate. He is nauseated and is throwing up. He denies any recent illness or
fever. His past medical history is unremarkable. He denies any tobacco, alcohol, or drug use. His parents
are both in good health. On examination, you see a young teenager lying on the bed with an emesis
basin. He is very uncomfortable and keeps shifting his position. His blood pressure is 150/100, his pulse
is 110, and his respirations are 24. On visualization of the penis, he is circumcised and there are no
lesions and no discharge from the meatus. His scrotal skin is tense and red. Palpation of the left testicle
causes severe pain and the patient begins to cry. His prostate examination is unremarkable. His
cremasteric reflex is absent on the left but is normal on the right. By catheter you get a urine sample and
the analysis is unremarkable. You send the boy with his mother to the emergency room for further
workup. ans: Torsion of the spermatic cord
Which is true of prostate cancer? ans: Ethnicity is a risk factor.
Which of the following conditions involves a tight prepuce which, once retracted, cannot be returned?
ans: Paraphimosis
A 12-year-old is brought to your clinic by his father. He was taught in his health class at school to do
monthly testicular self-examinations. Yesterday, when he felt his left testicle, it was enlarged and
tender. He isn't sure if he has had burning with urination and he says he has never had sexual
intercourse. He has had a sore throat, cough, and runny nose for the last three days. His past medical
history is significant for a tonsillectomy as a small child. His father has high blood pressure and his
mother is healthy. On examination, you see a child in no acute distress. His temperature is 100.8 and his
blood pressure and pulse are unremarkable. On visualization of his penis, he is uncircumcised and has
no lesions or discharge. His scrotum is red and tense on the left and normal appearing on the right.
Palpating his left testicle reveals a mildly sore swollen testicle. The right testicle is unremarkable. An
examining finger is put through both inguinal rings, and there are no bulges with bearing down. His
prostate examination is unremarkable. Urine analysis is also unremarkable. What abnormality of the
testes does this child most likely have? ans: Acute orchitis
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