Week 4 Midterm Exam Version 1, 2, 3 & 5
Question 46: After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?
a. Elevated thyroid-stimulating hormone (TSH)
b. Normal TSH
c. Low TSH
d. Undetectable TSH
Question 47: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?
a. Rice
b. Carrots
c. Spinach
d. Potatoes
Question 48: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?
a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin
Question 49 : In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?
a. Commitment
b. Consensus
c. Certification
d. Collaboration
Question 50: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Version 3
Question 1: In an outpatient setting, what is the most common reason for a malpractice suit?
a. Failure to treat a condition
b. Failure to diagnose correctly
c. Ordering the wrong medication
d. Failure to manage care
Question 2: How often should the clinician examine the feet of a person with diabetes?
a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit
Question 3: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?
a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics
Question 4: Which of the following medications is the treatment of choice for trichomonas?
a. Metranidazole
b. Ceftriaxone
c. Diflucan
d. Doxycycline
Question 5: Most adult poisonings are:
a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.
Question 6: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?
a. “It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”
Question 7: Which of the following is a specific test for multiple sclerosis (MS)?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.
Question 8: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?
a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above
Question 9: Which characteristic of delirium helps to distinguish delirium from dementia?
a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions
Question 10: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?
a. Decrease in level of consciousness (LOC)
b. Headache
c. Nausea
d. Widening pulse pressure
Question 11: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?
a. Posterior dislocations are more common than anterior dislocations.
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
c. Recurrent dislocations are uncommon and would require a greater force to result in injury.
d. Surgery is most commonly the treatment of choice.
Question 12: In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?
a. Commitment
b. Consensus
c. Certification
d. Collaboration
Question 13: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Question 14: Which of the following statements is true concerning the musculoskeletal exam?
a. The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
Question 15: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?
a. Overweight
b. Mild obesity
c. Moderate obesity
d. Morbid obesity
Question 16: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?
a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)
Question 17: Which of the following statements is true regarding the treatment of carpal tunnel syndrome?
a. The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above
Question 18: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?
a. Rice
b. Carrots
c. Spinach
d. Potatoes
Question 19: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?
a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome
Question 20: Which patient is more likely to have a cluster headache?
a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night
