NUR 550 Drexel Health Assessment Midterm

NUR 550 Drexel Health Assessment Midterm Exam Latest Update 2024-2025 250 Questions and 100% Verified Correct Answers Guaranteed 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 shortness of breath. He denies any recent traumas or illnesses. His past medical history is unremarkable. He doesn't smoke but drinks several beers on the weekend. He has tried marijuana several times but denies any other illegal drugs. He is an honors student and is on the basketball team. His parents are both in good health. He denies any recent weight gain, weight loss, fever, or night sweats. On examination you see a tall, thin young man in obvious distress. He is diaphoretic and is breathing at a rate of 35 breaths per minute.On auscultation you hear no breath sounds on the right side of his superior chest wall.On percussion he is hyperresonant over the right upper lobe. With palpation he h -

CORRECT ANSWER: B. Spontaneous pneumothorax

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?

• Traumatic
• Hematologic
• Inflammatory

D. Infectious - CORRECT ANSWER: C. Inflammatory

A 24-year-old graduate student comes to your clinic, complaining of burning during urination and increased urinary frequency. He has had a low-grade fever (100.5 degrees) and does not feel very well. He is very worried about sexually transmitted diseases because he had a drunken encounter 2 weeks ago and did not use a condom.He has had no recent weight loss, weight gain, or night sweats. His past medical history includes knee surgery in high school and genital warts in college. He does not smoke but drinks six beers every Friday and Saturday night. He denies using any IV drugs but has tried marijuana in the past. His father has high cholesterol but his mother is healthy.On examination he appears tired. His temperature is 99.5 degrees and his blood pressure is 110/70. His abdominal examination is normal. Visualization of the anus shows no masses, inflammation, or fissures. Digital rectal examination reveals a warm,

- CORRECT ANSWER: B. Prostatitis

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

• to 5 seconds, taking his breath away. He states he feels like he has to breathe 1 / 4

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. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that 2 weeks ago he had an upper respiratory infection with a severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married, and his wife has a baby due in 2 months. He denies any smoking or illegal drug use. He drinks two to three beers once a month. He states that he eats a healthy diet and runs regularly, but - CORRECT

ANSWER: A. Pleural pain

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?

• Aortic
• Pulmonic
• Tricuspid

D. Mitral - CORRECT ANSWER: D. Mitral

A 25-year-old radio announcer comes to the clinic for an annual examination. His BMI is 26.0 kg/m2. He is concerned about his weight. Based on this information, what is appropriate counsel for the patient during the visit?

• Give the patient information about reduction of fat and cholesterol because he is

obese.

• Give the patient information about reduction of fat, cholesterol, and calories because

he is overweight.

• Reassure the patient that he has a normal body weight.
• Refer the patient to a nutritionist because he is anorexic. - CORRECT ANSWER: B.

Give the patient information about reduction of fat, cholesterol, and calories because he is overweight.

A 47-year-old receptionist comes to your office, complaining of fever, shortness of breath, and a productive cough with golden sputum. She says she had a cold last week and her symptoms have only gotten worse, despite using over-the-counter cold remedies. She denies any weight gain, weight loss, or cardiac or gastrointestinal symptoms. Her past medical history includes type 2 diabetes for 5 years and high cholesterol. She takes an oral medication for both diseases. She has had no surgeries.She denies tobacco, alcohol, or drug use. Her mother has diabetes and high blood pressure. Her father passed away from colon cancer. On examination you see a middle- aged woman appearing her stated age. She looks ill and her temperature is elevated, at

• Her blood pressure and pulse are unremarkable. Her head, eyes, ears, nose, and

throat examinations are unremarkable except for edema of the nasal turbinates. On

auscultation she - CORRECT ANSWER: B. Pneumonia

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A 60-year-old coach comes to your clinic, complaining of difficulty starting to urinate for the last several months. He believes the problem is steadily getting worse. When asked he says he has a very weak stream and it feels like it takes 10 minutes to empty his bladder. He also has the urge to go to the bathroom more often than he used to. He denies any blood or sediment in his urine and any pain with urination. He has had no fever, weight gain, weight loss, or night sweats. His medical history includes type 2 diabetes and high blood pressure treated with medications. He does not smoke but drinks a six pack of beer weekly. He has been married for 35 years. His mother died of a myocardial infarction in her 70s and his father is currently in his 80s with high blood pressure and arthritis. On examination you see a mildly obese male who is alert and cooperative. His blood pressure is 130/70 with a heart rate of 80. He - CORRECT

ANSWER: B. Benign prostatic hyperplasia (BPH)

A 62-year-old construction worker presents to your clinic, complaining of almost a year of chronic cough and occasional shortness of breath. Although he has had worsening of symptoms occasionally with a cold, his symptoms have stayed about the same. The cough has occasional mucous drainage but never any blood. He denies any chest pain.He has had no weight gain, weight loss, fever, or night sweats. His past medical history is significant for high blood pressure and arthritis. He has smoked two packs a day for the past 45 years. He drinks occasionally but denies any illegal drug use. He is married and has two children. He denies any foreign travel. His father died of a heart attack and his mother died of Alzheimer's disease. On examination you see a man looking slightly older than his stated age. His blood pressure is 130/80 and his pulse is 88. He is breathing comfortably with respirations of 12. His head, eyes, ears - CORRECT

ANSWER: D. Chronic obstructive pulmonary disease (COPD)

A 62-year-old woman has been followed by you for 3 years and has had recent onset of hypertension. She is still not at goal despite three antihypertensive medicines, and you strongly doubt nonadherence. Her father died of a heart attack at age 58. Today her pressure is 168/94 and pressure on the other arm is similar. What would you do next?

• Add a fourth medicine
• Get a CT scan
• Listen closely to her abdomen

D. Refer to nephrology - CORRECT ANSWER: C. Listen closely to her abdomen

At this point, it is important to consider secondary causes for this woman's hypertension because of its severity, rapidity of progression, and lack of response to therapy. While you will most likely add a fourth medicine, it is important to carefully examine the abdomen for the presence of renal artery bruits. These are usually heard best in the upper quadrants. It may be necessary to have the patient hold her breath, to have a very quiet room, and to listen with the diaphragm for a very soft, high-pitched sound with systole. It may also help to simultaneously feel the patient's pulse (a bruit with both a systolic and diastolic component is very specific for a significant blockage, while a lone systolic bruit may not be abnormal). Obtaining a CT scan is not likely to be useful, and 3 / 4

you may save the delay, expense, and inconvenience of a nephrology referral if you can hear a bruit.

A 65-year old male presents to the clinic for a routine examination. The following is the documentation of his prostate examination. Which statement would be of concern?

a). Firm b). heart-shaped c). 2.5 cm long

d). median sulcus palpable - CORRECT ANSWER: a). Firm

A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease.Which of the following tests are appropriate to order to initially evaluate for this condition?

• Ankle-brachial index (ABI)
• PET scan
• Venogram

D. CT scan of the lower legs - CORRECT ANSWER: A. Ankle-brachial index (ABI)

A 72 year-old diabetic female patient has a complaint of SOB and nausea. She stated the symptoms started about 15 minutes ago while shoveling snow. She appears pale and diaphoretic. She also admits to uncontrolled HTN. Which of the following is first on your list of differential diagnoses.

a). costochrondritis b). myocardial infarction c). abdominal aortic aneurysms

d). pericarditis - CORRECT ANSWER: b). myocardial infarction

A 72-year-old teacher comes to your clinic for an annual examination. She is concerned about her risk for peripheral vascular disease and states that there is a place in town that does tests to let her know her if she has this or not. Which of the following disease processes is a risk factor for peripheral vascular disease?

• Coronary artery disease
• Gastroesophageal reflux disease
• Osteoarthritis

D. Migraine headaches - CORRECT ANSWER: A. Coronary artery disease

A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a low-grade fever for about 3 days. He denies any nausea, vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of popcorn at the movies with his grandson, 3 days before his symptoms began. He denies any other

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