Midterm Exam Version
Question 1: 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 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?
a. Cholinesterase inhibitors
d. Atypical antipsychotics
Question 3: Most adult poisonings are:
a. intentional and self-inflicted.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.
Question 4: 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 5: 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 6: 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 7: Which characteristic of delirium helps to distinguish delirium from dementia?
a. Abrupt onset
b. Impaired attention
c. Affective changes
Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?
a. Decrease in level of consciousness (LOC)
d. Widening pulse pressure
Question 9: 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 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
a. Decreased C-reactive protein
c. Morning stiffness
d. Weight gain
Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?
b. Mild obesity
c. Moderate obesity
d. Morbid obesity
Question 12: 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?
Question 13: 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
d. Polycystic ovarian syndrome
Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?
Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer?
a. Radical orchidectomy
c. Radiation implants
d. All of the above
Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
b. Human papillomavirus (HPV)
Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral
Question 18: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
d. Epithelial cells
Question 19: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?
Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?
a. Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test
Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
a. An enlarged rubbery gland
b. A hard irregular gland
c. A tender gland
d. A boggy gland
Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks
Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:
a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.
Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?
a. Sinus bradycardia
b. Atrial fibrillation
c. Supraventricular tachycardia
d. U waves
Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns
Question 26: Immunizations are an example of which type of prevention?
Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?
a. Permanent tissue damage may occur, resulting in necrosis to that body part.
b. The area will be super sensitive.
c. The area is prone to a repeat frostbite.
d. The area is as susceptible as any other area.
Question 28: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
a. Pregnancy test
b. Pelvic ultrasound
c. Endometrial biopsy
d. Platelet count
Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?
Question 30: 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