Herzing University NU631 Quiz 5 Latest

Adult Health Quiz 5

Question 1A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

Rice

Carrot s

Spinac h

Potato es

Question 2Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her examination and medical history, you suspect adhesive capsulitis, or “frozen shoulder.” Which clue in Mrs. Gray’s history supports this diagnosis?

History of hypertension

Her affected shoulder is also her dominant arm.

Her history of diabetes mellitus

Her work as a secretary predisposes her to repetitive motions.

Question 3A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?

No treatment at this time

Diet and exercise for 6-week trial

Diet, exercise, and oral medication

Diet, exercise, and exogenous insulin

Question 4The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as:

Apprehension sign

Bulge sign Thumb sign

None of the above

Question 5Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

Ecchymosis, edema, and erythema over the lateral epicondyle

Pain at the elbow with resisted movements at the wrist and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance

Question 6 What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

1,200 mg/day

1,000mg/d ay

1,300mg/d ay

1,500 mg/day

Question 7 Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

Fever, chills, and elevated erythrocyte sedimentation rate Pathologic fractures, severe night pain, weight loss, and fatigue

Question 8 After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Elevated TSH

Normal TSH Low TSH

Undetectable TSH

Question 9 Which of the following are common signs of type 2 DM?

Anorexia

Recurrent yeast infection

Weight gain

Elevated HDL cholesterol

Question 10 A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?

Ketoacidosis

Cirrhosis

Hypoglycemic episodes

All of the above

Question 11 Which of the following statements concerning the treatment of fibromyalgia syndrome is true?

 

There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible.

Treatment is directed toward controlling discomfort, improving sleep, and maintaining function.

Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications.

All of the above

Question 12One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?

Bone

Synoviu m

Tendons Fascia

Question 13 The clinician has instructed Joe, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

“You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

“You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

“You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

“It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 14Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

The goal of treatment is to prevent flexion and extension movements of the wrist.

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.

Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

All of the above

Question 15A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?

Serum calcium

TSH

Electrolytes

Urine specific gravity

Question 16 You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

Articular

Inflammat ory

Nonarticul ar

A and B

Question 17Which of the following medications can cause hyperglycemia?

Predniso ne

Metformi n

Synthroi d

Cephale xin

Question 18The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

and free T4

High sensitivity thyroid-stimulating hormone (TSH) and free T4

Free T4 and serum calcium Free T3 and T4

TSH and thyroxin antibodies

Question 19 A patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first?

Check his blood sugar.

Have him drink 4 ounces of juice.

Call 911.

Ask him about his usual eating habits.

Question 20The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

“I’ll take my pill at least 30 minutes before breakfast.”

“I’ll take my Glucotrol before bedtime.”

“It is important to take my medication right after I eat.”

“Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 21 Which of the following is diagnostic for diabetes mellitus?

 

A1C 7.0 on one occasion

Fasting blood sugar (FBS) of 100 mg/dL on two occasions

Random glucose of 200 mg/dL on two occasions

Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 22 Which of the following statements concerning the musculoskeletal examination is true?

The uninvolved side should be examined initially and then compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

When possible, the patient should not be asked to perform active range- of-motion (ROM) exercises to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 23 The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane’s description of her injury.

Which of the following clues in Diane’s examination or history would alert the clinician to the need for obtaining radiographs?

Inability to bear weight immediately after the injury

Development of marked ankle swelling and discoloration after the injury

Crepitation with palpation or movement of the ankle

All of the above

Question 24 Which of the following tests is considered the gold standard for definitively diagnosing osteoporosis?

Bone alkaline phosphatase levels

Urinary N-telopeptide assay

Bone mass density measurement by densitometry

Magnetic resonance imaging

Question 25 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?

Tricyclic antidepressants

Capsaicin cream

Vitamin B12 injections

Insulin

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