Abdomen,musculoskeltal, Female And Male Reproductive System Flashcards
A nurse practitioner is examining the hands of a 67-year-old patient and she notes bony nodules, looking at the distal into phalangeal joints in both hands. Which of the following is most likely?
A. Bouchard’s nodes
B. Swan neck, deformity.
C. Herberdens nodes
D. Tophi
Herberdens nodes on the distal interphalangeal joint top of finger from Bony overgrowth of osteoarthritis are hard and painless. Common in Middle-age. Older adults are associated with arthritic changes in their joints.
A 52-year-old female presents to your family medicine clinic with a two month history of intermittent pain in her wrist and forearm on both sides. In addition to numbness and tingling in the thumb and index fingers after prolonged use. The patient has positive Tenils sign, pain shooting from the rest of the hand. One performing Phelan’s test. Instructed the patient has been the rest for it completely for 60 seconds numbness, tingling and weakness or reproduce. The phalens test is used to assess?
Median nerve inflammation
Will obtaining a history from a young female adult client with abdominal pain, which of the following is a specific area that must be assessed in this population?
A. Food, preferences and dislikes
B. The location of the pain and associated symptoms.
C. Clients, medical history and medication history.
D. The first day of a clients last menstrual period
 D. The first day of the clients last menstrual period.
Pain in the right lower quadrant and left lower quadrant may be associated with pain from the ovaries. Obtaining menstrual cycle information is relevant to determine the cause of possible abdominal pain.
A 50-year-old Caucasian women presents to your office with morning joint stiffness stiffness, mostly in her feet and hands that leads up to two hours after starting her day. She puts this happened about a month ago and the rest are very sore but then she seem to get better. She also reports feeling tired lately, for clothes getting looser, and she think she may have been running a fever. Exam, so swollen and wants to the MCPs and PIPs on both hands. Based on his history and symptoms, what is your most likely diagnosis?
A. Rheumatoid arthritis
B. Osteoarthritis.
C. Systemic, lupus erthromatous
D. Carpal tunnel.
Rheumatoid arthritis. DIP, MCP, and wrist joints are frequently affected. MCPs and PIP is usually symmetric. Spindle shaped, swelling of PIPs, tender often warm, seldomly red. Weakness, fatigue, weight, loss, low-grade fever are common.
Hey sexy, for you, a woman presents with increasing achy pain at her knees for the past three years. However, in the last few months, it has been unbearable. The pain is worse at the end of the day. She denies any rash is fevers or changes in a week. One physical exam, she has decreased range of motion, and both her knees as well as crepitus. Which of the following image modalities would be ordered to confirm the diagnosis?
A. X-ray.
B. Computed tomography, scan.
C. Bone scan.
D. Magnetic resonance imaging.
X-ray imaging. Decreased range of motion with the presence of crepitus warrants x-ray imaging. It can be a precursor of knee osteoarthritis.
A nurse practitioner family practice clinic is evaluating a patient with any ankle injury. The patient is an otherwise healthy 20 year old male who hurt his ankle during a soccer game. He is able to bear weight and ambulate. Which of the following is indicated?
A. Referral to orthopedics.
B. X-ray ankle.
C. Rice.
D. Cast and nonweightbearing.
Rest and ice is warranted. No significant medical history, young adults, athletic, able to bear weight and walks more than four steps. This does not warrant an x-ray according to Ottawa. Resident ice is warranted.
A 56-year-old female requested DEXA scan. It is a woman without risk factors, and what age is bone density screening with Dexter recommended?
A. 60 years.
B. 63 years
C. 65 years.
D. 68 years.
DEXA scan of the lumbar spine and femoral neck is optimal standard for measuring BMD. Diagnosing osteoporosis and guiding treatment decisions. 65 and older for females. 70 in order for Males . 50-69 based on which factors for males.
The nurse practitioner is preparing to examine the admin of a client. What is the correct sequence in which to conduct examination?
A. Inspection, palpation, percussion, auscultation.
B. Palpation, percussion, auscultation, inspection.
C. Percussion, per Patient, asportation, inspection.
D. Inspection, auscultation, percussion, palpation.
Inspect first. Then auscultate before performing percussion or palpation. That may alter the characteristic of bowel sounds. Percuss then palpate.
Having your patient take a deep inspirations while you palpate from the left in the right upper quadrant of the abdomen subcostal area describes which test?
A. Khers sign.
B. McBurney’s point.
C. Murphy’s sign.
D. Rovsings sign.
Murphy sign. Murphy sign should be performed if the patient has right upper quadrant pain and suspected acute cholecystitis but does not have tenderness on palpation of the right upper quadrant. Sharp halting of inspiratory effort is a positive Murphy’s sign.
A 50-year-old man presents to the outpatient clinic at the beckoning of his wife to have a men’s health check up. He has no personal medical concerns. His brother was diagnosed with colon cancer at 56 and is currently recovering from surgery. He asked if he is at risk for colon cancer, and what he should do to avoid his brothers experience. He explained that he has regular bowel movements once every two days. They are. usually of normal consistently cons istency, although he has constipation, straining and hemorrhoids. He has not had a colonoscopy in the past. Given this patient’s family history what is appropriate next step?
A. Digital rectal examination.
B. Colonoscopy as soon as possible.
C. Fecal occult blood test.
D. Colonoscopy in five years.
Patients with a family history of colorectal cancer should begin screening earlier, usually with a colonoscopy and be tested more frequently. Screening for adults 45 to 75 years of age includes the stool based tests, annual fecal test, guaiac annually, fecal DNA, every two - three years. Colonoscopy every 10 years, sigmoidoscopy, every five years, fecal test with colonoscopy every 10 years with fecal every three years. CT colonography every five years. Adults 86 to 85 Should be individualize adults older than 85 do not need screening.
A 46 year old basketball player complains of anterior knee pain upon presentation to the urgent care clinic. He states that a few hours ago he went up for a layup and sustained a blow to his knee when he collided with his opponent. Since the injury, he has had difficulty putting weight on his knee Blood pressure, With a few steps. The patient’s temperature is 97.8°F, heart rate equals 80, respiratory rate equals 16, and blood pressure equals 120/80. His BMI is 22. Physical exam reveals tenderness over the anterior knee and fibula. There is also swelling around the knee, and he can not flex in each knee a 90° angle. Lachmanns test reveals a positive result, indicating ACL tear. According to the Ottawa new rule, the following are indications to perform x-ray to assess for possible bone damage, except:
A. His age.
B. Isolated tenderness of patella.
C. Tenderness of fibula.
D. And ability to flex need to 90°.
Otherwise, no roll indicates performing an x-ray. If the patient cannot bear weight for four steps. Lachman ACL test is positive indicating an ACL tear. Pain and anterior knee and fibula. Sue Phelan is present. Patient cannot flexes need to 90°.
The answer is A
The obturator and psoas sign , rosviings sign muscle test or used to evaluate for which condition?
A. Pancreatitis.
B. Inguinal hernia.
C. Cholecystitis.
D. Acute appendicitis
Acute appendicitis
To test for appendicitis use the obturator test , rosvings sign for psoas sign 
A 24 year old tennis player, complains of knee pain. Upon presentation to a clinic she claims it happened during one of her games a month ago, she quickly change direction to return a serve from her opponent . Then she felt uncomfortable, painful, twisting motion as she reached for the ball. After the incident, she was able to put weight on her knee and felt fine walking. However, recently she had felt increase in pain while walking, joint line tenderness and difficulty putting weight on the knee. The patient’s temperature is 98.3°F, heart rate is 70, RR 16, blood pressure is 120/80. Her BMI is 24.a McMurrays test is performed and the patient feels pain in the knee when it is flexed completely and examination provides the stress. Which of the following is the most likely diagnosis?
A. ACL tear.
B. MCL tear.
C. LCL tear
D. Medial meniscus tear.
D. Medial meniscus tear.
Medial meniscus test is diagnosed with McMurray’s test, it is positive if there is popping or locking, tenderness at the joint line. Clicking may also be heard.
Which of the following is most likely to signal an emergent condition?
A. Pain in a young adult that is rated as a five on a scale of one to 10 and is relieved by having a bowel movement.
B. Localized pain, steadily, increasing for more than six hours, and rebound tenderness and guarding
C. Pain in the young adult female and day 14 of a menstrual cycle that is sudden and onset and lies to the right lower quadrant under 14 hours.
D. Pain that follows the onset of vomiting and diarrhea.
Rebound tenderness and guarding can indicate acute and appendicitis and is emergent
Which factor increases a patient’s risk for acute gouty arthritis?
A. Female gender
B. A diet high in poultry.
C. Diuretic therapy.
D. BMI of 24.
Risk factors for acute Gouty arthritis are male gender , obesity, diuretics, alcohol, eating or drinking foods, high in fructose, CHF, hypertension, insulin resistance, diabetes, and poor kidney function 
