Med-Surg Final Diagnostics Exam

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1-1 What is the most common presentation of a client with a sprained ankle? A. Point tenderness over a ligament, ecchymoses, edema, and pain B. General achiness, reddened skin, and no edema C. Bony ... deformity, no edema, and cool skin D. Crepitus, ecchymoses, severe pain, and no point Tenderness Testicular torsion 1-3 Which of the following is a urological emergency? A. Testicular torsion B. Epididymitis C. Varicocele D. Hydrocele 14-28 Tommy, age 15, comes to the clinic in acute distress with “belly pain.” When obtaining his history, you find that he fell off his bike this morning and has vomited. Upon closer examination, you determine the belly pain to be left-sided groin pain, or pain in his left testicle. He is afebrile and reports no dysuria. You suspect A. testicular torsion. B. epididymitis. C. a hydrocele. D. a varicocele. 14-71 Jordan appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. You are trying to differentiate between epididymitis and testicular torsion. Which test to determine whether swelling is in the testis or the epididymis should be your first choice? A. X-ray B. Ultrasound C. Technetium scan D. Physical examination 14-84 Which of the following scrotal disorders is most common in adolescents? A. Acute epididymitis B. Testicular torsion C. Atrophic testes D. Scrotal edema Dementia 1-5 Your client Mrs. Jones, age 78, is brought to your primary care office by her son, James. He is describing recent changes in Mrs. Jones’s behavior and affect. You are trying to differentiate between depression and dementia. You know that A. the person with dementia usually tries to conceal memory problems. B. the person with depression has wide mood swings. C. dementia has a sudden onset. D. agitation always accompanies depression. Mr. Boyd, age 84, has dementia and is in a long-term care facility. His daughter and son-in-law are visiting. As they get ready to leave and begin to say good-bye, Mr. Boyd grabs his daughter’s arm and begins to cry, saying “Don’t leave me here. I will die in this place.” As she leaves the room, his daughter is visibly upset and asks you if she should visit again soon because it has so upset her father. The best reply for you to make is A. “You might try telephoning next time instead of visiting. Your father will know that you are thinking of him then.” B. “I will give you the number of the social worker. She will be able to arrange a team conference and family meeting.” D. “He needs time to adjust to this new setting. Perhaps it might be easier on you all if you just didn’t visit for a few days.” 1-58 What is the most common cause of progressive dementia in persons older than 55? A. Alzheimer ’ s disease B. Vascular disease C. Huntington ’ s disease D. Parkinson ’ s disease 3-66 Jan’s mother has Alzheimer’s disease. She tells you that her mother’s recent memory is poor and that she is easily disoriented, incorrectly identifies people, and is lethargic. Jan asks you, “Is this as bad as it gets?” You tell her that her mother is in which stage of the disease? A. Stage 1 B. Stage 2 C. Stage 3 C. “This is a very upsetting time for all of you. However, it is important that you continue to visit regularly. For now, I will go in and sit with your father for a little while.” D. Stage 4 7-23 Which medication should be avoided in clients with Alzheimer ’ s disease who have concurrent vascular dementia or vascular risk factors? A. Acetycholinesterase inhibitors like donepezil (Aricept) B. N -methyl-d-aspartate (NMDA) receptor antagonists C. Anxiolytics like bupirone (Buspar) D. Atypical antipsychotics like risperidone (Risperdal) 6-19 Mary is caring for her 83-year-old father at home. He has dementia and is unsteady on his feet. You recommend that Mary A. put her father in a nursing home so that she can have a life of her own. B. take in another elderly person so that her father can have company. C. get information on home safety and community resources. D. lock her father’s bedroom door at night so that he will not wander into the street. 6-118 Mr. Green is a vigorous 70-year-old who comes for early assessment of dementia. He wants to “work ” to keep up his mental capacities. You counsel that he should A. make sure he gets enough rest because cells need time to regenerate as a result of the stress of the aging process. B. begin taking a calcium supplement. C. consider a hobby that challenges his mental capacity, like building model ships or airplanes. D. play bridge (or any group card game) several times a week. 7-24 Dave, age 76, is brought in by his wife, who states that within the past 2 days Dave has become agitated and restless, has had few lucid moments, slept very poorly last night, and can remember only recent events. Of the following differential diagnoses, which seems the most logical from this brief history? A. Depression B. Dementia C. Delirium D. Schizophrenia 7-49 Clients with senile dementia of the Alzheimer’ s type often die of A. pneumonia. B. suicide. C. pressure sores. D. malnutrition. 7-69 Lynne, age 72, presents for the first time with her daughter. Her daughter describes some recent disturbing facts about her mother. How can you differentiate between depression and dementia? A. You might be able to pinpoint the onset of dementia, but the onset of depression is difficult to identify. B. A depressed person has wide mood swings, whereas a person with dementia demonstrates apathetic behavior. D. The person with dementia has a poor self-image, whereas the person with depression does not have a change in self-image. 7-70 Grace, age 82, has Alzheimer ’ s disease. Her daughter states that she is agitated, has time disorientation, and wanders during the afternoon and evening hours. How do you describe this behavior? A. Alzheimer’s dementia B. Sundowning C. Deficits of the Alzheimer’s type D. Senile dementia 7-100 Sophie is 82 and scores 25 on the Mini- Mental State Examination (MMSE). What is your initial thought? A. Normal for age B. Depression C. Early Alzheimer ’ s disease D. Late Alzheimer ’ s disease 7-112 What are the two most common causes of dementia in older adults? A. Polypharmacy and nutritional disorders B. Alzheimer’s disease and vascular disorders C. Metabolic disorders and space-occupying lesions D. Infections affecting the brain and polypharmacy Depression 3-43 Which of the following statements is true about the older adult? A. Older adults are at an increased risk for depression. B. Depression is a normal part of aging. [Show More]

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