KAPLAN MN568 Unit 8 Exam Latest 2018 March Question # 00599217 Course Code : MN568 Subject: Health Care Due on: 03/09/2019 Posted On: 03/09/2019 06:18 AM Tutorials: 1 Rating: 4.7/5

MN568 Primary
Care Across the Span

Unit 8 Exam

Question 1

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

Question
options:

a)

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

b)

“I’ll take
my Glucotrol before bedtime.”

c)

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

d)

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

Question 2

Urine-free
cortisol is one of four diagnostic tests recommended for Cushing’s syndrome.

Question
options:

a) True

b) False

Question 3

A patient is
diagnosed with hypothyroidism. Which of the following electrocardiogram changes
should the clinician expect as a manifestation of the disease?

Question options:

a)

Sinus
bradycardia

b)

Atrial
fibrillation

c)

Supraventricular
tachycardia

d)

U waves

Question 4

One of the
most frequent presenting signs/symptoms of osteoporosis is:

Question
options:

a)

Goiter

b)

Abnormal
serum calcium

c)

Elevated
urine biochemical markers

d)

Bony
fracture

Question 5

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?

Question
options:

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 6

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

Question
options:

a)

Bone
alkaline phosphatase levels

b)

Urinary
N-telopeptide assay

c)

Bone mass
density measurement by densitometry

d)

Magnetic
resonance imaging

Question 7

You are
performing muscle strength testing on a patient presenting with musculoskeletal
pain and find that the patient has complete ROM with gravity eliminated. Which
numeric grade of muscle strength would you give this patient?

Question
options:

a)

1

b)

2

c)

3

d)

4

e)

5

Question 8

Which of the
following is diagnostic for diabetes mellitus?

Question
options:

a)

A1C 7.0 on
one occasion

b)

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

c)

Random
plasma glucose greater than or equal to 200 in a person with symptoms of
hyperglycemia

d)

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

Question 9

Fruit juice
with added sugar is the treatment of choice for anyone experiencing
hypoglycemia.

Question
options:

a) True

b) False

Question 10

Osteoarthritis
is primarily a noninflammatory condition.

Question
options:

a) True

b) False

Question 11

Mrs. Allen
is a 60-year-old woman who has been diagnosed with osteoporosis. She is very
concerned about the risk of breast cancer associated with hormone replacement
therapy and is wondering what other treatments are available to her. The
clinician explains that bisphosphonates are another class of drugs used in the
prevention and treatment of osteoporosis. What teaching should the clinician
give Mrs. Allen in regard to taking bisphosphonates?

Question
options:

a)

Taking
bisphosphonates can result in hypercalcemia, so calcium intake should be
decreased while taking this class of drugs.

b)

There is
potential for upper GI irritation, so these medications are contraindicated in
people with abnormalities of the esophagus or delayed esophageal emptying.

c)

This class
of drugs can be taken at any time of the day without regard to meals.

d)

None of the
above

Question 12

A
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?

Question
options:

a)

Serum
calcium

b)

TSH

c)

Electrolytes

d)

Urine
specific gravity

Question 13

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

Question
options:

a)

Anorexia

b)

Recurrent
yeast infection

c)

Weight gain

d)

Elevated HDL
cholesterol

Question 14

The
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:

Question
options:

a)

Apprehension
sign

b)

Bulge sign

c)

Thumb sign

d)

None of the
above

Question 15

The
clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would
the clinician classify this patient?

Question
options:

a)

Overweight

b)

Mild obesity

c)

Moderate
obesity

d)

Morbid
obesity

Question 16

A 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?

Question
options:

a)

Rice

b)

Carrots

c)

Spinach

d)

Potatoes

Question 17

A BMI of 29
kg/m2 is considered obesity.

Question
options:

a) True

b) False

Question 18

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

Question
options:

a)

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

b)

Free T4 and
serum calcium

c)

Free T3 and
T4

d)

TSH and
thyroxin antibodies

Question 19

A
35-year-old woman presents with symptoms of hypoglycemia. There is no history
of diabetes mellitus. Which of the following should be included in the
differential diagnosis?

Question
options:

a)

Anxiety
disorder

b)

Pheochromocytoma

c)

Psychosis

d)

All of the
above

Question 20

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

Question
options:

a)

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

b)

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

c)

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

d)

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

Question 21

A diabetic
patient asks the clinician why he needs to check his blood sugar at home even
when he feels good. Which of the following responses would be most appropriate?

Question
options:

a)

“Control of
glucose will help postpone or delay complications.”

b)

“Regularly
checking blood sugar will help establish a routine.”

c)

“Monitoring
glucose will promote a sense of control.”

d)

All of the
above

Question 22

Which of the
following medications can cause hyperglycemia?

Question
options:

a)

Prednisone

b)

Metformin

c)

Synthroid

d)

Cephalexin

Question 23

A patient
with type 2 diabetes asks the clinician why she needs to exercise. In order to
answer her, the clinician must understand that exercise has what effect on the
patient with type 2 diabetes?

Question
options:

a)

Reduces
postprandial blood glucose

b)

Reduces
triglycerides and increases high-density lipoprotein (HDL)

c)

Reduces
total cholesterol

d)

All of the
above

Question 24

Mrs. 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:

Question
options:

a)

Ecchymosis,
edema, and erythema over the lateral epicondyle

b)

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

c)

Inability to
supinate and pronate the arm

d)

Inability to
flex or extend the elbow against resistance

Question 25

Which of the
following tests should you order to confirm Mr. W’s diagnosis?

Question
options:

a)

Bone scan

b)

Computed
tomography (CT) scan

c)

X-ray of the
foot

d)

Culture of
the ulcer

Question 26

Which stage
of Paget’s disease is characterized by elevated numbers of osteoblasts,
resulting in abnormal increases in bone remodeling and leading to an irregular
deposition of collagen fibers?

Question
options:

a)

Lytic

b)

Mixed

c)

Sclerotic

d)

All of the
above

Question 27

A
70-year-old female has fallen 2 weeks ago and developed immediate pain in her
left wrist. She thought she just bruised it but is worried because it has not
improved. She has used Tylenol® and ice at home, and that has helped slightly.
You examine her and find she has moderate swelling and ecchymosis but no
overtly obvious deformity. Her ROM is uncomfortable and severely diminished due
to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is
strong; and capillary refill is less than 2 seconds. What should you do?

Question
options:

a)

Make an
immediate referral for an orthopedic evaluation without further assessment.

b)

Tell her
that it takes time for these bruises to improve, so she should be patient.

c)

Obtain a
wrist x-ray and place her wrist in a splint or prescribe a splint.

d)

Send her to
the emergency room for reduction of this obvious wrist fracture.

Question 28

The presence
of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question
options:

a) True

b) False

Question 29

The
clinician should question the patient with suspected gout about use of which of
these medications?

Question
options:

a)

Low-dose
aspirin

b)

Thiazide
diuretics

c)

Ethambutol

d)

All of the
above

Question 30

Jennifer is
an 18-year-old 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
ROM in her left shoulder. The clinician has diagnosed Jennifer with a
dislocated shoulder. Which of the following statements are true concerning
shoulder dislocation?

Question
options:

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 great force to result in injury.

d)

Surgery is
most commonly the treatment of choice.

Question 31

A 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?

Question
options:

a)

No treatment
at this time

b)

Diet and
exercise for 6-week trial

c)

Diet,
exercise, and oral medication

d)

Diet,
exercise, and exogenous insulin

Question 32

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?

Question
options:

a)

Inability to
bear weight immediately after the injury

b)

Development
of marked ankle swelling and discoloration after the injury

c)

Crepitation
with palpation or movement of the ankle

d)

All of the
above

Question 33

Mrs. 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?

Question
options:

a)

History of
hypertension

b)

Her affected
shoulder is also her dominant arm.

c)

Her history
of diabetes mellitus

d)

Her work as
a secretary predisposes her to repetitive motions.

Question 34

Mrs.
Anderson is a 35-year-old woman who has been recently diagnosed with carpal
tunnel syndrome. She has two young children and asks the clinician what the
chances are that they also will develop carpal tunnel syndrome. Which of the
following responses would be correct regarding the risk of developing carpal
tunnel syndrome?

Question
options:

a)

Carpal
tunnel syndrome commonly occurs in families. Genetic factors are thought to
account for about one-half the risk of developing carpal tunnel.

b)

Only people
with occupations that require repeated flexion extension of the wrist, use of
hand tools that require forceful gripping, or use of hand tools that vibrate
are at risk for developing carpal tunnel.

c)

An
underlying musculoskeletal disorder must be present for a person to develop
carpal tunnel.

d)

Carpal
tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 35

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

Question
options:

a)

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

b)

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

c)

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

d)

All of the
above

Question 36

Janet is a
30-year-old who has recently been 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?

Question
options:

a)

Gastrocnemius
weakness

b)

A reduced or
absent ankle reflex

c)

Numbness in
the lateral foot

d)

Paresthesia
of the perineum and buttocks

Question 37

Which of the
following is essential for diagnosing thyroid cancer?

Question
options:

a)

Fine needle
aspiration

b)

Thyroid
ultrasound

c)

CT scan

d)

Magnetic
resonance imaging

Question 38

Mr. W, 53
years old, is seen in the clinic with concerns about his left foot. He has a
40-year history of type 1 diabetes with “fairly good” control on twice-daily
insulin. He denies injury but states that he tripped a few months ago and that
his foot is sore when he walks. Physical examination reveals an edematous,
erythremic, and warm foot. There is a superficial ulcer on the plantar surface.
Which of the following is the most likely diagnosis?

Question
options:

a)

Fallen arch

b)

Arthritis

c)

Charcot
joint

d)

Sprained
ankle

Question 39

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

Question
options:

a)

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

b)

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.

c)

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

d)

All of the
above

Question 40

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?

Question
options:

a)

Morning
stiffness and limited mobility of the lumbar spine

b)

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

c)

Fever,
chills, and elevated erythrocyte sedimentation rate

d)

Pathologic
fractures, severe night pain, weight loss, and fatigue

Question 41

One 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?

Question
options:

a)

Bone

b)

Synovium

c)

Tendons

d)

Fascia

Question 42

The patient
is prescribed radioactive iodine (RAI) and asks the clinician how this drug
works. The clinician’s response should include which of the following data?

Question
options:

a)

RAI prevents
the peripheral conversion of T4 to T3.

b)

RAI binds
free T4.

c)

RAI destroys
thyroid tissue.

d)

RAI reduces
freely circulating iodine.

Question 43

Joyce is seen
in the clinic complaining of vague symptoms of nervousness and irritability.
She says that her hair will not hold a permanent wave anymore. On physical
examination, the clinician finds an irregular heartbeat and brisk reflexes. The
differential diagnosis should include which of the following conditions?

Question
options:

a)

Myxedema

b)

Thyrotoxicosis

c)

Cushing’s
syndrome

d)

Pan-hypopituitarism

Question 44

Which of the
following medications for type 2 diabetes mellitus should not be prescribed
during pregnancy?

Question
options:

a)

Insulin

b)

Metformin

c)

Glucotrol

d)

Precose

Question 45

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?

Question
options:

a)

Ketoacidosis

b)

Cirrhosis

c)

Hypoglycemic
episodes

d)

All of the
above

Question 46

How often
should the clinician examine the feet of a person with diabetes?

Question
options:

a)

Once a year

b)

Every 6
months

c)

Every 3
months

d)

Every visit

Question 47

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

Question
options:

a)

Elevated TSH

b)

Normal TSH

c)

Low TSH

d)

Undetectable
TSH

Question 48

The
clinician has instructed Sam, 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?

Question
options:

a)

“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.”

b)

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

c)

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

d)

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

Question 49

Which of the
following statements is true concerning the management of the client with a
herniated disc?

Question
options:

a)

Muscle
relaxants and narcotics can be used to control moderate pain but should be
discontinued after 3 weeks of use.

b)

An epidural
injection is helpful in reducing leg pain that has persisted for at least 3
weeks after the herniation occurred.

c)

Intolerable
pain for more than a 3-month period is an indication for surgical intervention.

d)

All of the
above

Question 50

Metformin is
the first line of pharmacologic treatment for type 2 DM.

Question
options:

a) True

b) False