01 Oct Which laboratory test result is diagnostic for hypoglycemia?
Which laboratory test result is diagnostic for hypoglycemia?
A1c 7.0%
Fasting blood sugar of 75 mg/dL
Glucose level 43 mg/dL
Random glucose level 64 mg/dL
2Which 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 ROM exercises to avoid causing pain.
Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
3Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout.
Which of the following should the clinician expect in the initial test results for this patient?
Elevated uric acid level Elevated blood urea nitrogen
Decreased urine pH
Decreased C-reactive protein
4.Felice is a 64-year-old female who complains that walking and prolonged standing causes pain and weakness in her legs and buttocks. She expresses that she has short-term relief when she leans on the shopping cart. When she sleeps on her back, she sometimes wakes up in the night in pain. Which of the following diagnoses is most likely?
Multiple sclerosis
Herniated lumbar disc
Lumbar spinal stenosis
Cervical spondylosis
5Which 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
6Which blood test would confirm a diagnosis of diabetes mellitus?
A1c 5.5%
Fasting plasma glucose level of 120 mg/dL
Oral glucose tolerance test 250 mg/dL (2-hour level) Random plasma glucose level 175 mg/dL
7Fred has been diagnosed with a trigger finger of the ring finger. Which of the following management strategies is appropriate?
Surgical removal of the tendon sheath
NSAIDs
Local anesthetic injection into the tendon sheath
Splinting
8. 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:
Apprehension sign Bulge sign
Thumb sign
Lachman sign
9.Chris is a 28-year-old male who complains of lower back pain that began 3 days ago. The pain is worse when he stands or bends, and it is somewhat relieved when he sits. The clinician performs the straight-leg raise test and it is negative. Plain film x-ray is positive. Which diagnosis is most likely?
Osteoarthritis
Spinal stenosis
Scoliosis
Muscle strain
10The clinician should question the patient with suspected gout about use of which of these medications?
Antihypertensives
Thiazide diuretics Cardiac glycosides
Potassium supplements
11. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
Hyperalbuminemia
Morning stiffness Weight gain
12A nondiabetic patient has idiopathic hypoglycemia. Which dietary instruction should the clinician share with the patient?
Follow a low-protein, high-carbohydrate diet
Allow caffeine at each meal
Avoid nuts and seeds
Eat six small meals a day
13Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform?
Allen’s test
Phalen’s test Tinel’s sign
Finkelstein’s test
14. Which of the following is a common sign of type 2 DM? Anorexia
Recurrent yeast infection Fluid overload
Elevated high-density lipoprotein cholesterol
15. Which of the following is essential for diagnosing thyroid cancer?
Fine needle aspiration biopsy Thyroid ultrasound
Computed tomography scan
Magnetic resonance imaging
16After 6 months of Synthroid therapy, the clinician should expect which result in the repeat thyroid-stimulating hormone studies?
Elevated
Normal Low
Undetectable
17. How often should the clinician examine the feet of a person with diabetes?
Every year
Every 6 months
Every 3 months
Every visit
18Sam 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
19Mrs. 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 1 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 that radiates into the forearm and pain and weakness with gripping objects
Inability to supinate and pronate the arm
Inability to flex or extend the elbow against resistance
20. A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which condition that the patient also has would be a contraindication to taking metformin?
Ulcerative colitis
Inflammatory bowel disease
Chronic obstructive pulmonary disease
Renal disease
21. Connie is a 63-year-old seamstress who presents with pain at the base of her right thumb on abduction and extension of her right thumb. She also complains of pain on the radial side of her right wrist with lifting. Which of these diagnostic tests will help to determine if she has de Quervain’s tenosynovitis?
Allen’s test
Phalen’s maneuver
Tinel’s sign
Finkelstein’s test
22. The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate teaching has been effective?
“I’ll take my pill before breakfast.”
“I know to take my Glucotrol at 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.”
23. 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 muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes.
Which test should be ordered next?
Serum calcium
Thyroid-stimulating hormone Electrolytes
Urine specific gravity
24. 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?
Gastrocnemius weakness
A reduced or absent ankle reflex
Numbness in the lateral foot
Saddle area anesthesia
25. The clinician suspects a patient has Addison’s disease. Which clinical manifestation would the clinician observe upon a physical examination?
Moon face
Central obesity
Hyperpigmentation Myxedema coma
26After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?
Suggest the patient use a heating pad to improve circulation.
Refer to a podiatrist for a foot-care treatment plan. Send the patient for acupuncture treatments.
Recommend increased intake of vitamin B12.
27. The clinician sees a patient who has a body mass index (BMI) of 32.4 kg/m2. How would the clinician classify this patient?
Overweight
Obesity Class 1
Obesity Class 2
Obesity Class 1
Obesity Class 3
28. Which of the following statements concerning fibromyalgia is true?
Muscle pain that is caused by the development of trigger points within the muscle cannot occur concurrently with fibromyalgia.
A cause of myalgia can be fibromyalgia.
Bursitis cannot coexist with pain from fibromyalgia.
Fibromyalgia is an inflammatory musculoskeletal disorder.
A cause of myalgia can be fibromyalgia.
29You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ROM but cannot move it above gravity. Which numeric grade of muscle strength would you give this patient?
1
2
3
4
30.A clinician is examining a vertebral fracture, and the examination and diagnostic findings have shown a compression of the anterior column that includes both endplates. What type and subtype are these?
Compression fracture, type A Burst fracture, type B
Seat-belt type injury, level two
Fracture-dislocation, shear
31. A 35-year-old woman presents with symptoms of hypoglycemia. There is no history of diabetes mellitus. Which condition should be included in the differential diagnosis?
Peripheral vascular disease
Pheochromocytoma Cushing’s disease
Acromegaly
32. Willow is a post- menopausal female and her bone mineral density is more than 1 SD below the young adult reference mean. What is her diagnosis?
Normal bone mineral density
Osteopenia Osteoporosis
Severe osteoporosis
33. A male 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?
Administer glucagon subcutaneously.
Have him drink 4 ounces of juice. Call 911.
Ask him about his usual eating habits.
34Mrs. 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?
Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.
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.
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.
An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.
Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.
35. 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
Inflammatory
Nonarticular
Noninflammatory
36. What is the recommended daily calcium intake for a 60 year old male?
500 mg/day
750 mg/day
1,000 mg/day
1,500 mg/day
37. A patient is 66 inches in height, weighing 200 lbs, and newly diagnosed with type 2 diabetes mellitus (DM). The A1c is 7.1%. What is the best initial treatment?
No treatment at this time
Diet and exercise
Diet, exercise, and metformin
Diet, exercise, and metformin
Diet, exercise, and exogenous insulin
38. The patient with type 1 diabetes is exhibiting Kussmaul respirations, anorexia, fatigue, and increased thirst. Which condition is occurring?
Hypoglycemia
Somogyi effect
Diabetic ketoacidosis
Hyperosmolar hyperglycemic syndrome
39. The patient has metabolic syndrome. The patient is at increased risk for which condition?
Anxiety disorder
Gallbladder disease
Diabetes mellitus Hyperparathyroidism
40Which of the following is a risk factor for overuse syndrome with tendonitis?
Body mass index <18
Hypothyroidism
Rheumatoid arthritis Cardiac disease
