NR 509 Week 4 Midterm Exam
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does not address false negatives (negative results in individuals who actually have the disease), a highly specific test is good at ruling out true positive cases but may or may not be good at ruling it truly negative cases (this is determined by sensitivity). 4. Weight change may indicate the presence of important underlying pathology requiring further investigation. Which of the following best describes a significant weight change that requires further evaluation? a. A 45-year-old male with baseline weight of 280 lb who decides to undertake a light exercise regimen and loses 15% of his total body weight in 3 months Rationale: A safe rate of intentional weight loss is no more than 2 lb/week; this patient has lost about 3.5 lb/week. In addition, it would be reasonable to question why he experienced such rapid weight loss from such a small deviation in his baseline activity. 5. . A 19-year-old student of art history presents to clinic after a syncopal (fainting) episode at school. He is notably thin; on a thorough review of his medical history, he admits that he eats only minimally to maintain a very low body weight that he feels is ideal. He is embarrassed that his issues were discussed by peers after this episode, especially because he believes that this is a problem that is only faced by girls and women. Concerning the two most common eating disorders (anorexia nervosa and bulimia nervosa), which of the following statements is true? c. Both of these eating disorders are associated with a real or imagined fear of appearing fat. 6. A 55-year-old air traffic control agent reports his home blood pressure log to clinic after he was diagnosed with hypertension at a prior visit. He notes that he consistently measures within the normal range at home, but seems to fall outside the normal range every time he comes to the clinic. Which of the following blood pressure measurements is considered to be most accurate (i.e., reflecting the patient’s “true” blood pressure)? 9. A first-semester physician assistant student reports to his supervisor that he has trouble determining the diastolic blood pressure. On manual blood pressure, which of the following provides the best estimate of the true diastolic blood pressure? d. The disappearance of Korotkof f sounds following initial muffling. 10.A 72-year-old retiree presents to the cardiology clinic with palpitations after several months of symptoms. An electrocardiogram (ECG) shows a tachyarrhythmia, which the cardiologist diagnoses as atrial fibrillation. In measuring the blood pressure of a patient with chronic atrial fibrillation, which of the following statements is true? c. Ambulatory monitoring over 2–24 hours is recommended because this rhythm produces variable and inconsistent blood pressures. 11.A 42-year-old architect presents with widespread pain complaints, including headaches almost daily, pain at the site of an old motor vehicle accident injury, and generalized achiness and hypersensitivity throughout the body. He recounts that his first episodes of ongoing pain occurred in his early 20s, and he has been to many practitioners over several years seeking
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