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NR603 Week 2 Quiz

Question 1

A 29-year-old patient presents for follow-up care one week after experiencing a spontaneous miscarriage. She reports feeling emotionally overwhelmed, fatigued, and having little appetite. In addition to gynecologic care, which of the following assessments is the most critical to prioritize at this stage to ensure comprehensive care without complications?

1. Cardiovascular assessment to assess for circulatory abnormalities
2. Endocrine evaluation to rule out thyroid dysfunction

🟩✅ C. Mental health to evaluate emotional status

1. Gastrointestinal assessment to evaluate recent dietary changes

Question 2

A 68-year-old male presents with a worsening headache that has changed in intensity and character over the past week. He reports increased difficulty concentrating, occasional blurred vision, and a few instances of imbalance. What is the MOST appropriate next step in the evaluation of this patient?

1. Initiate migraine treatment and refer to outpatient neurology

🟩✅ B. Order urgent neuroimaging to evaluate for intracranial pathology

1. Assess for depression and start antidepressant therapy
2. Recommend rest, hydration, and follow-up in 48–72 hours

Question 3

During a patient interview, the provider asks, “How have you been coping emotionally since the event?” The patient responds, “It’s been really tough emotionally. I’ve been feeling very sad and overwhelmed, and sometimes it’s hard to get through the day.” Which of the following is the most appropriate next response by the provider?

🟩✅ A. “That sounds really difficult. Can you tell me more about what your days have been like?”

1. “Let’s move on to your medical history now.”
2. “It’s probably just temporary sadness. You’ll be fine with rest.”
3. “You should really try to be more positive. Things will get better soon.”

Question 4

A 35-year-old patient presents with mild tingling in the right lower extremity but has normal strength, coordination, reflexes, and gait. Which of the following is the MOST appropriate next step in management?

1. Follow up with the primary care provider in 6 months

🟩✅ B. Refer to physical therapy within 1–2 weeks

1. Begin opioid therapy and refer to pain management
2. Refer to an orthopedic surgeon within 1 week

Question 5

A patient presents with pain and tingling in the right lower extremity. She has some moderate lower spine tenderness but her exam otherwise is unremarkable. MRI confirms an L4–L5 disc bulge with nerve root impingement, consistent with lumbosacral radiculopathy. Which of the following is the MOST appropriate next step in this patient’s management?

1. Immediate referral to neurosurgery for surgical intervention
2. Prescribe high-dose opioids and recommend strict bed rest
3. Discharge without follow-up as the symptoms are expected to resolve spontaneously

🟩✅ D. Initiate physical therapy and reassess in 4–6 weeks

Question 6

In evaluating an adult with a new or worsening headache, why is it essential to review the patient’s current medication list, including over the counter medications and herbal supplements?

1. To determine which medications dosages need to be increased to prevent headaches
2. To assess compliance with prescribed psychiatric medications

✅ C. To identify possible drug-induced headache or adverse interactions

1. To identify medications that may be causing sleep disturbances

Question 7

The patient reports drinking alcohol occasionally and states, “I haven’t really said anything to my family. It’s been hard to reach out to anyone, even friends.” What is the PRIMARY concern raised by this response?

✅ A. The patient may be at increased risk for social isolation

 

1. The patient has no support system and should be hospitalized
2. The patient’s alcohol use indicates abuse
3. The patient may be hiding a substance use disorder

Question 8

A 66-year-old widower presents with headaches, fatigue, light sensitivity, and poor appetite. He describes feeling “empty” and has withdrawn from his usual activities since his wife passed away. Why is it important to assess for emotional distress during this visit?

1. Emotional distress has no clinical impact but should be acknowledged for patient rapport
2. Depression must be ruled out before any neurologic imaging is ordered
3. Headaches are rarely linked to mood disorders and should be managed separately

✅ D. Psychosocial stressors can amplify somatic symptoms and complicate diagnosis and treatment