NR511 EXAM QUESTIONS AND 100% CORRECT
ANSWERS
Bobby, aged 6 years, has persistent periumbilical pain migrating to the right lower
quadrant, vomiting, a small amount of diarrhea, no headache, a slight rise of the white
blood count with an early left shift, and white blood cells in the urine. Suspect:
1. Appendicitis.
2. Gastroenteritis.
3. Acute pancreatitis.
4. Rocky Mountain spotted fever. - ANSWER 1.
Appendicitis.
Melva is a 63-year-old female presenting with an acute exacerbation of pancreatitis, and
you are going to be admitting her into the hospital. Of the following, which is the most
significant predictor of a poor long-term outcome for her?
1.Age.
2.Infection.
3.Pain.
4.Duration between exacerbations. - ANSWER 2.
Infection.
A mother brings in her 4-year-old child and states that he has acute abdominal pain and
a rash. Of the following, which do you first rule out?
1. Rocky Mountain spotted fever.
2.Measles.
3. Appendicitis.
4. A food allergy.
,ANSWER 3.
Appendicitis.
Harvey just came back from Mexico. Which pathogen do you suspect is responsible for
his diarrhea?
1. Enterococci.
2. Escherichia coli.
3. Klebsiella.
4. Staphylococci.
ANSWER 2.
Escherichia coli.
To differentiate among the different diagnoses of inflammatory bowel diseases, you look
at the client's histological, culture, and radiological features. Mary has transmural
inflammation, granulomas, focal involvement of the colon with some skipped areas, and
sparing of the rectal mucosa. What do you suspect?
1.Crohn disease.
2.Ulcerative colitis.
3.Infectious colitis.
4.Ischemic colitis. - ANSWER 1.
Crohn disease.
Marian, 52 years old is obese. She presents with a sudden onset of severe right upper
quadrant abdominal colicky pain, nausea and vomiting. Your differential diagnosis could
be:
1. Appendicitis.
2. Crohn's disease.
3.Cholecystitis.
4.Irritable bowel syndrome. - ANSWER 3.
,Cholecystitis.
You suspect that Nikki has a gastroduodenal ulcer due to Helicobacter pylori and want
to treat her empirically. What medications would you order?
1.A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole
(Flagyl).
2. Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.Clarithromycin (Biaxin) and metronidazole (Flagyl). - ANSWER 1.
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole
(Flagyl).
What are the following medications/drugs not associated with causing heartburn or
dyspepsia?
1. Alcohol.
2. Motrin.
3. Prednisone.
4. Tylenol. - ANSWER 4.
Tylenol.
Icterus due to hyperbilirubinemia occurs when the serum level of bilirubin is greater
than?
1.2.5 mg/dL.
2.1.0 mg/dL.
3.2.0 mg/dL.
4.0.5 mg/dL. - ANS 1.
2.5 mg/dL.c
A 45-year-old homeless male presents to your urgent care for evaluation. His chief
, complaint is diarrhea. The patient reports he began to have diarrhea 2-3 days ago and
has been getting progressively worse. He also relates nausea without vomiting, dry
mouth, and double vision. On exam you find his pupillary reflex is absent. The patient
reports that he lives on the street and eats mainly canned goods that he retrieves from a
grocery store dumpster. What is the likely cause of the patient's symptoms?
1. Botulism.
2.Salmonella.
3Lyme disease.
4.Vitamin C deficiency. - ANSWER 1.
Botulism.
What is the most common bacterial cause of traveler's diarrhea?
1.Escherichia coli.
2. Campylobacter jejuni.
3.Salmonella.
4.Shigella. - ANSWER 1.
Escherichia coli.
A 7-year-old male presents to the urgent care clinic with his mother with complaints of
abdominal pain. He started having pain before bedtime; however, it has progressively
worsened and, for the most part, he admits that his pain is keeping him from sleep. His
nausea is present without vomiting, and he did not eat dinner because of his pain. The
patient does appear pale and is complaining of right-sided abdominal pain. Vital signs:
blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air.
On physical exam he is tender in the right lower quadrant. His CBC shows a WBC of
17.0. What is the patient's likely diagnosis?
1.Appendicitis.
2.Cholecystitis.
3.Constipation.
4.Gastroenteritis. - ANSWER 1.
Appendicitis.
ANSWERS
Bobby, aged 6 years, has persistent periumbilical pain migrating to the right lower
quadrant, vomiting, a small amount of diarrhea, no headache, a slight rise of the white
blood count with an early left shift, and white blood cells in the urine. Suspect:
1. Appendicitis.
2. Gastroenteritis.
3. Acute pancreatitis.
4. Rocky Mountain spotted fever. - ANSWER 1.
Appendicitis.
Melva is a 63-year-old female presenting with an acute exacerbation of pancreatitis, and
you are going to be admitting her into the hospital. Of the following, which is the most
significant predictor of a poor long-term outcome for her?
1.Age.
2.Infection.
3.Pain.
4.Duration between exacerbations. - ANSWER 2.
Infection.
A mother brings in her 4-year-old child and states that he has acute abdominal pain and
a rash. Of the following, which do you first rule out?
1. Rocky Mountain spotted fever.
2.Measles.
3. Appendicitis.
4. A food allergy.
,ANSWER 3.
Appendicitis.
Harvey just came back from Mexico. Which pathogen do you suspect is responsible for
his diarrhea?
1. Enterococci.
2. Escherichia coli.
3. Klebsiella.
4. Staphylococci.
ANSWER 2.
Escherichia coli.
To differentiate among the different diagnoses of inflammatory bowel diseases, you look
at the client's histological, culture, and radiological features. Mary has transmural
inflammation, granulomas, focal involvement of the colon with some skipped areas, and
sparing of the rectal mucosa. What do you suspect?
1.Crohn disease.
2.Ulcerative colitis.
3.Infectious colitis.
4.Ischemic colitis. - ANSWER 1.
Crohn disease.
Marian, 52 years old is obese. She presents with a sudden onset of severe right upper
quadrant abdominal colicky pain, nausea and vomiting. Your differential diagnosis could
be:
1. Appendicitis.
2. Crohn's disease.
3.Cholecystitis.
4.Irritable bowel syndrome. - ANSWER 3.
,Cholecystitis.
You suspect that Nikki has a gastroduodenal ulcer due to Helicobacter pylori and want
to treat her empirically. What medications would you order?
1.A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole
(Flagyl).
2. Bismuth subsalicylate (Pepto-Bismol) and omeprazole (Prilosec).
3.Amoxicillin (Amoxil) and omeprazole (Prilosec).
4.Clarithromycin (Biaxin) and metronidazole (Flagyl). - ANSWER 1.
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole
(Flagyl).
What are the following medications/drugs not associated with causing heartburn or
dyspepsia?
1. Alcohol.
2. Motrin.
3. Prednisone.
4. Tylenol. - ANSWER 4.
Tylenol.
Icterus due to hyperbilirubinemia occurs when the serum level of bilirubin is greater
than?
1.2.5 mg/dL.
2.1.0 mg/dL.
3.2.0 mg/dL.
4.0.5 mg/dL. - ANS 1.
2.5 mg/dL.c
A 45-year-old homeless male presents to your urgent care for evaluation. His chief
, complaint is diarrhea. The patient reports he began to have diarrhea 2-3 days ago and
has been getting progressively worse. He also relates nausea without vomiting, dry
mouth, and double vision. On exam you find his pupillary reflex is absent. The patient
reports that he lives on the street and eats mainly canned goods that he retrieves from a
grocery store dumpster. What is the likely cause of the patient's symptoms?
1. Botulism.
2.Salmonella.
3Lyme disease.
4.Vitamin C deficiency. - ANSWER 1.
Botulism.
What is the most common bacterial cause of traveler's diarrhea?
1.Escherichia coli.
2. Campylobacter jejuni.
3.Salmonella.
4.Shigella. - ANSWER 1.
Escherichia coli.
A 7-year-old male presents to the urgent care clinic with his mother with complaints of
abdominal pain. He started having pain before bedtime; however, it has progressively
worsened and, for the most part, he admits that his pain is keeping him from sleep. His
nausea is present without vomiting, and he did not eat dinner because of his pain. The
patient does appear pale and is complaining of right-sided abdominal pain. Vital signs:
blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air.
On physical exam he is tender in the right lower quadrant. His CBC shows a WBC of
17.0. What is the patient's likely diagnosis?
1.Appendicitis.
2.Cholecystitis.
3.Constipation.
4.Gastroenteritis. - ANSWER 1.
Appendicitis.
