FNP 652 Midterm Exam Newest Actual Exam With Complete Questions And
Correct Detailed Answers (Verified Answers) |Already Graded A+
Question 1
Which of the following is considered the most common cause of neonatal intestinal obstruction?
A) Pyloric stenosis
B) Intussusception
C) Hirschsprung Disease
D) Meckel’s diverticulum
E) Malrotation with volvulus
Correct Answer: C) Hirschsprung Disease
Rationale: Hirschsprung Disease is the most frequent cause of neonatal lower intestinal
obstruction. It occurs due to a failure of neural crest cells to migrate, resulting in a lack of
ganglion cells in the distal colon, which prevents normal peristalsis.
Question 2
What is the underlying pathophysiology of Hirschsprung disease?
A) Hypertrophy of the pyloric sphincter
B) Congenital absence of ganglion cells in a section of the large intestine
C) Invagination of the ileum into the cecum
D) Bacterial infection of the colonic mucosa
E) Chronic inflammation of the transmural layer of the GI tract
Correct Answer: B) Congenital absence of ganglion cells in a section of the large intestine
Rationale: The absence of ganglion cells (Auerbach’s and Meissner’s plexuses) results in a
functional obstruction because the affected segment cannot relax, leading to a lack of
motility and proximal dilation of the colon.
Question 3
Which diagnostic procedure is recognized as the "gold standard" for confirming a diagnosis of
Hirschsprung Disease?
A) Abdominal X-ray
B) Barium enema
C) Rectal biopsy
D) Abdominal ultrasound
E) Computed tomography (CT)
Correct Answer: C) Biopsy
Rationale: While imaging can suggest the disease (showing a transition zone), a suction
rectal biopsy is required to definitively demonstrate the absence of ganglion cells in the
submucosa, which is the hallmark of the disease.
Question 4
A 4-week-old male infant is brought to the clinic for forceful, non-bilious vomiting that has
become increasingly frequent. Which condition is most likely?
A) GERD
, 2
B) Hirschsprung Disease
C) Pyloric Stenosis
D) Intussusception
E) Gastroenteritis
Correct Answer: C) Pyloric Stenosis
Rationale: Hypertrophic pyloric stenosis typically presents between 3 to 6 weeks of age.
The vomiting is classically described as "forceful" or "projectile" and occurrs immediately
after feeding.
Question 5
During a physical examination of a 1-month-old infant with forceful vomiting and constant
hunger, the provider palpates a small, firm, "olive-shaped" mass in the right upper quadrant. This
finding is pathognomonic for:
A) Intussusception
B) Cholecystitis
C) Pyloric Stenosis
D) Nephroblastoma
E) Hepatomegaly
Correct Answer: C) Pyloric Stenosis
Rationale: The "olive mass" represents the hypertrophied pylorus. It is best palpated in the
RUQ or epigastrium, especially after the infant has vomited and the stomach is empty.
Question 6
What is the primary pharmacological treatment for Zollinger-Ellison Syndrome (ZES)?
A) H2 Antagonists
B) Antacids
C) Proton Pump Inhibitors (PPIs)
D) Sucralfate
E) Misoprostol
Correct Answer: C) PPI
Rationale: ZES involves a gastrinoma that causes massive gastric acid hypersecretion.
High-dose PPIs are the first-line medical treatment to control acid secretion and allow for
the healing of peptic ulcers.
Question 7
What is the minimum percentage of weight loss required to significantly improve obesity-related
comorbidities such as hypertension and insulin resistance?
A) 1-2%
B) 5-10%
C) 15-20%
D) 25%
, 3
E) 50%
Correct Answer: B) 5-10%
Rationale: Clinical guidelines state that a modest weight loss of 5% to 10% of total body
weight is sufficient to produce clinically meaningful improvements in cardiovascular risk
factors and metabolic health.
Question 8
Which obesity medication works by inhibiting the enzyme lipase, thereby blocking the digestion
and absorption of dietary fat?
A) Phentermine
B) Lorcaserin
C) Orlistat
D) Bupropion/Naltrexone
E) Liraglutide
Correct Answer: C) Orlistat
Rationale: Orlistat (Xenical/Alli) is a gastrointestinal lipase inhibitor. It prevents about 25-
30% of dietary fat from being absorbed, which is then excreted in the stool.
Question 9
A patient has a Body Mass Index (BMI) of 32 kg/m ². Which classification of obesity does this
fall into?
A) Overweight
B) Class I Obesity
C) Class II Obesity
D) Class III Obesity
E) Morbid Obesity
Correct Answer: B) I >30- <35
Rationale: Obesity is classified as: Class I (BMI 30 to <35), Class II (BMI 35 to <40), and
Class III (BMI ≥40, often termed extreme or morbid obesity).
Question 10
According to the Rome IV criteria, what is the required frequency and duration of symptoms to
diagnose Irritable Bowel Syndrome (IBS)?
A) Symptoms once a week for 1 month
B) Symptoms at least 3 days a month for at least 3 months
C) Continuous symptoms for 6 weeks
D) Symptoms only after eating for 2 months
E) Symptoms once a month for a year
Correct Answer: B) Symptoms present at least 3 days a month for at least 3 months.
Rationale: Chronic abdominal pain and altered bowel habits must be present for at least 3
, 4
months, with an onset at least 6 months prior, to meet the standardized diagnostic criteria
for IBS.
Question 11
A 30-year-old female presents with recurrent abdominal cramping and diarrhea. She has no
weight loss, no nocturnal diarrhea, and no blood in her stool. She reports her symptoms are
worse during times of stress. What is the most likely diagnosis?
A) Crohn’s Disease
B) Ulcerative Colitis
C) Irritable Bowel Syndrome (IBS)
D) Celiac Disease
E) Diverticulitis
Correct Answer: C) Irritable bowel syndrome
Rationale: The absence of "alarm" symptoms (weight loss, blood, anemia) and the
relationship with stress in a young female are classic indicators of IBS rather than
Inflammatory Bowel Disease (IBD).
Question 12
Which of the following describes the emergent condition where one segment of the bowel slides
into an adjacent segment?
A) Volvulus
B) Incarcerated hernia
C) Intussusception
D) Hirschsprung Disease
E) Pyloric Stenosis
Correct Answer: C) Intussusception
Rationale: Intussusception is the "telescoping" of the bowel, which can lead to ischemia,
perforation, and peritonitis if not treated urgently.
Question 13
A 2-year-old child presents with sudden onset paroxysmal abdominal pain and "currant jelly"
stools. This stool appearance is caused by:
A) Ingested food dye
B) Excessive iron intake
C) Mixture of blood and mucus from the intestinal wall
D) Upper GI bleeding
E) Malabsorption of fats
Correct Answer: C) Intussusception
Rationale: The "currant jelly" stool is a classic sign of intussusception, resulting from the
sloughing of the mucosa and blood leakage as the telescoped bowel becomes ischemic.
Correct Detailed Answers (Verified Answers) |Already Graded A+
Question 1
Which of the following is considered the most common cause of neonatal intestinal obstruction?
A) Pyloric stenosis
B) Intussusception
C) Hirschsprung Disease
D) Meckel’s diverticulum
E) Malrotation with volvulus
Correct Answer: C) Hirschsprung Disease
Rationale: Hirschsprung Disease is the most frequent cause of neonatal lower intestinal
obstruction. It occurs due to a failure of neural crest cells to migrate, resulting in a lack of
ganglion cells in the distal colon, which prevents normal peristalsis.
Question 2
What is the underlying pathophysiology of Hirschsprung disease?
A) Hypertrophy of the pyloric sphincter
B) Congenital absence of ganglion cells in a section of the large intestine
C) Invagination of the ileum into the cecum
D) Bacterial infection of the colonic mucosa
E) Chronic inflammation of the transmural layer of the GI tract
Correct Answer: B) Congenital absence of ganglion cells in a section of the large intestine
Rationale: The absence of ganglion cells (Auerbach’s and Meissner’s plexuses) results in a
functional obstruction because the affected segment cannot relax, leading to a lack of
motility and proximal dilation of the colon.
Question 3
Which diagnostic procedure is recognized as the "gold standard" for confirming a diagnosis of
Hirschsprung Disease?
A) Abdominal X-ray
B) Barium enema
C) Rectal biopsy
D) Abdominal ultrasound
E) Computed tomography (CT)
Correct Answer: C) Biopsy
Rationale: While imaging can suggest the disease (showing a transition zone), a suction
rectal biopsy is required to definitively demonstrate the absence of ganglion cells in the
submucosa, which is the hallmark of the disease.
Question 4
A 4-week-old male infant is brought to the clinic for forceful, non-bilious vomiting that has
become increasingly frequent. Which condition is most likely?
A) GERD
, 2
B) Hirschsprung Disease
C) Pyloric Stenosis
D) Intussusception
E) Gastroenteritis
Correct Answer: C) Pyloric Stenosis
Rationale: Hypertrophic pyloric stenosis typically presents between 3 to 6 weeks of age.
The vomiting is classically described as "forceful" or "projectile" and occurrs immediately
after feeding.
Question 5
During a physical examination of a 1-month-old infant with forceful vomiting and constant
hunger, the provider palpates a small, firm, "olive-shaped" mass in the right upper quadrant. This
finding is pathognomonic for:
A) Intussusception
B) Cholecystitis
C) Pyloric Stenosis
D) Nephroblastoma
E) Hepatomegaly
Correct Answer: C) Pyloric Stenosis
Rationale: The "olive mass" represents the hypertrophied pylorus. It is best palpated in the
RUQ or epigastrium, especially after the infant has vomited and the stomach is empty.
Question 6
What is the primary pharmacological treatment for Zollinger-Ellison Syndrome (ZES)?
A) H2 Antagonists
B) Antacids
C) Proton Pump Inhibitors (PPIs)
D) Sucralfate
E) Misoprostol
Correct Answer: C) PPI
Rationale: ZES involves a gastrinoma that causes massive gastric acid hypersecretion.
High-dose PPIs are the first-line medical treatment to control acid secretion and allow for
the healing of peptic ulcers.
Question 7
What is the minimum percentage of weight loss required to significantly improve obesity-related
comorbidities such as hypertension and insulin resistance?
A) 1-2%
B) 5-10%
C) 15-20%
D) 25%
, 3
E) 50%
Correct Answer: B) 5-10%
Rationale: Clinical guidelines state that a modest weight loss of 5% to 10% of total body
weight is sufficient to produce clinically meaningful improvements in cardiovascular risk
factors and metabolic health.
Question 8
Which obesity medication works by inhibiting the enzyme lipase, thereby blocking the digestion
and absorption of dietary fat?
A) Phentermine
B) Lorcaserin
C) Orlistat
D) Bupropion/Naltrexone
E) Liraglutide
Correct Answer: C) Orlistat
Rationale: Orlistat (Xenical/Alli) is a gastrointestinal lipase inhibitor. It prevents about 25-
30% of dietary fat from being absorbed, which is then excreted in the stool.
Question 9
A patient has a Body Mass Index (BMI) of 32 kg/m ². Which classification of obesity does this
fall into?
A) Overweight
B) Class I Obesity
C) Class II Obesity
D) Class III Obesity
E) Morbid Obesity
Correct Answer: B) I >30- <35
Rationale: Obesity is classified as: Class I (BMI 30 to <35), Class II (BMI 35 to <40), and
Class III (BMI ≥40, often termed extreme or morbid obesity).
Question 10
According to the Rome IV criteria, what is the required frequency and duration of symptoms to
diagnose Irritable Bowel Syndrome (IBS)?
A) Symptoms once a week for 1 month
B) Symptoms at least 3 days a month for at least 3 months
C) Continuous symptoms for 6 weeks
D) Symptoms only after eating for 2 months
E) Symptoms once a month for a year
Correct Answer: B) Symptoms present at least 3 days a month for at least 3 months.
Rationale: Chronic abdominal pain and altered bowel habits must be present for at least 3
, 4
months, with an onset at least 6 months prior, to meet the standardized diagnostic criteria
for IBS.
Question 11
A 30-year-old female presents with recurrent abdominal cramping and diarrhea. She has no
weight loss, no nocturnal diarrhea, and no blood in her stool. She reports her symptoms are
worse during times of stress. What is the most likely diagnosis?
A) Crohn’s Disease
B) Ulcerative Colitis
C) Irritable Bowel Syndrome (IBS)
D) Celiac Disease
E) Diverticulitis
Correct Answer: C) Irritable bowel syndrome
Rationale: The absence of "alarm" symptoms (weight loss, blood, anemia) and the
relationship with stress in a young female are classic indicators of IBS rather than
Inflammatory Bowel Disease (IBD).
Question 12
Which of the following describes the emergent condition where one segment of the bowel slides
into an adjacent segment?
A) Volvulus
B) Incarcerated hernia
C) Intussusception
D) Hirschsprung Disease
E) Pyloric Stenosis
Correct Answer: C) Intussusception
Rationale: Intussusception is the "telescoping" of the bowel, which can lead to ischemia,
perforation, and peritonitis if not treated urgently.
Question 13
A 2-year-old child presents with sudden onset paroxysmal abdominal pain and "currant jelly"
stools. This stool appearance is caused by:
A) Ingested food dye
B) Excessive iron intake
C) Mixture of blood and mucus from the intestinal wall
D) Upper GI bleeding
E) Malabsorption of fats
Correct Answer: C) Intussusception
Rationale: The "currant jelly" stool is a classic sign of intussusception, resulting from the
sloughing of the mucosa and blood leakage as the telescoped bowel becomes ischemic.
