NR 509 - Final Exam Bate's Interactive Question Bank
NR 509 - FINAL EXAM BATE'S INTERACTIVE QUESTION BANK NEWEST
2026/2027 STUDY GUIDE EXAM COMPLETE 150 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
A 76-year-old retired man with a history of prostate cancer and hypertension has
been screened annually for colon cancer using high sensitivity fecal occult blood
testing (FOBT). He presents for follow-up of his hypertension, during which the
clinician scans his chart to ensure he is up to date with his preventive health care.
He has a positive FOBT on one occasion at age 66 years and subsequently went for
a colonoscopy. Internal hemorrhoids and sigmoid diverticuli were found on
colonoscopy. He has no first-degree relatives with a history of colorectal cancer or
adenomatous polyps. What are the U.S. Preventive Services Task Force (USPSTF)
screening recommendations for this patient?
a. Do not screen routinely
b. Continue annual FOBT screening until age 80 years
c. Continue annual FOBT screening until age 85 years
d. Repeat colonoscopy this year
e. Sigmoidoscopy every 5 years with FOBT every 3 years - Correct Answer-a. Do
not screen routinely
An otherwise healthy 31-year-old accountant presents to an outpatient clinic with
a 3-year history of recurrent crampy abdominal pain that lasts for about 1-2 weeks
each episode and is associated with onset of constipation. She describes
infrequent, small hard stool that she finds very difficult to pass. She has tried to
increase dietary fiber and water intake, but usually this is not sufficient and she
1|Page
, NR 509 - Final Exam Bate's Interactive Question Bank
resorts to over-the-counter laxatives, which she finds upset her stomach but do
resolve the constipation. Symptoms typically gradually resolve with bowel
movements. Which of the following is the most likely physiological mechanism for
her constipation?
a. A large, firm fecal mass in the rectum
b. Decreased fecal bulk
c. Functional change in bowel movement
d. Spasm of the external sphincter
e. Impairment of autonomic innervations - Correct Answer-c. Functional change in
bowel movement
A 23-year-old woman comes to the respirology clinic for follow-up of her chronic
sinusitis and bronchiectasis that is associated with a rare congenital condition
called Kartagener syndrome. The preceptor notes that she has situs inversus and
asks for a physical exam. Which of the following descriptions best fits with findings
on the abdominal exam?
a. Tympany to percussion in the right upper quadrant, dullness to percussion of
the left upper quadrant
b. Protuberant abdomen that has scattered areas of tympany and dullness; stool is
felt on palpation
c. Liver dullness in the right upper quadrant that is displaced downward by the
low diaphragm due to chronic obstructive pulmonary disease
d. Dullness to percussion of the left lower anterior chest wall roughly at the
anterior axillary line
2|Page
, NR 509 - Final Exam Bate's Interactive Question Bank
e. A change in percussion from tympany to dullness in the left lower anterior chest
wall on inspiration - Correct Answer-a. Tympany to percussion in the right upper
quadrant, dullness to percussion of the left upper quadrant
An otherwise healthy 28-year-old lawyer presents to the Emergency Department
with a 1-day history of severe abdominal pain. The emergency physician suspects
appendicitis and general surgery is consulted. The resident believes the patient
has signs of peritonitis on exam. Which of the following physical exam findings
supports peritonitis?
a. Voluntary contraction of the abdominal wall that persists over several
examinations
b. Pressing down onto the abdomen firmly and slowly and withdrawing the hand
quickly produces pain
c. Abdominal pain that increases with hip flexion
d. Localized pain over McBurney point, which lies 2 inches from the anterior
superior iliac spinous process on a line drawn from the umbilicus
e. Pain with internal rotation of the right hip - Correct Answer-b. Pressing down
onto the abdomen firmly and slowly and withdrawing the hand quickly produces
pain
A 58-year-old man with a history of diabetes and alcohol addiction has been sober
for the last 10 months. He presents with a 4-month history of increasing
weakness, recurrent epigastric pain radiating to his back, chronic diarrhea with
stools 6-8 times daily, and weight loss of 18 lb over 4 months. What is the
mechanism of his most likely diagnosis?
3|Page
, NR 509 - Final Exam Bate's Interactive Question Bank
a. Helicobacter pylori infection
b. Inflammation of the gallbladder
c. Inflammation of colonic diverticulum
d. Reduced blood supply to the bowel
e. Fibrosis of the pancreas - Correct Answer-e. Fibrosis of the pancreas
A 46-year-old executive who is obese and otherwise healthy presents to a family
medicine clinic with a 3-month course of recurrent severe abdominal pain that
usually resolves on its own after a few hours. Her last episode was prolonged
lasting 6 hours, and she is frustrated that she has had to leave or miss work on
three separate occasions. She would like a diagnosis and the problem fixed. Which
symptoms or signs would be most suggestive of a diagnosis of biliary colic?
a. Exacerbating factor includes alcohol intake
b. Positive McBurney point tenderness
c. Poorly localized periumbilical pain
d. Vomiting of bile
e. Associated right shoulder pain - Correct Answer-e. Associated right shoulder
pain
A 67-year-old electronics technician with a history of hypertension and type 2
diabetes presents for his yearly physical examination and complains of
progressively worsening erectile dysfunction (ED). While counseling him, the
clinician mentions that multiple processes must take place to achieve an erection.
Which of the following structures would be most affected by vascular deficiencies
related to his preexisting medical conditions and is likely contributing to his
symptoms?
4|Page
NR 509 - FINAL EXAM BATE'S INTERACTIVE QUESTION BANK NEWEST
2026/2027 STUDY GUIDE EXAM COMPLETE 150 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
A 76-year-old retired man with a history of prostate cancer and hypertension has
been screened annually for colon cancer using high sensitivity fecal occult blood
testing (FOBT). He presents for follow-up of his hypertension, during which the
clinician scans his chart to ensure he is up to date with his preventive health care.
He has a positive FOBT on one occasion at age 66 years and subsequently went for
a colonoscopy. Internal hemorrhoids and sigmoid diverticuli were found on
colonoscopy. He has no first-degree relatives with a history of colorectal cancer or
adenomatous polyps. What are the U.S. Preventive Services Task Force (USPSTF)
screening recommendations for this patient?
a. Do not screen routinely
b. Continue annual FOBT screening until age 80 years
c. Continue annual FOBT screening until age 85 years
d. Repeat colonoscopy this year
e. Sigmoidoscopy every 5 years with FOBT every 3 years - Correct Answer-a. Do
not screen routinely
An otherwise healthy 31-year-old accountant presents to an outpatient clinic with
a 3-year history of recurrent crampy abdominal pain that lasts for about 1-2 weeks
each episode and is associated with onset of constipation. She describes
infrequent, small hard stool that she finds very difficult to pass. She has tried to
increase dietary fiber and water intake, but usually this is not sufficient and she
1|Page
, NR 509 - Final Exam Bate's Interactive Question Bank
resorts to over-the-counter laxatives, which she finds upset her stomach but do
resolve the constipation. Symptoms typically gradually resolve with bowel
movements. Which of the following is the most likely physiological mechanism for
her constipation?
a. A large, firm fecal mass in the rectum
b. Decreased fecal bulk
c. Functional change in bowel movement
d. Spasm of the external sphincter
e. Impairment of autonomic innervations - Correct Answer-c. Functional change in
bowel movement
A 23-year-old woman comes to the respirology clinic for follow-up of her chronic
sinusitis and bronchiectasis that is associated with a rare congenital condition
called Kartagener syndrome. The preceptor notes that she has situs inversus and
asks for a physical exam. Which of the following descriptions best fits with findings
on the abdominal exam?
a. Tympany to percussion in the right upper quadrant, dullness to percussion of
the left upper quadrant
b. Protuberant abdomen that has scattered areas of tympany and dullness; stool is
felt on palpation
c. Liver dullness in the right upper quadrant that is displaced downward by the
low diaphragm due to chronic obstructive pulmonary disease
d. Dullness to percussion of the left lower anterior chest wall roughly at the
anterior axillary line
2|Page
, NR 509 - Final Exam Bate's Interactive Question Bank
e. A change in percussion from tympany to dullness in the left lower anterior chest
wall on inspiration - Correct Answer-a. Tympany to percussion in the right upper
quadrant, dullness to percussion of the left upper quadrant
An otherwise healthy 28-year-old lawyer presents to the Emergency Department
with a 1-day history of severe abdominal pain. The emergency physician suspects
appendicitis and general surgery is consulted. The resident believes the patient
has signs of peritonitis on exam. Which of the following physical exam findings
supports peritonitis?
a. Voluntary contraction of the abdominal wall that persists over several
examinations
b. Pressing down onto the abdomen firmly and slowly and withdrawing the hand
quickly produces pain
c. Abdominal pain that increases with hip flexion
d. Localized pain over McBurney point, which lies 2 inches from the anterior
superior iliac spinous process on a line drawn from the umbilicus
e. Pain with internal rotation of the right hip - Correct Answer-b. Pressing down
onto the abdomen firmly and slowly and withdrawing the hand quickly produces
pain
A 58-year-old man with a history of diabetes and alcohol addiction has been sober
for the last 10 months. He presents with a 4-month history of increasing
weakness, recurrent epigastric pain radiating to his back, chronic diarrhea with
stools 6-8 times daily, and weight loss of 18 lb over 4 months. What is the
mechanism of his most likely diagnosis?
3|Page
, NR 509 - Final Exam Bate's Interactive Question Bank
a. Helicobacter pylori infection
b. Inflammation of the gallbladder
c. Inflammation of colonic diverticulum
d. Reduced blood supply to the bowel
e. Fibrosis of the pancreas - Correct Answer-e. Fibrosis of the pancreas
A 46-year-old executive who is obese and otherwise healthy presents to a family
medicine clinic with a 3-month course of recurrent severe abdominal pain that
usually resolves on its own after a few hours. Her last episode was prolonged
lasting 6 hours, and she is frustrated that she has had to leave or miss work on
three separate occasions. She would like a diagnosis and the problem fixed. Which
symptoms or signs would be most suggestive of a diagnosis of biliary colic?
a. Exacerbating factor includes alcohol intake
b. Positive McBurney point tenderness
c. Poorly localized periumbilical pain
d. Vomiting of bile
e. Associated right shoulder pain - Correct Answer-e. Associated right shoulder
pain
A 67-year-old electronics technician with a history of hypertension and type 2
diabetes presents for his yearly physical examination and complains of
progressively worsening erectile dysfunction (ED). While counseling him, the
clinician mentions that multiple processes must take place to achieve an erection.
Which of the following structures would be most affected by vascular deficiencies
related to his preexisting medical conditions and is likely contributing to his
symptoms?
4|Page
