NR 511 Final Exam Comprehensive Study Guide (Weeks 5-8) 2026
Chamberlain
1. Which heart murmur is best heard at the 2nd right intercostal space and
radiates to the carotid arteries?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: A
Rationale: Aortic stenosis is a systolic murmur characterized by a crescendo-decrescendo
pattern heard best at the right upper sternal border with radiation to the neck.
2. According to JNC 8 guidelines, what is the blood pressure goal for a 65-year-
old patient without diabetes or chronic kidney disease?
A. <140/90
B. <130/80
C. <150/90
D. <140/80
Answer: C
Rationale: JNC 8 recommends a goal of <150/90 mmHg for general populations aged 60
and older.
,3. Which of the following is considered a ‘gold standard’ diagnostic test for
confirming Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Spirometry
C. Arterial Blood Gas
D. Peak Flow Meter
Answer: B
Rationale: Spirometry is required to make a clinical diagnosis of COPD; a post-
bronchodilator FEV1/FVC ratio <0.70 confirms persistent airflow limitation.
4. A 24-year-old female presents with a ‘strawberry cervix’ and malodorous
green-yellow discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
C. Candidiasis
B. Chlamydia
D. Trichomoniasis
Answer: D
Rationale: Trichomoniasis is often associated with a strawberry cervix (petechiae) and
frothy, green-yellow discharge.
5. What is the first-line antibiotic treatment for an uncomplicated urinary tract
infection (UTI) in a non-pregnant woman?
A. Nitrofurantoin (Macrobid)
B. Ciprofloxacin
C. Amoxicillin
D. Doxycycline
Answer: A
Rationale: Nitrofurantoin, TMP-SMX, and Fosfomycin are first-line agents for
uncomplicated UTIs according to IDSA guidelines.
, 6. Which physical exam maneuver is specifically used to assess for acute
cholecystitis?
A. McBurney’s sign
B. Murphy’s sign
C. Psoas sign
D. Rovsing’s sign
Answer: B
Rationale: Murphy’s sign involves palpating the right upper quadrant while the patient
takes a deep breath; inspiratory arrest due to pain suggests cholecystitis.
7. In the treatment of Community-Acquired Pneumonia (CAP) in a healthy adult
with no comorbidities, which is a recommended first-line option?
A. Vancomycin
B. Levofloxacin
C. Ceftriaxone
D. Amoxicillin 1g TID
Answer: D
Rationale: For healthy outpatients with CAP, high-dose amoxicillin, doxycycline, or a
macrolide (if local resistance is <25%) are recommended.
8. Which screening tool is used to assess for alcohol misuse in the primary care
setting?
A. PHQ-9
B. GAD-7
C. CAGE questionnaire
D. COW scale
Answer: C
Rationale: The CAGE questionnaire (Cut down, Annoyed, Guilty, Eye-opener) is a validated
tool for screening for alcohol use disorder.
Chamberlain
1. Which heart murmur is best heard at the 2nd right intercostal space and
radiates to the carotid arteries?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: A
Rationale: Aortic stenosis is a systolic murmur characterized by a crescendo-decrescendo
pattern heard best at the right upper sternal border with radiation to the neck.
2. According to JNC 8 guidelines, what is the blood pressure goal for a 65-year-
old patient without diabetes or chronic kidney disease?
A. <140/90
B. <130/80
C. <150/90
D. <140/80
Answer: C
Rationale: JNC 8 recommends a goal of <150/90 mmHg for general populations aged 60
and older.
,3. Which of the following is considered a ‘gold standard’ diagnostic test for
confirming Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Spirometry
C. Arterial Blood Gas
D. Peak Flow Meter
Answer: B
Rationale: Spirometry is required to make a clinical diagnosis of COPD; a post-
bronchodilator FEV1/FVC ratio <0.70 confirms persistent airflow limitation.
4. A 24-year-old female presents with a ‘strawberry cervix’ and malodorous
green-yellow discharge. What is the most likely diagnosis?
A. Bacterial Vaginosis
C. Candidiasis
B. Chlamydia
D. Trichomoniasis
Answer: D
Rationale: Trichomoniasis is often associated with a strawberry cervix (petechiae) and
frothy, green-yellow discharge.
5. What is the first-line antibiotic treatment for an uncomplicated urinary tract
infection (UTI) in a non-pregnant woman?
A. Nitrofurantoin (Macrobid)
B. Ciprofloxacin
C. Amoxicillin
D. Doxycycline
Answer: A
Rationale: Nitrofurantoin, TMP-SMX, and Fosfomycin are first-line agents for
uncomplicated UTIs according to IDSA guidelines.
, 6. Which physical exam maneuver is specifically used to assess for acute
cholecystitis?
A. McBurney’s sign
B. Murphy’s sign
C. Psoas sign
D. Rovsing’s sign
Answer: B
Rationale: Murphy’s sign involves palpating the right upper quadrant while the patient
takes a deep breath; inspiratory arrest due to pain suggests cholecystitis.
7. In the treatment of Community-Acquired Pneumonia (CAP) in a healthy adult
with no comorbidities, which is a recommended first-line option?
A. Vancomycin
B. Levofloxacin
C. Ceftriaxone
D. Amoxicillin 1g TID
Answer: D
Rationale: For healthy outpatients with CAP, high-dose amoxicillin, doxycycline, or a
macrolide (if local resistance is <25%) are recommended.
8. Which screening tool is used to assess for alcohol misuse in the primary care
setting?
A. PHQ-9
B. GAD-7
C. CAGE questionnaire
D. COW scale
Answer: C
Rationale: The CAGE questionnaire (Cut down, Annoyed, Guilty, Eye-opener) is a validated
tool for screening for alcohol use disorder.
