NR 603 CEA PRE-DIAGNOSTIC EXAM || MOST
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An adult female returns to the clinic with severe profuse
watery diarrhea, abdominal pain, and cramping after
treatment with Cipro x 10 days. WBC is 12.5, stool culture
is positive for c diff. The NP would recommend: - Answer-
Metronidazole 500 tid for 10-14 d
Rationale: Treatment of C Diff should include
metronidazole (Flagyl) or PO vancomycin.
An adult presents with increasing abdominal girth. The
nurse practitioner suspects ascites. Which finding on
physical exam would confirm the suspicion of ascites? -
Answer-Dullness shifts to the more dependent side
Rationale: In the fluid wave test for ascites, dullness shifts
to the more dependent side. The impulse of the wave
should be easily palpable.
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A 45-year-old woman presents with chronic diarrhea,
weight loss, and abdominal pain. Endoscopy reveals
villous atrophy of the small intestine. What is the most
appropriate initial management? - Answer-Gluten-free diet
Rationale: Villous atrophy in the small intestine supports a
diagnosis of celiac disease which can be managed by
avoidance of gluten.
A 49-year-old male presents to your service with
symptoms of fever 102.3, jaundice, and abdominal pain.
Imagining reveals a biliary obstruction. Which diagnosis is
most likely for this patient? - Answer-Cholangitis
Rationale: The most common cause of this is a biliary
stone causing obstruction and allowing for ascending of
bacteria and infection
An adult female presents with a 1-week history of left
lower quadrant abdominal pain. T=101.2 degrees F. (38.4
degrees C) and an elevated WBC count. This is the
patient's first episode of severe abdominal pain. The nurse
practitioner suspects diverticulitis. Which of the following
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diagnostic tests would confirm the diagnosis? - Answer-CT
scan of the abdomen
The most common side effect of the oral ribavirin used in
the treatment of hepatitis C is: - Answer-Depression
Rationale: It is important to note that ribavirin will not treat
hepatitis C unless it is taken with another medication
called pegylated-interferon α (PEG-IFNα).
Which of the following gastrointestinal changes is
associated with normal aging? - Answer-Decreased
production of gastric acid
A 63-year-old male presents with a suspected lower GI
bleed. He reports passing frank small amounts of blood
several times today. He denies use of NSAID's or blood
thinners. What questions would be important to ask to
further differentiate your diagnosis? - Answer-All options
are appropriate
Rationale: All the above, these questions would help
determine if this bleed was associated with a potential
diverticular bleed (typically painless), painful bowel
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movement associated with IBD (UC/Crohn's), and
changes in bowel habit/colonoscopy risk for malignancy.
Anorexia nervosa occurs most commonly in which of the
following? - Answer-High-level athletes
A 29-year-old male presents with severe abdominal pain,
he has a history of alcohol abuse, and recurrent
pancreatitis. Patient's Lipase is elevated, and he has
nausea and vomiting as well. Abdominal CT shows
inflammatory changes around the pancreas. What is the
most important intervention to consider in the acute
phase? - Answer-Admit to the hospital for fluid
resuscitation to avoid hypovolemic state, and reduce risk
of developing further complications
A 59-year-old male presents with symptoms of abdominal
pain, jaundice, and weight loss which he has not been
trying to lose weight. What would be a malignancy
associated with these symptoms? - Answer-Pancreatic
cancer