NU 631 ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ A patient comes to the emergency room for evaluation of shortness of
breath. To which anatomic region would you assign the symptom?A)
ReproductiveB) UrinaryC) CardiacD) Hematologic.
Answer: C)cardiac
◍ A 58-year-old gardener comes to your office for evaluation of a new lesion
on her upper chest. The lesion appears to be "stuck on" and is oval, brown,
and slightly elevated with a flat surface. It has a rough, wartlike texture on
palpation. Based on this description, what is your most likely diagnosis?A)
Actinic keratosisB) Seborrheic keratosisC) Basal cell carcinomaD)
Squamous cell carcinoma.
Answer: B) seborrheic keratosis "stuck on"
◍ Mrs.
T. comes for her regular visit to the clinic. She is on your schedule because
her regular provider is on vacation and she wanted to be seen. You have
heard about her many times from your colleague and are aware that she is a
very talkative person. Which of the following is a helpful technique to
improve the quality of the interview for both the provider and the patient?A)
Allow the patient to speak uninterrupted for the duration of the
appointment.B) Briefly summarize what you heard from the patient in the
first 5 minutes and then try to have her focus on one aspect of what she told
you.C) Set the time limit at the beginning of the interview and stick with it,
no matter what occurs in the course of the interview.D) Allow your
impatience to show so that the patient picks up on your nonverbal cue that
the appointment needs to end..
Answer: B) briefly summarize what you heard from the patient in the first 5
minutes and then try to have her focus on one aspect of what she told you
,◍ A 55-year-old bookkeeper comes to your office for a routine visit. You note
that on a previous visit for treatment of contact dermatitis, her blood
pressure was elevated. She does not have prior elevated readings and her
family history is negative for hypertension. You measure her blood pressure
in your office today. Which of the following factors can result in a false high
reading?A) Blood pressure cuff is tightly fitted.B) Patient is seated quietly
for 10 minutes prior to measurement.C) Blood pressure is measured on a
bare arm.D) Patient's arm is resting, supported by your arm at her mid-chest
level as you stand to measure the blood pressure..
Answer: A) blood pressure cuff is tightly fitted
◍ You are performing a young woman's first pelvic examination. You make
sure to tell her verbally what is coming next and what to expect. Then you
carry out each maneuver of the examination. You let her know at the outset
that if she needs a break or wants to stop, this is possible. You ask several
times during the examination, "How are you doing, Brittney?" What are you
accomplishing with these techniques?A) Increasing the patient's sense of
controlB) Increasing the patient's trust in you as a caregiverC) Decreasing
her sense of vulnerabilityD) All of the above.
Answer: D) all of the above
◍ 3. Is the following information subjective or objective?Mr.
M. has shortness of breath that has persisted for the past 10 days; it is worse
with activity and relieved by rest.A) SubjectiveB) Objective.
Answer: A) subjective this is information given by the patient
◍ You have recently returned from a medical missions trip to sub-Saharan
Africa, where you learned a great deal about malaria. You decide to use
some of the same questions and maneuvers in your "routine" when
examining patients in the midwestern United States. You are disappointed to
find that despite getting some positive answers and findings, on further
workup, none of your patients has malaria except one, who recently
emigrated from Ghana. How should you next approach these questions and
maneuvers?A) Continue asking these questions in a more selective way.B)
, Stop asking these questions, because they are low yield.C) Question the
validity of the questions.D) Ask these questions of all your patients..
Answer: A) continue asking these questions in a more selective way
◍ a 72 year old woman presents with a newly formed painless, pearly,
ulcerated nodule with an overlying telangiectasis on the upper lip. this most
likely represents:a. actinic keratosis b. basal cell carcinoma c. squamous cell
carcinoma d. molluscum contagiosa.
Answer: basal cell carcinoma remember PUT ON
◍ Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the knees,
HTN, and obstructive sleep apnea. His BMI is 43 and he has been
discouraged by his difficulty in losing weight. He is also discouraged that
his goal weight is 158 pounds away. What would you tell him?A) "When
you get down to your goal weight, you will feel so much better."B) "Some
people seem to be able to lose weight and others just can't, no matter how
hard they try."C) "We are coming up with new medicines and methods to
treat your conditions every day."D) "Even a weight loss of 10% can make a
noticeable improvement in the problems you mention.".
Answer: D) even a weight loss of 10% can make a noticeable improvement
in the problems you mention benefits often come with even a 10% weight
loss
◍ A 28-year-old patient comes to the office for evaluation of a rash. At first
there was only one large patch, but then more lesions erupted suddenly on
the back and torso; the lesions itch. On physical examination, you note that
the pattern of eruption is like a Christmas tree and that there are a variety of
erythematous papules and macules on the cleavage lines of the back. Based
on this description, what is the most likely diagnosis?A) Pityriasis roseaB)
Tinea versicolorC) PsoriasisD) Atopic eczema.
Answer: a) pityriasis rosea one large patch that erupted into many lesions
"Christmas tree pattern"
◍ A 68-year-old retired farmer comes to your office for evaluation of a skin
lesion. On the right temporal area of the forehead, you see a flattened papule
, the same color as his skin, covered by a dry scale that is round and feels
hard. He has several more of these scattered on the forehead, arms, and legs.
Based on this description, what is your most likely diagnosis?A) Actinic
keratosisB) Seborrheic keratosisC) Basal cell carcinomaD) Squamous cell
carcinoma.
Answer: A) actinic keratosis
◍ An 18-year-old college freshman presents to the clinic for evaluation of
gastroenteritis. You measure the patient's temperature and it is 104 degrees
Fahrenheit. What type of pulse would you expect to feel during his initial
examination?A) Large amplitude, forcefulB) Small amplitude, weakC)
NormalD) Bigeminal.
Answer: A) large amplitude, forcefulfever results in increased stroke volume
◍ A 25-year-old radio announcer comes to the clinic for an annual
examination. His BMI is 26.0 kg/m2. He is concerned about his weight.
Based on this information, what is appropriate counsel for the patient during
the visit?A) Refer the patient to a nutritionist because he is anorexic.B)
Reassure the patient that he has a normal body weight.C) Give the patient
information about reduction of fat, cholesterol, and calories because he is
overweight.D) Give the patient information about reduction of fat and
cholesterol because he is obese..
Answer: C) give the patient information about reduction of fat, cholesterol,
and calories because he is overweight overweight BMI is 25-29.9
◍ Treatment of glucagonomas.
Answer: -surgical resection-Octreotide/Lanreotide: for symptom relief of
those with mets or who failed surgical resection
◍ A 72-year-old retired truck driver comes to the clinic with his wife for
evaluation of hearing loss. He has noticed some decreased ability to hear
what his wife and grandchildren are saying to him. He admits to lip-reading
more. He has a history of noise exposure in his young adult years: He
worked as a sound engineer at a local arena and had to attend a lot of
concerts. Based on this information, what is the most likely finding
QUESTIONS WITH ANSWERS GRADED A+
◍ A patient comes to the emergency room for evaluation of shortness of
breath. To which anatomic region would you assign the symptom?A)
ReproductiveB) UrinaryC) CardiacD) Hematologic.
Answer: C)cardiac
◍ A 58-year-old gardener comes to your office for evaluation of a new lesion
on her upper chest. The lesion appears to be "stuck on" and is oval, brown,
and slightly elevated with a flat surface. It has a rough, wartlike texture on
palpation. Based on this description, what is your most likely diagnosis?A)
Actinic keratosisB) Seborrheic keratosisC) Basal cell carcinomaD)
Squamous cell carcinoma.
Answer: B) seborrheic keratosis "stuck on"
◍ Mrs.
T. comes for her regular visit to the clinic. She is on your schedule because
her regular provider is on vacation and she wanted to be seen. You have
heard about her many times from your colleague and are aware that she is a
very talkative person. Which of the following is a helpful technique to
improve the quality of the interview for both the provider and the patient?A)
Allow the patient to speak uninterrupted for the duration of the
appointment.B) Briefly summarize what you heard from the patient in the
first 5 minutes and then try to have her focus on one aspect of what she told
you.C) Set the time limit at the beginning of the interview and stick with it,
no matter what occurs in the course of the interview.D) Allow your
impatience to show so that the patient picks up on your nonverbal cue that
the appointment needs to end..
Answer: B) briefly summarize what you heard from the patient in the first 5
minutes and then try to have her focus on one aspect of what she told you
,◍ A 55-year-old bookkeeper comes to your office for a routine visit. You note
that on a previous visit for treatment of contact dermatitis, her blood
pressure was elevated. She does not have prior elevated readings and her
family history is negative for hypertension. You measure her blood pressure
in your office today. Which of the following factors can result in a false high
reading?A) Blood pressure cuff is tightly fitted.B) Patient is seated quietly
for 10 minutes prior to measurement.C) Blood pressure is measured on a
bare arm.D) Patient's arm is resting, supported by your arm at her mid-chest
level as you stand to measure the blood pressure..
Answer: A) blood pressure cuff is tightly fitted
◍ You are performing a young woman's first pelvic examination. You make
sure to tell her verbally what is coming next and what to expect. Then you
carry out each maneuver of the examination. You let her know at the outset
that if she needs a break or wants to stop, this is possible. You ask several
times during the examination, "How are you doing, Brittney?" What are you
accomplishing with these techniques?A) Increasing the patient's sense of
controlB) Increasing the patient's trust in you as a caregiverC) Decreasing
her sense of vulnerabilityD) All of the above.
Answer: D) all of the above
◍ 3. Is the following information subjective or objective?Mr.
M. has shortness of breath that has persisted for the past 10 days; it is worse
with activity and relieved by rest.A) SubjectiveB) Objective.
Answer: A) subjective this is information given by the patient
◍ You have recently returned from a medical missions trip to sub-Saharan
Africa, where you learned a great deal about malaria. You decide to use
some of the same questions and maneuvers in your "routine" when
examining patients in the midwestern United States. You are disappointed to
find that despite getting some positive answers and findings, on further
workup, none of your patients has malaria except one, who recently
emigrated from Ghana. How should you next approach these questions and
maneuvers?A) Continue asking these questions in a more selective way.B)
, Stop asking these questions, because they are low yield.C) Question the
validity of the questions.D) Ask these questions of all your patients..
Answer: A) continue asking these questions in a more selective way
◍ a 72 year old woman presents with a newly formed painless, pearly,
ulcerated nodule with an overlying telangiectasis on the upper lip. this most
likely represents:a. actinic keratosis b. basal cell carcinoma c. squamous cell
carcinoma d. molluscum contagiosa.
Answer: basal cell carcinoma remember PUT ON
◍ Mr. Curtiss has a history of obesity, diabetes, osteoarthritis of the knees,
HTN, and obstructive sleep apnea. His BMI is 43 and he has been
discouraged by his difficulty in losing weight. He is also discouraged that
his goal weight is 158 pounds away. What would you tell him?A) "When
you get down to your goal weight, you will feel so much better."B) "Some
people seem to be able to lose weight and others just can't, no matter how
hard they try."C) "We are coming up with new medicines and methods to
treat your conditions every day."D) "Even a weight loss of 10% can make a
noticeable improvement in the problems you mention.".
Answer: D) even a weight loss of 10% can make a noticeable improvement
in the problems you mention benefits often come with even a 10% weight
loss
◍ A 28-year-old patient comes to the office for evaluation of a rash. At first
there was only one large patch, but then more lesions erupted suddenly on
the back and torso; the lesions itch. On physical examination, you note that
the pattern of eruption is like a Christmas tree and that there are a variety of
erythematous papules and macules on the cleavage lines of the back. Based
on this description, what is the most likely diagnosis?A) Pityriasis roseaB)
Tinea versicolorC) PsoriasisD) Atopic eczema.
Answer: a) pityriasis rosea one large patch that erupted into many lesions
"Christmas tree pattern"
◍ A 68-year-old retired farmer comes to your office for evaluation of a skin
lesion. On the right temporal area of the forehead, you see a flattened papule
, the same color as his skin, covered by a dry scale that is round and feels
hard. He has several more of these scattered on the forehead, arms, and legs.
Based on this description, what is your most likely diagnosis?A) Actinic
keratosisB) Seborrheic keratosisC) Basal cell carcinomaD) Squamous cell
carcinoma.
Answer: A) actinic keratosis
◍ An 18-year-old college freshman presents to the clinic for evaluation of
gastroenteritis. You measure the patient's temperature and it is 104 degrees
Fahrenheit. What type of pulse would you expect to feel during his initial
examination?A) Large amplitude, forcefulB) Small amplitude, weakC)
NormalD) Bigeminal.
Answer: A) large amplitude, forcefulfever results in increased stroke volume
◍ A 25-year-old radio announcer comes to the clinic for an annual
examination. His BMI is 26.0 kg/m2. He is concerned about his weight.
Based on this information, what is appropriate counsel for the patient during
the visit?A) Refer the patient to a nutritionist because he is anorexic.B)
Reassure the patient that he has a normal body weight.C) Give the patient
information about reduction of fat, cholesterol, and calories because he is
overweight.D) Give the patient information about reduction of fat and
cholesterol because he is obese..
Answer: C) give the patient information about reduction of fat, cholesterol,
and calories because he is overweight overweight BMI is 25-29.9
◍ Treatment of glucagonomas.
Answer: -surgical resection-Octreotide/Lanreotide: for symptom relief of
those with mets or who failed surgical resection
◍ A 72-year-old retired truck driver comes to the clinic with his wife for
evaluation of hearing loss. He has noticed some decreased ability to hear
what his wife and grandchildren are saying to him. He admits to lip-reading
more. He has a history of noise exposure in his young adult years: He
worked as a sound engineer at a local arena and had to attend a lot of
concerts. Based on this information, what is the most likely finding
