NUR611/NUR 611 Exam 4 V1 | Adv
Practice Nursing I Q&A with Rationale |
William Paterson University
1. A 45-year-old patient presents with epigastric pain that is relieved by eating but returns 2-3
hours after a meal. Which of the following is the most likely diagnosis?
A. The patient is likely experiencing a gastric ulcer.
B. The patient is likely experiencing acute cholecystitis.
C. The patient is likely experiencing a duodenal ulcer.
D. The patient is likely experiencing gastroesophageal reflux disease.
Correct Answer: C
Expert Explanation: Duodenal ulcers typically present with pain that is relieved by food
intake because the bicarbonate secretion into the duodenum buffers the acid. The pain
usually recurs as the stomach empties and acid reaches the duodenum again. In contrast,
gastric ulcers often cause pain that is worsened by eating due to increased acid production
and mechanical friction.
2. During a physical examination, the clinician elicits a positive Murphy’s sign. Which
condition does this finding strongly suggest?
A. This finding suggests that the patient has acute appendicitis.
B. This finding suggests that the patient has acute diverticulitis.
,C. This finding suggests that the patient has acute pancreatitis.
D. This finding suggests that the patient has acute cholecystitis.
Correct Answer: D
Expert Explanation: Murphy’s sign is assessed by palpating the right upper quadrant
while the patient takes a deep breath. A positive sign is defined as the arrest of inspiration
due to pain when the inflamed gallbladder touches the examiner’s fingers. This is a classic
clinical indicator for cholecystitis and helps differentiate it from other causes of abdominal
pain.
3. A patient reports a history of chronic heartburn and is found to have Barrett’s esophagus
on endoscopy. What is the primary concern regarding this finding?
A. The patient has a significant risk for developing esophageal adenocarcinoma.
B. The patient is at high risk for developing esophageal varices.
C. The patient will likely require immediate surgical resection of the esophagus.
D. The patient will develop a permanent stricture that prevents swallowing.
Correct Answer: A
Expert Explanation: Barrett’s esophagus is a metaplastic change where squamous
epithelium is replaced by columnar epithelium due to chronic acid exposure. This condition
is considered a precancerous state that significantly increases the risk of esophageal
adenocarcinoma. Periodic endoscopic surveillance is required to monitor for dysplastic
changes and early malignancy.
, 4. Which physical examination maneuver is used to assess for a possible meniscus tear in the
knee?
A. The clinician should perform the McMurray test.
B. The clinician should perform the Lachman test.
C. The clinician should perform the Anterior Drawer test.
D. The clinician should perform the Phalen’s maneuver.
Correct Answer: A
Expert Explanation: The McMurray test involves rotating the knee with internal and
external rotation while extending the leg to feel for a click or pop. This maneuver
specifically assesses the integrity of the medial and lateral menisci. Positive results often
correlate with joint line tenderness and mechanical symptoms like locking or catching.
5. A 60-year-old female presents with morning stiffness in her hands that lasts for about 15
minutes and worsens with activity throughout the day. Which diagnosis is most consistent
with these symptoms?
A. The patient most likely has Osteoarthritis.
B. The patient most likely has Systemic Lupus Erythematosus.
C. The patient most likely has Rheumatoid Arthritis.
D. The patient most likely has Psoriatic Arthritis.
Correct Answer: A
Practice Nursing I Q&A with Rationale |
William Paterson University
1. A 45-year-old patient presents with epigastric pain that is relieved by eating but returns 2-3
hours after a meal. Which of the following is the most likely diagnosis?
A. The patient is likely experiencing a gastric ulcer.
B. The patient is likely experiencing acute cholecystitis.
C. The patient is likely experiencing a duodenal ulcer.
D. The patient is likely experiencing gastroesophageal reflux disease.
Correct Answer: C
Expert Explanation: Duodenal ulcers typically present with pain that is relieved by food
intake because the bicarbonate secretion into the duodenum buffers the acid. The pain
usually recurs as the stomach empties and acid reaches the duodenum again. In contrast,
gastric ulcers often cause pain that is worsened by eating due to increased acid production
and mechanical friction.
2. During a physical examination, the clinician elicits a positive Murphy’s sign. Which
condition does this finding strongly suggest?
A. This finding suggests that the patient has acute appendicitis.
B. This finding suggests that the patient has acute diverticulitis.
,C. This finding suggests that the patient has acute pancreatitis.
D. This finding suggests that the patient has acute cholecystitis.
Correct Answer: D
Expert Explanation: Murphy’s sign is assessed by palpating the right upper quadrant
while the patient takes a deep breath. A positive sign is defined as the arrest of inspiration
due to pain when the inflamed gallbladder touches the examiner’s fingers. This is a classic
clinical indicator for cholecystitis and helps differentiate it from other causes of abdominal
pain.
3. A patient reports a history of chronic heartburn and is found to have Barrett’s esophagus
on endoscopy. What is the primary concern regarding this finding?
A. The patient has a significant risk for developing esophageal adenocarcinoma.
B. The patient is at high risk for developing esophageal varices.
C. The patient will likely require immediate surgical resection of the esophagus.
D. The patient will develop a permanent stricture that prevents swallowing.
Correct Answer: A
Expert Explanation: Barrett’s esophagus is a metaplastic change where squamous
epithelium is replaced by columnar epithelium due to chronic acid exposure. This condition
is considered a precancerous state that significantly increases the risk of esophageal
adenocarcinoma. Periodic endoscopic surveillance is required to monitor for dysplastic
changes and early malignancy.
, 4. Which physical examination maneuver is used to assess for a possible meniscus tear in the
knee?
A. The clinician should perform the McMurray test.
B. The clinician should perform the Lachman test.
C. The clinician should perform the Anterior Drawer test.
D. The clinician should perform the Phalen’s maneuver.
Correct Answer: A
Expert Explanation: The McMurray test involves rotating the knee with internal and
external rotation while extending the leg to feel for a click or pop. This maneuver
specifically assesses the integrity of the medial and lateral menisci. Positive results often
correlate with joint line tenderness and mechanical symptoms like locking or catching.
5. A 60-year-old female presents with morning stiffness in her hands that lasts for about 15
minutes and worsens with activity throughout the day. Which diagnosis is most consistent
with these symptoms?
A. The patient most likely has Osteoarthritis.
B. The patient most likely has Systemic Lupus Erythematosus.
C. The patient most likely has Rheumatoid Arthritis.
D. The patient most likely has Psoriatic Arthritis.
Correct Answer: A
