NR 511 FINAL EXAM DIFFERENTIAL DIAGNOSIS & PRIMARY CARE PRACTICUM
NR 511 / NR511 FINAL EXAM 1
The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following
neurotransmitters plays a role in anxiety?
Gamma-aminobutyric acid (GABA)
The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Associations
Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive
worry or apprehension must be present more days than not for at least?
6 months
A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of
the following is the treatment of choice for gonorrhea?
a. Ceftriaxone
b. Doxycycline
c. Acyclovir
d. Metronidazole
Ceftriaxone
A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which
of the following questions should be asked?
a. "Do you have a history of liver disease?"
b. "What medications are you currently taking?"
c. "Have you noticed swelling in your ankles?"
d. All of the above
"What medications are you currently taking"
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should
inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
NSAIDS
A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no
previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a
diagnosis of lower UTI?
a. Back and abdominal pain
b. Fever, chills, costovertebral angle (CVA) tenderness
,c. Blood in urine and frequency
d. Foul-smelling discharge, perineal itch
Blood in urine ad frequency
A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows
greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?
a. Lower urinary tract infection
b. Chlamydia infection
c. Candidiasis
d. Pyelonephritis
Lower urinary tract infection
A patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria. Which
of the following diagnoses is most likely given the above information?
a. Pyelonephritis
b. Cystitis
c. Renal calculi
d. Bladder tumor
Pyelonephritis
A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question
the patient about which of these contraindications to this medication?
a. Diarrhea
b. Parkinson's disease
c. Closed-angle glaucoma
d. Breast cancer
Closed-angle glaucoma
A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for
which risk factor for kidney stones?
a. Hypertension
b. Constipation
c. Tubal ligation
d. Diabetes
Hypertension
A patient is diagnosed with overactive bladder. Which of the following instructions should be given to
this woman?
a. "Limit the amount of water that you drink."
b. "Eliminate caffeine from your diet."
c. "Wear panty liners."
d. All of the above
Eliminate caffeine from your diet
, A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the
following actions should be taken next?
a. Send a urine specimen for microscopy and evaluate for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Send a urine specimen for microscopy and evaluate for fungal colonies
Which of the following are predisposing factors for pyelonephritis?
a. Pregnancy
b. Dehydration
c. Smoking
d. Alkaline urine
Pregnancy
A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is
diagnosed with acute pyelonephritis. How should this patient be managed?
a. 3-day course of oral antibiotics
b. Hospitalization
c. Encourage cranberry juice intake.
d. 6-week course of antibiotics
Hospitalization
Oral antibiotics may be prescribed in mild cases of acute pyelonephritis, characterized by the absence of
nausea and vomiting or signs of sepsis. First-line therapy includes ciprofloxacin (Cipro) 500 mg two times
daily for 7 days, or ciprofloxacin extended-release (Cipro XR) 1,000 mg daily for 7 days, or levofloxacin
(Levaquin) 750 mg daily for 5 days.
Hospitalization may be indicated, depending on the patient's ability to maintain adequate fluid intake
and to tolerate oral antibiotics, along with the severity of the symptoms and evidence of bacteremia.
Hospitalization of patients who are pregnant, vomiting, or dehydrated should be strongly considered.
Likewise, the patient's degree of systemic illness (bacteremia or urosepsis), age, history of chronic
disease, or nonadherence to therapy may lead to the assessment that hospitalization is necessary.
Ninety- five percent of patients demonstrate a good response within 48 hours to IV antibiotic treatment
and may be discharged on appropriate oral medication, once urine culture and antibiotic sensitivity
results are available and subsequent antimicrobial therapy may be narrowed in spectrum.
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis.
In addition to nephrolithiasis, which of the following should be added to the list of differential
diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
NR 511 / NR511 FINAL EXAM 1
The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following
neurotransmitters plays a role in anxiety?
Gamma-aminobutyric acid (GABA)
The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Associations
Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive
worry or apprehension must be present more days than not for at least?
6 months
A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of
the following is the treatment of choice for gonorrhea?
a. Ceftriaxone
b. Doxycycline
c. Acyclovir
d. Metronidazole
Ceftriaxone
A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which
of the following questions should be asked?
a. "Do you have a history of liver disease?"
b. "What medications are you currently taking?"
c. "Have you noticed swelling in your ankles?"
d. All of the above
"What medications are you currently taking"
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should
inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
NSAIDS
A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no
previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a
diagnosis of lower UTI?
a. Back and abdominal pain
b. Fever, chills, costovertebral angle (CVA) tenderness
,c. Blood in urine and frequency
d. Foul-smelling discharge, perineal itch
Blood in urine ad frequency
A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows
greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?
a. Lower urinary tract infection
b. Chlamydia infection
c. Candidiasis
d. Pyelonephritis
Lower urinary tract infection
A patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria. Which
of the following diagnoses is most likely given the above information?
a. Pyelonephritis
b. Cystitis
c. Renal calculi
d. Bladder tumor
Pyelonephritis
A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question
the patient about which of these contraindications to this medication?
a. Diarrhea
b. Parkinson's disease
c. Closed-angle glaucoma
d. Breast cancer
Closed-angle glaucoma
A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for
which risk factor for kidney stones?
a. Hypertension
b. Constipation
c. Tubal ligation
d. Diabetes
Hypertension
A patient is diagnosed with overactive bladder. Which of the following instructions should be given to
this woman?
a. "Limit the amount of water that you drink."
b. "Eliminate caffeine from your diet."
c. "Wear panty liners."
d. All of the above
Eliminate caffeine from your diet
, A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the
following actions should be taken next?
a. Send a urine specimen for microscopy and evaluate for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Send a urine specimen for microscopy and evaluate for fungal colonies
Which of the following are predisposing factors for pyelonephritis?
a. Pregnancy
b. Dehydration
c. Smoking
d. Alkaline urine
Pregnancy
A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is
diagnosed with acute pyelonephritis. How should this patient be managed?
a. 3-day course of oral antibiotics
b. Hospitalization
c. Encourage cranberry juice intake.
d. 6-week course of antibiotics
Hospitalization
Oral antibiotics may be prescribed in mild cases of acute pyelonephritis, characterized by the absence of
nausea and vomiting or signs of sepsis. First-line therapy includes ciprofloxacin (Cipro) 500 mg two times
daily for 7 days, or ciprofloxacin extended-release (Cipro XR) 1,000 mg daily for 7 days, or levofloxacin
(Levaquin) 750 mg daily for 5 days.
Hospitalization may be indicated, depending on the patient's ability to maintain adequate fluid intake
and to tolerate oral antibiotics, along with the severity of the symptoms and evidence of bacteremia.
Hospitalization of patients who are pregnant, vomiting, or dehydrated should be strongly considered.
Likewise, the patient's degree of systemic illness (bacteremia or urosepsis), age, history of chronic
disease, or nonadherence to therapy may lead to the assessment that hospitalization is necessary.
Ninety- five percent of patients demonstrate a good response within 48 hours to IV antibiotic treatment
and may be discharged on appropriate oral medication, once urine culture and antibiotic sensitivity
results are available and subsequent antimicrobial therapy may be narrowed in spectrum.
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis.
In addition to nephrolithiasis, which of the following should be added to the list of differential
diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
