NR 511 Midterm Exam with
Complete Updated Solutions
2025
Differential Diagnosis & Primary Care
Practicum
, lOMoAR cPSD| 16310474
NR511 Midterm Study Guide Worksheet
Disease Risk Subjective Finding Objective Findings Diagnostics Treatment Education
GI DISORDERS
Appendicitis -Most common between -Dx made clinically, -May have HTN\tachy -Labs are not diagnostic -Surgical; preoperative -F\U with surgeon -
10-30yrs; but can occur based primarily on H&P proportional to and nonspecific care, NPO, correction of Ambulation after
at any age; rare in exam pain\symptoms -Women should have fluid\electrolyte imbalances surgery -Adv diet
infants and older adults - Classic -When lying flat, may urine human chorionic -Avoid narcotics - when bowel sounds
-men more at risk - presentation includes flex R knee to relieve gonadotrophin to r\o Atb with 3rd gen return -Return to
Diets low in fiber, high acute onset of mild to tension in abd muscle - ectopic pregnancy - cephalosporin; Ex: hosp with s\s of
in fat, refined sugars, & severe colicky, Pain with palpation in +Rovsing’s Sign- ampicillin, gentamycin,
infection -Avoid
other carbs at epigastric, or abd, diffuse in early deep palpation & flagyl
heavy lifting for at
increased risk. periumbilical pain - Pain stages. Localized to release in LLQ causes
- Obstruction of is vague at first then rebound pain in RLQ - least 2 wks
RLQ later
appendix is cause of localizes within 24hrs to -Positive for rebound +Psoas Sign- lift R leg
majority of appendicitis RLQ pain; ask pt to cough against gentle
- contributing - Pain to localize pain pressure causes pain -
factors: Intra-abdominal exacerbated by location +Obturator Sign- flex
tumors, positive family walking\coughing - Men -Sudden cessation of R hip & knee and
hx may feel radiated pain pain means perforation slowly rotate internally
- Recent in testes and is ER causes pain
roundworm infection or - Abd muscle - +McBurney’s
viral GI infection rigidity, Sign- pain with
N\V, anorexia pressure applied to
- Mildly point
elevated temp 99-100F between umbilicus &
common ilium
- If RLQ - x-ray\CT
accompanied by helpful when paired
shaking chills, with positive H&P
perforation should be findings
suspected
- Older adults
may present with
weakness, anorexia,
abd distention, mild pain
leading to delayed dx
and increased
morbidity.
, lOMoAR cPSD| 16310474
NR511 Midterm Study Guide Worksheet
Celiac disease ** Mostly diagnosed in Many asymptomatic. Muscle wasting Serologic testing for lifelong adherence to a teaching related to
(autoimmune disorder adulthood. May complain of (anemia), reduces anti-tTG IgA antibody strict gluten-free diet. gluten free diet.
caused by an diarrhea, gas, subcutaneous fat, Some people with
immunologic response A family member with dyspepsia, wt. loss. ataxia, & peripheral Total IgA (2% of pts Referral to a dietician to celiac disease have
to gluten) celiac disease or Atypical symptoms: neuropathy (vitamin have IgA deficiency and help. vitamin or nutrient
dermatitis herpetiformis fatigue, B12 deficiencies) will falsely test deficiencies that do
bone or joint pain, osteoporosis or negative) Some pts may need not cause them to
Type 1 diabetes arthritis, osteoporosis, osteopenia (bone loss) treatment with feel ill, such as
or osteopenia (bone hypothyroidism duodenal biopsies immunomodulating agents. anemia due to iron
Down syndrome or loss) liver and biliary
deficiency or bone
Turner syndrome tract disorders Pts with dermatitis Test for nutritional loss due to vitamin D
(transaminitis, fatty herpetiformis found to deficiencies associated deficiency. However,
liver, primary sclerosing have signs of celiac
Autoimmune thyroid with malabsorption of these deficiencies
cholangitis, depression disease on intestinal
disease C.D. (hemoglobin, iron, can cause problems
or anxiety peripheral biopsy. folate, vit B12, over the long term.
neuropathy seizures or
Microscopic colitis Calcium, and Vitamin
migraines missed Untreated
(lymphocytic or menstrual periods D.)
celiac/developing
collagenous colitis) infertility or recurrent certain types of
miscarriage gastrointestinal
Addison's disease canker sores inside the cancer. This risk can
mouth be reduced by eating
a gluten-free diet.
, lOMoAR cPSD| 16310474
NR511 Midterm Study Guide Worksheet
dermatitis herpetiformis
(itchy skin rash)
Cholelithiasis is the formation of Patient complaint of Right side involuntary Mild elevation of WBC a. Initial Nonsurgical
gallstones and is found in indigestion, nausea, guarding of abdominal up to 15, 000 management--begins with intervention: weight
90% of patients with vomiting (after muscles, Positive Abdominal Xray: Quick, definitive diagnosis. When loss, avoidance of
cholecystitis. consuming meal high in Murphy's sign, possible noninvasive, reliable, asymptomatic (normally an fatty foods to
--Risk factors--2 types of fat), and pain in RUG or palpable gallbladder, and costeffective incidental finding while decrease attacks,
stones (cholesterol and epigastrium that may Low grade fever means of identifying exploring another problem) alternative birth
pigmented) require no further treatment
radiate to the middle of between 99-101 the presence of control for persons
a. Cholesterol except teaching s/sx of
the back, infrascapular degrees. Possible cholelithiasis. taking oral
(most common form): "gallbladder attack".
female, obesity, area or right shoulder. jaundice from common Nonsurgical candidate can contraceptives,
pregnancy, increased bile duct edema and be treated with dissolution menopausal women
age, druginduced (oral diminished bowel therapy or lithotripsy. Acute taking estrogen
contraceptives and sounds. includes hydration (IV informed about
clofibrates: cholesterol fluids), antibiotics, alternative sources of
lowering agent), cystic analgesics, GI rest. phytoestrogens (soy
fibrosis, rapid weight loss, b. Treatment of products).
spinal cord injury, Ileal choice for Acute
disease with extensive cholecystitis is early surgical
resection, Diabetes intervention after
mellitus, sickle cell stabilization. Poor surgical
anemia. risk may benefit from
b. Pigmented:
cholecystectomy operatively
hemolytic diseases,
or percutaneously.
increasing
age, hyperalimentation
(artificial supply of
nutrients, typically IV),
cirrhosis, biliary stasis,
chronic biliary infections.
Complete Updated Solutions
2025
Differential Diagnosis & Primary Care
Practicum
, lOMoAR cPSD| 16310474
NR511 Midterm Study Guide Worksheet
Disease Risk Subjective Finding Objective Findings Diagnostics Treatment Education
GI DISORDERS
Appendicitis -Most common between -Dx made clinically, -May have HTN\tachy -Labs are not diagnostic -Surgical; preoperative -F\U with surgeon -
10-30yrs; but can occur based primarily on H&P proportional to and nonspecific care, NPO, correction of Ambulation after
at any age; rare in exam pain\symptoms -Women should have fluid\electrolyte imbalances surgery -Adv diet
infants and older adults - Classic -When lying flat, may urine human chorionic -Avoid narcotics - when bowel sounds
-men more at risk - presentation includes flex R knee to relieve gonadotrophin to r\o Atb with 3rd gen return -Return to
Diets low in fiber, high acute onset of mild to tension in abd muscle - ectopic pregnancy - cephalosporin; Ex: hosp with s\s of
in fat, refined sugars, & severe colicky, Pain with palpation in +Rovsing’s Sign- ampicillin, gentamycin,
infection -Avoid
other carbs at epigastric, or abd, diffuse in early deep palpation & flagyl
heavy lifting for at
increased risk. periumbilical pain - Pain stages. Localized to release in LLQ causes
- Obstruction of is vague at first then rebound pain in RLQ - least 2 wks
RLQ later
appendix is cause of localizes within 24hrs to -Positive for rebound +Psoas Sign- lift R leg
majority of appendicitis RLQ pain; ask pt to cough against gentle
- contributing - Pain to localize pain pressure causes pain -
factors: Intra-abdominal exacerbated by location +Obturator Sign- flex
tumors, positive family walking\coughing - Men -Sudden cessation of R hip & knee and
hx may feel radiated pain pain means perforation slowly rotate internally
- Recent in testes and is ER causes pain
roundworm infection or - Abd muscle - +McBurney’s
viral GI infection rigidity, Sign- pain with
N\V, anorexia pressure applied to
- Mildly point
elevated temp 99-100F between umbilicus &
common ilium
- If RLQ - x-ray\CT
accompanied by helpful when paired
shaking chills, with positive H&P
perforation should be findings
suspected
- Older adults
may present with
weakness, anorexia,
abd distention, mild pain
leading to delayed dx
and increased
morbidity.
, lOMoAR cPSD| 16310474
NR511 Midterm Study Guide Worksheet
Celiac disease ** Mostly diagnosed in Many asymptomatic. Muscle wasting Serologic testing for lifelong adherence to a teaching related to
(autoimmune disorder adulthood. May complain of (anemia), reduces anti-tTG IgA antibody strict gluten-free diet. gluten free diet.
caused by an diarrhea, gas, subcutaneous fat, Some people with
immunologic response A family member with dyspepsia, wt. loss. ataxia, & peripheral Total IgA (2% of pts Referral to a dietician to celiac disease have
to gluten) celiac disease or Atypical symptoms: neuropathy (vitamin have IgA deficiency and help. vitamin or nutrient
dermatitis herpetiformis fatigue, B12 deficiencies) will falsely test deficiencies that do
bone or joint pain, osteoporosis or negative) Some pts may need not cause them to
Type 1 diabetes arthritis, osteoporosis, osteopenia (bone loss) treatment with feel ill, such as
or osteopenia (bone hypothyroidism duodenal biopsies immunomodulating agents. anemia due to iron
Down syndrome or loss) liver and biliary
deficiency or bone
Turner syndrome tract disorders Pts with dermatitis Test for nutritional loss due to vitamin D
(transaminitis, fatty herpetiformis found to deficiencies associated deficiency. However,
liver, primary sclerosing have signs of celiac
Autoimmune thyroid with malabsorption of these deficiencies
cholangitis, depression disease on intestinal
disease C.D. (hemoglobin, iron, can cause problems
or anxiety peripheral biopsy. folate, vit B12, over the long term.
neuropathy seizures or
Microscopic colitis Calcium, and Vitamin
migraines missed Untreated
(lymphocytic or menstrual periods D.)
celiac/developing
collagenous colitis) infertility or recurrent certain types of
miscarriage gastrointestinal
Addison's disease canker sores inside the cancer. This risk can
mouth be reduced by eating
a gluten-free diet.
, lOMoAR cPSD| 16310474
NR511 Midterm Study Guide Worksheet
dermatitis herpetiformis
(itchy skin rash)
Cholelithiasis is the formation of Patient complaint of Right side involuntary Mild elevation of WBC a. Initial Nonsurgical
gallstones and is found in indigestion, nausea, guarding of abdominal up to 15, 000 management--begins with intervention: weight
90% of patients with vomiting (after muscles, Positive Abdominal Xray: Quick, definitive diagnosis. When loss, avoidance of
cholecystitis. consuming meal high in Murphy's sign, possible noninvasive, reliable, asymptomatic (normally an fatty foods to
--Risk factors--2 types of fat), and pain in RUG or palpable gallbladder, and costeffective incidental finding while decrease attacks,
stones (cholesterol and epigastrium that may Low grade fever means of identifying exploring another problem) alternative birth
pigmented) require no further treatment
radiate to the middle of between 99-101 the presence of control for persons
a. Cholesterol except teaching s/sx of
the back, infrascapular degrees. Possible cholelithiasis. taking oral
(most common form): "gallbladder attack".
female, obesity, area or right shoulder. jaundice from common Nonsurgical candidate can contraceptives,
pregnancy, increased bile duct edema and be treated with dissolution menopausal women
age, druginduced (oral diminished bowel therapy or lithotripsy. Acute taking estrogen
contraceptives and sounds. includes hydration (IV informed about
clofibrates: cholesterol fluids), antibiotics, alternative sources of
lowering agent), cystic analgesics, GI rest. phytoestrogens (soy
fibrosis, rapid weight loss, b. Treatment of products).
spinal cord injury, Ileal choice for Acute
disease with extensive cholecystitis is early surgical
resection, Diabetes intervention after
mellitus, sickle cell stabilization. Poor surgical
anemia. risk may benefit from
b. Pigmented:
cholecystectomy operatively
hemolytic diseases,
or percutaneously.
increasing
age, hyperalimentation
(artificial supply of
nutrients, typically IV),
cirrhosis, biliary stasis,
chronic biliary infections.
