NR 511 Midterm EXAM NEWEST ACTUAL EXAM
NR 511 MIDTERM EXAM NEWEST ACTUAL EXAM COMPLETE 250
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) WITH RATIONALES |ALREADY GRADED A+||BRAND
NEW VERSION!!
A 20-year-old male presents to your primary care clinic. This patient is a college
student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On
physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose
and throat exam shows mild erythema of the nasal mucosa and edematous,
enlarged tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar
exudates. He has inflamed posterior cervical lymph nodes. He has a mild
nonproductive cough and clear lung exam. What is his most likely diagnosis?
1.Viral pharyngitis.
2.Mononucleosis.
3.Streptococcal pharyngitis.
4.Upper respiratory infection - Correct Answer-Mono
rationale: This presentation could be a viral pharyngitis; however, with posterior
cervical lymphadenitis, you would suspect mononucleosis.
The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment
failure in children is:
1.Amoxicillin (Amoxil).
2.Amoxicillin and potassium clavulanate (Augmentin).
3.Azithromycin (Zithromax).
4.Prednisone (Deltasone) - Correct Answer-Augmentin
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, NR 511 Midterm EXAM NEWEST ACTUAL EXAM
rationale: The antibiotic of choice for recurrent AOM or treatment failure is
amoxicillin and potassium clavulanate (Augmentin)
A 65-year-old man presents complaining of a left-sided, deep, throbbing headache
and mild fatigue. On examination, the client has a tender, tortuous temporal
artery. You suspect giant cell arteritis (GCA), or temporal arteritis. What is the
least invasive procedure to help with diagnosis?
1. Magnetic resonance imaging (MRI) of the head.
2.Erythrocyte sedimentation rate (ESR).
3.Electroencephalogram (EEG).
4.Otoscopy - Correct Answer-ESR
rationale: An elevated ESR—anywhere from 30 to 100 mm/h—may be seen in
giant cell arteritis (temporal arteritis); however, the ESR may also be normal.
The temporal artery supplies the optic nerve; if temporal arteritis is suspected
due to the age of the client (50 and older) and the location and character of the
pain, it is essential that a referral to a surgeon be made for immediate biopsy of
the artery before damage to the optic nerve occurs. A temporal artery biopsy
(TAB), an invasive procedure, is the criterion standard for diagnosing temporal
arteritis
Aaron, age 4, is brought in to the clinic by his father. His tympanic membrane is
perforated from otitis media. His father asks about repair of the eardrum. How do
you respond?
1."The eardrum, in most cases, heals within several weeks."
2."We need to schedule Aaron for a surgical repair."
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, NR 511 Midterm EXAM NEWEST ACTUAL EXAM
3."He must absolutely stay out of the water for 3 to 6 months."
4."If the eardrum is not healed in several months, it can be surgically repaired." -
Correct Answer-"The eardrum, in most cases, heals within several weeks.
rationale: Most perforated tympanic membranes seen with acute otitis media
heal within several weeks
Martin, age 24, presents to the office with an erythematous ear canal and pain on
manipulation of the auricle. He is on vacation and has been swimming daily at the
resort. What is your diagnosis?
1.Acute otitis media.
2.Chronic otitis media.
3.External otitis.
4.Temporomandibular joint (TMJ) syndrome - Correct Answer-External otitis
rationale: With external otitis, there is pain, an erythematous ear canal, and
usually a history of recent swimming
Max, age 35, states that he thinks he has an ear infection because he just flew
back from a business trip and feels unusual pressure in his ear. You diagnose
barotrauma. What is your next action?
1.Prescribe nasal steroids and oral decongestants.
2.Prescribe antibiotic ear drops.
3.Prescribe systemic antibiotics.
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, NR 511 Midterm EXAM NEWEST ACTUAL EXAM
4.Refer Max to an ear, nose, and throat specialist - Correct Answer-Prescribe nasal
steroids and oral decongestants.
rationale: Barotrauma of the auditory canal, causing a sensation of abnormal
middle ear pressure, may be relieved by the use of nasal steroids and oral
decongestants.
A 64-year-old obese woman comes in complaining of difficulty swallowing for the
past 3 weeks. She states that "some foods get stuck" and she has been having
"heartburn" at night when she lies down, especially if she has had a heavy meal.
Occasionally, she awakes at night coughing. She denies weight gain and/or weight
loss, vomiting, or change in bowel movements or color of stools. She denies
alcohol and tobacco use. There is no pertinent family history or findings on review
of systems (ROS). Physical examination is normal, with no abdominal tenderness,
and the stool is occult blood (OB) negative. What is the most likely diagnosis?
1.Esophageal varices.
2.Esophageal cancer.
3.Gastroesophageal reflux disease (GERD).
4.Peptic ulcer disease (PUD) - Correct Answer-Gastroesophageal reflux disease
(GERD)
rationale: Though the historical data are incomplete, this client has no obvious
risk factors for esophageal varices or esophageal cancer. She is a nondrinker and
denies weight loss and changes in bowel function or color of stools, which could
be a clue to a gastrointestinal bleed. The fact that her worst symptoms occur at
night with regurgitation and heartburn is classic for GERD. Dysphagia is
frequently a prominent symptom of GERD. She has no abdominal tenderness,
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NR 511 MIDTERM EXAM NEWEST ACTUAL EXAM COMPLETE 250
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) WITH RATIONALES |ALREADY GRADED A+||BRAND
NEW VERSION!!
A 20-year-old male presents to your primary care clinic. This patient is a college
student. He complains of fatigue, sore throat, and low-grade fever for 3 days. On
physical exam, he has a temperature of 100.7°F. His ear exam is normal. His nose
and throat exam shows mild erythema of the nasal mucosa and edematous,
enlarged tonsils bilaterally, with erythema of the pharyngeal wall and tonsillar
exudates. He has inflamed posterior cervical lymph nodes. He has a mild
nonproductive cough and clear lung exam. What is his most likely diagnosis?
1.Viral pharyngitis.
2.Mononucleosis.
3.Streptococcal pharyngitis.
4.Upper respiratory infection - Correct Answer-Mono
rationale: This presentation could be a viral pharyngitis; however, with posterior
cervical lymphadenitis, you would suspect mononucleosis.
The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment
failure in children is:
1.Amoxicillin (Amoxil).
2.Amoxicillin and potassium clavulanate (Augmentin).
3.Azithromycin (Zithromax).
4.Prednisone (Deltasone) - Correct Answer-Augmentin
1|Page
, NR 511 Midterm EXAM NEWEST ACTUAL EXAM
rationale: The antibiotic of choice for recurrent AOM or treatment failure is
amoxicillin and potassium clavulanate (Augmentin)
A 65-year-old man presents complaining of a left-sided, deep, throbbing headache
and mild fatigue. On examination, the client has a tender, tortuous temporal
artery. You suspect giant cell arteritis (GCA), or temporal arteritis. What is the
least invasive procedure to help with diagnosis?
1. Magnetic resonance imaging (MRI) of the head.
2.Erythrocyte sedimentation rate (ESR).
3.Electroencephalogram (EEG).
4.Otoscopy - Correct Answer-ESR
rationale: An elevated ESR—anywhere from 30 to 100 mm/h—may be seen in
giant cell arteritis (temporal arteritis); however, the ESR may also be normal.
The temporal artery supplies the optic nerve; if temporal arteritis is suspected
due to the age of the client (50 and older) and the location and character of the
pain, it is essential that a referral to a surgeon be made for immediate biopsy of
the artery before damage to the optic nerve occurs. A temporal artery biopsy
(TAB), an invasive procedure, is the criterion standard for diagnosing temporal
arteritis
Aaron, age 4, is brought in to the clinic by his father. His tympanic membrane is
perforated from otitis media. His father asks about repair of the eardrum. How do
you respond?
1."The eardrum, in most cases, heals within several weeks."
2."We need to schedule Aaron for a surgical repair."
2|Page
, NR 511 Midterm EXAM NEWEST ACTUAL EXAM
3."He must absolutely stay out of the water for 3 to 6 months."
4."If the eardrum is not healed in several months, it can be surgically repaired." -
Correct Answer-"The eardrum, in most cases, heals within several weeks.
rationale: Most perforated tympanic membranes seen with acute otitis media
heal within several weeks
Martin, age 24, presents to the office with an erythematous ear canal and pain on
manipulation of the auricle. He is on vacation and has been swimming daily at the
resort. What is your diagnosis?
1.Acute otitis media.
2.Chronic otitis media.
3.External otitis.
4.Temporomandibular joint (TMJ) syndrome - Correct Answer-External otitis
rationale: With external otitis, there is pain, an erythematous ear canal, and
usually a history of recent swimming
Max, age 35, states that he thinks he has an ear infection because he just flew
back from a business trip and feels unusual pressure in his ear. You diagnose
barotrauma. What is your next action?
1.Prescribe nasal steroids and oral decongestants.
2.Prescribe antibiotic ear drops.
3.Prescribe systemic antibiotics.
3|Page
, NR 511 Midterm EXAM NEWEST ACTUAL EXAM
4.Refer Max to an ear, nose, and throat specialist - Correct Answer-Prescribe nasal
steroids and oral decongestants.
rationale: Barotrauma of the auditory canal, causing a sensation of abnormal
middle ear pressure, may be relieved by the use of nasal steroids and oral
decongestants.
A 64-year-old obese woman comes in complaining of difficulty swallowing for the
past 3 weeks. She states that "some foods get stuck" and she has been having
"heartburn" at night when she lies down, especially if she has had a heavy meal.
Occasionally, she awakes at night coughing. She denies weight gain and/or weight
loss, vomiting, or change in bowel movements or color of stools. She denies
alcohol and tobacco use. There is no pertinent family history or findings on review
of systems (ROS). Physical examination is normal, with no abdominal tenderness,
and the stool is occult blood (OB) negative. What is the most likely diagnosis?
1.Esophageal varices.
2.Esophageal cancer.
3.Gastroesophageal reflux disease (GERD).
4.Peptic ulcer disease (PUD) - Correct Answer-Gastroesophageal reflux disease
(GERD)
rationale: Though the historical data are incomplete, this client has no obvious
risk factors for esophageal varices or esophageal cancer. She is a nondrinker and
denies weight loss and changes in bowel function or color of stools, which could
be a clue to a gastrointestinal bleed. The fact that her worst symptoms occur at
night with regurgitation and heartburn is classic for GERD. Dysphagia is
frequently a prominent symptom of GERD. She has no abdominal tenderness,
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