NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
QUESTIONS AND ANSWERS WITH RATIONALE GRADED A
COMPLETE QUESTION AND ANSWER 100% ACCURATE FALL-
SPRING GRADED A+ GUARANTEED PASS
A 31-year-old woman presents with a purpural rash covering her arms, legs, and
abdomen. She also has fever, chills, nausea, abdominal tenderness, tachycardia,
and generalized myalgias. Prior to the development of the rash, the patient noted
that she had a headache, cough, and sore throat. Laboratory studies were positive
for Gram-negative diplococci in the blood, along with thrombocytopenia and an
elevation in PMNs. Urinalysis showed blood, protein, and casts. Vital signs are as
follows: PB 92/66, P 96, RR 14, T 39. The patient denies any foreign travel and
does not have any sick contacts. However, she does work part time as a nurse in a
local hospital.
Question
The patient is diagnosed with Meningococcemia; she is admitted to the hospital
and placed in respiratory isolation. What major course of therapy should this
patient receive?
Answer Choices
1 Steroids
2 Supportive care
3 Antibiotics
4 Transfusion
5 Bacterici - Correct Answer-Antibiotics
1|Page
, NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
Antibiotics are the treatment of choice for meningococcemia. The preferred drug
for active infection is penicillin G. For those allergic to penicillin, chloramphenicol
and cephalosporins (ie, cefotaxime, cefuroxime) may be used as alternatives.
Patients will also receive supportive care, but antibiotic therapy must be initiated
quickly if the patient is to survive. Intensive care placement may be necessary if
organ failure is imminent. Ventilatory support, inotropic support, and IV fluids are
necessary in some. If adrenal insufficiency occurs, corticosteroid replacement may
be considered. A central venous line helps to provide large amounts of volume
expanders and inotropic medications for adequate tissue perfusion.
Steroids have not been shown to play a major role in the treatment of
meningococcemia. However, they have been used in addition to antibiotic
therapy. In the case of adrenal insufficiency, for example, steroid replacement has
been shown to be beneficial.
Transfusion does not generally play a major role in treatment. If the patient suffers
from a devastating coagulopathy, blood or blood products may be replaced as
necessary.
Bactericidal/permeability-increasing protein is a protein stored in the granules of
neutrophils. It binds to endotoxin in vitro and neutralizes it. This technique is
experimental, and it is not used in everyday treatment of meningococcemia.
In myasthenia gravis, weakness is a result of insufficient acetylcholine
transmission at the neuromuscular junction; however, weakness can also occur
with overdosing of the cholinergic medications used to treat myasthenia. What
symptom helps differentiate a myasthenic crisis from a cholinergic crisis?
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, NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
Answer Choices
1 Respiratory failure
2 Bilateral ptosis
3 Muscle fasciculations
4 Diplopia
5 Normal muscle stretch reflexes
ANS: 3 - Correct Answer-Muscle Fasiculations
Signs of cholinergic overdosage include muscle fasciculation, rhinorrhea,
lacrimation, salivation, increased bronchial secretions, nausea, or diarrhea. The
presence of any of these suggests that the patient's weakness may be due to
cholinergic crisis. The other signs are due to weakness and can occur in either
condition.
A 54-year-old man presents after having a generalized seizure. The patient is HIV
positive, but he has been unable to afford antiretroviral therapy since losing his
job 2 years ago. Other than cachexia, the physical exam is unremarkable. Upon
further inquiry, the patient also notes that he has become short-tempered and
hypercritical; at times, he seems confused. An MRI of the brain is performed, and
it reveals several cortical ring-enhancing lesions.
Question
What is the most likely diagnosis?
Answer Choices
1 AIDS dementia complex
2 Cryptococcal meningitis
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, NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
3 Cytomegalovirus encephalitis
4 Progressive multifocal leukoencephalopathy
5 Toxoplasma encephalitis
ANS:5 - Correct Answer-Toxoplasma encephalitis
The patient's symptoms and MRI findings are most consistent with the diagnosis
of toxoplasma encephalitis. Toxoplasmosis is the most common cerebral mass
lesion among HIV-positive patients. Infection with the Toxoplasma gondii parasite
is relatively common and usually asymptomatic. Reactivation occurs in HIV
positive patients due to failing cellular immunity, and it causes a multifocal
necrotizing encephalitis. Seizures may be the initial manifestation of central
nervous system (CNS) infection; other common clinical manifestations include
focal neurologic deficits, such as impaired speech and hemiparesis. Personality
change, lethargy, headache, and confusion are also observed. The MRI in patients
with toxoplasma encephalitis characteristically reveals multiple, ring-enhancing
lesions with surrounding edema; these lesions usually occur bilaterally in the
frontal and parietal cortices.
AIDS dementia complex describes a constellation of cognitive symptoms seen
among HIV positive patients. The condition occurs when HIV virus disseminates to
the CNS. Within the CNS, the virus tends to concentrate in the basal ganglia and
subcortical regions. Symptoms include a constellation of cognitive, behavioral, and
motor disturbances that cause varying degrees of functional impairment.
Characteristic MRI findings include non-enhancing white matter, cerebral atrophy,
and ventricular enlargement. The diagnosis requires that other central nervous
system infections, carcinoma, as well as general medical conditions and substance
abuse have been excluded.
Cryptococcal meningitis is caused by the encapsulated fungus Cryptococcus
neoformans. Among HIV positive patients, the illness may be the result of new
4|Page
NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
QUESTIONS AND ANSWERS WITH RATIONALE GRADED A
COMPLETE QUESTION AND ANSWER 100% ACCURATE FALL-
SPRING GRADED A+ GUARANTEED PASS
A 31-year-old woman presents with a purpural rash covering her arms, legs, and
abdomen. She also has fever, chills, nausea, abdominal tenderness, tachycardia,
and generalized myalgias. Prior to the development of the rash, the patient noted
that she had a headache, cough, and sore throat. Laboratory studies were positive
for Gram-negative diplococci in the blood, along with thrombocytopenia and an
elevation in PMNs. Urinalysis showed blood, protein, and casts. Vital signs are as
follows: PB 92/66, P 96, RR 14, T 39. The patient denies any foreign travel and
does not have any sick contacts. However, she does work part time as a nurse in a
local hospital.
Question
The patient is diagnosed with Meningococcemia; she is admitted to the hospital
and placed in respiratory isolation. What major course of therapy should this
patient receive?
Answer Choices
1 Steroids
2 Supportive care
3 Antibiotics
4 Transfusion
5 Bacterici - Correct Answer-Antibiotics
1|Page
, NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
Antibiotics are the treatment of choice for meningococcemia. The preferred drug
for active infection is penicillin G. For those allergic to penicillin, chloramphenicol
and cephalosporins (ie, cefotaxime, cefuroxime) may be used as alternatives.
Patients will also receive supportive care, but antibiotic therapy must be initiated
quickly if the patient is to survive. Intensive care placement may be necessary if
organ failure is imminent. Ventilatory support, inotropic support, and IV fluids are
necessary in some. If adrenal insufficiency occurs, corticosteroid replacement may
be considered. A central venous line helps to provide large amounts of volume
expanders and inotropic medications for adequate tissue perfusion.
Steroids have not been shown to play a major role in the treatment of
meningococcemia. However, they have been used in addition to antibiotic
therapy. In the case of adrenal insufficiency, for example, steroid replacement has
been shown to be beneficial.
Transfusion does not generally play a major role in treatment. If the patient suffers
from a devastating coagulopathy, blood or blood products may be replaced as
necessary.
Bactericidal/permeability-increasing protein is a protein stored in the granules of
neutrophils. It binds to endotoxin in vitro and neutralizes it. This technique is
experimental, and it is not used in everyday treatment of meningococcemia.
In myasthenia gravis, weakness is a result of insufficient acetylcholine
transmission at the neuromuscular junction; however, weakness can also occur
with overdosing of the cholinergic medications used to treat myasthenia. What
symptom helps differentiate a myasthenic crisis from a cholinergic crisis?
2|Page
, NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
Answer Choices
1 Respiratory failure
2 Bilateral ptosis
3 Muscle fasciculations
4 Diplopia
5 Normal muscle stretch reflexes
ANS: 3 - Correct Answer-Muscle Fasiculations
Signs of cholinergic overdosage include muscle fasciculation, rhinorrhea,
lacrimation, salivation, increased bronchial secretions, nausea, or diarrhea. The
presence of any of these suggests that the patient's weakness may be due to
cholinergic crisis. The other signs are due to weakness and can occur in either
condition.
A 54-year-old man presents after having a generalized seizure. The patient is HIV
positive, but he has been unable to afford antiretroviral therapy since losing his
job 2 years ago. Other than cachexia, the physical exam is unremarkable. Upon
further inquiry, the patient also notes that he has become short-tempered and
hypercritical; at times, he seems confused. An MRI of the brain is performed, and
it reveals several cortical ring-enhancing lesions.
Question
What is the most likely diagnosis?
Answer Choices
1 AIDS dementia complex
2 Cryptococcal meningitis
3|Page
, NR 603 EXAM 2025/2026 LATEST COMPLETE FULL EXAM
3 Cytomegalovirus encephalitis
4 Progressive multifocal leukoencephalopathy
5 Toxoplasma encephalitis
ANS:5 - Correct Answer-Toxoplasma encephalitis
The patient's symptoms and MRI findings are most consistent with the diagnosis
of toxoplasma encephalitis. Toxoplasmosis is the most common cerebral mass
lesion among HIV-positive patients. Infection with the Toxoplasma gondii parasite
is relatively common and usually asymptomatic. Reactivation occurs in HIV
positive patients due to failing cellular immunity, and it causes a multifocal
necrotizing encephalitis. Seizures may be the initial manifestation of central
nervous system (CNS) infection; other common clinical manifestations include
focal neurologic deficits, such as impaired speech and hemiparesis. Personality
change, lethargy, headache, and confusion are also observed. The MRI in patients
with toxoplasma encephalitis characteristically reveals multiple, ring-enhancing
lesions with surrounding edema; these lesions usually occur bilaterally in the
frontal and parietal cortices.
AIDS dementia complex describes a constellation of cognitive symptoms seen
among HIV positive patients. The condition occurs when HIV virus disseminates to
the CNS. Within the CNS, the virus tends to concentrate in the basal ganglia and
subcortical regions. Symptoms include a constellation of cognitive, behavioral, and
motor disturbances that cause varying degrees of functional impairment.
Characteristic MRI findings include non-enhancing white matter, cerebral atrophy,
and ventricular enlargement. The diagnosis requires that other central nervous
system infections, carcinoma, as well as general medical conditions and substance
abuse have been excluded.
Cryptococcal meningitis is caused by the encapsulated fungus Cryptococcus
neoformans. Among HIV positive patients, the illness may be the result of new
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