NU 611
Clinical Decision Making
Proctored Final Exam Review
(With Solutions)
2026
1
,1. Case: A 45-year-old male presents with chest pain radiating to the
left arm. ECG shows ST elevation.
Question: What is the most appropriate immediate decision?
- A. Administer nitroglycerin and discharge
- B. Refer for emergent PCI
- C. Prescribe aspirin for home use
- D. Order chest X-ray
Answer: B. Refer for emergent PCI
Rationale: ST-elevation MI requires urgent reperfusion therapy.
---
2. Case: A 30-year-old female presents with fatigue, pallor, and
spoon-shaped nails. Labs show microcytic anemia.
Question: Which diagnostic test best confirms the etiology?
- A. Serum ferritin
- B. Vitamin B12 level
- C. Reticulocyte count
- D. Bone marrow biopsy
Answer: A. Serum ferritin
Rationale: Low ferritin confirms iron deficiency anemia.
---
3. Case: A 70-year-old diabetic patient presents with foot ulcer and
fever.
Question: Which imaging is most appropriate to rule out
osteomyelitis?
- A. X-ray
- B. MRI
- C. CT scan
- D. Ultrasound
Answer: B. MRI
2
, Rationale: MRI is most sensitive for detecting osteomyelitis.
---
4. Case: A patient presents with acute shortness of breath,
tachycardia, and pleuritic chest pain.
Question: Which decision tool aids in ruling out pulmonary
embolism?
- A. Wells score
- B. CHA₂DS₂-VASc score
- C. APGAR score
- D. CURB-65 score
Answer: A. Wells score
Rationale: Wells score stratifies PE risk.
---
5. Case: A 25-year-old presents with dysuria and frequency.
Urinalysis shows nitrites and leukocyte esterase.
Question: Which antibiotic is first-line for uncomplicated UTI?
- A. Ciprofloxacin
- B. Nitrofurantoin
- C. Vancomycin
- D. Amoxicillin-clavulanate
Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is first-line for uncomplicated cystitis.
---
6. Case: A patient with hypertension is prescribed lisinopril.
Question: Which lab must be monitored?
- A. Serum potassium
- B. Serum calcium
- C. Hemoglobin
3
Clinical Decision Making
Proctored Final Exam Review
(With Solutions)
2026
1
,1. Case: A 45-year-old male presents with chest pain radiating to the
left arm. ECG shows ST elevation.
Question: What is the most appropriate immediate decision?
- A. Administer nitroglycerin and discharge
- B. Refer for emergent PCI
- C. Prescribe aspirin for home use
- D. Order chest X-ray
Answer: B. Refer for emergent PCI
Rationale: ST-elevation MI requires urgent reperfusion therapy.
---
2. Case: A 30-year-old female presents with fatigue, pallor, and
spoon-shaped nails. Labs show microcytic anemia.
Question: Which diagnostic test best confirms the etiology?
- A. Serum ferritin
- B. Vitamin B12 level
- C. Reticulocyte count
- D. Bone marrow biopsy
Answer: A. Serum ferritin
Rationale: Low ferritin confirms iron deficiency anemia.
---
3. Case: A 70-year-old diabetic patient presents with foot ulcer and
fever.
Question: Which imaging is most appropriate to rule out
osteomyelitis?
- A. X-ray
- B. MRI
- C. CT scan
- D. Ultrasound
Answer: B. MRI
2
, Rationale: MRI is most sensitive for detecting osteomyelitis.
---
4. Case: A patient presents with acute shortness of breath,
tachycardia, and pleuritic chest pain.
Question: Which decision tool aids in ruling out pulmonary
embolism?
- A. Wells score
- B. CHA₂DS₂-VASc score
- C. APGAR score
- D. CURB-65 score
Answer: A. Wells score
Rationale: Wells score stratifies PE risk.
---
5. Case: A 25-year-old presents with dysuria and frequency.
Urinalysis shows nitrites and leukocyte esterase.
Question: Which antibiotic is first-line for uncomplicated UTI?
- A. Ciprofloxacin
- B. Nitrofurantoin
- C. Vancomycin
- D. Amoxicillin-clavulanate
Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is first-line for uncomplicated cystitis.
---
6. Case: A patient with hypertension is prescribed lisinopril.
Question: Which lab must be monitored?
- A. Serum potassium
- B. Serum calcium
- C. Hemoglobin
3
