1|Page
NR509 MIDTERM EXAM BATES TEST BANK 2026
ALL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK|NEW AND
REVISED
A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
vomiting and occurs 1 to 2 hours after eating greasy foods. Which one of
the following physical examination descriptions would be most
consistent with the diagnosis of cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant,
without rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant
with inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area,
without rebound or
guarding. - ANSWER- C)
Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.
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In cholecystitis, the pain, which originates from the gallbladder, is
located in the
right upper quadrant. Severity of pain with inspiration that is
sufficient to stop further inhalation
is also known as Murphy's sign, which, if present, is further
indicative of inflammation of the
gallbladder.
A 55-year-old data entry operator comes to the clinic to establish care.
She has the following
symptoms: headache, neck pain, sinus congestion, sore throat, ringing in
ears, sharp brief chest
pains at rest, burning abdominal pain with spicy foods, constipation,
urinary frequency that is worse with coughing and sneezing, and
swelling in legs. This cluster of symptoms is explained
by:
A) One disease process
B) More than one disease process - ANSWER- B) More than one
disease process
The patient appears to have several possible conditions: allergic
rhinitis, arthritis,
,3|Page
conductive hearing loss, pleuritic chest pains, heartburn, stress
urinary incontinence, and venous stasis, among other conditions.
Although we always try, it is very difficult to assign all of these
symptoms to one cohesive diagnosis.
A 62-year-old teacher presents to the clinic for evaluation of the
following symptoms: fever, headache, sinus congestion, sore throat,
green nasal discharge, and cough. This cluster of symptoms is best
explained by:
A) One disease process
B) More than one disease process - ANSWER- A) One disease process
This cluster of symptoms is most consistent with sinusitis. The
chance that all of these symptoms are caused by multiple
synchronous conditions in the same patient is much less than the
possibility of having one problem which accounts for all of them.
Steve has just seen a 5-year-old girl who wheezes when exposed to cats.
The patient's family history is positive for asthma. You think the child
most likely has asthma. What have you just accomplished?
A) You have tested your hypothesis.
B) You have developed a plan.
C) You have established a working diagnosis.
, 4|Page
D) You have created a hypothesis. - ANSWER- D) You have created a
hypothesis.
As you go through a history and examination, you will start to
generate ideas to explain the patient's symptoms. It is best to keep
an open mind and make as many hypotheses
as you can, to avoid missing a possibility. A common mistake is to
latch onto one idea too early.
Ms. Washington is a 67-year-old who had a heart attack last month.
Now she complains of shortness of breath and not being able to sleep in
a flat position (orthopnea). On examination you note increased jugular
venous pressure, an S3 gallop, crackles low in the lung fields, and
swollen ankles (edema). This is an example of a:
A) Pathophysiologic problem
B) Psychopathologic problem - ANSWER- A) Pathophysiologic
problem
This is an example of a pathophysiologic problem because Ms.
Washington's
symptoms are consistent with a pathophysiologic process. The heart
attack reduced the ability of her heart to handle her volume status
and subsequently produced the many features of congestive heart
failure.
NR509 MIDTERM EXAM BATES TEST BANK 2026
ALL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ALREADY A
GRADED WITH EXPERT FEEDBACK|NEW AND
REVISED
A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
vomiting and occurs 1 to 2 hours after eating greasy foods. Which one of
the following physical examination descriptions would be most
consistent with the diagnosis of cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant,
without rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant
with inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area,
without rebound or
guarding. - ANSWER- C)
Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the
point of stopping inspiration, and there is no rebound or guarding.
,2|Page
In cholecystitis, the pain, which originates from the gallbladder, is
located in the
right upper quadrant. Severity of pain with inspiration that is
sufficient to stop further inhalation
is also known as Murphy's sign, which, if present, is further
indicative of inflammation of the
gallbladder.
A 55-year-old data entry operator comes to the clinic to establish care.
She has the following
symptoms: headache, neck pain, sinus congestion, sore throat, ringing in
ears, sharp brief chest
pains at rest, burning abdominal pain with spicy foods, constipation,
urinary frequency that is worse with coughing and sneezing, and
swelling in legs. This cluster of symptoms is explained
by:
A) One disease process
B) More than one disease process - ANSWER- B) More than one
disease process
The patient appears to have several possible conditions: allergic
rhinitis, arthritis,
,3|Page
conductive hearing loss, pleuritic chest pains, heartburn, stress
urinary incontinence, and venous stasis, among other conditions.
Although we always try, it is very difficult to assign all of these
symptoms to one cohesive diagnosis.
A 62-year-old teacher presents to the clinic for evaluation of the
following symptoms: fever, headache, sinus congestion, sore throat,
green nasal discharge, and cough. This cluster of symptoms is best
explained by:
A) One disease process
B) More than one disease process - ANSWER- A) One disease process
This cluster of symptoms is most consistent with sinusitis. The
chance that all of these symptoms are caused by multiple
synchronous conditions in the same patient is much less than the
possibility of having one problem which accounts for all of them.
Steve has just seen a 5-year-old girl who wheezes when exposed to cats.
The patient's family history is positive for asthma. You think the child
most likely has asthma. What have you just accomplished?
A) You have tested your hypothesis.
B) You have developed a plan.
C) You have established a working diagnosis.
, 4|Page
D) You have created a hypothesis. - ANSWER- D) You have created a
hypothesis.
As you go through a history and examination, you will start to
generate ideas to explain the patient's symptoms. It is best to keep
an open mind and make as many hypotheses
as you can, to avoid missing a possibility. A common mistake is to
latch onto one idea too early.
Ms. Washington is a 67-year-old who had a heart attack last month.
Now she complains of shortness of breath and not being able to sleep in
a flat position (orthopnea). On examination you note increased jugular
venous pressure, an S3 gallop, crackles low in the lung fields, and
swollen ankles (edema). This is an example of a:
A) Pathophysiologic problem
B) Psychopathologic problem - ANSWER- A) Pathophysiologic
problem
This is an example of a pathophysiologic problem because Ms.
Washington's
symptoms are consistent with a pathophysiologic process. The heart
attack reduced the ability of her heart to handle her volume status
and subsequently produced the many features of congestive heart
failure.
