NRS-460
Complex Disease
Management
Midterm Exam Prep
2026
1. Case: A 65-year-old male with CHF presents with worsening dyspnea and orthopnea.
Question: Which intervention is most appropriate for acute decompensated CHF?
- A. IV furosemide
- B. Oral ACE inhibitor only
- C. Fluid bolus
- D. High-dose corticosteroids
Answer: A
Rationale: IV diuretics relieve pulmonary congestion rapidly; fluid bolus worsens CHF.
,---
2. Case: A patient with COPD exacerbation presents with hypoxemia.
Question: Which oxygen delivery strategy is safest?
- A. High-flow oxygen at 10 L/min
- B. Titrated oxygen to maintain SpO₂ 88–92%
- C. Room air only
- D. Hyperbaric oxygen therapy
Answer: B
Rationale: COPD patients risk CO₂ retention; oxygen must be titrated.
---
3. Case: A diabetic patient presents with foot ulcer and cellulitis.
Question: Which factor most increases risk of amputation?
- A. Neuropathy
- B. Hyperlipidemia
, - C. Hypertension
- D. Retinopathy
Answer: A
Rationale: Neuropathy leads to unnoticed trauma and poor healing.
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4. Case: A patient with ESRD on dialysis presents with hyperkalemia.
Question: Which immediate intervention is indicated?
- A. IV calcium gluconate
- B. Oral potassium binder
- C. Low-potassium diet
- D. Increase dialysis frequency only
Answer: A
Rationale: Calcium stabilizes cardiac membranes in life-threatening hyperkalemia.
---
, 5. Case: A patient with metastatic breast cancer reports severe bone pain.
Question: Which intervention provides best palliation?
- A. NSAIDs only
- B. Radiation therapy to affected bone
- C. Chemotherapy dose escalation
- D. Vitamin D supplementation
Answer: B
Rationale: Local radiation is effective for metastatic bone pain.
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6. Case: A patient with HIV presents with fever and cough.
Question: Which opportunistic infection is most likely with CD4 <200?
- A. Pneumocystis jirovecii pneumonia
- B. Tuberculosis
- C. CMV retinitis
Complex Disease
Management
Midterm Exam Prep
2026
1. Case: A 65-year-old male with CHF presents with worsening dyspnea and orthopnea.
Question: Which intervention is most appropriate for acute decompensated CHF?
- A. IV furosemide
- B. Oral ACE inhibitor only
- C. Fluid bolus
- D. High-dose corticosteroids
Answer: A
Rationale: IV diuretics relieve pulmonary congestion rapidly; fluid bolus worsens CHF.
,---
2. Case: A patient with COPD exacerbation presents with hypoxemia.
Question: Which oxygen delivery strategy is safest?
- A. High-flow oxygen at 10 L/min
- B. Titrated oxygen to maintain SpO₂ 88–92%
- C. Room air only
- D. Hyperbaric oxygen therapy
Answer: B
Rationale: COPD patients risk CO₂ retention; oxygen must be titrated.
---
3. Case: A diabetic patient presents with foot ulcer and cellulitis.
Question: Which factor most increases risk of amputation?
- A. Neuropathy
- B. Hyperlipidemia
, - C. Hypertension
- D. Retinopathy
Answer: A
Rationale: Neuropathy leads to unnoticed trauma and poor healing.
---
4. Case: A patient with ESRD on dialysis presents with hyperkalemia.
Question: Which immediate intervention is indicated?
- A. IV calcium gluconate
- B. Oral potassium binder
- C. Low-potassium diet
- D. Increase dialysis frequency only
Answer: A
Rationale: Calcium stabilizes cardiac membranes in life-threatening hyperkalemia.
---
, 5. Case: A patient with metastatic breast cancer reports severe bone pain.
Question: Which intervention provides best palliation?
- A. NSAIDs only
- B. Radiation therapy to affected bone
- C. Chemotherapy dose escalation
- D. Vitamin D supplementation
Answer: B
Rationale: Local radiation is effective for metastatic bone pain.
---
6. Case: A patient with HIV presents with fever and cough.
Question: Which opportunistic infection is most likely with CD4 <200?
- A. Pneumocystis jirovecii pneumonia
- B. Tuberculosis
- C. CMV retinitis
