NR 511 Final Exam: Questions & Answers 2026 update

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NR 511 FINAL EXAM WITH QUESTIONS AND DETAILE
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D ANSWERS 2026 LATEST UPDATED EXAM BANK INCL
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UDING EXPERT VERIFIED SOLUTIONS FOR A SURE PA v v v v v v v



SS
Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadra
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nt abdominal cramping pain, nausea, and vomiting. What is your leading differential
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diagnosis?
Cholecystitis
A rapid onset of severe right upper quadrant (RUQ) abdominal cramping pain with n
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ausea and vomiting is a classic presentation of acute cholecystitis; 90% to 95% of pati
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ents with acute cholecystitis also have gallstones. Other symptoms include low-
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grade fever, epigastric tenderness, guarding, and pain on inspiration during palpation
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of the RUQ (Murphy sign). The 7 Fs of cholecystitis are fair, fat, 40, female, fertile, f
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at intolerant, and flatulent.
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You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori and
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plan to treat her empirically. What medications should you order?
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A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazol
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e (Flagyl)
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All of the drugs listed are used in the eradication of H pylori. Traditional 14-
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day "triple therapy" with a proton pump inhibitor (omeprazole), tetracycline or amox
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icillin, and metronidazole (Flagyl) has consistently produced eradication rates of appr
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oximately 95% and is the least expensive therapy.
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You elicit costovertebral angle tenderness in Gordon, age 29. Which condition do you
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suspect?
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Inflammation of the kidney v v v

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Costovertebral angle tenderness is tenderness or sharp pain that is elicited when one
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hand is "thumped" with the ulnar edge of the other fist over the 12th rib at the costove
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rtebral angle on the back. It indicates inflammation of the kidney (and possible assoc
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iated renal calculi, renal artery or vein occlusion, and perirenal abscess).
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To differentiate among the different diagnoses of inflammatory bowel diseases, you
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look at the patient's histological, culture, and radiological features. Mary has transmu
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ral inflammation, granulomas, focal involvement of the colon with some skipped are
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as, and sparing of the rectal mucosa. What do you suspect?
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Crohn's disease v




Crohn's disease would show transmural inflammation, granulomas, focal involveme
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nt of the colon with some skipped areas, and sparing of the rectal mucosa. The key w
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ords are "skipped areas of mucosal involvement."
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Margie, age 52, has an extremely stressful job and was just given a diagnosis of gastri
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c ulcer. She tells you she is sure it is going to be malignant. How do you respond?
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About 95% of gastric ulcers are benign."
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About 3% to 5% of gastric ulcers of benign-appearing ulcers prove to be cancer.
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Rose has gastroesophageal reflux disease (GERD). Which statement by the patient indic
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ates that she misunderstands your teaching?
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"I will have a snack before retiring so that the esophagus and stomach are not empty a
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t bedtime."
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Rose should not have a snack before retiring. Patients with GERD should be instructe
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d to avoid coffee, alcohol, chocolate, peppermint, and spicy foods; eat
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smaller meals; stop smoking; remain upright for 2 hours after meals; elevate the head
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of the bed on 6- to 8-inch blocks; and refrain from eating for 3 hours before retiring.
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Which is the most important diagnostic test for celiac disease? An
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IgA-tTG test, followed by a biopsy of the small intestine
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There are several serologic tests available that screen for celiac disease antibodies, b
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ut the most important diagnostic test is called an IgA-
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tTG test. Although it may be falsely negative, if the test results suggest celiac disease
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, it is recommended that a biopsy of the small intestine be done to confirm the diagno
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sis.




Susan, age 59, has no specific complaints when she comes in for her annual examination
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. She does, however, have type 2 diabetes mellitus (DM), slight hypertension, dyslipide
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mia, and central obesity. How would you diagnose her?
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As having metabolic syndrome
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Susan has a constellation of symptoms known as metabolic syndrome. The World He
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alth Organization (WHO), National Cholesterol Education Program Adult Treatment
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Panel III (NCEP ATP III), and International Diabetes Federation (IDF) have slightly
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different criteria for this diagnosis. They all, however, include hypertension, dyslipid
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emia, and central obesity. v v v




Which gastrointestinal disease below could theoretically be completely eradicated wi
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th a total colectomy?
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Ulcerative colitis v

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Ulcerative colitis is a disease only of the colon. Although it is not the first treatment c
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hoice, total colectomy is a treatment option that can completely resolve this problem.
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Matt, age 26, recently returned from a camping trip and has gastroenteritis. He says th
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at he has been eating only canned food. Which of the following pathogens do you sus
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pect?
Clostridium botulinum v




C botulinum is an anaerobic, gram-
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positive bacillus that produces toxins. It is widely distributed in the soil and vegetat
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ion. Improperly processed home-canned low-
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acid vegetables and contaminated meats are the usual cause of food-
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borne botulism. v




Melva, age 63, presents with an acute exacerbation of pancreatitis, and you are going t
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o admit her to the hospital. Which is the most important factor in determining a negati
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ve long-term outcome for her?
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Infection
The most important factor in determining long-
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term negative outcomes for pancreatitis is the presence of infection. Despite best prac
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tices, mortality associated with severe acute pancreatitis remains approximately 20%
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to 25% because of systemic complications.
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Which is the most common presenting symptom of gastric cancer? Weight
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loss