NUR 612 - FINAL EXAM UPDATED
ACTUAL Questions and CORRECT
Answers
1. A 58-year-old male reports "chest pressure" when walking up stairs. Which
element of the history is most important to clarify first?
• A. Family history of coronary artery disease
• B. Onset, duration, and relieving factors of the pressure
• C. Last physical examination
• D. Immunization history
Correct ,,,,,answer,,,,: B
Rationale: For a symptom like chest pressure, using the OLDCARTS
framework (Onset, Location, Duration, Character, Aggravating/Relieving
factors, Timing, Severity) is critical for diagnostic reasoning. Characterizing
the symptom is the first and most important step .
2. During a review of systems, a patient endorses "black, tarry stools." This
finding most strongly suggests:
• A. Hemorrhoids
• B. Upper gastrointestinal bleeding
• C. Diverticulitis
• D. Lactose intolerance
Correct ,,,,,answer,,,,: B
Rationale: Melena, or black, tarry stool, indicates the presence of blood that
has been digested from the upper GI tract (esophagus, stomach, proximal
small intestine) .
,3. A patient describes bilateral knee pain that is worse in the morning and
improves with activity. This pattern suggests:
• A. Osteoarthritis
• B. Rheumatoid arthritis or inflammatory arthritis
• C. Septic arthritis
• D. Gout
Correct ,,,,,answer,,,,: B
Rationale: Morning stiffness lasting more than 30 minutes that improves
with activity is a classic hallmark of inflammatory arthritis, such as
rheumatoid arthritis .
4. Which of the following disorders is known to be hereditary?
• A. Peripheral neuropathy
• B. Meningitis
• C. Huntington Chorea
• D. Seizure disorder
Correct ,,,,,answer,,,,: C
Rationale: Huntington's chorea is a well-known autosomal dominant
hereditary disorder .
5. A patient reports unintentional weight loss of 20 lbs over 3 months. This is
most likely to indicate:
• A. Normal aging
• B. Malignancy, chronic infection, or metabolic disorder
• C. Improved diet and exercise
• D. Medication side effect only
Correct ,,,,,answer,,,,: B
Rationale: Unintentional weight loss of more than 5% over 6-12 months is a
red flag and often points to a serious underlying condition like cancer,
hyperthyroidism, malabsorption, or chronic infection .
,6. When a patient uses the term "dizzy," the provider should first:
• A. Assume it means vertigo
• B. Ask the patient to describe exactly what is felt (lightheaded, spinning, off-
balance)
• C. Order a CT head
• D. Check orthostatic vital signs
Correct ,,,,,answer,,,,: B
Rationale: "Dizzy" is a nonspecific term. The provider must clarify the
exact sensation (vertigo, presyncope, disequilibrium, or lightheadedness) to
guide the differential diagnosis .
7. A patient reports urinary frequency and nocturia. Which associated
symptom most suggests benign prostatic hyperplasia versus infection?
• A. Dysuria
• B. Fever
• C. Slow or intermittent stream
• D. Suprapubic pain
Correct ,,,,,answer,,,,: C
Rationale: A weak or intermittent urinary stream suggests obstruction from
BPH, whereas dysuria, fever, and suprapubic pain are more indicative of a
urinary tract infection .
8. In taking a sexual history, the most appropriate opening question is:
• A. "Do you have sex with men, women, or both?"
• B. "Are you sexually active?"
• C. "What do you use for birth control?"
• D. "Have you ever had an STI?"
Correct ,,,,,answer,,,,: B
Rationale: A non-judgmental and broad opening question like "Are you
, sexually active?" allows for further exploration of partners, practices, and
protection .
9. A patient with known hypertension reports new onset of morning
headaches, blurred vision, and nausea. These symptoms raise concern for:
• A. Tension headache
• B. Hypertensive emergency
• C. Migraine with aura
• D. Sinusitis
Correct ,,,,,answer,,,,: B
Rationale: Morning headache combined with visual changes and nausea in
a hypertensive patient suggests malignant hypertension with possible
encephalopathy .
10. A 35-year-old reports episodes of palpitations that start and stop suddenly.
The most useful next question is:
• A. "Do you drink coffee?"
• B. "How long do they last and what are you doing when they start?"
• C. "Has anyone in your family died suddenly?"
• D. "Do you have chest pain?"
Correct ,,,,,answer,,,,: B
Rationale: Paroxysmal onset and offset of palpitations suggest a reentrant
arrhythmia like SVT. Knowing the triggers and duration is key to guiding
the workup .
11. The examiner asks the patient to close her eyes and then place a vibrating
tuning fork on the patient's ankle and asks her to indicate what is felt. What is
being assessed?
• A. Fine motor coordination
• B. Primary sensory function
ACTUAL Questions and CORRECT
Answers
1. A 58-year-old male reports "chest pressure" when walking up stairs. Which
element of the history is most important to clarify first?
• A. Family history of coronary artery disease
• B. Onset, duration, and relieving factors of the pressure
• C. Last physical examination
• D. Immunization history
Correct ,,,,,answer,,,,: B
Rationale: For a symptom like chest pressure, using the OLDCARTS
framework (Onset, Location, Duration, Character, Aggravating/Relieving
factors, Timing, Severity) is critical for diagnostic reasoning. Characterizing
the symptom is the first and most important step .
2. During a review of systems, a patient endorses "black, tarry stools." This
finding most strongly suggests:
• A. Hemorrhoids
• B. Upper gastrointestinal bleeding
• C. Diverticulitis
• D. Lactose intolerance
Correct ,,,,,answer,,,,: B
Rationale: Melena, or black, tarry stool, indicates the presence of blood that
has been digested from the upper GI tract (esophagus, stomach, proximal
small intestine) .
,3. A patient describes bilateral knee pain that is worse in the morning and
improves with activity. This pattern suggests:
• A. Osteoarthritis
• B. Rheumatoid arthritis or inflammatory arthritis
• C. Septic arthritis
• D. Gout
Correct ,,,,,answer,,,,: B
Rationale: Morning stiffness lasting more than 30 minutes that improves
with activity is a classic hallmark of inflammatory arthritis, such as
rheumatoid arthritis .
4. Which of the following disorders is known to be hereditary?
• A. Peripheral neuropathy
• B. Meningitis
• C. Huntington Chorea
• D. Seizure disorder
Correct ,,,,,answer,,,,: C
Rationale: Huntington's chorea is a well-known autosomal dominant
hereditary disorder .
5. A patient reports unintentional weight loss of 20 lbs over 3 months. This is
most likely to indicate:
• A. Normal aging
• B. Malignancy, chronic infection, or metabolic disorder
• C. Improved diet and exercise
• D. Medication side effect only
Correct ,,,,,answer,,,,: B
Rationale: Unintentional weight loss of more than 5% over 6-12 months is a
red flag and often points to a serious underlying condition like cancer,
hyperthyroidism, malabsorption, or chronic infection .
,6. When a patient uses the term "dizzy," the provider should first:
• A. Assume it means vertigo
• B. Ask the patient to describe exactly what is felt (lightheaded, spinning, off-
balance)
• C. Order a CT head
• D. Check orthostatic vital signs
Correct ,,,,,answer,,,,: B
Rationale: "Dizzy" is a nonspecific term. The provider must clarify the
exact sensation (vertigo, presyncope, disequilibrium, or lightheadedness) to
guide the differential diagnosis .
7. A patient reports urinary frequency and nocturia. Which associated
symptom most suggests benign prostatic hyperplasia versus infection?
• A. Dysuria
• B. Fever
• C. Slow or intermittent stream
• D. Suprapubic pain
Correct ,,,,,answer,,,,: C
Rationale: A weak or intermittent urinary stream suggests obstruction from
BPH, whereas dysuria, fever, and suprapubic pain are more indicative of a
urinary tract infection .
8. In taking a sexual history, the most appropriate opening question is:
• A. "Do you have sex with men, women, or both?"
• B. "Are you sexually active?"
• C. "What do you use for birth control?"
• D. "Have you ever had an STI?"
Correct ,,,,,answer,,,,: B
Rationale: A non-judgmental and broad opening question like "Are you
, sexually active?" allows for further exploration of partners, practices, and
protection .
9. A patient with known hypertension reports new onset of morning
headaches, blurred vision, and nausea. These symptoms raise concern for:
• A. Tension headache
• B. Hypertensive emergency
• C. Migraine with aura
• D. Sinusitis
Correct ,,,,,answer,,,,: B
Rationale: Morning headache combined with visual changes and nausea in
a hypertensive patient suggests malignant hypertension with possible
encephalopathy .
10. A 35-year-old reports episodes of palpitations that start and stop suddenly.
The most useful next question is:
• A. "Do you drink coffee?"
• B. "How long do they last and what are you doing when they start?"
• C. "Has anyone in your family died suddenly?"
• D. "Do you have chest pain?"
Correct ,,,,,answer,,,,: B
Rationale: Paroxysmal onset and offset of palpitations suggest a reentrant
arrhythmia like SVT. Knowing the triggers and duration is key to guiding
the workup .
11. The examiner asks the patient to close her eyes and then place a vibrating
tuning fork on the patient's ankle and asks her to indicate what is felt. What is
being assessed?
• A. Fine motor coordination
• B. Primary sensory function
