NR 511 Final Exam Practice Questions and
ANSWERs 2026/2027
Question 1
A 45-year-old male presents with acute onset of severe, tearing chest pain radiating to the back. Blood
pressure is 100/60 in the right arm and 140/90 in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
ANSWER: C) Aortic dissection
Rationale: Aortic dissection classically presents with acute, severe, tearing chest pain radiating to the
back with asymmetric blood pressures between arms. This is a vascular emergency requiring immediate
referral .
Question 2
A 28-year-old female presents with recurrent episodes of abdominal pain, bloating, and altered bowel
habits. She reports that symptoms improve with defecation. Physical exam is unremarkable. Labs
including CBC, ESR, and thyroid function are normal. What is the most likely diagnosis?
A) Inflammatory bowel disease
B) Irritable bowel syndrome
C) Celiac disease
,D) Colon cancer
ANSWER: B) Irritable bowel syndrome (IBS)
Rationale: IBS is a disorder of bowel function characterized by abdominal pain associated with changes
in bowel habits. Diagnosis is made on careful history and physical exam with normal labs. Unlike IBD, IBS
has no anatomic abnormality and no serious medical consequences .
Question 3
Which of the following findings would differentiate IBS from inflammatory bowel disease (IBD)?
A) Presence of abdominal pain
B) Changes in bowel habits
C) Normal inflammatory markers and endoscopic findings
D) Extra-intestinal symptoms
ANSWER: C) Normal inflammatory markers and endoscopic findings
Rationale: IBS is a functional disorder with normal inflammatory markers (CBC, ESR) and normal
endoscopic findings. IBD demonstrates evidence of inflammation on labs and endoscopy .
Question 4
A 72-year-old male presents with melena and fatigue. EGD reveals a gastric ulcer. Which of the following
is the most common cause of peptic ulcer disease?
A) NSAID use
B) H. pylori infection
C) Zollinger-Ellison syndrome
D) Stress
,ANSWER: B) H. pylori infection
Rationale: H. pylori infection is the most common cause of peptic ulcer disease, followed by NSAID use.
Treatment includes amoxicillin, clarithromycin, and a PPI for 2 weeks .
Question 5
A 32-year-old female presents with progressive fatigue, pallor, and heavy menstrual periods. Labs show
hemoglobin 8.2 g/dL, MCV 72 fL, serum ferritin 5 ng/mL, and elevated TIBC. What is the most likely type
of anemia?
A) Anemia of chronic disease
B) Iron deficiency anemia
C) Thalassemia
D) Sideroblastic anemia
ANSWER: B) Iron deficiency anemia
Rationale: Iron deficiency anemia presents with microcytic anemia (low MCV), low serum ferritin, and
elevated total iron-binding capacity (TIBC). Heavy menstrual bleeding is a common cause in
premenopausal women .
Question 6
Which laboratory finding distinguishes iron deficiency anemia from anemia of chronic disease?
A) Low hemoglobin
B) Low MCV
C) Low ferritin with elevated TIBC
D) Normal ferritin
ANSWER: C) Low ferritin with elevated TIBC
, Rationale: Iron deficiency anemia shows ↓ serum iron, ↑ TIBC, and ↓ ferritin. Anemia of chronic
disease shows ↓ serum iron, ↓ TIBC, and normal or ↑ ferritin .
Question 7
A 24-year-old with acute gastroenteritis asks about treatment. Which of the following is appropriate
initial management?
A) Ciprofloxacin immediately
B) Fluids, supportive care, and BRAT diet
C) Hospital admission for IV antibiotics
D) Antimotility agents only
ANSWER: B) Fluids, supportive care, and BRAT diet
Rationale: Treatment for gastroenteritis includes fluids, Imodium (for non-febrile, non-bloody diarrhea),
BRAT diet (banana, rice, applesauce, toast), and Zofran PRN. Antibiotics are not routinely indicated .
Question 8
A 3-year-old presents with low-grade fever, loss of appetite, copious watery diarrhea, flatulence,
vomiting, and stomach cramps. What is the most likely pathogen?
A) Salmonella
B) Rotavirus
C) Giardia
D) E. coli
ANSWER: B) Rotavirus
ANSWERs 2026/2027
Question 1
A 45-year-old male presents with acute onset of severe, tearing chest pain radiating to the back. Blood
pressure is 100/60 in the right arm and 140/90 in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
ANSWER: C) Aortic dissection
Rationale: Aortic dissection classically presents with acute, severe, tearing chest pain radiating to the
back with asymmetric blood pressures between arms. This is a vascular emergency requiring immediate
referral .
Question 2
A 28-year-old female presents with recurrent episodes of abdominal pain, bloating, and altered bowel
habits. She reports that symptoms improve with defecation. Physical exam is unremarkable. Labs
including CBC, ESR, and thyroid function are normal. What is the most likely diagnosis?
A) Inflammatory bowel disease
B) Irritable bowel syndrome
C) Celiac disease
,D) Colon cancer
ANSWER: B) Irritable bowel syndrome (IBS)
Rationale: IBS is a disorder of bowel function characterized by abdominal pain associated with changes
in bowel habits. Diagnosis is made on careful history and physical exam with normal labs. Unlike IBD, IBS
has no anatomic abnormality and no serious medical consequences .
Question 3
Which of the following findings would differentiate IBS from inflammatory bowel disease (IBD)?
A) Presence of abdominal pain
B) Changes in bowel habits
C) Normal inflammatory markers and endoscopic findings
D) Extra-intestinal symptoms
ANSWER: C) Normal inflammatory markers and endoscopic findings
Rationale: IBS is a functional disorder with normal inflammatory markers (CBC, ESR) and normal
endoscopic findings. IBD demonstrates evidence of inflammation on labs and endoscopy .
Question 4
A 72-year-old male presents with melena and fatigue. EGD reveals a gastric ulcer. Which of the following
is the most common cause of peptic ulcer disease?
A) NSAID use
B) H. pylori infection
C) Zollinger-Ellison syndrome
D) Stress
,ANSWER: B) H. pylori infection
Rationale: H. pylori infection is the most common cause of peptic ulcer disease, followed by NSAID use.
Treatment includes amoxicillin, clarithromycin, and a PPI for 2 weeks .
Question 5
A 32-year-old female presents with progressive fatigue, pallor, and heavy menstrual periods. Labs show
hemoglobin 8.2 g/dL, MCV 72 fL, serum ferritin 5 ng/mL, and elevated TIBC. What is the most likely type
of anemia?
A) Anemia of chronic disease
B) Iron deficiency anemia
C) Thalassemia
D) Sideroblastic anemia
ANSWER: B) Iron deficiency anemia
Rationale: Iron deficiency anemia presents with microcytic anemia (low MCV), low serum ferritin, and
elevated total iron-binding capacity (TIBC). Heavy menstrual bleeding is a common cause in
premenopausal women .
Question 6
Which laboratory finding distinguishes iron deficiency anemia from anemia of chronic disease?
A) Low hemoglobin
B) Low MCV
C) Low ferritin with elevated TIBC
D) Normal ferritin
ANSWER: C) Low ferritin with elevated TIBC
, Rationale: Iron deficiency anemia shows ↓ serum iron, ↑ TIBC, and ↓ ferritin. Anemia of chronic
disease shows ↓ serum iron, ↓ TIBC, and normal or ↑ ferritin .
Question 7
A 24-year-old with acute gastroenteritis asks about treatment. Which of the following is appropriate
initial management?
A) Ciprofloxacin immediately
B) Fluids, supportive care, and BRAT diet
C) Hospital admission for IV antibiotics
D) Antimotility agents only
ANSWER: B) Fluids, supportive care, and BRAT diet
Rationale: Treatment for gastroenteritis includes fluids, Imodium (for non-febrile, non-bloody diarrhea),
BRAT diet (banana, rice, applesauce, toast), and Zofran PRN. Antibiotics are not routinely indicated .
Question 8
A 3-year-old presents with low-grade fever, loss of appetite, copious watery diarrhea, flatulence,
vomiting, and stomach cramps. What is the most likely pathogen?
A) Salmonella
B) Rotavirus
C) Giardia
D) E. coli
ANSWER: B) Rotavirus
