NRP 571 FINAL EXAM
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT
1. A 65-year-old patient presents with a harsh, mid-systolic crescendo-decrescendo murmur
heard best at the right second intercostal space that radiates to the carotid arteries. What is
the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a systolic ejection murmur
at the right upper sternal border radiating to the neck. Mitral regurgitation is holosystolic
and radiates to the axilla.
2. When performing a physical exam on a patient with suspected bacterial pneumonia, which
finding is most consistent with consolidation?
A. Hyperresonance on percussion
,B. Decreased tactile fremitus
C. Increased tactile fremitus
D. Vesicular breath sounds throughout
Answer: C
Conceptual Explanation: Consolidation (fluid/pus in the lung) increases the transmission
of vibrations, leading to increased tactile fremitus and dullness to percussion.
Hyperresonance is seen in pneumothorax or COPD.
3. A patient presents with sudden onset of ‘curtain dropping’ over their vision and floaters.
This clinical presentation is most indicative of:
A. Retinal Detachment
B. Acute Angle-Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment is characterized by floaters, flashes of light,
and a progressive shadow or curtain in the field of vision. Glaucoma involves pain and
halos.
, 4. Which physical exam maneuver is most sensitive for detecting an Anterior Cruciate
Ligament (ACL) tear?
A. McMurray Test
B. Valgus Stress Test
C. Posterior Drawer Test
D. Lachman Test
Answer: D
Conceptual Explanation: The Lachman test is considered more sensitive and specific for
ACL injury than the anterior drawer test. McMurray is for meniscus, and Valgus is for MCL.
5. A 45-year-old male presents with severe pain in his great toe. Physical exam shows
erythema and edema at the first metatarsophalangeal joint. What is the definitive diagnostic
gold standard?
A. Serum Uric Acid level
B. X-ray of the foot
C. Joint aspiration for urate crystals
D. Response to Colchicine
Answer: C
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT
1. A 65-year-old patient presents with a harsh, mid-systolic crescendo-decrescendo murmur
heard best at the right second intercostal space that radiates to the carotid arteries. What is
the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a systolic ejection murmur
at the right upper sternal border radiating to the neck. Mitral regurgitation is holosystolic
and radiates to the axilla.
2. When performing a physical exam on a patient with suspected bacterial pneumonia, which
finding is most consistent with consolidation?
A. Hyperresonance on percussion
,B. Decreased tactile fremitus
C. Increased tactile fremitus
D. Vesicular breath sounds throughout
Answer: C
Conceptual Explanation: Consolidation (fluid/pus in the lung) increases the transmission
of vibrations, leading to increased tactile fremitus and dullness to percussion.
Hyperresonance is seen in pneumothorax or COPD.
3. A patient presents with sudden onset of ‘curtain dropping’ over their vision and floaters.
This clinical presentation is most indicative of:
A. Retinal Detachment
B. Acute Angle-Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment is characterized by floaters, flashes of light,
and a progressive shadow or curtain in the field of vision. Glaucoma involves pain and
halos.
, 4. Which physical exam maneuver is most sensitive for detecting an Anterior Cruciate
Ligament (ACL) tear?
A. McMurray Test
B. Valgus Stress Test
C. Posterior Drawer Test
D. Lachman Test
Answer: D
Conceptual Explanation: The Lachman test is considered more sensitive and specific for
ACL injury than the anterior drawer test. McMurray is for meniscus, and Valgus is for MCL.
5. A 45-year-old male presents with severe pain in his great toe. Physical exam shows
erythema and edema at the first metatarsophalangeal joint. What is the definitive diagnostic
gold standard?
A. Serum Uric Acid level
B. X-ray of the foot
C. Joint aspiration for urate crystals
D. Response to Colchicine
Answer: C
