NR 511 EXAM 3 COMPREHENSIVE
ASSESSMENT QUESTIONS & VERIFIED
ANSWERS 2026/2027 UPDATE
1. A 45-year-old patient presents with a ‘curtain-like’ shadow over their vision, floaters, and
flashes of light. Which of the following is the most likely diagnosis?
A. Retinal Detachment
B. Acute Angle-Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment classically presents with sudden floaters,
photopsia (flashes), and a visual field loss often described as a ‘curtain’ being pulled over
the eye.
2. Which of the following findings is most diagnostic for Otitis Media with Effusion (OME)
rather than Acute Otitis Media (AOM)?
A. Erythematous tympanic membrane with bulging
B. Severe otalgia and fever
C. Purulent drainage in the external canal
,D. Fluid behind the membrane without signs of acute infection
Answer: D
Conceptual Explanation: OME is defined by fluid in the middle ear without signs or
symptoms of acute infection, whereas AOM requires signs of inflammation like bulging and
fever.
3. Using the Centor Criteria, which of the following patients is most likely to require empiric
antibiotic treatment or rapid antigen testing for GABHS?
A. 20-year-old with cough, rhinorrhea, and sore throat
B. 8-year-old with fever, tonsillar exudates, and tender anterior cervical lymphadenopathy
C. 50-year-old with hoarseness and posterior cervical lymphadenopathy
D. 30-year-old with productive cough and no fever
Answer: B
Conceptual Explanation: The Centor criteria include fever, tonsillar exudates, tender
anterior cervical nodes, and absence of cough. Age 3-14 adds a point. A score of 3 or more
warrants testing or treatment.
4. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions on the trunk. What is the diagnosis?
A. Tinea Corporis
B. Pityriasis Rosea
, C. Psoriasis
D. Secondary Syphilis
Answer: B
Conceptual Explanation: Pityriasis Rosea typically begins with a herald patch and
progresses to a Christmas tree pattern along skin cleavage lines.
5. What is the first-line treatment for an adult patient with Community-Acquired Pneumonia
(CAP) who has no comorbidities and no recent antibiotic use?
A. Levofloxacin 750mg daily
B. Ciprofloxacin 500mg BID
C. Ceftriaxone IM plus Azithromycin
D. Amoxicillin 1g TID or Doxycycline 100mg BID
Answer: D
Conceptual Explanation: Updated ATS/IDSA guidelines recommend high-dose
Amoxicillin or Doxycycline for healthy outpatients without comorbidities.
6. Which physical exam finding is most consistent with a diagnosis of Chronic Obstructive
Pulmonary Disease (COPD)?
A. Hyperresonance upon percussion
B. Increased tactile fremitus
C. Dullness to percussion at the bases
ASSESSMENT QUESTIONS & VERIFIED
ANSWERS 2026/2027 UPDATE
1. A 45-year-old patient presents with a ‘curtain-like’ shadow over their vision, floaters, and
flashes of light. Which of the following is the most likely diagnosis?
A. Retinal Detachment
B. Acute Angle-Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment classically presents with sudden floaters,
photopsia (flashes), and a visual field loss often described as a ‘curtain’ being pulled over
the eye.
2. Which of the following findings is most diagnostic for Otitis Media with Effusion (OME)
rather than Acute Otitis Media (AOM)?
A. Erythematous tympanic membrane with bulging
B. Severe otalgia and fever
C. Purulent drainage in the external canal
,D. Fluid behind the membrane without signs of acute infection
Answer: D
Conceptual Explanation: OME is defined by fluid in the middle ear without signs or
symptoms of acute infection, whereas AOM requires signs of inflammation like bulging and
fever.
3. Using the Centor Criteria, which of the following patients is most likely to require empiric
antibiotic treatment or rapid antigen testing for GABHS?
A. 20-year-old with cough, rhinorrhea, and sore throat
B. 8-year-old with fever, tonsillar exudates, and tender anterior cervical lymphadenopathy
C. 50-year-old with hoarseness and posterior cervical lymphadenopathy
D. 30-year-old with productive cough and no fever
Answer: B
Conceptual Explanation: The Centor criteria include fever, tonsillar exudates, tender
anterior cervical nodes, and absence of cough. Age 3-14 adds a point. A score of 3 or more
warrants testing or treatment.
4. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions on the trunk. What is the diagnosis?
A. Tinea Corporis
B. Pityriasis Rosea
, C. Psoriasis
D. Secondary Syphilis
Answer: B
Conceptual Explanation: Pityriasis Rosea typically begins with a herald patch and
progresses to a Christmas tree pattern along skin cleavage lines.
5. What is the first-line treatment for an adult patient with Community-Acquired Pneumonia
(CAP) who has no comorbidities and no recent antibiotic use?
A. Levofloxacin 750mg daily
B. Ciprofloxacin 500mg BID
C. Ceftriaxone IM plus Azithromycin
D. Amoxicillin 1g TID or Doxycycline 100mg BID
Answer: D
Conceptual Explanation: Updated ATS/IDSA guidelines recommend high-dose
Amoxicillin or Doxycycline for healthy outpatients without comorbidities.
6. Which physical exam finding is most consistent with a diagnosis of Chronic Obstructive
Pulmonary Disease (COPD)?
A. Hyperresonance upon percussion
B. Increased tactile fremitus
C. Dullness to percussion at the bases
