FINAL EXAM: NR511 (LATEST UPDATE ) DIFFERENTIAL
DIAGNOSIS & PRIMARY CARE PRACTICUM EXAM QUESTIONS AND
100%CORRECT DETAILED ANSWERS|| GRADED A+
A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the
following should be included in the history and physical exam? -ANSWER: Digital rectal
exam, Sexual history, Pelvic exam
A patient is seen in the office and is complaining of constipation. The patient lists all of the
following medications. Which drug could be responsible for the constipation? -ANSWER:
Pepto-Bismol
A patient with complaints of diarrhea is seen. Which of the following should be included on the
differential diagnosis list for a patient with diarrhea? -ANSWER: Gastroenteritis, Lactase
deficiency, Inflammatory bowel disease
Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had
intermittent heartburn for several months for which he takes Tums with temporary relief. He has
been waking during the night with a burning sensation in his chest. Which additional information
would lead you to believe that gastro esophageal reflux disease (GERD) is the cause of his pain?
-ANSWER: He awakens at night coughing with a bad taste in his mouth.
A 29-year-old Englishman is seen in the office with complaints of pain in his chest and belly for
2 weeks. He gets temporary relief from Alka Seltzer. The burning pain wakes him at night and
,radiates up into his chest. Which factor favors a diagnosis of gastric ulcer? -ANSWER: His use
of Alka Seltzer
Which of the following is most effective in diagnosing appendicitis? -ANSWER: History and
physical
Which of the following is associated with celiac disease (celiac sprue)? -ANSWER:
Malabsorption
A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her
physical exam is remarkable for left lower quadrant (LLQ) tenderness. Which of the following
should be considered in the differential diagnosis at this time? -ANSWER: Endometriosis,
Diverticulitis, Colon cancer
A 46-year-old patient is seen in the clinic with abdominal pain. Which of the following tests is
essential for this patient? -ANSWER: Urine hCG
A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after
meals. She is often constipated and takes laxatives. Following this, she has diarrhea for a couple
of days. She temporarily feels better after a bowel movement. She states she is embarrassed by
flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This
problem has gone on for about 6 months. What should the next step be? -ANSWER: Obtain a
complete history.
A 28-year-old patient is seen in the clinic with colicky abdominal pain, particularly with meals.
She has frequent constipation, flatulence, and abdominal distension. Which of the data make a
diagnosis of diverticulitis unlikely? -ANSWER: Her age
, A 28-year-old patient is seen with complaints of diarrhea. Which of the following questions
would help the clinician establish the diagnosis of irritable bowel syndrome? -ANSWER: Feels
relief after a bowel movement, Sometimes is constipated, Does not defecate in the middle of the
night
A patient is diagnosed with gastroesophageal reflux disease (GERD), and his endoscopic report
reveals the presence of Barrett's epithelium. Which of the following information should the
clinician include in the explanation of the pathology report? -ANSWER: This is a premalignant
tissue. This tissue is resistant to gastric acid. This tissue supports healing of the esophagus.
Which of the following dietary information should be given to a patient with gastroesophageal
reflux disease (GERD)? -ANSWER: Eliminate coffee.
The patient with gastroesophageal reflux disease (GERD) should be instructed to eliminate
which of these activities? -ANSWER: Weight lifting
A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the
following would be the appropriate treatment? -ANSWER: Metronidazole
A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in
appendicitis? -ANSWER: Very early
Tests for appendicitis -ANSWER: Rovsing deep palpation of left lower quad with quick
release. Psoas lift right leg against gentle pressure. Obturator rotate right leg internally.
McBurney pressure halfway between umbilicus and anterior spine.
DIAGNOSIS & PRIMARY CARE PRACTICUM EXAM QUESTIONS AND
100%CORRECT DETAILED ANSWERS|| GRADED A+
A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the
following should be included in the history and physical exam? -ANSWER: Digital rectal
exam, Sexual history, Pelvic exam
A patient is seen in the office and is complaining of constipation. The patient lists all of the
following medications. Which drug could be responsible for the constipation? -ANSWER:
Pepto-Bismol
A patient with complaints of diarrhea is seen. Which of the following should be included on the
differential diagnosis list for a patient with diarrhea? -ANSWER: Gastroenteritis, Lactase
deficiency, Inflammatory bowel disease
Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had
intermittent heartburn for several months for which he takes Tums with temporary relief. He has
been waking during the night with a burning sensation in his chest. Which additional information
would lead you to believe that gastro esophageal reflux disease (GERD) is the cause of his pain?
-ANSWER: He awakens at night coughing with a bad taste in his mouth.
A 29-year-old Englishman is seen in the office with complaints of pain in his chest and belly for
2 weeks. He gets temporary relief from Alka Seltzer. The burning pain wakes him at night and
,radiates up into his chest. Which factor favors a diagnosis of gastric ulcer? -ANSWER: His use
of Alka Seltzer
Which of the following is most effective in diagnosing appendicitis? -ANSWER: History and
physical
Which of the following is associated with celiac disease (celiac sprue)? -ANSWER:
Malabsorption
A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her
physical exam is remarkable for left lower quadrant (LLQ) tenderness. Which of the following
should be considered in the differential diagnosis at this time? -ANSWER: Endometriosis,
Diverticulitis, Colon cancer
A 46-year-old patient is seen in the clinic with abdominal pain. Which of the following tests is
essential for this patient? -ANSWER: Urine hCG
A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after
meals. She is often constipated and takes laxatives. Following this, she has diarrhea for a couple
of days. She temporarily feels better after a bowel movement. She states she is embarrassed by
flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This
problem has gone on for about 6 months. What should the next step be? -ANSWER: Obtain a
complete history.
A 28-year-old patient is seen in the clinic with colicky abdominal pain, particularly with meals.
She has frequent constipation, flatulence, and abdominal distension. Which of the data make a
diagnosis of diverticulitis unlikely? -ANSWER: Her age
, A 28-year-old patient is seen with complaints of diarrhea. Which of the following questions
would help the clinician establish the diagnosis of irritable bowel syndrome? -ANSWER: Feels
relief after a bowel movement, Sometimes is constipated, Does not defecate in the middle of the
night
A patient is diagnosed with gastroesophageal reflux disease (GERD), and his endoscopic report
reveals the presence of Barrett's epithelium. Which of the following information should the
clinician include in the explanation of the pathology report? -ANSWER: This is a premalignant
tissue. This tissue is resistant to gastric acid. This tissue supports healing of the esophagus.
Which of the following dietary information should be given to a patient with gastroesophageal
reflux disease (GERD)? -ANSWER: Eliminate coffee.
The patient with gastroesophageal reflux disease (GERD) should be instructed to eliminate
which of these activities? -ANSWER: Weight lifting
A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the
following would be the appropriate treatment? -ANSWER: Metronidazole
A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in
appendicitis? -ANSWER: Very early
Tests for appendicitis -ANSWER: Rovsing deep palpation of left lower quad with quick
release. Psoas lift right leg against gentle pressure. Obturator rotate right leg internally.
McBurney pressure halfway between umbilicus and anterior spine.
