NR511 / NR 511 FINAL EXAM QUESTIONS & ANSWERS|LATEST
: DIFFERENTIAL DIAGNOSIS & PRIMARY CARE
PRACTICUM (VERIFIED ANSWERS)
1.Muscle strains - answer •Strain-can be due to not warming up prior to exercise; Teachable
moment when the patient presents with a strain is just to suggest stretching and warm-up
exercises prior to the full exercise routine
2.Bacterial Prostatitis - answer
•Note: The etiology of urethral discharge or difficulty voiding can include acute and chronic
prostatitis and prostatic abscess. Young adult males in their 20s usually have acute prostatitis
from gonorrhea or other bacterial infections.
•The rectal examination should be performed gently because vigorous manipulation of the
prostate can result in septicemia. Therefore, prostatic massage is contraindicated.
•Acute bacterial prostatitis is always associated with a UTI and has a characteristically abrupt
onset. Fever, chills, low back pain, tenesmus, and urinary complaints typical of UTI are common.
3.inflammatory bowel disease - answer disease-the mucosal surface of the colon is inflamed
4.inflammatory bowel disease - answer •Results in friability, erosions, and bleeding
5.inflammatory bowel disease - answer •Occurs in the rectum and sigmoid colon
•Characterized by bloody and purulent diarrhea
6.inflammatory bowel disease - answer •total colectomy is a treatment option that can
completely resolve this problem.
7.Diverticulitis - answer bleeding not associated with pain or discomfort.
,8.Diverticulitis - answer localized pain and tenderness in the LLQ of the abdomen with
associated anorexia, nausea and vomiting
9.Diverticulitis - answer •High-fiber diet is best management
10.C. difficile - answer •Infection of the large intestine
11.C. diff - answer •Exists in air, water, soil, processed food and human feces
•Causes profuse, watery, mucoid diarrhea
12.1Mild C. Diff - answer -Watery diarrhea three or more times/day for two or more days
13.Severe C. diff - answer -Watery diarrhea (10-15 stools/day)
-Strong foul odor
-Acute abdomen secondary to toxic megacolon with perforation
-Abdominal distention
-Fever
-Nausea/vomiting/dehydration requiring hospitalization
-Blood or pus in the stools (severe cases)
14.Enzyme-linked immunodeficiency assay (ELISA): - answer identifies toxins that produce C.
diff bacteria
15.Cell cytotoxicity assay - answer identifies the effects of bacterial toxins on human cells
16.Polymerase chain reaction (PCR): - answer detects bacterial genes
, 17.Endoscopy - answer if the patient is unresponsive to treatment; will show
pseudomembranes that suggest c-diff infection
18.C. diff treatment - answer •Metronidazole
•Probiotics- to restore the healthy growth of normal GI bacteria
•Colectomy in severe cases
•Maintain fluids
•Clear liquid diet
•Eat starchy foods to prevent diarrhea
•Avoid caffeine, spicy foods, milk and greasy foods
•May require a GI consult
19.Gerd - answer Symptoms occur at night with regurgitation; heartburn is classic for GERD
(mild to severe).
20.GERD (gastroesophageal reflux disease) - answer •, including regurgitation, water brash
(reflex salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing,
hoarseness, or wheezing, usually at night.
21.endoscopy - answer • If patient has been treated with diet modifications and 6 weeks of
omeprazole without improvement of symptoms, the next step is an
22.GERD teaching - answer •Patients should be instructed to avoid coffee, alcohol, chocolate,
peppermint, and spicy foods; eat smaller meals; stop smoking; remain upright for 2 hours after
meals; elevate the head of the bed on 6- to 8-in blocks; and refrain from eating for 3 hours
before retiring.
23.Rotovirus - answer common in children younger than age 3.
: DIFFERENTIAL DIAGNOSIS & PRIMARY CARE
PRACTICUM (VERIFIED ANSWERS)
1.Muscle strains - answer •Strain-can be due to not warming up prior to exercise; Teachable
moment when the patient presents with a strain is just to suggest stretching and warm-up
exercises prior to the full exercise routine
2.Bacterial Prostatitis - answer
•Note: The etiology of urethral discharge or difficulty voiding can include acute and chronic
prostatitis and prostatic abscess. Young adult males in their 20s usually have acute prostatitis
from gonorrhea or other bacterial infections.
•The rectal examination should be performed gently because vigorous manipulation of the
prostate can result in septicemia. Therefore, prostatic massage is contraindicated.
•Acute bacterial prostatitis is always associated with a UTI and has a characteristically abrupt
onset. Fever, chills, low back pain, tenesmus, and urinary complaints typical of UTI are common.
3.inflammatory bowel disease - answer disease-the mucosal surface of the colon is inflamed
4.inflammatory bowel disease - answer •Results in friability, erosions, and bleeding
5.inflammatory bowel disease - answer •Occurs in the rectum and sigmoid colon
•Characterized by bloody and purulent diarrhea
6.inflammatory bowel disease - answer •total colectomy is a treatment option that can
completely resolve this problem.
7.Diverticulitis - answer bleeding not associated with pain or discomfort.
,8.Diverticulitis - answer localized pain and tenderness in the LLQ of the abdomen with
associated anorexia, nausea and vomiting
9.Diverticulitis - answer •High-fiber diet is best management
10.C. difficile - answer •Infection of the large intestine
11.C. diff - answer •Exists in air, water, soil, processed food and human feces
•Causes profuse, watery, mucoid diarrhea
12.1Mild C. Diff - answer -Watery diarrhea three or more times/day for two or more days
13.Severe C. diff - answer -Watery diarrhea (10-15 stools/day)
-Strong foul odor
-Acute abdomen secondary to toxic megacolon with perforation
-Abdominal distention
-Fever
-Nausea/vomiting/dehydration requiring hospitalization
-Blood or pus in the stools (severe cases)
14.Enzyme-linked immunodeficiency assay (ELISA): - answer identifies toxins that produce C.
diff bacteria
15.Cell cytotoxicity assay - answer identifies the effects of bacterial toxins on human cells
16.Polymerase chain reaction (PCR): - answer detects bacterial genes
, 17.Endoscopy - answer if the patient is unresponsive to treatment; will show
pseudomembranes that suggest c-diff infection
18.C. diff treatment - answer •Metronidazole
•Probiotics- to restore the healthy growth of normal GI bacteria
•Colectomy in severe cases
•Maintain fluids
•Clear liquid diet
•Eat starchy foods to prevent diarrhea
•Avoid caffeine, spicy foods, milk and greasy foods
•May require a GI consult
19.Gerd - answer Symptoms occur at night with regurgitation; heartburn is classic for GERD
(mild to severe).
20.GERD (gastroesophageal reflux disease) - answer •, including regurgitation, water brash
(reflex salivation), sour taste in the mouth in the morning, odynophagia, belching, coughing,
hoarseness, or wheezing, usually at night.
21.endoscopy - answer • If patient has been treated with diet modifications and 6 weeks of
omeprazole without improvement of symptoms, the next step is an
22.GERD teaching - answer •Patients should be instructed to avoid coffee, alcohol, chocolate,
peppermint, and spicy foods; eat smaller meals; stop smoking; remain upright for 2 hours after
meals; elevate the head of the bed on 6- to 8-in blocks; and refrain from eating for 3 hours
before retiring.
23.Rotovirus - answer common in children younger than age 3.
