NSG5003 TEST PAPER UPDATED QUESTIONS AND
ANSWERS GRADED A+
✔✔Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history
of an appendectomy, presenting with an acute onset of significant right upper-quadrant
abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a
proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon
questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain
seems to radiate to his back. Despite a family history of cardiac disease, he reports no
classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs
and denies fever, night sweats, and unintended weight loss. Finally, there are no
dermatologic signs, nor genitourinary symptoms.
When all lab work is returned within normal limits, what is the most practical imaging
study to order, considering cost, availability, and sensitivity? - ✔✔Abdominal ultrasound
✔✔A common auscultatory finding in advanced CHF is: - ✔✔S3 gallop rhythm
✔✔Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to
his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and
went away after sitting down. What is his most likely diagnosis based on his presenting
symptoms? - ✔✔Angina
✔✔The chosen imaging study reveals: "GB normal in size without wall-thickening, but
with 5-6 stones with shadowing. Common bile duct not dilated. Liver is homogenous
and normal in size. Pancreas and kidneys are normal." What is the most effective
therapeutic/management option at this point? - ✔✔HIDA scan
✔✔A nurse practitioner reports that your patient's abdominal X-ray demonstrates
multiple air-fluid levels in the bowel. This is a diagnostic finding found in: - ✔✔Bowel
obstruction
✔✔The most common etiologic organism for community-acquired pneumonia is: -
✔✔Streptococcus pneumoniae
✔✔A 76-year-old patient with a 200-pack year smoking history presents with complaints
of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2
months. The physical exam reveals decreased breath sounds and dullness to
percussion over the left lower lung field. The chest X-ray demonstrates shift of the
mediastinum and trachea to the left. These are classic signs of: - ✔✔Lung cancer
✔✔Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue,
palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is
not associated with activity or exertion. Food does not exacerbate or relieve the pain.
The pain is usually located under the left nipple. Jeff is concerned because his father
, has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and
hears a mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this is
a hallmark sign of: - ✔✔Mitral valve prolapse
✔✔Which of the following is considered a "red flag" when diagnosing a patient with
pneumonia? - ✔✔Pleural effusion on chest x-ray
✔✔Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history
of an appendectomy, presenting with an acute onset of significant right upper-quadrant
abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a
proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon
questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain
seems to radiate to his back. Despite a family history of cardiac disease, he reports no
classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs
and denies fever, night sweats, and unintended weight loss. Finally, there are no
dermatologic signs, nor genitourinary symptoms.
Of the following lab studies, which would provide little help in determining your
differential diagnosis? - ✔✔Abdominal plain films
✔✔In addition to the complete blood count (CBC) with differential, which of the following
laboratory tests is considered to be most useful in diagnosing ACD and IDA? -
✔✔Serum ferritin
✔✔What is the most common valvular heart disease in the older adult? - ✔✔Aortic
stenosis
✔✔Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia.
This classification refers to which of the following laboratory data? - ✔✔Mean
Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH)
✔✔A 22-year-old female comes to your office with complaints of right lower quadrant
abdominal pain, which has been worsening over the last 24 hours. On examination of
the abdomen, there is a palpable mass and rebound tenderness over the right lower
quadrant. The clinician should recognize the importance of: - ✔✔Pelvic examination
✔✔Which of the following details are NOT considered while staging asthma? - ✔✔Long-
acting beta agonist usage
✔✔Dan G., a 65-year-old man, presents to your primary care office for the evaluation of
chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including
walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10.
Began a few months ago, intermittent, aggravated by exercise, and relieved by rest.
Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects
ANSWERS GRADED A+
✔✔Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history
of an appendectomy, presenting with an acute onset of significant right upper-quadrant
abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a
proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon
questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain
seems to radiate to his back. Despite a family history of cardiac disease, he reports no
classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs
and denies fever, night sweats, and unintended weight loss. Finally, there are no
dermatologic signs, nor genitourinary symptoms.
When all lab work is returned within normal limits, what is the most practical imaging
study to order, considering cost, availability, and sensitivity? - ✔✔Abdominal ultrasound
✔✔A common auscultatory finding in advanced CHF is: - ✔✔S3 gallop rhythm
✔✔Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to
his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and
went away after sitting down. What is his most likely diagnosis based on his presenting
symptoms? - ✔✔Angina
✔✔The chosen imaging study reveals: "GB normal in size without wall-thickening, but
with 5-6 stones with shadowing. Common bile duct not dilated. Liver is homogenous
and normal in size. Pancreas and kidneys are normal." What is the most effective
therapeutic/management option at this point? - ✔✔HIDA scan
✔✔A nurse practitioner reports that your patient's abdominal X-ray demonstrates
multiple air-fluid levels in the bowel. This is a diagnostic finding found in: - ✔✔Bowel
obstruction
✔✔The most common etiologic organism for community-acquired pneumonia is: -
✔✔Streptococcus pneumoniae
✔✔A 76-year-old patient with a 200-pack year smoking history presents with complaints
of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2
months. The physical exam reveals decreased breath sounds and dullness to
percussion over the left lower lung field. The chest X-ray demonstrates shift of the
mediastinum and trachea to the left. These are classic signs of: - ✔✔Lung cancer
✔✔Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue,
palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is
not associated with activity or exertion. Food does not exacerbate or relieve the pain.
The pain is usually located under the left nipple. Jeff is concerned because his father
, has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and
hears a mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this is
a hallmark sign of: - ✔✔Mitral valve prolapse
✔✔Which of the following is considered a "red flag" when diagnosing a patient with
pneumonia? - ✔✔Pleural effusion on chest x-ray
✔✔Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history
of an appendectomy, presenting with an acute onset of significant right upper-quadrant
abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a
proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon
questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain
seems to radiate to his back. Despite a family history of cardiac disease, he reports no
classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs
and denies fever, night sweats, and unintended weight loss. Finally, there are no
dermatologic signs, nor genitourinary symptoms.
Of the following lab studies, which would provide little help in determining your
differential diagnosis? - ✔✔Abdominal plain films
✔✔In addition to the complete blood count (CBC) with differential, which of the following
laboratory tests is considered to be most useful in diagnosing ACD and IDA? -
✔✔Serum ferritin
✔✔What is the most common valvular heart disease in the older adult? - ✔✔Aortic
stenosis
✔✔Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia.
This classification refers to which of the following laboratory data? - ✔✔Mean
Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH)
✔✔A 22-year-old female comes to your office with complaints of right lower quadrant
abdominal pain, which has been worsening over the last 24 hours. On examination of
the abdomen, there is a palpable mass and rebound tenderness over the right lower
quadrant. The clinician should recognize the importance of: - ✔✔Pelvic examination
✔✔Which of the following details are NOT considered while staging asthma? - ✔✔Long-
acting beta agonist usage
✔✔Dan G., a 65-year-old man, presents to your primary care office for the evaluation of
chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including
walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10.
Began a few months ago, intermittent, aggravated by exercise, and relieved by rest.
Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects
