NR576/NR 576 FINAL EXAM LATEST 2025 WITH
CORRECT QUESTIONS AND DETAILED
ANSWERS/ALREADY GRADED A+
31. Describe how to perform a
Tinnel test - ---------correct answer------Purpose: Assess for compression neuropathy
Procedure: Percuss the median nerve at the wrist. If the patient complains of tingling in the
digits (POSITIVE TINEL SIGN), compression at the site of percussion is likely.
8. Discuss common characteristics (objective findings) of patients with lumbar spinal
stenosis - ---------correct answer------- Muscle weakness
- Impaired proprioception
- Diminished reflexes
- Sensory changes (numbness/tingling)
- Bowel or bladder symptoms
o Sphincter tone decreased
o Don't confuse w/ prostate problems in older me
Acute appendicitis - ---------correct answer------Inflammation of the vermiform appendix; due
to obstruction or infection
Most common surgical emergency of the abdomen
Hollow tube - most common cause is obstruction of appendix
Fecaltih - hard lump of fecal matter
Undigested seeds
Pinworm infections
Lymphoid follicle growth/lymphoid hyperplasia Symptoms
4. Symptoms
Nausea/vomiting
RLQ pain
Guarding
Acute appendicitis diagnostics - ---------correct answer------Diagnosis is made clinically and
based on history and physical
,Elevated WBC
Mild Fever, 99-100
RLQ pain/McBurneys point
CT abd may help rule out other diagnostic possibilities
ABD ultrasound helps to visualize the inflamed appendix
Acute appendicitis treatment - ---------correct answer------• Appendectomy
• Antibiotic
• Drain abscesses
• Can be removed prophylactically
Acute cholecystitis - ---------correct answer------Inflammation of gallbladder (GB)
Usually due to gallstone in cystic duct
1. Cystic duct - leaves gall bladder & connects to common bile duct
Symptoms
Patient will have mid-epigastric pain
Because GB is still squeezing, increasing pressure w/ nowhere for bile to go
Can lead to nausea/vomting
Stone can get more stuck w/ more squeezing
Bile starts to irritate mucosa
Mucosa starts to produce mucous and inflamm enzymes
Leads to inflammation, distention, pressure build up
Bacterial growth (E. coli, enterococci, bacteroides fragilis, colstriduim)
As GB "balloons", pain shifts to RUQ, R scapula/shoulder
Bacteria invades in & through GB wall, into peritoneum, causing peritonitis
Rebound tenderness
Murphy's Sign = Put pressure on right side under ribs. This will hold GB in place. Have
patient take a deep breath. The diaphragm will push on the GB & a painful response =
Cholecystitis
Immune response
Neutrophilic leukocytosis
, Feve
Acute cholecystitis diagnostics - ---------correct answer------US confirmed
Detects stones
Sonographic murphy sign
Tenderness when sonogram is over gallbladder
GB wall thickening
Sludge
Distention of GB or common bile duct
Cholescintigraphy (HIDA scan)
Radiolabeled marker used to visualize the biliary system
Acute cholecys - ducts are blocked, GB can't be seen
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscope down to pancreas
Dye injected & viewed via fluoro
Magnetic Resonance Cholangiopancreatography (MRCP)
1. Visualizes bili system with MRI
Acute cholecystitis treatment - ---------correct answer------o Supportive measures
IV
Pain management
ATB
o Surgical Removal
1. Cholecystectomy
1. Laparoscopic
Acute pancreatitis - ---------correct answer------Sudden inflammation and hemorrhaging of
the pancreas due to destruction by its own digestive enzymes
1. Autodigestion
Most of the time mild, but can be severe
Pancreas
Long skinny gland, length of dollar bill
Located in upper abdomen
CORRECT QUESTIONS AND DETAILED
ANSWERS/ALREADY GRADED A+
31. Describe how to perform a
Tinnel test - ---------correct answer------Purpose: Assess for compression neuropathy
Procedure: Percuss the median nerve at the wrist. If the patient complains of tingling in the
digits (POSITIVE TINEL SIGN), compression at the site of percussion is likely.
8. Discuss common characteristics (objective findings) of patients with lumbar spinal
stenosis - ---------correct answer------- Muscle weakness
- Impaired proprioception
- Diminished reflexes
- Sensory changes (numbness/tingling)
- Bowel or bladder symptoms
o Sphincter tone decreased
o Don't confuse w/ prostate problems in older me
Acute appendicitis - ---------correct answer------Inflammation of the vermiform appendix; due
to obstruction or infection
Most common surgical emergency of the abdomen
Hollow tube - most common cause is obstruction of appendix
Fecaltih - hard lump of fecal matter
Undigested seeds
Pinworm infections
Lymphoid follicle growth/lymphoid hyperplasia Symptoms
4. Symptoms
Nausea/vomiting
RLQ pain
Guarding
Acute appendicitis diagnostics - ---------correct answer------Diagnosis is made clinically and
based on history and physical
,Elevated WBC
Mild Fever, 99-100
RLQ pain/McBurneys point
CT abd may help rule out other diagnostic possibilities
ABD ultrasound helps to visualize the inflamed appendix
Acute appendicitis treatment - ---------correct answer------• Appendectomy
• Antibiotic
• Drain abscesses
• Can be removed prophylactically
Acute cholecystitis - ---------correct answer------Inflammation of gallbladder (GB)
Usually due to gallstone in cystic duct
1. Cystic duct - leaves gall bladder & connects to common bile duct
Symptoms
Patient will have mid-epigastric pain
Because GB is still squeezing, increasing pressure w/ nowhere for bile to go
Can lead to nausea/vomting
Stone can get more stuck w/ more squeezing
Bile starts to irritate mucosa
Mucosa starts to produce mucous and inflamm enzymes
Leads to inflammation, distention, pressure build up
Bacterial growth (E. coli, enterococci, bacteroides fragilis, colstriduim)
As GB "balloons", pain shifts to RUQ, R scapula/shoulder
Bacteria invades in & through GB wall, into peritoneum, causing peritonitis
Rebound tenderness
Murphy's Sign = Put pressure on right side under ribs. This will hold GB in place. Have
patient take a deep breath. The diaphragm will push on the GB & a painful response =
Cholecystitis
Immune response
Neutrophilic leukocytosis
, Feve
Acute cholecystitis diagnostics - ---------correct answer------US confirmed
Detects stones
Sonographic murphy sign
Tenderness when sonogram is over gallbladder
GB wall thickening
Sludge
Distention of GB or common bile duct
Cholescintigraphy (HIDA scan)
Radiolabeled marker used to visualize the biliary system
Acute cholecys - ducts are blocked, GB can't be seen
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscope down to pancreas
Dye injected & viewed via fluoro
Magnetic Resonance Cholangiopancreatography (MRCP)
1. Visualizes bili system with MRI
Acute cholecystitis treatment - ---------correct answer------o Supportive measures
IV
Pain management
ATB
o Surgical Removal
1. Cholecystectomy
1. Laparoscopic
Acute pancreatitis - ---------correct answer------Sudden inflammation and hemorrhaging of
the pancreas due to destruction by its own digestive enzymes
1. Autodigestion
Most of the time mild, but can be severe
Pancreas
Long skinny gland, length of dollar bill
Located in upper abdomen
