(Midterm Exams) NR 511 Chamberlain – Complete
Package Bundle
1. A 45-year-old male presents with acute-onset right
lower quadrant pain, nausea, and low-grade fever.
What is the most likely diagnosis?
A) Diverticulitis
B) Gastroenteritis
C) Acute appendicitis
D) Renal colic
Correct Answer: C
Rationale: RLQ pain after periumbilical migration,
anorexia, and fever suggest appendicitis. Diverticulitis
usually presents with LLQ pain.
2. A 68-year-old with history of DM type 2 reports new,
sharp chest pain when walking, relieved by rest. Which
differential is most likely?
A) Pericarditis
B) Stable angina
1
,C) Unstable angina
D) GERD
Correct Answer: B
Rationale: Exertional chest pain relieved by rest is classic
stable angina. Unstable angina occurs at rest or with
minimal exertion.
3. A 22-year-old female reports dysuria, frequency, and
hematuria but no fever. Urinalysis shows +nitrites,
+leukocyte esterase. What is the most appropriate
treatment?
A) Fluconazole 150 mg PO x1
B) Trimethoprim-sulfamethoxazole for 3 days
C) Ciprofloxacin for 7 days
D) IV ceftriaxone
Correct Answer: B
*Rationale: Uncomplicated cystitis in a young woman.
TMP-SMX for 3 days is first-line if local resistance
<20%.*
2
,4. A patient presents with a bullseye rash on the thigh
after a tick bite 2 weeks ago in Connecticut. Which drug
is first-line?
A) Doxycycline
B) Amoxicillin
C) Azithromycin
D) Ceftriaxone
Correct Answer: A
*Rationale: Early localized Lyme disease – doxycycline
100 mg BID x 10-14 days (or amoxicillin if
pregnant/child).*
5. A 56-year-old smoker with COPD has increased
sputum purulence and dyspnea. No fever, WBC normal.
What is the most likely etiology?
A) Viral exacerbation
B) Bacterial bronchitis
C) Pneumonia
D) Pulmonary embolism
3
, Correct Answer: A
*Rationale: Most COPD exacerbations are viral;
antibiotics only if purulent sputum + increased dyspnea +
increased sputum volume (Anthonisen type 1).*
6. A 30-year-old female has episodic bilateral throbbing
headache with photophobia, nausea, and aura. What is
first-line acute therapy?
A) Naproxen
B) Sumatriptan
C) Acetaminophen
D) Propranolol
Correct Answer: B
Rationale: Migraine with aura – triptans for acute
moderate-severe migraine. Propranolol is preventive.
7. Which clinical feature best distinguishes heart failure
with preserved ejection fraction (HFpEF) from HFrEF?
A) BNP level
B) LVEF
4
Package Bundle
1. A 45-year-old male presents with acute-onset right
lower quadrant pain, nausea, and low-grade fever.
What is the most likely diagnosis?
A) Diverticulitis
B) Gastroenteritis
C) Acute appendicitis
D) Renal colic
Correct Answer: C
Rationale: RLQ pain after periumbilical migration,
anorexia, and fever suggest appendicitis. Diverticulitis
usually presents with LLQ pain.
2. A 68-year-old with history of DM type 2 reports new,
sharp chest pain when walking, relieved by rest. Which
differential is most likely?
A) Pericarditis
B) Stable angina
1
,C) Unstable angina
D) GERD
Correct Answer: B
Rationale: Exertional chest pain relieved by rest is classic
stable angina. Unstable angina occurs at rest or with
minimal exertion.
3. A 22-year-old female reports dysuria, frequency, and
hematuria but no fever. Urinalysis shows +nitrites,
+leukocyte esterase. What is the most appropriate
treatment?
A) Fluconazole 150 mg PO x1
B) Trimethoprim-sulfamethoxazole for 3 days
C) Ciprofloxacin for 7 days
D) IV ceftriaxone
Correct Answer: B
*Rationale: Uncomplicated cystitis in a young woman.
TMP-SMX for 3 days is first-line if local resistance
<20%.*
2
,4. A patient presents with a bullseye rash on the thigh
after a tick bite 2 weeks ago in Connecticut. Which drug
is first-line?
A) Doxycycline
B) Amoxicillin
C) Azithromycin
D) Ceftriaxone
Correct Answer: A
*Rationale: Early localized Lyme disease – doxycycline
100 mg BID x 10-14 days (or amoxicillin if
pregnant/child).*
5. A 56-year-old smoker with COPD has increased
sputum purulence and dyspnea. No fever, WBC normal.
What is the most likely etiology?
A) Viral exacerbation
B) Bacterial bronchitis
C) Pneumonia
D) Pulmonary embolism
3
, Correct Answer: A
*Rationale: Most COPD exacerbations are viral;
antibiotics only if purulent sputum + increased dyspnea +
increased sputum volume (Anthonisen type 1).*
6. A 30-year-old female has episodic bilateral throbbing
headache with photophobia, nausea, and aura. What is
first-line acute therapy?
A) Naproxen
B) Sumatriptan
C) Acetaminophen
D) Propranolol
Correct Answer: B
Rationale: Migraine with aura – triptans for acute
moderate-severe migraine. Propranolol is preventive.
7. Which clinical feature best distinguishes heart failure
with preserved ejection fraction (HFpEF) from HFrEF?
A) BNP level
B) LVEF
4
