NSG 6001 WEEK 5 MIDTERM AND FINAL ACTUAL EXAM REVIEW AND
BEST STUDY GUIDE 150 QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES 2026 LATEST
1. Gail, a 35-year-old female patient, is seen in the clinic in the morning. She complains of abrupt
onset of nausea, vomiting, colicky abdominal cramps, and profuse watery diarrhea that began last
night. Her vitals are BP: 110/70, HR: 110, temperature: 99°F, RR: 12. She recently came back from a
vacation in Switzerland, ate leftovers for dinner last night, and had a cold 2 weeks ago. Which of the
following is the most probable cause of her condition?
A. Salmonella
B. Staphylococcus
C. Norovirus
D. Escherichia coli
Answer: B
Rationale: Staphylococcus aureus causes rapid-onset food poisoning (within hours) with nausea,
vomiting, cramps, and watery diarrhea, often from improperly stored leftovers.
2. Cameron, 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had
intermittent heartburn for several months and takes antacids 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 gastroesophageal reflux disease (GERD) is the cause of his pain?
A. Pain improves after exercise
B. He wakes at night coughing with a bad taste in his mouth
C. Pain radiates to his shoulder
D. Pain is relieved by lying down
Answer: B
Rationale: Nocturnal symptoms such as coughing and regurgitation of sour material are indicative of
GERD.
3. Hannah is a patient that just had an appendectomy after a diagnosis of appendicitis and had no
complications. Which of the following patient education points is correct?
A. Start a regular diet immediately
B. Avoid all solid foods for one week
C. Your diet will be advanced when bowel sounds return
D. Only clear liquids for the first month
Answer: C
,Rationale: Postoperative diet should progress from clear liquids to solids once bowel function returns.
4. Which of the following patients should be referred to a hepatologist?
A. Patient with transient elevated ALT
B. Patient with persistent elevation of HBsAg
C. Patient with mild fatty liver on ultrasound
D. Patient with acute viral hepatitis that resolves in 2 weeks
Answer: B
Rationale: Persistent HBsAg indicates chronic hepatitis B infection, requiring specialist management.
5. A 29-year-old is seen in the office with complaints of pain in his chest and belly. He quit smoking 6
months ago. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer®
and Pepto-Bismol®. The burning pain wakes him at night and radiates up to his chest. Which factor
favors a diagnosis of gastric ulcer?
A. Pain radiates to the chest
B. Waking at night with pain
C. Use of Alka-Seltzer
D. Recent smoking cessation
Answer: C
Rationale: Pain temporarily relieved by antacids suggests a gastric ulcer; duodenal ulcer pain often
improves with food.
6. Which of the following causes of gastrointestinal bleeding is found in the lower
gastrointestinal tract?
A. Peptic ulcer
B. Gastritis
C. Esophageal varices
D. Meckel's diverticulum
Answer: D
Rationale: Meckel’s diverticulum is a congenital anomaly in the distal ileum and can cause
painless lower GI bleeding, typically in children or young adults.
,7. A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a
runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-
the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her
boyfriend had mononucleosis about 1 month ago, and she wonders if she might have it also.
Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the
following labs would be most helpful in the differential diagnosis at this point?
A. CBC with differential
B. Liver function tests
C. Antihepatitis D virus
D. Blood culture
Answer: C
Rationale: Antihepatitis D virus antibodies help differentiate viral hepatitis from other viral
illnesses like mononucleosis.
8. A patient presents with symptoms of infectious mononucleosis. Which lab chemistry test
should the clinician order?
A. CBC
B. Liver enzymes
C. Heterophile antibody test
D. EBV PCR
Answer: C
Rationale: The heterophile antibody (Monospot) test is the standard initial diagnostic test for
infectious mononucleosis.
9. A patient is seen in the clinic with right upper quadrant pain that is radiating to the
middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the
following laboratory findings?
A. Elevated AST/ALT only
B. Elevated alkaline phosphatase
C. Elevated amylase only
D. Normal labs
Answer: B
, Rationale: Obstruction from gallstones often causes cholestatic pattern: elevated alkaline
phosphatase and sometimes bilirubin.
10. Which of the following are included in Ranson's criteria for assessing the severity of
pancreatitis at the time of diagnosis?
A. Serum glucose > 200 mg/dL
B. Age over 60
C. Base deficit greater than 4 mEq/L
D. AST > 100 U/L
Answer: C
Rationale: Ranson’s criteria at admission include age, WBC, glucose, LDH, AST, and base
deficit as indicators of severity.
11. Donna is a 36-year-old African American woman with chronic pancreatitis. Which of
the following are necessary to manage her condition?
A. High-protein diet
B. A low-fat diet of less than 50 g of fat per day
C. Ketogenic diet
D. Fasting therapy
Answer: B
Rationale: Chronic pancreatitis patients benefit from a low-fat diet to reduce pancreatic
stimulation and prevent steatorrhea.
12. Which of the following diagnostic tests is ordered for a cecal volvulus bowel
obstruction?
A. Colonoscopy
B. Barium enema
C. CT scan only
D. MRI
Answer: B
Rationale: A barium enema can diagnose and sometimes reduce cecal volvulus.
BEST STUDY GUIDE 150 QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES 2026 LATEST
1. Gail, a 35-year-old female patient, is seen in the clinic in the morning. She complains of abrupt
onset of nausea, vomiting, colicky abdominal cramps, and profuse watery diarrhea that began last
night. Her vitals are BP: 110/70, HR: 110, temperature: 99°F, RR: 12. She recently came back from a
vacation in Switzerland, ate leftovers for dinner last night, and had a cold 2 weeks ago. Which of the
following is the most probable cause of her condition?
A. Salmonella
B. Staphylococcus
C. Norovirus
D. Escherichia coli
Answer: B
Rationale: Staphylococcus aureus causes rapid-onset food poisoning (within hours) with nausea,
vomiting, cramps, and watery diarrhea, often from improperly stored leftovers.
2. Cameron, 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had
intermittent heartburn for several months and takes antacids 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 gastroesophageal reflux disease (GERD) is the cause of his pain?
A. Pain improves after exercise
B. He wakes at night coughing with a bad taste in his mouth
C. Pain radiates to his shoulder
D. Pain is relieved by lying down
Answer: B
Rationale: Nocturnal symptoms such as coughing and regurgitation of sour material are indicative of
GERD.
3. Hannah is a patient that just had an appendectomy after a diagnosis of appendicitis and had no
complications. Which of the following patient education points is correct?
A. Start a regular diet immediately
B. Avoid all solid foods for one week
C. Your diet will be advanced when bowel sounds return
D. Only clear liquids for the first month
Answer: C
,Rationale: Postoperative diet should progress from clear liquids to solids once bowel function returns.
4. Which of the following patients should be referred to a hepatologist?
A. Patient with transient elevated ALT
B. Patient with persistent elevation of HBsAg
C. Patient with mild fatty liver on ultrasound
D. Patient with acute viral hepatitis that resolves in 2 weeks
Answer: B
Rationale: Persistent HBsAg indicates chronic hepatitis B infection, requiring specialist management.
5. A 29-year-old is seen in the office with complaints of pain in his chest and belly. He quit smoking 6
months ago. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer®
and Pepto-Bismol®. The burning pain wakes him at night and radiates up to his chest. Which factor
favors a diagnosis of gastric ulcer?
A. Pain radiates to the chest
B. Waking at night with pain
C. Use of Alka-Seltzer
D. Recent smoking cessation
Answer: C
Rationale: Pain temporarily relieved by antacids suggests a gastric ulcer; duodenal ulcer pain often
improves with food.
6. Which of the following causes of gastrointestinal bleeding is found in the lower
gastrointestinal tract?
A. Peptic ulcer
B. Gastritis
C. Esophageal varices
D. Meckel's diverticulum
Answer: D
Rationale: Meckel’s diverticulum is a congenital anomaly in the distal ileum and can cause
painless lower GI bleeding, typically in children or young adults.
,7. A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a
runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-
the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her
boyfriend had mononucleosis about 1 month ago, and she wonders if she might have it also.
Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the
following labs would be most helpful in the differential diagnosis at this point?
A. CBC with differential
B. Liver function tests
C. Antihepatitis D virus
D. Blood culture
Answer: C
Rationale: Antihepatitis D virus antibodies help differentiate viral hepatitis from other viral
illnesses like mononucleosis.
8. A patient presents with symptoms of infectious mononucleosis. Which lab chemistry test
should the clinician order?
A. CBC
B. Liver enzymes
C. Heterophile antibody test
D. EBV PCR
Answer: C
Rationale: The heterophile antibody (Monospot) test is the standard initial diagnostic test for
infectious mononucleosis.
9. A patient is seen in the clinic with right upper quadrant pain that is radiating to the
middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the
following laboratory findings?
A. Elevated AST/ALT only
B. Elevated alkaline phosphatase
C. Elevated amylase only
D. Normal labs
Answer: B
, Rationale: Obstruction from gallstones often causes cholestatic pattern: elevated alkaline
phosphatase and sometimes bilirubin.
10. Which of the following are included in Ranson's criteria for assessing the severity of
pancreatitis at the time of diagnosis?
A. Serum glucose > 200 mg/dL
B. Age over 60
C. Base deficit greater than 4 mEq/L
D. AST > 100 U/L
Answer: C
Rationale: Ranson’s criteria at admission include age, WBC, glucose, LDH, AST, and base
deficit as indicators of severity.
11. Donna is a 36-year-old African American woman with chronic pancreatitis. Which of
the following are necessary to manage her condition?
A. High-protein diet
B. A low-fat diet of less than 50 g of fat per day
C. Ketogenic diet
D. Fasting therapy
Answer: B
Rationale: Chronic pancreatitis patients benefit from a low-fat diet to reduce pancreatic
stimulation and prevent steatorrhea.
12. Which of the following diagnostic tests is ordered for a cecal volvulus bowel
obstruction?
A. Colonoscopy
B. Barium enema
C. CT scan only
D. MRI
Answer: B
Rationale: A barium enema can diagnose and sometimes reduce cecal volvulus.
