NR 511 FInal Exam
(Latest 2025-2026 Edition) 100% Verified Q&A + Answer
210+
Key Solutions
VERIFIED ANSWERS
Question 1
Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea,
and vomiting. What is your leading differential diagnosis?
Correct Answer
Cholecystitis
A rapid onset of severe right upper quadrant (RUQ) abdominal cramping pain with nausea and vomiting is a classic
presentation of acute cholecystitis; 90% to 95% of patients with acute cholecystitis also have gallstones. Other symptoms
include low-grade fever, epigastric tenderness, guarding, and pain on inspiration during palpation of the RUQ (Murphy
sign). The 7 Fs of cholecystitis are fair, fat, 40, female, fertile, fat intolerant, and flatulent.
Question 2
You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori and plan to treat her empirically. What
medications should you order?
Correct Answer
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl)
All of the drugs listed are used in the eradication of H pylori. Traditional 14-day "triple therapy" with a proton pump
inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl) has consistently produced eradication rates
of approximately 95% and is the least expensive therapy.
Question 3
You elicit costovertebral angle tenderness in Gordon, age 29. Which condition do you suspect?
Correct Answer
Inflammation of the kidney
Costovertebral angle tenderness is tenderness or sharp pain that is elicited when one hand is "thumped" with the ulnar
edge of the other fist over the 12th rib at the costovertebral angle on the back. It indicates inflammation of the kidney
(and possible associated renal calculi, renal artery or vein occlusion, and perirenal abscess).
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,Question 4
To differentiate among the different diagnoses of inflammatory bowel diseases, you look at the patient's histological,
culture, and radiological features. Mary has transmural inflammation, granulomas, focal involvement of the colon with some
skipped areas, and sparing of the rectal mucosa. What do you suspect?
Correct Answer
Crohn's disease
Crohn's disease would show transmural inflammation, granulomas, focal involvement of the colon with some skipped
areas, and sparing of the rectal mucosa. The key words are "skipped areas of mucosal involvement."
Question 5
Margie, age 52, has an extremely stressful job and was just given a diagnosis of gastric ulcer. She tells you she is sure it is
going to be malignant. How do you respond?
Correct Answer
About 95% of gastric ulcers are benign."
About 3% to 5% of gastric ulcers of benign-appearing ulcers prove to be cancer.
Question 6
Rose has gastroesophageal reflux disease (GERD). Which statement by the patient indicates that she misunderstands your
teaching?
Correct Answer
"I will have a snack before retiring so that the esophagus and stomach are not empty at bedtime."
Rose should not have a snack before retiring. Patients with GERD 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-inch blocks; and refrain from eating for 3 hours before retiring.
Question 7
Which is the most important diagnostic test for celiac disease?
Correct Answer
An IgA-tTG test, followed by a biopsy of the small intestine
There are several serologic tests available that screen for celiac disease antibodies, but the most important diagnostic test
is called an IgA-tTG test. Although it may be falsely negative, if the test results suggest celiac disease, it is recommended
that a biopsy of the small intestine be done to confirm the diagnosis.
Question 8
Susan, age 59, has no specific complaints when she comes in for her annual examination. She does, however, have type 2
diabetes mellitus (DM), slight hypertension, dyslipidemia, and central obesity. How would you diagnose her?
Correct Answer
As having metabolic syndrome
Susan has a constellation of symptoms known as metabolic syndrome. The World Health Organization (WHO), National
Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and International Diabetes Federation (IDF) have
slightly different criteria for this diagnosis. They all, however, include hypertension, dyslipidemia, and central obesity.
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,Question 9
Which gastrointestinal disease below could theoretically be completely eradicated with a total colectomy?
Correct Answer
Ulcerative colitis
Ulcerative colitis is a disease only of the colon. Although it is not the first treatment choice, total colectomy is a treatment
option that can completely resolve this problem.
Question 10
Matt, age 26, recently returned from a camping trip and has gastroenteritis. He says that he has been eating only canned
food. Which of the following pathogens do you suspect?
Correct Answer
Clostridium botulinum
C botulinum is an anaerobic, gram-positive bacillus that produces toxins. It is widely distributed in the soil and vegetation.
Improperly processed home-canned low-acid vegetables and contaminated meats are the usual cause of food-borne
botulism.
Question 11
Melva, age 63, presents with an acute exacerbation of pancreatitis, and you are going to admit her to the hospital. Which is
the most important factor in determining a negative long-term outcome for her?
Correct Answer
Infection
The most important factor in determining long-term negative outcomes for pancreatitis is the presence of infection.
Despite best practices, mortality associated with severe acute pancreatitis remains approximately 20% to 25% because of
systemic complications.
Question 12
Which is the most common presenting symptom of gastric cancer?
Correct Answer
Weight loss
Question 13
Stacy, a nursing student, is to begin her series of hepatitis B vaccinations. You test her for a serological marker, and the
results show hepatitis B surface antibodies (HBsAb). What do you tell Stacy?
Correct Answer
"You need to be tested again because one reading is not indicative of immunity."
The presence of hepatitis B surface antibodies indicates that Stacy is permanently immune to hepatitis B.
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, Question 14
Shelby has recently been diagnosed with pancreatitis. Of the following objective findings that can result from the pancreatic
inflammatory process, which is known as Grey Turner sign?
Correct Answer
Bluish discoloration over the flanks
Question 15
What is the most common bacterial cause of traveler's diarrhea?
Correct Answer
Escherichia coli
Question 16
Olive has an acute exacerbation of Crohn's disease. Which laboratory test value(s) would you expect to be decreased?
Correct Answer
Vitamin A, B complex, and C levels
Folic acid and serum levels of most vitamins, including A, B complex, C, and the fat-soluble vitamins, are decreased in
Crohn's disease as a result of malabsorption.
Question 17
A 7-year-old male presents with his mother to the urgent care clinic complaining of abdominal pain. He started to complain
of pain before going to bed; however, it has gotten progressively worse and is now preventing him from sleeping. He is
nauseous but has not vomited and did not eat dinner because of the pain. The patient appears pale and is complaining of
right-sided abdominal pain. His vitals are as follows: blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry
98% on room air. On physical exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a white
blood cell count (WBC) of 17.0. What is the patient's likely diagnosis?
Correct Answer
Appendicitis
Question 18
All of the following medications are used for the control of nausea and vomiting. Which medication works by affecting the
chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter
pressure?
Correct Answer
Antidopaminergic and cholinergic agents, such as metoclopramide (Reglan)
Metoclopramide (Reglan) is used for diabetic gastroparesis and postoperative nausea and vomiting. It works by affecting
the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal
sphincter pressure.
Trusted by thousands of students and professionals worldwide Page 4 of 46
(Latest 2025-2026 Edition) 100% Verified Q&A + Answer
210+
Key Solutions
VERIFIED ANSWERS
Question 1
Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea,
and vomiting. What is your leading differential diagnosis?
Correct Answer
Cholecystitis
A rapid onset of severe right upper quadrant (RUQ) abdominal cramping pain with nausea and vomiting is a classic
presentation of acute cholecystitis; 90% to 95% of patients with acute cholecystitis also have gallstones. Other symptoms
include low-grade fever, epigastric tenderness, guarding, and pain on inspiration during palpation of the RUQ (Murphy
sign). The 7 Fs of cholecystitis are fair, fat, 40, female, fertile, fat intolerant, and flatulent.
Question 2
You suspect that Nikki has a gastroduodenal ulcer caused by Helicobacter pylori and plan to treat her empirically. What
medications should you order?
Correct Answer
A proton pump inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl)
All of the drugs listed are used in the eradication of H pylori. Traditional 14-day "triple therapy" with a proton pump
inhibitor (omeprazole), tetracycline or amoxicillin, and metronidazole (Flagyl) has consistently produced eradication rates
of approximately 95% and is the least expensive therapy.
Question 3
You elicit costovertebral angle tenderness in Gordon, age 29. Which condition do you suspect?
Correct Answer
Inflammation of the kidney
Costovertebral angle tenderness is tenderness or sharp pain that is elicited when one hand is "thumped" with the ulnar
edge of the other fist over the 12th rib at the costovertebral angle on the back. It indicates inflammation of the kidney
(and possible associated renal calculi, renal artery or vein occlusion, and perirenal abscess).
Trusted by thousands of students and professionals worldwide Page 1 of 46
,Question 4
To differentiate among the different diagnoses of inflammatory bowel diseases, you look at the patient's histological,
culture, and radiological features. Mary has transmural inflammation, granulomas, focal involvement of the colon with some
skipped areas, and sparing of the rectal mucosa. What do you suspect?
Correct Answer
Crohn's disease
Crohn's disease would show transmural inflammation, granulomas, focal involvement of the colon with some skipped
areas, and sparing of the rectal mucosa. The key words are "skipped areas of mucosal involvement."
Question 5
Margie, age 52, has an extremely stressful job and was just given a diagnosis of gastric ulcer. She tells you she is sure it is
going to be malignant. How do you respond?
Correct Answer
About 95% of gastric ulcers are benign."
About 3% to 5% of gastric ulcers of benign-appearing ulcers prove to be cancer.
Question 6
Rose has gastroesophageal reflux disease (GERD). Which statement by the patient indicates that she misunderstands your
teaching?
Correct Answer
"I will have a snack before retiring so that the esophagus and stomach are not empty at bedtime."
Rose should not have a snack before retiring. Patients with GERD 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-inch blocks; and refrain from eating for 3 hours before retiring.
Question 7
Which is the most important diagnostic test for celiac disease?
Correct Answer
An IgA-tTG test, followed by a biopsy of the small intestine
There are several serologic tests available that screen for celiac disease antibodies, but the most important diagnostic test
is called an IgA-tTG test. Although it may be falsely negative, if the test results suggest celiac disease, it is recommended
that a biopsy of the small intestine be done to confirm the diagnosis.
Question 8
Susan, age 59, has no specific complaints when she comes in for her annual examination. She does, however, have type 2
diabetes mellitus (DM), slight hypertension, dyslipidemia, and central obesity. How would you diagnose her?
Correct Answer
As having metabolic syndrome
Susan has a constellation of symptoms known as metabolic syndrome. The World Health Organization (WHO), National
Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and International Diabetes Federation (IDF) have
slightly different criteria for this diagnosis. They all, however, include hypertension, dyslipidemia, and central obesity.
Trusted by thousands of students and professionals worldwide Page 2 of 46
,Question 9
Which gastrointestinal disease below could theoretically be completely eradicated with a total colectomy?
Correct Answer
Ulcerative colitis
Ulcerative colitis is a disease only of the colon. Although it is not the first treatment choice, total colectomy is a treatment
option that can completely resolve this problem.
Question 10
Matt, age 26, recently returned from a camping trip and has gastroenteritis. He says that he has been eating only canned
food. Which of the following pathogens do you suspect?
Correct Answer
Clostridium botulinum
C botulinum is an anaerobic, gram-positive bacillus that produces toxins. It is widely distributed in the soil and vegetation.
Improperly processed home-canned low-acid vegetables and contaminated meats are the usual cause of food-borne
botulism.
Question 11
Melva, age 63, presents with an acute exacerbation of pancreatitis, and you are going to admit her to the hospital. Which is
the most important factor in determining a negative long-term outcome for her?
Correct Answer
Infection
The most important factor in determining long-term negative outcomes for pancreatitis is the presence of infection.
Despite best practices, mortality associated with severe acute pancreatitis remains approximately 20% to 25% because of
systemic complications.
Question 12
Which is the most common presenting symptom of gastric cancer?
Correct Answer
Weight loss
Question 13
Stacy, a nursing student, is to begin her series of hepatitis B vaccinations. You test her for a serological marker, and the
results show hepatitis B surface antibodies (HBsAb). What do you tell Stacy?
Correct Answer
"You need to be tested again because one reading is not indicative of immunity."
The presence of hepatitis B surface antibodies indicates that Stacy is permanently immune to hepatitis B.
Trusted by thousands of students and professionals worldwide Page 3 of 46
, Question 14
Shelby has recently been diagnosed with pancreatitis. Of the following objective findings that can result from the pancreatic
inflammatory process, which is known as Grey Turner sign?
Correct Answer
Bluish discoloration over the flanks
Question 15
What is the most common bacterial cause of traveler's diarrhea?
Correct Answer
Escherichia coli
Question 16
Olive has an acute exacerbation of Crohn's disease. Which laboratory test value(s) would you expect to be decreased?
Correct Answer
Vitamin A, B complex, and C levels
Folic acid and serum levels of most vitamins, including A, B complex, C, and the fat-soluble vitamins, are decreased in
Crohn's disease as a result of malabsorption.
Question 17
A 7-year-old male presents with his mother to the urgent care clinic complaining of abdominal pain. He started to complain
of pain before going to bed; however, it has gotten progressively worse and is now preventing him from sleeping. He is
nauseous but has not vomited and did not eat dinner because of the pain. The patient appears pale and is complaining of
right-sided abdominal pain. His vitals are as follows: blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry
98% on room air. On physical exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a white
blood cell count (WBC) of 17.0. What is the patient's likely diagnosis?
Correct Answer
Appendicitis
Question 18
All of the following medications are used for the control of nausea and vomiting. Which medication works by affecting the
chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter
pressure?
Correct Answer
Antidopaminergic and cholinergic agents, such as metoclopramide (Reglan)
Metoclopramide (Reglan) is used for diabetic gastroparesis and postoperative nausea and vomiting. It works by affecting
the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal
sphincter pressure.
Trusted by thousands of students and professionals worldwide Page 4 of 46
