NR 667 Exit Exam Questions And Answers
With Complete Solution
Your 51-year-old female patient has been diagnosed with a "new murmur" during a near
syncopal episode workup. In evaluating this patient, during which phase of the cardiac
cycle would you anticipate auscultation of an S1 heart sound? - Systole
The initial workup for a patient with a new chief complaint of palpitations should include
which of the following tests first? - Basic metabolic profile
Which of the following locations is most commonly described as the best location to
identify the aortic valve in a healthy adult? - 2nd intercostal space, right sternal border
Jason, a 63-year-old male who had a cardiac drug-eluting stent placed and had an elevated
troponin of 1.6, asks how long he will need to be on aspirin plus clopidogrel (Plavix). How
long should Jason be on dual antiplatelet therapy after his stent? - 12 months minimum
What illness or diagnosis would localized egophony on auscultation over the left lower lobe
most likely imply? - Consolidation (pneumonia)
While assessing a 15-year-old patient for a new onset of cough, how does
performing percussion of the thorax assist the provider during the physical examination? -
To identify if underlying tissues are air-filled, fluid-filled, or consolidated
Which of the following patients would you expect to show a less-than-expected forced vital
capacity (FVC) on pulmonary function testing? - Severe interstitial lung disease
In obstructive lung disease, a decreased level in which of the following spirometry
parameters is most suggestive of diagnosis? - Forced Expiratory Volume in 1 second (FEV₁)
Your newly established patient developed a progressively enlarged thyroid gland (goiter)
along with symptoms of anxiety, palpitations, and tremor over the last year. Which
diagnosis is most likely based on these findings? - Graves' Disease
A 32-year-old female with a diagnosis of hyperthyroidism might exhibit which of the
following typical signs on exam? - Exophthalmos
Your patient has Cushing's disease. Which of the following would you NOT expect to find
during examination? - Low body temperature
In a patient with Diabetes Mellitus Type 2, the evaluation for end-organ dysfunction should
include which of the following? - of these are appropriate
, A patient with severe cirrhosis awaiting possible liver transplant should be evaluated with
which scoring system to assess liver function and prognosis? - Model for End-Stage Liver
Disease (MELD) Score
You suspect mononucleosis in a 12-year-old with left upper quadrant pain and likely
splenomegaly. Which examination step should be avoided over that area? - Deep
palpitation
A 21-year-old female may have a perforated gastric ulcer with peritonitis. Which type of
bacteria is most likely the causative agent? - Gram negative rods
A 22-year-old male power lifter complains his scrotum is very enlarged and fluid-like.
Which diagnosis is most likely? - Hydrocele
A 22-year-old female has sinus pressure and congestion. Which maneuver may help
reproduce sinus-related pain and support the diagnosis? - Leaning forward
A 49-year-old male presents with weight loss, night sweats, anhedonia, and CXR showing
profoundly enlarged hilar adenopathy. Which diagnosis should be in your differential? -
Lymphoma
Which of the following diseases is associated with vitreous detachment? - Ehlers-Danlos
A patient presents with a unilateral visual deficit described as loss of visual fields on the
right side in both eyes. This is known as what? - Homonymous hemianopia
An adolescent female with microcytic, hypochromic anemia and elevated RDW most likely
has iron deficiency. Which labs will you order first? - TIBC and ferritin
A microcytic anemia with normal RDW is most likely which type of anemia? - Thalassemia
trait
A 43-year-old male with macrocytic anemia should be evaluated for which lab level to help
narrow the etiology? - Vitamin B12
A 66-year-old female with end-stage renal disease on dialysis has labs showing high
creatinine/BUN. On CBC, you'd typically see which result? - Normal MCH, hemoglobin 9.6
During a routine physical, a 12-year-old with a history of Reye syndrome is noted. Which
agent is most often implicated in causing Reye syndrome? - Aspirin use
Your patient is diagnosed with hepatitis A. Which immunoglobulin is the first to be elevated
in the serum? - IgM
A patient had new onset hepatitis B about one year ago. Which marker is most likely
elevated now? - Hepatitis Core antibody
With Complete Solution
Your 51-year-old female patient has been diagnosed with a "new murmur" during a near
syncopal episode workup. In evaluating this patient, during which phase of the cardiac
cycle would you anticipate auscultation of an S1 heart sound? - Systole
The initial workup for a patient with a new chief complaint of palpitations should include
which of the following tests first? - Basic metabolic profile
Which of the following locations is most commonly described as the best location to
identify the aortic valve in a healthy adult? - 2nd intercostal space, right sternal border
Jason, a 63-year-old male who had a cardiac drug-eluting stent placed and had an elevated
troponin of 1.6, asks how long he will need to be on aspirin plus clopidogrel (Plavix). How
long should Jason be on dual antiplatelet therapy after his stent? - 12 months minimum
What illness or diagnosis would localized egophony on auscultation over the left lower lobe
most likely imply? - Consolidation (pneumonia)
While assessing a 15-year-old patient for a new onset of cough, how does
performing percussion of the thorax assist the provider during the physical examination? -
To identify if underlying tissues are air-filled, fluid-filled, or consolidated
Which of the following patients would you expect to show a less-than-expected forced vital
capacity (FVC) on pulmonary function testing? - Severe interstitial lung disease
In obstructive lung disease, a decreased level in which of the following spirometry
parameters is most suggestive of diagnosis? - Forced Expiratory Volume in 1 second (FEV₁)
Your newly established patient developed a progressively enlarged thyroid gland (goiter)
along with symptoms of anxiety, palpitations, and tremor over the last year. Which
diagnosis is most likely based on these findings? - Graves' Disease
A 32-year-old female with a diagnosis of hyperthyroidism might exhibit which of the
following typical signs on exam? - Exophthalmos
Your patient has Cushing's disease. Which of the following would you NOT expect to find
during examination? - Low body temperature
In a patient with Diabetes Mellitus Type 2, the evaluation for end-organ dysfunction should
include which of the following? - of these are appropriate
, A patient with severe cirrhosis awaiting possible liver transplant should be evaluated with
which scoring system to assess liver function and prognosis? - Model for End-Stage Liver
Disease (MELD) Score
You suspect mononucleosis in a 12-year-old with left upper quadrant pain and likely
splenomegaly. Which examination step should be avoided over that area? - Deep
palpitation
A 21-year-old female may have a perforated gastric ulcer with peritonitis. Which type of
bacteria is most likely the causative agent? - Gram negative rods
A 22-year-old male power lifter complains his scrotum is very enlarged and fluid-like.
Which diagnosis is most likely? - Hydrocele
A 22-year-old female has sinus pressure and congestion. Which maneuver may help
reproduce sinus-related pain and support the diagnosis? - Leaning forward
A 49-year-old male presents with weight loss, night sweats, anhedonia, and CXR showing
profoundly enlarged hilar adenopathy. Which diagnosis should be in your differential? -
Lymphoma
Which of the following diseases is associated with vitreous detachment? - Ehlers-Danlos
A patient presents with a unilateral visual deficit described as loss of visual fields on the
right side in both eyes. This is known as what? - Homonymous hemianopia
An adolescent female with microcytic, hypochromic anemia and elevated RDW most likely
has iron deficiency. Which labs will you order first? - TIBC and ferritin
A microcytic anemia with normal RDW is most likely which type of anemia? - Thalassemia
trait
A 43-year-old male with macrocytic anemia should be evaluated for which lab level to help
narrow the etiology? - Vitamin B12
A 66-year-old female with end-stage renal disease on dialysis has labs showing high
creatinine/BUN. On CBC, you'd typically see which result? - Normal MCH, hemoglobin 9.6
During a routine physical, a 12-year-old with a history of Reye syndrome is noted. Which
agent is most often implicated in causing Reye syndrome? - Aspirin use
Your patient is diagnosed with hepatitis A. Which immunoglobulin is the first to be elevated
in the serum? - IgM
A patient had new onset hepatitis B about one year ago. Which marker is most likely
elevated now? - Hepatitis Core antibody
