NRNP 6531 WEEK 8 KNOWLEDGE CHECK GASTROINTESTINAL GENITOURINARY ENDOCRINE AND
HEMATOLOGIC CONDITIONS FALL QTR NRNP 6531 WEEK 8 KNOWLEDGE CHECK QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED
A+...
Question 1
A 45-year-old male presents with a 2-month history of epigastric pain that worsens with eating, early satiety,
and a 6 kg unintentional weight loss. He has a 20-pack-year smoking history. Which diagnostic test is most
appropriate initially?
A. Abdominal ultrasound
B. Upper endoscopy with biopsy
C. Barium swallow
D. CT scan of the abdomen without contrast
🟢 Correct Answer:
B. Upper endoscopy with biopsy
🔴 RATIONALE:
Alarm symptoms such as unintentional weight loss, early satiety, and progressive epigastric pain in a middle-
aged smoker raise concern for gastric malignancy or peptic ulcer disease. Upper endoscopy with biopsy is the
gold standard for diagnosis. Ultrasound and barium swallow are less sensitive; CT without contrast is not the
initial diagnostic test.
Question 2
A 32-year-old female presents with right upper quadrant pain, nausea, and vomiting after eating fatty meals.
Physical exam reveals a positive Murphy sign. Which is the most likely diagnosis?
,A. Acute pancreatitis
B. Cholecystitis
C. Peptic ulcer disease
D. Hepatitis
🟢 Correct Answer:
B. Cholecystitis
🔴 RATIONALE:
Cholecystitis presents with right upper quadrant pain, nausea, vomiting, and a positive Murphy sign, often after
fatty meals. Pancreatitis typically causes epigastric pain radiating to the back; peptic ulcer disease causes
epigastric pain; hepatitis may cause right upper quadrant discomfort but not a positive Murphy sign.
Question 3
A 58-year-old male with type 2 diabetes presents with a 2-day history of dysuria, urinary frequency, and low-
grade fever. Urine dipstick is positive for leukocyte esterase and nitrites. Which is the most appropriate
treatment?
A. Oral nitrofurantoin for 5 days
B. Oral ciprofloxacin for 7 to 14 days
C. Intravenous vancomycin
D. Observation without antibiotics
🟢 Correct Answer:
B. Oral ciprofloxacin for 7 to 14 days
🔴 RATIONALE:
In a male with diabetes and symptoms of urinary tract infection, a 7- to 14-day course of a fluoroquinolone
,such as ciprofloxacin is appropriate. Nitrofurantoin is generally used for uncomplicated cystitis in women.
Vancomycin is not first-line; observation is unsafe.
Question 4
A 50-year-old female presents with fatigue, weight gain, and cold intolerance. Physical exam reveals dry skin,
bradycardia, and delayed deep tendon reflexes. Which laboratory finding is most consistent with the suspected
diagnosis?
A. Low TSH and low free T4
B. High TSH and low free T4
C. Low TSH and high free T4
D. High TSH and high free T4
🟢 Correct Answer:
B. High TSH and low free T4
🔴 RATIONALE:
Primary hypothyroidism is characterized by an elevated TSH due to loss of negative feedback and a low free T4.
Low TSH with high free T4 indicates hyperthyroidism; low TSH with low free T4 suggests secondary
hypothyroidism.
Question 5
A 65-year-old male presents with fatigue, pallor, and a smooth, sore tongue. Laboratory tests reveal macrocytic
anemia with hypersegmented neutrophils. Which deficiency is most likely?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folic acid deficiency only
D. Vitamin D deficiency
, 🟢 Correct Answer:
B. Vitamin B12 deficiency
🔴 RATIONALE:
Vitamin B12 deficiency causes macrocytic anemia with hypersegmented neutrophils and glossitis. Iron
deficiency causes microcytic anemia; folic acid deficiency also causes macrocytosis but is less likely to cause
neurological symptoms; vitamin D deficiency affects bones.
Question 6
A 28-year-old female presents with recurrent episodes of severe lower abdominal pain, bloating, and
alternating diarrhea and constipation. Physical exam is unremarkable. Which is the most likely diagnosis?
A. Irritable bowel syndrome
B. Ulcerative colitis
C. Crohn's disease
D. Celiac disease
🟢 Correct Answer:
A. Irritable bowel syndrome
🔴 RATIONALE:
Irritable bowel syndrome is a functional gastrointestinal disorder characterized by abdominal pain and altered
bowel habits without structural abnormalities. Ulcerative colitis and Crohn's disease cause inflammation and
bleeding; celiac disease is associated with malabsorption and positive serologies.
Question 7
A 70-year-old male presents with acute onset of severe flank pain radiating to the groin and hematuria. Which
diagnostic test is most appropriate initially?
HEMATOLOGIC CONDITIONS FALL QTR NRNP 6531 WEEK 8 KNOWLEDGE CHECK QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED
A+...
Question 1
A 45-year-old male presents with a 2-month history of epigastric pain that worsens with eating, early satiety,
and a 6 kg unintentional weight loss. He has a 20-pack-year smoking history. Which diagnostic test is most
appropriate initially?
A. Abdominal ultrasound
B. Upper endoscopy with biopsy
C. Barium swallow
D. CT scan of the abdomen without contrast
🟢 Correct Answer:
B. Upper endoscopy with biopsy
🔴 RATIONALE:
Alarm symptoms such as unintentional weight loss, early satiety, and progressive epigastric pain in a middle-
aged smoker raise concern for gastric malignancy or peptic ulcer disease. Upper endoscopy with biopsy is the
gold standard for diagnosis. Ultrasound and barium swallow are less sensitive; CT without contrast is not the
initial diagnostic test.
Question 2
A 32-year-old female presents with right upper quadrant pain, nausea, and vomiting after eating fatty meals.
Physical exam reveals a positive Murphy sign. Which is the most likely diagnosis?
,A. Acute pancreatitis
B. Cholecystitis
C. Peptic ulcer disease
D. Hepatitis
🟢 Correct Answer:
B. Cholecystitis
🔴 RATIONALE:
Cholecystitis presents with right upper quadrant pain, nausea, vomiting, and a positive Murphy sign, often after
fatty meals. Pancreatitis typically causes epigastric pain radiating to the back; peptic ulcer disease causes
epigastric pain; hepatitis may cause right upper quadrant discomfort but not a positive Murphy sign.
Question 3
A 58-year-old male with type 2 diabetes presents with a 2-day history of dysuria, urinary frequency, and low-
grade fever. Urine dipstick is positive for leukocyte esterase and nitrites. Which is the most appropriate
treatment?
A. Oral nitrofurantoin for 5 days
B. Oral ciprofloxacin for 7 to 14 days
C. Intravenous vancomycin
D. Observation without antibiotics
🟢 Correct Answer:
B. Oral ciprofloxacin for 7 to 14 days
🔴 RATIONALE:
In a male with diabetes and symptoms of urinary tract infection, a 7- to 14-day course of a fluoroquinolone
,such as ciprofloxacin is appropriate. Nitrofurantoin is generally used for uncomplicated cystitis in women.
Vancomycin is not first-line; observation is unsafe.
Question 4
A 50-year-old female presents with fatigue, weight gain, and cold intolerance. Physical exam reveals dry skin,
bradycardia, and delayed deep tendon reflexes. Which laboratory finding is most consistent with the suspected
diagnosis?
A. Low TSH and low free T4
B. High TSH and low free T4
C. Low TSH and high free T4
D. High TSH and high free T4
🟢 Correct Answer:
B. High TSH and low free T4
🔴 RATIONALE:
Primary hypothyroidism is characterized by an elevated TSH due to loss of negative feedback and a low free T4.
Low TSH with high free T4 indicates hyperthyroidism; low TSH with low free T4 suggests secondary
hypothyroidism.
Question 5
A 65-year-old male presents with fatigue, pallor, and a smooth, sore tongue. Laboratory tests reveal macrocytic
anemia with hypersegmented neutrophils. Which deficiency is most likely?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folic acid deficiency only
D. Vitamin D deficiency
, 🟢 Correct Answer:
B. Vitamin B12 deficiency
🔴 RATIONALE:
Vitamin B12 deficiency causes macrocytic anemia with hypersegmented neutrophils and glossitis. Iron
deficiency causes microcytic anemia; folic acid deficiency also causes macrocytosis but is less likely to cause
neurological symptoms; vitamin D deficiency affects bones.
Question 6
A 28-year-old female presents with recurrent episodes of severe lower abdominal pain, bloating, and
alternating diarrhea and constipation. Physical exam is unremarkable. Which is the most likely diagnosis?
A. Irritable bowel syndrome
B. Ulcerative colitis
C. Crohn's disease
D. Celiac disease
🟢 Correct Answer:
A. Irritable bowel syndrome
🔴 RATIONALE:
Irritable bowel syndrome is a functional gastrointestinal disorder characterized by abdominal pain and altered
bowel habits without structural abnormalities. Ulcerative colitis and Crohn's disease cause inflammation and
bleeding; celiac disease is associated with malabsorption and positive serologies.
Question 7
A 70-year-old male presents with acute onset of severe flank pain radiating to the groin and hematuria. Which
diagnostic test is most appropriate initially?
