NR 511 MIDTERM COMPREHENSIVE
EXAM REVIEW
1. A high sensitivity test is most useful for which of the following clinical actions?
A. Ruling in a diagnosis (SpPIn)
B. Ruling out a diagnosis (SnNOut)
C. Determining the prevalence of a disease
D. Calculating the positive predictive value
Answer: B
Conceptual Explanation: Sensitivity (Sn) relates to the ability of a test to correctly identify
those with the disease. A negative result in a highly sensitive test helps ‘rule out’ the
disease (SnNOut).
2. A patient presents with a single, 3 cm ‘herald patch’ on the trunk, followed by a
generalized eruption of smaller oval lesions in a ‘Christmas tree’ distribution. What is the
most likely diagnosis?
A. Tinea Corporis
B. Secondary Syphilis
,C. Psoriasis
D. Pityriasis Rosea
Answer: D
Conceptual Explanation: Pityriasis Rosea typically begins with a herald patch and
progresses to a Christmas tree pattern distribution on the trunk; it is often self-limiting.
3. According to the Centor Criteria, which of the following clinical features is NOT worth one
point in the screening for Group A Beta-Hemolytic Streptococcus (GABHS)?
A. Tonsillar exudates
B. Cough
C. History of fever
D. Tender anterior cervical adenopathy
Answer: B
Conceptual Explanation: The presence of a cough actually suggests a viral etiology and
results in zero points (or negative points in some modified versions), while absence of
cough adds one point for GABHS suspicion.
4. A 24-year-old female presents with ear pain. Physical exam reveals pain with manipulation
of the tragus and an erythematous, edematous ear canal with debris. The tympanic
membrane is partially visible and intact. What is the first-line treatment?
A. Topical Ciprofloxacin/Dexamethasone drops
, B. Oral Ciprofloxacin
C. Oral Amoxicillin
D. Watchful waiting for 48 hours
Answer: A
Conceptual Explanation: This describes Otitis Externa. Topical antibiotic/steroid drops
are the standard of care. Oral antibiotics are reserved for severe cases or systemic
involvement.
5. A KOH prep of a skin scraping shows branching hyphae and spores. This finding confirms
which type of infection?
A. Bacterial
B. Viral
C. Fungal
D. Parasitic
Answer: C
Conceptual Explanation: KOH (Potassium Hydroxide) preparation is used to visualize
fungal elements like hyphae and spores by dissolving keratinocytes.
6. What is the Gold Standard for diagnosing Asthma in patients old enough to perform the
maneuver?
A. Spirometry showing reversible airway obstruction
EXAM REVIEW
1. A high sensitivity test is most useful for which of the following clinical actions?
A. Ruling in a diagnosis (SpPIn)
B. Ruling out a diagnosis (SnNOut)
C. Determining the prevalence of a disease
D. Calculating the positive predictive value
Answer: B
Conceptual Explanation: Sensitivity (Sn) relates to the ability of a test to correctly identify
those with the disease. A negative result in a highly sensitive test helps ‘rule out’ the
disease (SnNOut).
2. A patient presents with a single, 3 cm ‘herald patch’ on the trunk, followed by a
generalized eruption of smaller oval lesions in a ‘Christmas tree’ distribution. What is the
most likely diagnosis?
A. Tinea Corporis
B. Secondary Syphilis
,C. Psoriasis
D. Pityriasis Rosea
Answer: D
Conceptual Explanation: Pityriasis Rosea typically begins with a herald patch and
progresses to a Christmas tree pattern distribution on the trunk; it is often self-limiting.
3. According to the Centor Criteria, which of the following clinical features is NOT worth one
point in the screening for Group A Beta-Hemolytic Streptococcus (GABHS)?
A. Tonsillar exudates
B. Cough
C. History of fever
D. Tender anterior cervical adenopathy
Answer: B
Conceptual Explanation: The presence of a cough actually suggests a viral etiology and
results in zero points (or negative points in some modified versions), while absence of
cough adds one point for GABHS suspicion.
4. A 24-year-old female presents with ear pain. Physical exam reveals pain with manipulation
of the tragus and an erythematous, edematous ear canal with debris. The tympanic
membrane is partially visible and intact. What is the first-line treatment?
A. Topical Ciprofloxacin/Dexamethasone drops
, B. Oral Ciprofloxacin
C. Oral Amoxicillin
D. Watchful waiting for 48 hours
Answer: A
Conceptual Explanation: This describes Otitis Externa. Topical antibiotic/steroid drops
are the standard of care. Oral antibiotics are reserved for severe cases or systemic
involvement.
5. A KOH prep of a skin scraping shows branching hyphae and spores. This finding confirms
which type of infection?
A. Bacterial
B. Viral
C. Fungal
D. Parasitic
Answer: C
Conceptual Explanation: KOH (Potassium Hydroxide) preparation is used to visualize
fungal elements like hyphae and spores by dissolving keratinocytes.
6. What is the Gold Standard for diagnosing Asthma in patients old enough to perform the
maneuver?
A. Spirometry showing reversible airway obstruction
