NR 511 COMPREHENSIVE PRIMARY
CARE EXAM PREP QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with acute onset of right great toe pain, redness, and swelling.
He reports consuming a large steak and several beers the night before. Which of the following
is the most appropriate initial pharmacological intervention?
A. Allopurinol 100mg daily
B. Intravenous morphine
C. Probenecid 250mg twice daily
D. Indomethacin 50mg three times daily
Answer: D
Conceptual Explanation: Indomethacin or other NSAIDs are first-line for acute gouty
arthritis attacks. Allopurinol and Probenecid are for long-term prevention and should not
be started during an acute flare as they can worsen the condition by shifting urate levels.
,2. When performing a physical examination, the clinician elicits pain upon deep inspiration
while palpating the right upper quadrant. This finding is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. McBurney’s sign
D. Psoas sign
Answer: A
Conceptual Explanation: Murphy’s sign is an indicator of acute cholecystitis. It is positive
when the patient stops breathing in (inspiratory arrest) because the gallbladder descends
and hits the clinician’s hand.
3. According to the American Heart Association, what is the blood pressure threshold for
diagnosing Stage 2 Hypertension?
A. 130/80 mmHg
B. 150/95 mmHg
C. 120/80 mmHg
D. 140/90 mmHg
Answer: D
Conceptual Explanation: Stage 1 Hypertension is 130-139 systolic or 80-89 diastolic.
Stage 2 Hypertension is defined as systolic at least 140 or diastolic at least 90 mmHg.
, 4. A patient presents with a ‘velvety’ hyperpigmentation in the axilla and neck folds. This skin
condition, known as Acanthosis Nigricans, is most commonly associated with:
A. Hypothyroidism
B. Systemic Lupus Erythematosus
C. Vitamin B12 deficiency
D. Insulin resistance
Answer: D
Conceptual Explanation: Acanthosis Nigricans is a dermatologic manifestation frequently
associated with insulin resistance and hyperinsulinemia, often seen in Type 2 Diabetes or
obesity.
5. Which physical exam maneuver is specifically used to assess for a meniscus tear in the
knee?
A. Lachman test
B. Anterior Drawer test
C. Phalen’s test
D. McMurray test
Answer: D
CARE EXAM PREP QUESTIONS AND
ANSWERS
1. A 45-year-old male presents with acute onset of right great toe pain, redness, and swelling.
He reports consuming a large steak and several beers the night before. Which of the following
is the most appropriate initial pharmacological intervention?
A. Allopurinol 100mg daily
B. Intravenous morphine
C. Probenecid 250mg twice daily
D. Indomethacin 50mg three times daily
Answer: D
Conceptual Explanation: Indomethacin or other NSAIDs are first-line for acute gouty
arthritis attacks. Allopurinol and Probenecid are for long-term prevention and should not
be started during an acute flare as they can worsen the condition by shifting urate levels.
,2. When performing a physical examination, the clinician elicits pain upon deep inspiration
while palpating the right upper quadrant. This finding is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. McBurney’s sign
D. Psoas sign
Answer: A
Conceptual Explanation: Murphy’s sign is an indicator of acute cholecystitis. It is positive
when the patient stops breathing in (inspiratory arrest) because the gallbladder descends
and hits the clinician’s hand.
3. According to the American Heart Association, what is the blood pressure threshold for
diagnosing Stage 2 Hypertension?
A. 130/80 mmHg
B. 150/95 mmHg
C. 120/80 mmHg
D. 140/90 mmHg
Answer: D
Conceptual Explanation: Stage 1 Hypertension is 130-139 systolic or 80-89 diastolic.
Stage 2 Hypertension is defined as systolic at least 140 or diastolic at least 90 mmHg.
, 4. A patient presents with a ‘velvety’ hyperpigmentation in the axilla and neck folds. This skin
condition, known as Acanthosis Nigricans, is most commonly associated with:
A. Hypothyroidism
B. Systemic Lupus Erythematosus
C. Vitamin B12 deficiency
D. Insulin resistance
Answer: D
Conceptual Explanation: Acanthosis Nigricans is a dermatologic manifestation frequently
associated with insulin resistance and hyperinsulinemia, often seen in Type 2 Diabetes or
obesity.
5. Which physical exam maneuver is specifically used to assess for a meniscus tear in the
knee?
A. Lachman test
B. Anterior Drawer test
C. Phalen’s test
D. McMurray test
Answer: D
