• NR 509 Midterm 09/05/2026
Exam
NR 509 Midterm Exam – (2026) Actual
Questions & Answers (Chamberlain) 100%
Guarantee Pass
A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at night. This
has been steadily increasing for the past 2 months. Which one of the following is the most reassuring in this
patient with back pain?
A) Age over 50
B) Pain at night
C) Pain lasting more than 1 month or not responding to therapy
D) Pain that is bilateral –
Correct Answer :D) Pain that is bilateral
P 1
, • NR 509 Midterm 09/05/2026
Exam
While bilateral pain can be associated with serious illness, it is not one of the "red
flags" of back pain. Red flags should make one suspicious for serious underlying systemic
disease such as cancer, infection, or others. This list includes: age over 50, history of cancer,
unexplained weight loss, pain lasting more than 1 month or not responding to treatment, pain at
night or increased by rest, history of intravenous drug use, or presence of infection. The
presence of one of these with low back pain indicates a 10% probability of a serious systemic
disease.
Marion presents to your office with back pain associated with constipation and urinary
retention. Which of the following is most likely?
A) Sciatica
B) Epidural abscess
C) Cauda equina
D) Idiopathic low back pain –
Correct Answer :C) Cauda equina
The presence of bowel and bladder symptoms associated with back pain is
worrisome and should suggest impingement of nerve roots S2-S4. For this reason idiopathic low back pain is
unlikely. Epidural abscess may present with midline pain which can be
increased with percussion over the spinous processes. Sciatica is associated with pain which
radiates into the buttocks and/or down the posterior leg in the S1 distribution.
Louise, a 60-year-old, complains of left knee pain associated with tenderness throughout, redness, and warmth
over the joint. Which of the following is least helpful in determining if a joint problem is inflammatory?
A) Tenderness
P 2
, • NR 509 Midterm 09/05/2026
Exam
B) Pain
C) Warmth
D) Redness –
Correct Answer :B) Pain
Pain is present in both inflammatory and noninflammatory conditions. Warmth,
redness, and tenderness to palpation should lead one to consider an inflammatory etiology for the
pain.
Pain, swelling, loss of both active and passive motion, locking, and deformity would be consistent with which of
the following?
A) Articular joint pain
B) Bursitis
C) Muscular injury
D) Nerve damage - Correct Answer :A) Articular joint pain
These features are consistent with articular joint pain, whereas the other problems are associated with extra-
articular structures.
You are working in a college health clinic and seeing a young woman with a red, painful,
swollen DIP joint on the left index finger. There are also a few papules, pustules, and vesicles on reddened bases,
located on the distal extremities. This would be consistent with which of
the following?
A) Lyme disease
B) Systemic lupus erythematosus
P 3
, • NR 509 Midterm 09/05/2026
Exam
C) Hives (urticaria)
D) Gonococcal arthritis - Correct Answer :D) Gonococcal arthritis
The presentation of a monoarthritis in this age group should lead one to think of
gonococcal disease. Skin findings are often seen in conjunction with arthritis. Lyme disease is associated with an
expanding erythematous patch. Lupus is associated with a "butterfly" rash
on the cheeks, while serum sickness and drug reactions can be associated with hives.
An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is concerned
because an aunt had severe osteoporosis. Which of the following is a risk factor for osteoporosis?
A) Obesity
B) Late menopause
C) Having an aunt with osteoporosis
D) Delayed menarche - Correct Answer :D) Delayed menarche
Obesity and late menopause are not associated with osteoporosis. Having a first-degree relative with
osteoporosis is a risk factor, but an aunt is a second-degree relative.
Delayed menarche is the only choice which is a known risk factor for osteoporosis.
A 38-year-old woman comes to you and has multiple small joints involved with pain, swelling, and stiffness.
Which of the following is the most likely explanation?
A) Rheumatoid arthritis
B) Septic arthritis
C) Gout
D) Trauma - Correct Answer :A) Rheumatoid arthritis
Rheumatoid arthritis is a systemic disease and accounts for multiple symmetrically
P 4
Exam
NR 509 Midterm Exam – (2026) Actual
Questions & Answers (Chamberlain) 100%
Guarantee Pass
A 58-year-old man comes to your office complaining of bilateral back pain that now awakens him at night. This
has been steadily increasing for the past 2 months. Which one of the following is the most reassuring in this
patient with back pain?
A) Age over 50
B) Pain at night
C) Pain lasting more than 1 month or not responding to therapy
D) Pain that is bilateral –
Correct Answer :D) Pain that is bilateral
P 1
, • NR 509 Midterm 09/05/2026
Exam
While bilateral pain can be associated with serious illness, it is not one of the "red
flags" of back pain. Red flags should make one suspicious for serious underlying systemic
disease such as cancer, infection, or others. This list includes: age over 50, history of cancer,
unexplained weight loss, pain lasting more than 1 month or not responding to treatment, pain at
night or increased by rest, history of intravenous drug use, or presence of infection. The
presence of one of these with low back pain indicates a 10% probability of a serious systemic
disease.
Marion presents to your office with back pain associated with constipation and urinary
retention. Which of the following is most likely?
A) Sciatica
B) Epidural abscess
C) Cauda equina
D) Idiopathic low back pain –
Correct Answer :C) Cauda equina
The presence of bowel and bladder symptoms associated with back pain is
worrisome and should suggest impingement of nerve roots S2-S4. For this reason idiopathic low back pain is
unlikely. Epidural abscess may present with midline pain which can be
increased with percussion over the spinous processes. Sciatica is associated with pain which
radiates into the buttocks and/or down the posterior leg in the S1 distribution.
Louise, a 60-year-old, complains of left knee pain associated with tenderness throughout, redness, and warmth
over the joint. Which of the following is least helpful in determining if a joint problem is inflammatory?
A) Tenderness
P 2
, • NR 509 Midterm 09/05/2026
Exam
B) Pain
C) Warmth
D) Redness –
Correct Answer :B) Pain
Pain is present in both inflammatory and noninflammatory conditions. Warmth,
redness, and tenderness to palpation should lead one to consider an inflammatory etiology for the
pain.
Pain, swelling, loss of both active and passive motion, locking, and deformity would be consistent with which of
the following?
A) Articular joint pain
B) Bursitis
C) Muscular injury
D) Nerve damage - Correct Answer :A) Articular joint pain
These features are consistent with articular joint pain, whereas the other problems are associated with extra-
articular structures.
You are working in a college health clinic and seeing a young woman with a red, painful,
swollen DIP joint on the left index finger. There are also a few papules, pustules, and vesicles on reddened bases,
located on the distal extremities. This would be consistent with which of
the following?
A) Lyme disease
B) Systemic lupus erythematosus
P 3
, • NR 509 Midterm 09/05/2026
Exam
C) Hives (urticaria)
D) Gonococcal arthritis - Correct Answer :D) Gonococcal arthritis
The presentation of a monoarthritis in this age group should lead one to think of
gonococcal disease. Skin findings are often seen in conjunction with arthritis. Lyme disease is associated with an
expanding erythematous patch. Lupus is associated with a "butterfly" rash
on the cheeks, while serum sickness and drug reactions can be associated with hives.
An obese 55-year-old woman went through menarche at age 16 and menopause 2 years ago. She is concerned
because an aunt had severe osteoporosis. Which of the following is a risk factor for osteoporosis?
A) Obesity
B) Late menopause
C) Having an aunt with osteoporosis
D) Delayed menarche - Correct Answer :D) Delayed menarche
Obesity and late menopause are not associated with osteoporosis. Having a first-degree relative with
osteoporosis is a risk factor, but an aunt is a second-degree relative.
Delayed menarche is the only choice which is a known risk factor for osteoporosis.
A 38-year-old woman comes to you and has multiple small joints involved with pain, swelling, and stiffness.
Which of the following is the most likely explanation?
A) Rheumatoid arthritis
B) Septic arthritis
C) Gout
D) Trauma - Correct Answer :A) Rheumatoid arthritis
Rheumatoid arthritis is a systemic disease and accounts for multiple symmetrically
P 4
