NR 511 Midterm Exam Questions and
Correct Answers plus Rationales | Latest
Update 2026-2027 | Graded A+
Gastrointestinal / Nausea / ENT / Eyes
1. Which medications used to treat nausea and vomiting work by affecting the
chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility
and increasing lower esophageal sphincter pressure?
A. Anticholinergics such as scopolamine
B. Metoclopramide (Reglan)
C. Ondansetron (Zofran)
D. Promethazine (Phenergan)
B. Metoclopramide (Reglan)
Rationale: Metoclopramide is a prokinetic and antidopaminergic agent that
blocks the CTZ and increases GI motility/LES pressure. Source key says
anticholinergics, but that is incorrect.
2. The antibiotic of choice for recurrent acute otitis media (AOM) and/or
treatment failure in children is:
A. Amoxicillin
B. Amoxicillin-clavulanate (Augmentin)
C. Azithromycin
D. Cephalexin
B. Amoxicillin-clavulanate (Augmentin)
Rationale: Augmentin covers beta-lactamase–producing organisms and is
preferred after recent antibiotic exposure or treatment failure.
3. A 67-year-old female on multiple medications for chronic conditions was just
diagnosed with GERD. What medication should the clinician recommend she
refrain from using?
A. Acetaminophen
B. NSAIDs
,C. Calcium carbonate
D. Metformin
B. NSAIDs
Rationale: NSAIDs increase gastric irritation and worsen GERD.
4. A 30-year-old male presents with intermittent diarrhea. He thinks his antacids
cause it because loose stools occur within 30 minutes of taking them. How
should the clinician respond?
A. Antacids may contain magnesium, which decreases bowel transit time and may
contain poorly absorbed salts that cause an osmotic draw of fluid into the bowel,
resulting in diarrhea.
B. Antacids never cause diarrhea.
C. Stop all antacids forever.
D. This is likely infectious.
A.
Rationale: Magnesium-containing antacids are laxative; osmotic salts can cause
diarrhea.
5. When the Weber test is performed with a tuning fork to assess hearing and
there is no lateralization, the clinician should document this finding as:
A. Abnormal
B. Conductive hearing loss
C. Sensorineural hearing loss
D. Normal
D. Normal
Rationale: No lateralization suggests symmetric hearing.
6. A 72-year-old male presents for annual physical. He only has a bowel
movement every three days. How should the clinician respond?
A. There is no such thing as a “normal” pattern of defecation. Patterns vary widely
and may be affected by diet, fluids, stool bacteria, stress, or voluntary
postponement. Defecating every third day could be his routine; ask if this is
normal for him.
B. He has obstipation and needs laxatives.
C. He needs a colonoscopy immediately.
D. He should have a bowel movement daily.
, A.
Rationale: Assess change from baseline rather than imposing a universal
frequency.
7. A 21-year-old female presents for pre-operative tonsillectomy clearance. She
is concerned about permanent taste changes. What should the clinician tell her?
A. Although some clients report a significant subjective drop in taste function
following surgery, none have ongoing taste dysfunction.
B. Taste loss is permanent in most patients.
C. Taste changes only occur in children.
D. She should cancel surgery.
A.
Rationale: Taste changes are usually temporary.
8. In a young child, unilateral purulent rhinitis is most often caused by:
A. Viral URI
B. Foreign body
C. Allergic rhinitis
D. Sinusitis
B. A foreign body
Rationale: Unilateral purulent nasal discharge in a child should raise suspicion for
inserted foreign body.
9. Nausea is difficult to discern in a young child. What question should the
clinician ask to determine if a child has nausea?
A. “Are you hungry?”
B. “Does your stomach hurt?”
C. “Do you feel like vomiting?”
D. “Have you eaten?”
A. “Are you hungry?”
Rationale: Loss of appetite is a practical proxy for nausea in young children.
10. A 38-year-old male has recently had an ileostomy for ulcerative colitis.
Which self-care measure should the clinician teach him to relieve food
blockade?
A. Massage the peristomal area
B. Increase high-fiber foods
, C. Drink less fluid
D. Lie flat
A. Massage the peristomal area
Rationale: For suspected food blockage, massage peristomal area, take warm
baths, increase fluids, and avoid high-fiber foods temporarily.
11. A 52-year-old female is suspected of having a gastric ulcer and will undergo
EGD. She is concerned because she heard gastric ulcers can be malignant. How
should the clinician respond?
A. About 95% of gastric ulcers are benign, even though they may look malignant
on x-ray.
B. All gastric ulcers are malignant.
C. EGD is unnecessary.
D. Only duodenal ulcers are malignant.
A.
Rationale: Most gastric ulcers are benign; biopsy during EGD is definitive.
12. A 29-year-old female just returned from Central America with traveler’s
diarrhea. Which is the best treatment?
A. Supportive care
B. Immediate antibiotics
C. Antimotility agents alone
D. Hospitalization
A. Supportive care
Rationale: Most traveler’s diarrhea is self-limited; fluids and symptomatic care
are usually sufficient.
13. A 75-year-old female presents with dizziness and ringing in both ears for one
day. She describes vertigo. Rinne test reveals air conduction greater than bone
conduction bilaterally; Weber lateralizes to the left. She cannot hear whisper on
the right but can on the left. What is the next step?
A. Start a low-salt diet, prescribe meclizine for vertigo, and refer to ENT
B. Start antibiotics
C. Immediate MRI
D. Reassurance only
A.
Correct Answers plus Rationales | Latest
Update 2026-2027 | Graded A+
Gastrointestinal / Nausea / ENT / Eyes
1. Which medications used to treat nausea and vomiting work by affecting the
chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility
and increasing lower esophageal sphincter pressure?
A. Anticholinergics such as scopolamine
B. Metoclopramide (Reglan)
C. Ondansetron (Zofran)
D. Promethazine (Phenergan)
B. Metoclopramide (Reglan)
Rationale: Metoclopramide is a prokinetic and antidopaminergic agent that
blocks the CTZ and increases GI motility/LES pressure. Source key says
anticholinergics, but that is incorrect.
2. The antibiotic of choice for recurrent acute otitis media (AOM) and/or
treatment failure in children is:
A. Amoxicillin
B. Amoxicillin-clavulanate (Augmentin)
C. Azithromycin
D. Cephalexin
B. Amoxicillin-clavulanate (Augmentin)
Rationale: Augmentin covers beta-lactamase–producing organisms and is
preferred after recent antibiotic exposure or treatment failure.
3. A 67-year-old female on multiple medications for chronic conditions was just
diagnosed with GERD. What medication should the clinician recommend she
refrain from using?
A. Acetaminophen
B. NSAIDs
,C. Calcium carbonate
D. Metformin
B. NSAIDs
Rationale: NSAIDs increase gastric irritation and worsen GERD.
4. A 30-year-old male presents with intermittent diarrhea. He thinks his antacids
cause it because loose stools occur within 30 minutes of taking them. How
should the clinician respond?
A. Antacids may contain magnesium, which decreases bowel transit time and may
contain poorly absorbed salts that cause an osmotic draw of fluid into the bowel,
resulting in diarrhea.
B. Antacids never cause diarrhea.
C. Stop all antacids forever.
D. This is likely infectious.
A.
Rationale: Magnesium-containing antacids are laxative; osmotic salts can cause
diarrhea.
5. When the Weber test is performed with a tuning fork to assess hearing and
there is no lateralization, the clinician should document this finding as:
A. Abnormal
B. Conductive hearing loss
C. Sensorineural hearing loss
D. Normal
D. Normal
Rationale: No lateralization suggests symmetric hearing.
6. A 72-year-old male presents for annual physical. He only has a bowel
movement every three days. How should the clinician respond?
A. There is no such thing as a “normal” pattern of defecation. Patterns vary widely
and may be affected by diet, fluids, stool bacteria, stress, or voluntary
postponement. Defecating every third day could be his routine; ask if this is
normal for him.
B. He has obstipation and needs laxatives.
C. He needs a colonoscopy immediately.
D. He should have a bowel movement daily.
, A.
Rationale: Assess change from baseline rather than imposing a universal
frequency.
7. A 21-year-old female presents for pre-operative tonsillectomy clearance. She
is concerned about permanent taste changes. What should the clinician tell her?
A. Although some clients report a significant subjective drop in taste function
following surgery, none have ongoing taste dysfunction.
B. Taste loss is permanent in most patients.
C. Taste changes only occur in children.
D. She should cancel surgery.
A.
Rationale: Taste changes are usually temporary.
8. In a young child, unilateral purulent rhinitis is most often caused by:
A. Viral URI
B. Foreign body
C. Allergic rhinitis
D. Sinusitis
B. A foreign body
Rationale: Unilateral purulent nasal discharge in a child should raise suspicion for
inserted foreign body.
9. Nausea is difficult to discern in a young child. What question should the
clinician ask to determine if a child has nausea?
A. “Are you hungry?”
B. “Does your stomach hurt?”
C. “Do you feel like vomiting?”
D. “Have you eaten?”
A. “Are you hungry?”
Rationale: Loss of appetite is a practical proxy for nausea in young children.
10. A 38-year-old male has recently had an ileostomy for ulcerative colitis.
Which self-care measure should the clinician teach him to relieve food
blockade?
A. Massage the peristomal area
B. Increase high-fiber foods
, C. Drink less fluid
D. Lie flat
A. Massage the peristomal area
Rationale: For suspected food blockage, massage peristomal area, take warm
baths, increase fluids, and avoid high-fiber foods temporarily.
11. A 52-year-old female is suspected of having a gastric ulcer and will undergo
EGD. She is concerned because she heard gastric ulcers can be malignant. How
should the clinician respond?
A. About 95% of gastric ulcers are benign, even though they may look malignant
on x-ray.
B. All gastric ulcers are malignant.
C. EGD is unnecessary.
D. Only duodenal ulcers are malignant.
A.
Rationale: Most gastric ulcers are benign; biopsy during EGD is definitive.
12. A 29-year-old female just returned from Central America with traveler’s
diarrhea. Which is the best treatment?
A. Supportive care
B. Immediate antibiotics
C. Antimotility agents alone
D. Hospitalization
A. Supportive care
Rationale: Most traveler’s diarrhea is self-limited; fluids and symptomatic care
are usually sufficient.
13. A 75-year-old female presents with dizziness and ringing in both ears for one
day. She describes vertigo. Rinne test reveals air conduction greater than bone
conduction bilaterally; Weber lateralizes to the left. She cannot hear whisper on
the right but can on the left. What is the next step?
A. Start a low-salt diet, prescribe meclizine for vertigo, and refer to ENT
B. Start antibiotics
C. Immediate MRI
D. Reassurance only
A.
