NR 511 Differential Diagnosis and Primary Care- Final Exam
Review Questions with Verified Answers (Correct Update)
Question 1: A 38-year-old male patient has recentmassage ly had an ileostomy for ulcerative
colitis. Which self-care measures should the clinician teach him about to relieve food blockage?
Answer: the peristomal area
Question 2: Which of the following is true regarding diobesity verticula
Answer: is correlated
Question 3: Left lower quadrant abdominal pain for 2 Acute days, the pain started suddenly and
then fever, chills, anorexia, nausea and painless bloody stools.
Answer: diverticulitis
Question 4: An 82-year-old female has been diagnosed bulk with irritable bowel, chronic
constipation, and diverticulosis following a colonoscopy. Which pharmacological agent should
the clinician recommend?
Answer: laxative
Question 5: Which of the following is part of the treat- High ment plan for the patient with
irritable bowel syndrome?
Answer: fiber diet
Question 6: A 35-year-old female patent is seen in digital the clinic complaining of abdominal
pain. exam Which of the following should be included in the history and physical exam?
Answer: rectal exam, Sexual history, Pelvic
Question 7: A 28-year-old patent is seen in the clin- Her ic with colicky abdominal pain,
particularly with meals. She has frequent constipation, flatulence, and abdominal distension.
Which of the data make a diagnosis of diverticulitis unlikely?
Answer: age
Question 8: A 54-year-old female presents to your pri- Order mary care office for routine
reevaluation for in treatment gastroesophageal reflux disease (GERD). ogy She has been treated
with diet modifica- GERD tions and 6 weeks of omeprazole without improvement of her
symptoms. What is the next step in the management of this patient's GERD?
Answer: an endoscopy (This is the next step in order to evaluate the etiolof the patient's and consider
biopsy if necessary)
Page 1
,Question 9: A 67-year-old female on multiple medicanonsteroidal tions for chronic conditions
was just diagnosed with gastroesophageal reflux disease (GERD). In teaching the patient about
the disease, what medication should the clinician recommend that the patient refrain from using?
Answer: anti-inflammatory drugs
Question 10: The patient with gastro esophageal reflux Weight disease (GERD) should be
instructed to eliminate which of these activities?
Answer: lifting
Question 11: A patient is seen with a sudden onset of Pancreatitis, flank pain culitis, accompanied
by nausea, vomiting, and dithe aphoresis, in addition to nephrolithiasis, which of the following
should be added to the list of differential diagnoses?
Answer: peptic ulcer disease, diverti- All of above
Question 12: A patient is diagnosed with Giardia after a
Answer: Metrinidazole backpacking trip in the mountains. Which of the following would be the
appropriate treatment?
Question 13: A patient is seen in the clinic with right up- Elevated per quadrant (RUQ) pain that
is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician
should expect which of the following laboratory findings?
Answer: alkaline phosphatase
Question 14: A patient is diagnosed with gastroe- This sophageal reflux disease resistant
(GERD), and his endoscopic report reveals gastric the presence of of Barretts epithelium. Which
of the following All information should the clinician include in the explanation of the pathology
Answer: is a premalignant tissue, This tissue is to acid, This tissue supports healing the esophagus: of
the above
Question 15: which of the following dietary information Eliminate should be given to a patient
with gastroesophageal reflux disease (GERD)
Answer: cottee
Question 16: Mark has necrotizing fasciitis of his left low- Clostridium er extremity. Pressure on
the skin reveals crepitus due to gas production by which anaerobic bacteria?
Answer: perfringens
Page 2
, Question 17: A patient is diagnosed with GERD, the clinstop ician knows that she
misunderstands the eat teaching when she says:
-have
Answer: smoking smaller meals a snack before retiring for bed.
Question 18: a patient presents to the clinic with a dry
Answer: GERD cough, non smoker, for 5 weeks. the cough increases at night, he reports episodes of
heartburn after meals. what should the differential include?
Question 19: stuck" and she has been having "heartburn" at night when she lies down, especially
if she has had a heavy meal. Occasionally, she awakes at night coughing. She denies weight gain
and/or weight loss, vomiting, or change in bowel movements or color of stools. She denies alcohol
and tobacco use. There is no pertinent family history or findings on review of systems (ROS).
Physical examination is normal, with no abdominal tenderness, and the stool is occult blood (OB)
negative. What is the most likely diagnosis?
Answer: A 64-year-old obese woman comes in com- 29. GERD plaining of difficulty swallowing for the
past 3 weeks. She states that "some foods get
Question 20: Mr. J. K., 38 years old, is 5 feet 8 inches tall He and weighs 189 pounds. He reports
that he taste has had intermittent heartburn for several months for which he takes Tums with
temporary relief. He has been waking during the night with a burning sensation in his chest.
Which additional information's would lead you to believe that gastro esophageal reflux disease
(GERD) is the cause of his pain?
Answer: awakens at night coughing with a bad in his mouth
Question 21: Which of the following dietary information's Stop should be given to a patent with
gastroesophageal reflux disease (GERD)
Answer: cottee
Question 22: A 29-year-old Englishman is seen in the of- His fice with complaints of pain in his
chest and belly for 2 weeks. He gets temporary relief from Alka Seltzer. The burning pain wakes
him at night and radiates up into his chest. Which factor favors a diagnosis of gastric ulcer?
Answer: use of Alka Seltzer
Question 23: You suspect that Harry has a peptic ulcer Infection and tell him that it has been
found to be 90% strongly associated with: c infection
Answer: by Helicobacter pylori (About of cases of pepti ulcers have been found to be caused by with the
bacteria H pylori)
Page 3
Review Questions with Verified Answers (Correct Update)
Question 1: A 38-year-old male patient has recentmassage ly had an ileostomy for ulcerative
colitis. Which self-care measures should the clinician teach him about to relieve food blockage?
Answer: the peristomal area
Question 2: Which of the following is true regarding diobesity verticula
Answer: is correlated
Question 3: Left lower quadrant abdominal pain for 2 Acute days, the pain started suddenly and
then fever, chills, anorexia, nausea and painless bloody stools.
Answer: diverticulitis
Question 4: An 82-year-old female has been diagnosed bulk with irritable bowel, chronic
constipation, and diverticulosis following a colonoscopy. Which pharmacological agent should
the clinician recommend?
Answer: laxative
Question 5: Which of the following is part of the treat- High ment plan for the patient with
irritable bowel syndrome?
Answer: fiber diet
Question 6: A 35-year-old female patent is seen in digital the clinic complaining of abdominal
pain. exam Which of the following should be included in the history and physical exam?
Answer: rectal exam, Sexual history, Pelvic
Question 7: A 28-year-old patent is seen in the clin- Her ic with colicky abdominal pain,
particularly with meals. She has frequent constipation, flatulence, and abdominal distension.
Which of the data make a diagnosis of diverticulitis unlikely?
Answer: age
Question 8: A 54-year-old female presents to your pri- Order mary care office for routine
reevaluation for in treatment gastroesophageal reflux disease (GERD). ogy She has been treated
with diet modifica- GERD tions and 6 weeks of omeprazole without improvement of her
symptoms. What is the next step in the management of this patient's GERD?
Answer: an endoscopy (This is the next step in order to evaluate the etiolof the patient's and consider
biopsy if necessary)
Page 1
,Question 9: A 67-year-old female on multiple medicanonsteroidal tions for chronic conditions
was just diagnosed with gastroesophageal reflux disease (GERD). In teaching the patient about
the disease, what medication should the clinician recommend that the patient refrain from using?
Answer: anti-inflammatory drugs
Question 10: The patient with gastro esophageal reflux Weight disease (GERD) should be
instructed to eliminate which of these activities?
Answer: lifting
Question 11: A patient is seen with a sudden onset of Pancreatitis, flank pain culitis, accompanied
by nausea, vomiting, and dithe aphoresis, in addition to nephrolithiasis, which of the following
should be added to the list of differential diagnoses?
Answer: peptic ulcer disease, diverti- All of above
Question 12: A patient is diagnosed with Giardia after a
Answer: Metrinidazole backpacking trip in the mountains. Which of the following would be the
appropriate treatment?
Question 13: A patient is seen in the clinic with right up- Elevated per quadrant (RUQ) pain that
is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician
should expect which of the following laboratory findings?
Answer: alkaline phosphatase
Question 14: A patient is diagnosed with gastroe- This sophageal reflux disease resistant
(GERD), and his endoscopic report reveals gastric the presence of of Barretts epithelium. Which
of the following All information should the clinician include in the explanation of the pathology
Answer: is a premalignant tissue, This tissue is to acid, This tissue supports healing the esophagus: of
the above
Question 15: which of the following dietary information Eliminate should be given to a patient
with gastroesophageal reflux disease (GERD)
Answer: cottee
Question 16: Mark has necrotizing fasciitis of his left low- Clostridium er extremity. Pressure on
the skin reveals crepitus due to gas production by which anaerobic bacteria?
Answer: perfringens
Page 2
, Question 17: A patient is diagnosed with GERD, the clinstop ician knows that she
misunderstands the eat teaching when she says:
-have
Answer: smoking smaller meals a snack before retiring for bed.
Question 18: a patient presents to the clinic with a dry
Answer: GERD cough, non smoker, for 5 weeks. the cough increases at night, he reports episodes of
heartburn after meals. what should the differential include?
Question 19: stuck" and she has been having "heartburn" at night when she lies down, especially
if she has had a heavy meal. Occasionally, she awakes at night coughing. She denies weight gain
and/or weight loss, vomiting, or change in bowel movements or color of stools. She denies alcohol
and tobacco use. There is no pertinent family history or findings on review of systems (ROS).
Physical examination is normal, with no abdominal tenderness, and the stool is occult blood (OB)
negative. What is the most likely diagnosis?
Answer: A 64-year-old obese woman comes in com- 29. GERD plaining of difficulty swallowing for the
past 3 weeks. She states that "some foods get
Question 20: Mr. J. K., 38 years old, is 5 feet 8 inches tall He and weighs 189 pounds. He reports
that he taste has had intermittent heartburn for several months for which he takes Tums with
temporary relief. He has been waking during the night with a burning sensation in his chest.
Which additional information's would lead you to believe that gastro esophageal reflux disease
(GERD) is the cause of his pain?
Answer: awakens at night coughing with a bad in his mouth
Question 21: Which of the following dietary information's Stop should be given to a patent with
gastroesophageal reflux disease (GERD)
Answer: cottee
Question 22: A 29-year-old Englishman is seen in the of- His fice with complaints of pain in his
chest and belly for 2 weeks. He gets temporary relief from Alka Seltzer. The burning pain wakes
him at night and radiates up into his chest. Which factor favors a diagnosis of gastric ulcer?
Answer: use of Alka Seltzer
Question 23: You suspect that Harry has a peptic ulcer Infection and tell him that it has been
found to be 90% strongly associated with: c infection
Answer: by Helicobacter pylori (About of cases of pepti ulcers have been found to be caused by with the
bacteria H pylori)
Page 3
