NR511 Final Exam | Questions and Correct Answers
plus Rationale | Latest Update 2026-2027
Question 1 Janet is a 30 year old woman who has been recently diagnosed with
a herniated disc at the level of L5-S1. She is currently in the emergency room
with suspicion of cauda equina compression. Which of the following is a sign or
symptom of cauda equina compression?
a. gastrocnemius weakness
b. reduced or absent ankle reflexes
c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks
Correct answer: d.
Rationale: Cauda equina syndrome classically presents with saddle anesthesia
(perineum/buttocks), bowel/bladder dysfunction, and severe radicular pain.
Lateral foot numbness and ankle reflex changes are more consistent with L5-S1
radiculopathy.
Question 2 The patient has acute pancreatitis with 7 of the diagnostic criteria
from Ranson's Criteria. In order to plan care, the clinician understands that this
criteria score has which of the following meanings?
a. a high mortality rate
b. an increased chance of recurrence
c. 7% chance of the disease becoming chronic
d. all of the above
Correct answer: a.
Rationale: Ranson criteria score ≥7 is associated with severe acute pancreatitis
and a high mortality rate.
,Question 3 Reuben, age 24, has HIV and just had a routine viral load test done.
The results show a falling viral load. What does this indicate?
a. a favorable diagnostic trend
b. disease progression
c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV
Correct answer: a.
Rationale: A falling HIV viral load indicates the virus is being suppressed, which is
a favorable response to therapy. It does not mean eradication.
Question 4 Which is the differentiating symptom between labyrinthitis and
vestibular neuritis?
a. symptoms with vestibular neuritis are usually acute in onset, whereas with
labyrinthitis the onset is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with
labyrinthitis
c. symptoms with labyrinthitis are usually acute in onset, whereas with vestibular
neuritis the onset is more gradual
d. hearing loss may be associated with labyrinthitis, but not with vestibular
neuritis.
Correct answer: d.
Rationale: Labyrinthitis involves both vestibular and cochlear structures, so
hearing loss can occur. Vestibular neuritis affects only the vestibular nerve, sparing
hearing.
Question 5 A 27 year old female presents with a chief complaint of burning and
pain on urination. She has no previous history of urinary tract infection. What
are some additional symptoms consistent with a diagnosis of lower UTI?
a. back and abdominal pain
b. fever, chills, costovertebral angle (CVA) tenderness
,c. blood in urine and frequency
d. foul-smelling discharge, perineal itch
Correct answer: c.
Rationale: Lower UTI (cystitis) typically presents with dysuria, frequency, urgency,
hematuria, and suprapubic discomfort. Fever/chills/CVA tenderness suggest upper
UTI/pyelonephritis.
Question 6 The differential diagnosis for vertigo can be classified into which of
the following categories:
a. peripheral vestibular disease
b. CNS disorders
c. Systemic disorders
d. all of the above
Correct answer: d.
Rationale: Vertigo can arise from peripheral vestibular, central nervous system, or
systemic causes.
Question 7 Sam is a 25-year-old man who has been diagnosed with low back
strain based on his history of localized low back pain and muscle spasm along
with a normal neurological examination. As the clinician, you explain to Sam
that low back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus
pulposus or ruptured disc?
a. morning stiffness and limited mobility of the lumbar spine
b. unilateral radicular pain symptoms that extend below the knee and are equal
to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. pathologic fractures, severe night pain, weight loss and fatigue
Correct answer: b.
Rationale: Radicular pain extending below the knee, often greater than back pain,
suggests nerve root compression from a herniated disc.
, Question 8 Preceptors must always see the patients that the students see in the
clinical setting
a. true
b. false
Correct answer: a.
Rationale: Clinical preceptors are responsible for supervising students and must
see the patients students evaluate to ensure appropriate care and teaching.
Question 9 An 82 year old man is seen in the primary care office with complaints
of dribbling urine and difficulty starting his stream. Which of the following
should be included in the list of differentials?
a. BPH
b. Prostate cancer
c. UTI
d. all of the above
Correct answer: d.
Rationale: Dribbling and difficulty initiating stream in an older man can be due to
BPH, prostate cancer, UTI, or other causes.
Question 10 Which causes the greatest percentage of mammalian bites?
a. dogs
b. cats
c. humans
d. rodents
Correct answer: a.
Rationale: Dog bites account for the majority of mammalian bites.
plus Rationale | Latest Update 2026-2027
Question 1 Janet is a 30 year old woman who has been recently diagnosed with
a herniated disc at the level of L5-S1. She is currently in the emergency room
with suspicion of cauda equina compression. Which of the following is a sign or
symptom of cauda equina compression?
a. gastrocnemius weakness
b. reduced or absent ankle reflexes
c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks
Correct answer: d.
Rationale: Cauda equina syndrome classically presents with saddle anesthesia
(perineum/buttocks), bowel/bladder dysfunction, and severe radicular pain.
Lateral foot numbness and ankle reflex changes are more consistent with L5-S1
radiculopathy.
Question 2 The patient has acute pancreatitis with 7 of the diagnostic criteria
from Ranson's Criteria. In order to plan care, the clinician understands that this
criteria score has which of the following meanings?
a. a high mortality rate
b. an increased chance of recurrence
c. 7% chance of the disease becoming chronic
d. all of the above
Correct answer: a.
Rationale: Ranson criteria score ≥7 is associated with severe acute pancreatitis
and a high mortality rate.
,Question 3 Reuben, age 24, has HIV and just had a routine viral load test done.
The results show a falling viral load. What does this indicate?
a. a favorable diagnostic trend
b. disease progression
c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV
Correct answer: a.
Rationale: A falling HIV viral load indicates the virus is being suppressed, which is
a favorable response to therapy. It does not mean eradication.
Question 4 Which is the differentiating symptom between labyrinthitis and
vestibular neuritis?
a. symptoms with vestibular neuritis are usually acute in onset, whereas with
labyrinthitis the onset is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with
labyrinthitis
c. symptoms with labyrinthitis are usually acute in onset, whereas with vestibular
neuritis the onset is more gradual
d. hearing loss may be associated with labyrinthitis, but not with vestibular
neuritis.
Correct answer: d.
Rationale: Labyrinthitis involves both vestibular and cochlear structures, so
hearing loss can occur. Vestibular neuritis affects only the vestibular nerve, sparing
hearing.
Question 5 A 27 year old female presents with a chief complaint of burning and
pain on urination. She has no previous history of urinary tract infection. What
are some additional symptoms consistent with a diagnosis of lower UTI?
a. back and abdominal pain
b. fever, chills, costovertebral angle (CVA) tenderness
,c. blood in urine and frequency
d. foul-smelling discharge, perineal itch
Correct answer: c.
Rationale: Lower UTI (cystitis) typically presents with dysuria, frequency, urgency,
hematuria, and suprapubic discomfort. Fever/chills/CVA tenderness suggest upper
UTI/pyelonephritis.
Question 6 The differential diagnosis for vertigo can be classified into which of
the following categories:
a. peripheral vestibular disease
b. CNS disorders
c. Systemic disorders
d. all of the above
Correct answer: d.
Rationale: Vertigo can arise from peripheral vestibular, central nervous system, or
systemic causes.
Question 7 Sam is a 25-year-old man who has been diagnosed with low back
strain based on his history of localized low back pain and muscle spasm along
with a normal neurological examination. As the clinician, you explain to Sam
that low back pain is a diagnosis of exclusion. Which of the following symptoms
would alert the clinician to the more serious finding of a herniated nucleus
pulposus or ruptured disc?
a. morning stiffness and limited mobility of the lumbar spine
b. unilateral radicular pain symptoms that extend below the knee and are equal
to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. pathologic fractures, severe night pain, weight loss and fatigue
Correct answer: b.
Rationale: Radicular pain extending below the knee, often greater than back pain,
suggests nerve root compression from a herniated disc.
, Question 8 Preceptors must always see the patients that the students see in the
clinical setting
a. true
b. false
Correct answer: a.
Rationale: Clinical preceptors are responsible for supervising students and must
see the patients students evaluate to ensure appropriate care and teaching.
Question 9 An 82 year old man is seen in the primary care office with complaints
of dribbling urine and difficulty starting his stream. Which of the following
should be included in the list of differentials?
a. BPH
b. Prostate cancer
c. UTI
d. all of the above
Correct answer: d.
Rationale: Dribbling and difficulty initiating stream in an older man can be due to
BPH, prostate cancer, UTI, or other causes.
Question 10 Which causes the greatest percentage of mammalian bites?
a. dogs
b. cats
c. humans
d. rodents
Correct answer: a.
Rationale: Dog bites account for the majority of mammalian bites.
