NR511 MIDTERM EXAM 2025 ACTUAL 2 VERSIONS WITH OVER
350 QUESTIONS WITH DETAILED VERIFIED ANSWERS AND
RATIONALES
Which |medications |used |to |treat |nausea |and |vomiting |works |by |affecting |the |chemoreceptor
|trigger |zone, |thereby |stimulating |upper |gastrointestinal |motility |and |increasing |lower |esophageal
|sphincter |pressure? |- |CORRECT |ANSWER-Anticholinergics, |such |as |scopolamine |(Donnatal).
The |antibiotic |of |choice |for |recurrent |acute |otitis |media |(AM) |and/or
treatment |failure |in |children |is: |- |CORRECT |ANSWER-Amoxicillin |and |potassium |clavulanate |(Augmentin).
A |67-year |old |female |on |multiple |medications |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? |- |CORRECT |ANSWER-Nonsteroidal |anti-
|inflammatory |drugs |(NSAIDs).
A |30-year-old |male |presents |to |the |clinic |with |intermittent
diarrhea. |He |is |pretty |sure |that |the |antacids |taken |for |heartburn
|
are |the |cause |since |the |loose |stools |always |occur |within |30
|
minutes |after |taking
|
them. |How |should |the |clinician |respond? |- |CORRECT |ANSWER-Antacids |may |contain |magnesium,
|which |decreases |bowel
transit |time |and |may |contain |poorly |absorbed |salts |that |result
in |an |osmotic |draw |iofufluid |into |the |bowel |resulting |in |diarrhea.
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: |- |CORRECT |ANSWER-A |normal |finding.
|
A |72-year-old |male |patient |presents |to |the |clinic |for |his |annual
,physical. |He |states |that |he |is |worried |because |he |only |has |a |bowel
movement |every |three |days. |How |should |the |clinician |respond? |- |CORRECT |ANSWER-There |is |no
|such |thing |as |a |"normal" |pattern |of |defecation.
Patterns |of |defecation |vary |widely |and |may |in |part |be
affected |by |dietary |habits, |fluid |intake, |bacteria |in |the |stool,
|
psychological |stress, |or |voluntary |postponement |of
|
defecation. |Defecating |every |third |day |could |be |the |routine
|
pattern |for |Simon. |He |should |be |questioned |if |this |is
|
routine |for |him.
|
A |21-year-old |female |patient |presents |to |the |clinic |for |pre-operative
tonsillectomy |clearance. |She |has |heard |about |permanent |taste
|
changes |after |a |tonsillectomy |and |is |concerned. |What |should |the
|
clinician |tell |her? |- |CORRECT |ANSWER-Although |some |clients |report |a |significant |subjective |drop |in
taste |function |following |surgery, |none |have |ongoing |taste
|
dysfunction.
In |a |young |child, |unilateral |purulent |rhinitis |is |most |often |caused |by: |- |CORRECT |ANSWER-A |foreign |body.
Nausea |is |difficult |to |discern |in |a |young |child |what |question |should |the |clinician |asked |to |determine
|if |a |child |has |nausea |- |CORRECT |ANSWER-Are |you |hungry
A |38-year-old |male |has |recently |had |an |iliomy |for |ulcerative |colitis |which |self-care |measure |should |the
|clinician |teach |him |to |relieve |food |blockade |- |CORRECT |ANSWER-Massage |the |periosteum |area
52 |year |old |female |as |suspected |of |having |a |gastric |ulcer |and |will |undergo |an |EGD |she's
|concerned |because |she |heard |that |gastric |ulcers |can |be |malignant |how |should |the |clinician
|respond |- |CORRECT |ANSWER-About |95% |of |gastric |ulcers |are |Banan |even |though |they |seem |to
|like |a |malignant |on |x-ray
A |29 |year |old |female |just |returned |from |Central |America |with |travelers |diarrhea |and |presents |to
|the |clinic |for |evaluation |which |of |the |following |is |the |best |treatment |- |CORRECT |ANSWER-
Supportive |care
,A |75-year-old |female |presents |to |your |office |complaining |of |dizziness |and |ringing |in |both |ears |for
|one |day |she |describes |the |dizziness |as |feeling |like |the |room |is |spinning |on |physical |exam |the |run |test
|reveals |the |air |connection |is |greater |than |bone |conduction |bilaterally |the |web |or |test |reveals
|lateralization |to |the |left |she |is |unable |to |hear |the |examiners |whisper |on |the |right |but |she |can |hear
|the |whisper |on |the |left |what |is |the |next |step |to |helping |this |patient |symptoms |- |CORRECT |ANSWER-
Start |the |patient |on |a |low |salt |diet |prescribe |meclizine |for |vertigo |and |refer |to |ENT
An |82-year-old |female |has |been |diagnosed |with |IBS |and |chronic |constipation |and |diverticulitis
|following |a |colonoscopy |what |pharmacologic |agent |should |the |clinician |recommend |- |CORRECT
|ANSWER-Bulking |agent
A |26-year-old |male |recently |returned |from |a |camping |trip |with |symptoms |of |acute |gastroenteritis |he
|reports |that |he |only |ate |vegetables |from |his |garden |that |he |can't |prior |to |the |attic |which |of |the
|following |pathogens |might |be |causing |his |symptoms |- |CORRECT |ANSWER-Clostridium |botulinum
A |20-year-old |male |presents |to |your |office |in |summer |complaining |of |chest |discoloration |he |is |a
|lifeguard |and |has |been |out |in |the |sun |without |a |shirt |for |a |long |period |of |time |his |physical |exam |so
|small |flat |circular |hypopigmented |macules |on |his |chest |that |he |states |are |mildly |paretic |what |is |the
|treatment |choice |for |this |diagnosis |- |CORRECT |ANSWER-Selenium |sulfide |shampoo
Mary |H |82 |presents |with |several |other |problems |she |states |that |her |eyes |are |always |draw |and |look
|sunken |in |what |do |you |suspect |- |CORRECT |ANSWER-Age |related |changes
Sharon |a |47-year-old |bank |taylor |is |saying |by |the |nurse |practitioner |in |the |office |for |red |are |you |were
|trying |to |decide |between |a |diagnosis |of |conjunctivitis |in |irritate |us |why |distinguishing |character
|between |the |two |is |- |CORRECT |ANSWER-A |Cillary |flush |when |trying |to |decide |between |a |diagnosis |of
|conjunctivitis |and |he |irritates |one |distinguishing |characteristic |is |the |Silveri |fret |flush |the |toilet
|present |in |irritate |us
Which |of |the |following |patients |does |not |have |an |increased |risk |of |candidia |- |CORRECT |ANSWER-A
|patient |with |a |history |of |coronary |artery |disease
A |25-year-old |male |present |to |your |urgent |care |clinic |complaining |of |genital |pruritus. |On |physical
|exam |the |patient |has |small |erythematous |excoriated |papules |on |his |pubic |hair |nomads |are
|identified |there's |no |penile |discharge |and |the |patient |has |no |constitutional |symptoms |he |sexually
|active |but |where |is |condoms |during |all |sexual |experiences |what |is |the |most |likely |diagnosis |-
|CORRECT |ANSWER-Chlamydia
, A |rash |that |looks |like |the |patient |was |slapped |on |the |cheeks |of |the |face |is |a |hallmark |characteristics
|for |what |disease |- |CORRECT |ANSWER-Fifths |disease
A |27 |year |old |mail |comes |into |your |primary |care |office |complaining |of |a |hairy |oriole |rash |the
|patient |notice |burning |around |her |lips |a |couple |days |ago |that |quickly |went |away |she |awoke |from
|sleep |yesterday |and |noticed |a |group |of |vesicles |with |erythematous |faces |were |the |burning |had
|been |before |there |is |no |burning |today |she |is |afebrile |and |has |no |difficulty |eating |or |swallowing
|what |test |would |confirm |her |diagnosis |- |CORRECT |ANSWER-Tzanck |smear
84-year-old |male |presents |to |your |pediatric |clinic |with |his |mother |complaining |of |an |itchy |rash
|mostly |between |his |fingers |this |is |been |going |on |for |multiple |days |and |has |been |getting |worse |the
|patient |recently |started |a |new |daycare |on |physical |exam |the |patient |is |afebrile |and |has |multiple
|small |one |to |two |MM |read |papules |and |sets |of |three |located |on |the |web |spaces |between |his |fingers
|he |also |has |signs |of |excoriation |what |is |the |treatment |of |the |problem |- |CORRECT |ANSWER-
Permethrin |lotion |For |the |patient |and |also |his |family |members
Mrs. |Johnson |of |54 |year |old |accountant |presents |to |the |office |with |a |painful |read |out |without
|discharge |you |should |suspect |- |CORRECT |ANSWER-Iritis
A |three-year-old |patient |presents |to |your |pediatric |office |with |her |mother |she |has |recently |started |a
|daycare |her |mother |notice |lot |Perry |orbital |erythema |on |the |right |side |of |the |patient's |mouth |last
|night |before |bed |the |patient |at |work |today |with |three |small |superficial |honey |colored |bicycles |with
|erythema |what |was |last |night |the |patient |has |no |surrounding |erythema |presently |she |had |no
|difficulty |eating |this |morning |and |is |active |and |energetic |and |doesn't |appear |lethargic |or |fatigued
|she's |also |afebrile |how |would |you |trade |this |child |- |CORRECT |ANSWER-Local |debridement |and
|mupirocin |for |five |days
A |22-year-old |college |student |presents |to |your |urgent |care |clinic |complaining |of |a |rash |she |was
|recently |on |spring |break |and |spent |every |night |in |the |hot |tub |of |her |hotel |on |physical |exam |she |has
|multiple |small |areas |of |want |to |two |MM |erythematous |pustules |that |are |mostly |present |with |her
|bathing |suit |covered |her |buttocks |what |is |the |most |likely |pathogen |causing |these |- |CORRECT
|ANSWER-Pseudo |Jonas |aeruginosa
18-year-old |male |presents |to |the |office |with |his |mother |with |complaints |of |itchy |and |red |eyes |for
|one |day |he |reports |watering |drainage |in |both |eyes |associated |with |repetitive |itching |he |has |no
|fever |or |constitutional |symptoms |the |patient |has |a |sibling |with |that |just |started |daycare |recently
|upon |examination |vision |is |2020 |with |glasses |he |has |mild |to |moderate |conjunctival |hyperemia |with
|Balletto
350 QUESTIONS WITH DETAILED VERIFIED ANSWERS AND
RATIONALES
Which |medications |used |to |treat |nausea |and |vomiting |works |by |affecting |the |chemoreceptor
|trigger |zone, |thereby |stimulating |upper |gastrointestinal |motility |and |increasing |lower |esophageal
|sphincter |pressure? |- |CORRECT |ANSWER-Anticholinergics, |such |as |scopolamine |(Donnatal).
The |antibiotic |of |choice |for |recurrent |acute |otitis |media |(AM) |and/or
treatment |failure |in |children |is: |- |CORRECT |ANSWER-Amoxicillin |and |potassium |clavulanate |(Augmentin).
A |67-year |old |female |on |multiple |medications |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? |- |CORRECT |ANSWER-Nonsteroidal |anti-
|inflammatory |drugs |(NSAIDs).
A |30-year-old |male |presents |to |the |clinic |with |intermittent
diarrhea. |He |is |pretty |sure |that |the |antacids |taken |for |heartburn
|
are |the |cause |since |the |loose |stools |always |occur |within |30
|
minutes |after |taking
|
them. |How |should |the |clinician |respond? |- |CORRECT |ANSWER-Antacids |may |contain |magnesium,
|which |decreases |bowel
transit |time |and |may |contain |poorly |absorbed |salts |that |result
in |an |osmotic |draw |iofufluid |into |the |bowel |resulting |in |diarrhea.
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: |- |CORRECT |ANSWER-A |normal |finding.
|
A |72-year-old |male |patient |presents |to |the |clinic |for |his |annual
,physical. |He |states |that |he |is |worried |because |he |only |has |a |bowel
movement |every |three |days. |How |should |the |clinician |respond? |- |CORRECT |ANSWER-There |is |no
|such |thing |as |a |"normal" |pattern |of |defecation.
Patterns |of |defecation |vary |widely |and |may |in |part |be
affected |by |dietary |habits, |fluid |intake, |bacteria |in |the |stool,
|
psychological |stress, |or |voluntary |postponement |of
|
defecation. |Defecating |every |third |day |could |be |the |routine
|
pattern |for |Simon. |He |should |be |questioned |if |this |is
|
routine |for |him.
|
A |21-year-old |female |patient |presents |to |the |clinic |for |pre-operative
tonsillectomy |clearance. |She |has |heard |about |permanent |taste
|
changes |after |a |tonsillectomy |and |is |concerned. |What |should |the
|
clinician |tell |her? |- |CORRECT |ANSWER-Although |some |clients |report |a |significant |subjective |drop |in
taste |function |following |surgery, |none |have |ongoing |taste
|
dysfunction.
In |a |young |child, |unilateral |purulent |rhinitis |is |most |often |caused |by: |- |CORRECT |ANSWER-A |foreign |body.
Nausea |is |difficult |to |discern |in |a |young |child |what |question |should |the |clinician |asked |to |determine
|if |a |child |has |nausea |- |CORRECT |ANSWER-Are |you |hungry
A |38-year-old |male |has |recently |had |an |iliomy |for |ulcerative |colitis |which |self-care |measure |should |the
|clinician |teach |him |to |relieve |food |blockade |- |CORRECT |ANSWER-Massage |the |periosteum |area
52 |year |old |female |as |suspected |of |having |a |gastric |ulcer |and |will |undergo |an |EGD |she's
|concerned |because |she |heard |that |gastric |ulcers |can |be |malignant |how |should |the |clinician
|respond |- |CORRECT |ANSWER-About |95% |of |gastric |ulcers |are |Banan |even |though |they |seem |to
|like |a |malignant |on |x-ray
A |29 |year |old |female |just |returned |from |Central |America |with |travelers |diarrhea |and |presents |to
|the |clinic |for |evaluation |which |of |the |following |is |the |best |treatment |- |CORRECT |ANSWER-
Supportive |care
,A |75-year-old |female |presents |to |your |office |complaining |of |dizziness |and |ringing |in |both |ears |for
|one |day |she |describes |the |dizziness |as |feeling |like |the |room |is |spinning |on |physical |exam |the |run |test
|reveals |the |air |connection |is |greater |than |bone |conduction |bilaterally |the |web |or |test |reveals
|lateralization |to |the |left |she |is |unable |to |hear |the |examiners |whisper |on |the |right |but |she |can |hear
|the |whisper |on |the |left |what |is |the |next |step |to |helping |this |patient |symptoms |- |CORRECT |ANSWER-
Start |the |patient |on |a |low |salt |diet |prescribe |meclizine |for |vertigo |and |refer |to |ENT
An |82-year-old |female |has |been |diagnosed |with |IBS |and |chronic |constipation |and |diverticulitis
|following |a |colonoscopy |what |pharmacologic |agent |should |the |clinician |recommend |- |CORRECT
|ANSWER-Bulking |agent
A |26-year-old |male |recently |returned |from |a |camping |trip |with |symptoms |of |acute |gastroenteritis |he
|reports |that |he |only |ate |vegetables |from |his |garden |that |he |can't |prior |to |the |attic |which |of |the
|following |pathogens |might |be |causing |his |symptoms |- |CORRECT |ANSWER-Clostridium |botulinum
A |20-year-old |male |presents |to |your |office |in |summer |complaining |of |chest |discoloration |he |is |a
|lifeguard |and |has |been |out |in |the |sun |without |a |shirt |for |a |long |period |of |time |his |physical |exam |so
|small |flat |circular |hypopigmented |macules |on |his |chest |that |he |states |are |mildly |paretic |what |is |the
|treatment |choice |for |this |diagnosis |- |CORRECT |ANSWER-Selenium |sulfide |shampoo
Mary |H |82 |presents |with |several |other |problems |she |states |that |her |eyes |are |always |draw |and |look
|sunken |in |what |do |you |suspect |- |CORRECT |ANSWER-Age |related |changes
Sharon |a |47-year-old |bank |taylor |is |saying |by |the |nurse |practitioner |in |the |office |for |red |are |you |were
|trying |to |decide |between |a |diagnosis |of |conjunctivitis |in |irritate |us |why |distinguishing |character
|between |the |two |is |- |CORRECT |ANSWER-A |Cillary |flush |when |trying |to |decide |between |a |diagnosis |of
|conjunctivitis |and |he |irritates |one |distinguishing |characteristic |is |the |Silveri |fret |flush |the |toilet
|present |in |irritate |us
Which |of |the |following |patients |does |not |have |an |increased |risk |of |candidia |- |CORRECT |ANSWER-A
|patient |with |a |history |of |coronary |artery |disease
A |25-year-old |male |present |to |your |urgent |care |clinic |complaining |of |genital |pruritus. |On |physical
|exam |the |patient |has |small |erythematous |excoriated |papules |on |his |pubic |hair |nomads |are
|identified |there's |no |penile |discharge |and |the |patient |has |no |constitutional |symptoms |he |sexually
|active |but |where |is |condoms |during |all |sexual |experiences |what |is |the |most |likely |diagnosis |-
|CORRECT |ANSWER-Chlamydia
, A |rash |that |looks |like |the |patient |was |slapped |on |the |cheeks |of |the |face |is |a |hallmark |characteristics
|for |what |disease |- |CORRECT |ANSWER-Fifths |disease
A |27 |year |old |mail |comes |into |your |primary |care |office |complaining |of |a |hairy |oriole |rash |the
|patient |notice |burning |around |her |lips |a |couple |days |ago |that |quickly |went |away |she |awoke |from
|sleep |yesterday |and |noticed |a |group |of |vesicles |with |erythematous |faces |were |the |burning |had
|been |before |there |is |no |burning |today |she |is |afebrile |and |has |no |difficulty |eating |or |swallowing
|what |test |would |confirm |her |diagnosis |- |CORRECT |ANSWER-Tzanck |smear
84-year-old |male |presents |to |your |pediatric |clinic |with |his |mother |complaining |of |an |itchy |rash
|mostly |between |his |fingers |this |is |been |going |on |for |multiple |days |and |has |been |getting |worse |the
|patient |recently |started |a |new |daycare |on |physical |exam |the |patient |is |afebrile |and |has |multiple
|small |one |to |two |MM |read |papules |and |sets |of |three |located |on |the |web |spaces |between |his |fingers
|he |also |has |signs |of |excoriation |what |is |the |treatment |of |the |problem |- |CORRECT |ANSWER-
Permethrin |lotion |For |the |patient |and |also |his |family |members
Mrs. |Johnson |of |54 |year |old |accountant |presents |to |the |office |with |a |painful |read |out |without
|discharge |you |should |suspect |- |CORRECT |ANSWER-Iritis
A |three-year-old |patient |presents |to |your |pediatric |office |with |her |mother |she |has |recently |started |a
|daycare |her |mother |notice |lot |Perry |orbital |erythema |on |the |right |side |of |the |patient's |mouth |last
|night |before |bed |the |patient |at |work |today |with |three |small |superficial |honey |colored |bicycles |with
|erythema |what |was |last |night |the |patient |has |no |surrounding |erythema |presently |she |had |no
|difficulty |eating |this |morning |and |is |active |and |energetic |and |doesn't |appear |lethargic |or |fatigued
|she's |also |afebrile |how |would |you |trade |this |child |- |CORRECT |ANSWER-Local |debridement |and
|mupirocin |for |five |days
A |22-year-old |college |student |presents |to |your |urgent |care |clinic |complaining |of |a |rash |she |was
|recently |on |spring |break |and |spent |every |night |in |the |hot |tub |of |her |hotel |on |physical |exam |she |has
|multiple |small |areas |of |want |to |two |MM |erythematous |pustules |that |are |mostly |present |with |her
|bathing |suit |covered |her |buttocks |what |is |the |most |likely |pathogen |causing |these |- |CORRECT
|ANSWER-Pseudo |Jonas |aeruginosa
18-year-old |male |presents |to |the |office |with |his |mother |with |complaints |of |itchy |and |red |eyes |for
|one |day |he |reports |watering |drainage |in |both |eyes |associated |with |repetitive |itching |he |has |no
|fever |or |constitutional |symptoms |the |patient |has |a |sibling |with |that |just |started |daycare |recently
|upon |examination |vision |is |2020 |with |glasses |he |has |mild |to |moderate |conjunctival |hyperemia |with
|Balletto
