NUR 524 Exam 3 Questions and Answers Fully Solved Latest Update 2025-2026
A 14-year-old boy presents with symptoms of fatigue and oliguria with cola-colored urine,
following streptococcal pharyngitis two weeks ago. Physical examination reveals elevated
blood pressure and swelling in the hands and feet. Urinalysis shows proteinuria and hematuria
with red blood cell casts. What is the most likely diagnosis?
Acute glomerulonephritis
Acute pyelonephritis
Acute tubular necrosis
Initial onset of diabetes mellitus - Answers Acute glomerulonephritis
Acute glomerulonephritis can occur 1-3 weeks after a streptococcal infection. The reaction that
occurs as a result of streptococcal infection is the result of an abnormal immunologic response,
resulting in damage to the glomeruli. Symptoms include hematuria, cola-colored urine, oliguria,
hypertension, and edema of the face and extremities. Urinalysis reveals red blood cells, mild
proteinuria, and red blood cell casts. Pediatric patients usually have depressed C3 complement
levels. In adults, elevation of creatinine levels is more common. Management of postinfectious
glomerulonephritis is supportive, with water and salt restriction. Calcium channel blockers or
ACE inhibitors may be used in cases of severe hypertension. More than 90% of children achieve
full recovery; complete remission in adults is 26-56%, depending on age and other comorbidities.
A 23-year-old woman presents to the clinic with a history of debilitating, unilateral headaches
that only occur shortly before her period and take her several days to recover. Which one of the
following triptans has been found to be effective in preventing these kinds of headaches?
Almotriptan
Frovatriptan
Rizatriptan
Sumatriptan - Answers Frovatriptan
Frovatriptan and naratriptan are two long-acting triptans that have been found to be effective in
preventing menstrual migraine if taken around-the-clock starting two days before menses and
continuing for a total of five to six days. Menstrual migraines are migraine headaches that occur
exclusively near the time of menses. Triptans are drugs specific to migraine treatment and bind
to serotonergic receptors. They are considered first-line treatment for moderate to severe
migraines or for mild-to-moderate migraine headaches that have failed other analgesics.
, Triptans have vasoconstrictive properties so their use is contraindicated in those with ischemic
heart disease, stroke, uncontrolled hypertension, or basilar migraine
A 55-year-old woman with restless legs syndrome presents with worsening leg symptoms
described as crawling and fidgeting over the past 4 weeks. Her symptoms have been interfering
with her quality of sleep. When asked about medications, she reports only taking pramipexole
0.5 mg (normal dose range: 0.125-0.5 mg) in the evenings. Which of the following is the most
appropriate next step in management?
Discontinue pramipexole and start gabapentin
Offer reassurance and recommend a melatonin supplement at bedtime
Order a CBC
Refer to neurology - Answers Order a CBC
Restless legs syndrome is a condition characterized by sensory disturbances and an irresistible
urge to move the legs during periods of rest. Patients will often report disturbed sleep patterns
and daytime sleepiness. Certain conditions can predispose individuals to developing the
syndrome, such as family history of restless legs syndrome, Parkinson disease, pregnancy, iron
deficiency anemia, or diabetic peripheral neuropathy
A 42-year-old woman presents to the office with double vision and eye pain. She reports these
symptoms started 4 days ago, and she experienced a similar episode around 3 months ago. She
reports pain and blurring of vision in her left eye. She has no significant past medical history and
takes no medications. On physical examination, her vital signs are normal. A focused neurologic
examination reveals that the patient cannot fully adduct her left eye while at the same time you
notice nystagmus on abduction of the right eye. There is dysmetria with finger-nose testing in
the right arm. What would be the first test to order on this patient based on the suspected
diagnosis?
Cerebrospinal fluid analysis for oligoclonal bands
Computed tomography of the brain with and without contrast
Magnetic resonance imaging of the brain with and without contrast
Visual evoked potentials - Answers Magnetic resonance imaging of the brain with and without
contrast
The first test to order in the above patient who is suspected of having multiple sclerosis (MS)
would be a contrast-enhanced MRI of the brain. She is presenting with what appears to be optic
A 14-year-old boy presents with symptoms of fatigue and oliguria with cola-colored urine,
following streptococcal pharyngitis two weeks ago. Physical examination reveals elevated
blood pressure and swelling in the hands and feet. Urinalysis shows proteinuria and hematuria
with red blood cell casts. What is the most likely diagnosis?
Acute glomerulonephritis
Acute pyelonephritis
Acute tubular necrosis
Initial onset of diabetes mellitus - Answers Acute glomerulonephritis
Acute glomerulonephritis can occur 1-3 weeks after a streptococcal infection. The reaction that
occurs as a result of streptococcal infection is the result of an abnormal immunologic response,
resulting in damage to the glomeruli. Symptoms include hematuria, cola-colored urine, oliguria,
hypertension, and edema of the face and extremities. Urinalysis reveals red blood cells, mild
proteinuria, and red blood cell casts. Pediatric patients usually have depressed C3 complement
levels. In adults, elevation of creatinine levels is more common. Management of postinfectious
glomerulonephritis is supportive, with water and salt restriction. Calcium channel blockers or
ACE inhibitors may be used in cases of severe hypertension. More than 90% of children achieve
full recovery; complete remission in adults is 26-56%, depending on age and other comorbidities.
A 23-year-old woman presents to the clinic with a history of debilitating, unilateral headaches
that only occur shortly before her period and take her several days to recover. Which one of the
following triptans has been found to be effective in preventing these kinds of headaches?
Almotriptan
Frovatriptan
Rizatriptan
Sumatriptan - Answers Frovatriptan
Frovatriptan and naratriptan are two long-acting triptans that have been found to be effective in
preventing menstrual migraine if taken around-the-clock starting two days before menses and
continuing for a total of five to six days. Menstrual migraines are migraine headaches that occur
exclusively near the time of menses. Triptans are drugs specific to migraine treatment and bind
to serotonergic receptors. They are considered first-line treatment for moderate to severe
migraines or for mild-to-moderate migraine headaches that have failed other analgesics.
, Triptans have vasoconstrictive properties so their use is contraindicated in those with ischemic
heart disease, stroke, uncontrolled hypertension, or basilar migraine
A 55-year-old woman with restless legs syndrome presents with worsening leg symptoms
described as crawling and fidgeting over the past 4 weeks. Her symptoms have been interfering
with her quality of sleep. When asked about medications, she reports only taking pramipexole
0.5 mg (normal dose range: 0.125-0.5 mg) in the evenings. Which of the following is the most
appropriate next step in management?
Discontinue pramipexole and start gabapentin
Offer reassurance and recommend a melatonin supplement at bedtime
Order a CBC
Refer to neurology - Answers Order a CBC
Restless legs syndrome is a condition characterized by sensory disturbances and an irresistible
urge to move the legs during periods of rest. Patients will often report disturbed sleep patterns
and daytime sleepiness. Certain conditions can predispose individuals to developing the
syndrome, such as family history of restless legs syndrome, Parkinson disease, pregnancy, iron
deficiency anemia, or diabetic peripheral neuropathy
A 42-year-old woman presents to the office with double vision and eye pain. She reports these
symptoms started 4 days ago, and she experienced a similar episode around 3 months ago. She
reports pain and blurring of vision in her left eye. She has no significant past medical history and
takes no medications. On physical examination, her vital signs are normal. A focused neurologic
examination reveals that the patient cannot fully adduct her left eye while at the same time you
notice nystagmus on abduction of the right eye. There is dysmetria with finger-nose testing in
the right arm. What would be the first test to order on this patient based on the suspected
diagnosis?
Cerebrospinal fluid analysis for oligoclonal bands
Computed tomography of the brain with and without contrast
Magnetic resonance imaging of the brain with and without contrast
Visual evoked potentials - Answers Magnetic resonance imaging of the brain with and without
contrast
The first test to order in the above patient who is suspected of having multiple sclerosis (MS)
would be a contrast-enhanced MRI of the brain. She is presenting with what appears to be optic
