NSG 555 EVALUATION EXAM ACTUAL QUESTIONS AND
SOLUTIONS GRADED A+
✔✔What is the recommended treatment for Group E in COPD management? -
✔✔LABA + LAMA; consider adding ICS if blood eosinophils are 300 or greater.
✔✔What is the first-line treatment for exacerbations in COPD? - ✔✔SABA with or
without SAMA.
✔✔When should antibiotics be used in COPD exacerbations? - ✔✔When signs of
bacterial infection are present; azithromycin for 5 days.
✔✔What is the maximum duration for systemic corticosteroids during COPD
exacerbations? - ✔✔No more than 5 days.
✔✔What is the essential criterion for diagnosing Pulmonary Arterial Hypertension
(PAH)? - ✔✔Mean Pulmonary Artery pressure of 25 mmHg or higher.
✔✔What are the late signs of Pulmonary Arterial Hypertension? - ✔✔Syncope,
abdominal distention, ascites, peripheral edema.
✔✔What is the GOLD standard diagnostic tool for Pulmonary Hypertension? - ✔✔Right
Heart catheterization.
✔✔What initial treatment is recommended for Group 1 Pulmonary Hypertension? -
✔✔Calcium Channel Blockers.
✔✔What is the essential diagnosis for Sarcoidosis? - ✔✔Demonstration of
noncaseating granulomas from a biopsy.
✔✔What are common clinical findings in Sarcoidosis? - ✔✔Asymptomatic or insidious
onset; skin lesions like erythema nodosum or Lupus Pernio.
✔✔What laboratory findings may indicate Sarcoidosis? - ✔✔Leukopenia, elevated ESR,
and hypercalcemia.
✔✔What is the primary treatment for Sarcoidosis? - ✔✔Oral corticosteroids; long-term
therapy may be necessary.
✔✔What is the first symptom of idiopathic pulmonary fibrosis? - ✔✔A chronic dry cough.
✔✔What differentiates asthma from COPD in terms of management? - ✔✔Medication
management as per algorithms in pocket guides is critical.
,✔✔What are the common etiologies of chronic cough? - ✔✔Post nasal drip, acid reflux,
and asthma.
✔✔What effect does acid reflux have on the respiratory system? - ✔✔Stomach acid can
irritate the throat and airways, leading to inflammation.
✔✔What is the significance of elevated jugular venous pressure (JVP) in pulmonary
conditions? - ✔✔It is an indicator of potential heart failure or pulmonary hypertension.
✔✔What is the role of long-term azithromycin or erythromycin in COPD? - ✔✔It can
prevent exacerbations but may increase bacterial resistance and hearing impairment.
✔✔What are the categories of Pulmonary Hypertension? - ✔✔Group 1: pulmonary
vasculopathy; Group 2: left heart disease; Group 3: parenchymal disease; Group 4:
thromboembolic diseases; Group 5: multifactorial.
✔✔What should be ruled out when diagnosing pulmonary hypertension? -
✔✔Pulmonary emboli.
✔✔What is the importance of understanding the pathophysiology of chronic cough? -
✔✔It directs the priority of pharmacologic treatment.
✔✔What are the main areas covered in the exam for Module 3 (GI/GU)? - ✔✔Hepatitis,
MASLD, renal failure, and cirrhosis.
✔✔What are the common causes of anal fissures? - ✔✔Trauma to the anal canal
during defecation caused by straining, constipation, or high internal sphincter tone.
✔✔What symptoms do patients with anal fissures typically report? - ✔✔Severe tearing
pain during defecation followed by throbbing discomfort, which may lead to constipation
due to fear of recurrent pain.
✔✔How are anal fissures diagnosed? - ✔✔Visual inspection; acute fissures appear as
cracks in the epithelium, while chronic fissures result in fibrosis and a skin tag.
✔✔What is the primary treatment for anal fissures? - ✔✔Promoting effortless, painless
bowel movements, and the use of topical anesthetics like 5% lidocaine.
✔✔What is the prognosis for healing anal fissures? - ✔✔Healing within 2 months in up
to 45% of patients.
✔✔What causes perianal abscesses? - ✔✔Infection of the anal glands located at the
base of the anal crypts.
, ✔✔What are the symptoms of a perianal abscess? - ✔✔Throbbing, continuous perianal
pain, erythema, fluctuance, and swelling.
✔✔What is the treatment for a perianal abscess? - ✔✔Local incision and drainage;
ischiorectal abscesses require drainage in the operating room.
✔✔What is a common complication after drainage of a perianal abscess? - ✔✔Most
patients are found to have a fistula in ano.
✔✔What techniques are used for healing a fistula in ano? - ✔✔Endoanal advancement
flap over the internal opening and insertion of a bioprosthetic plug.
✔✔What characterizes perianal pruritus? - ✔✔Perianal itching and discomfort.
✔✔What are some causes of perianal pruritus? - ✔✔Poor anal hygiene, fistulas,
fissures, prolapsed hemorrhoids, skin tags, incontinence, and overzealous cleansing.
✔✔What are some differential diagnoses for perianal pruritus? - ✔✔Contact dermatitis,
atopic dermatitis, bacterial infections, candidal infections, STIs, and other skin
conditions.
✔✔What dietary items should be avoided in cases of perianal pruritus? - ✔✔Spicy
foods, coffee, chocolate, and tomatoes.
✔✔What is Barrett's esophagus? - ✔✔A condition where the squamous epithelium of
the esophagus is replaced by metaplastic columnar epithelium containing goblet and
columnar cells.
✔✔What causes Barrett's esophagus? - ✔✔Chronic reflux-induced injury to the
esophageal squamous epithelium, increased in patients with truncal obesity.
✔✔How is Barrett's esophagus diagnosed? - ✔✔Endoscopy shows orange, gastric-type
epithelium extending upward more than 1 cm from the gastroesophageal junction;
biopsies confirm diagnosis.
✔✔What is a significant complication of Barrett's esophagus? - ✔✔Esophageal
adenocarcinoma with a risk of 0.2-0.5% per year.
✔✔What are the recommendations for endoscopic screenings in Barrett's esophagus? -
✔✔Adults with weekly GERD symptoms for 5 or more years and three or more risk
factors should undergo screenings.
SOLUTIONS GRADED A+
✔✔What is the recommended treatment for Group E in COPD management? -
✔✔LABA + LAMA; consider adding ICS if blood eosinophils are 300 or greater.
✔✔What is the first-line treatment for exacerbations in COPD? - ✔✔SABA with or
without SAMA.
✔✔When should antibiotics be used in COPD exacerbations? - ✔✔When signs of
bacterial infection are present; azithromycin for 5 days.
✔✔What is the maximum duration for systemic corticosteroids during COPD
exacerbations? - ✔✔No more than 5 days.
✔✔What is the essential criterion for diagnosing Pulmonary Arterial Hypertension
(PAH)? - ✔✔Mean Pulmonary Artery pressure of 25 mmHg or higher.
✔✔What are the late signs of Pulmonary Arterial Hypertension? - ✔✔Syncope,
abdominal distention, ascites, peripheral edema.
✔✔What is the GOLD standard diagnostic tool for Pulmonary Hypertension? - ✔✔Right
Heart catheterization.
✔✔What initial treatment is recommended for Group 1 Pulmonary Hypertension? -
✔✔Calcium Channel Blockers.
✔✔What is the essential diagnosis for Sarcoidosis? - ✔✔Demonstration of
noncaseating granulomas from a biopsy.
✔✔What are common clinical findings in Sarcoidosis? - ✔✔Asymptomatic or insidious
onset; skin lesions like erythema nodosum or Lupus Pernio.
✔✔What laboratory findings may indicate Sarcoidosis? - ✔✔Leukopenia, elevated ESR,
and hypercalcemia.
✔✔What is the primary treatment for Sarcoidosis? - ✔✔Oral corticosteroids; long-term
therapy may be necessary.
✔✔What is the first symptom of idiopathic pulmonary fibrosis? - ✔✔A chronic dry cough.
✔✔What differentiates asthma from COPD in terms of management? - ✔✔Medication
management as per algorithms in pocket guides is critical.
,✔✔What are the common etiologies of chronic cough? - ✔✔Post nasal drip, acid reflux,
and asthma.
✔✔What effect does acid reflux have on the respiratory system? - ✔✔Stomach acid can
irritate the throat and airways, leading to inflammation.
✔✔What is the significance of elevated jugular venous pressure (JVP) in pulmonary
conditions? - ✔✔It is an indicator of potential heart failure or pulmonary hypertension.
✔✔What is the role of long-term azithromycin or erythromycin in COPD? - ✔✔It can
prevent exacerbations but may increase bacterial resistance and hearing impairment.
✔✔What are the categories of Pulmonary Hypertension? - ✔✔Group 1: pulmonary
vasculopathy; Group 2: left heart disease; Group 3: parenchymal disease; Group 4:
thromboembolic diseases; Group 5: multifactorial.
✔✔What should be ruled out when diagnosing pulmonary hypertension? -
✔✔Pulmonary emboli.
✔✔What is the importance of understanding the pathophysiology of chronic cough? -
✔✔It directs the priority of pharmacologic treatment.
✔✔What are the main areas covered in the exam for Module 3 (GI/GU)? - ✔✔Hepatitis,
MASLD, renal failure, and cirrhosis.
✔✔What are the common causes of anal fissures? - ✔✔Trauma to the anal canal
during defecation caused by straining, constipation, or high internal sphincter tone.
✔✔What symptoms do patients with anal fissures typically report? - ✔✔Severe tearing
pain during defecation followed by throbbing discomfort, which may lead to constipation
due to fear of recurrent pain.
✔✔How are anal fissures diagnosed? - ✔✔Visual inspection; acute fissures appear as
cracks in the epithelium, while chronic fissures result in fibrosis and a skin tag.
✔✔What is the primary treatment for anal fissures? - ✔✔Promoting effortless, painless
bowel movements, and the use of topical anesthetics like 5% lidocaine.
✔✔What is the prognosis for healing anal fissures? - ✔✔Healing within 2 months in up
to 45% of patients.
✔✔What causes perianal abscesses? - ✔✔Infection of the anal glands located at the
base of the anal crypts.
, ✔✔What are the symptoms of a perianal abscess? - ✔✔Throbbing, continuous perianal
pain, erythema, fluctuance, and swelling.
✔✔What is the treatment for a perianal abscess? - ✔✔Local incision and drainage;
ischiorectal abscesses require drainage in the operating room.
✔✔What is a common complication after drainage of a perianal abscess? - ✔✔Most
patients are found to have a fistula in ano.
✔✔What techniques are used for healing a fistula in ano? - ✔✔Endoanal advancement
flap over the internal opening and insertion of a bioprosthetic plug.
✔✔What characterizes perianal pruritus? - ✔✔Perianal itching and discomfort.
✔✔What are some causes of perianal pruritus? - ✔✔Poor anal hygiene, fistulas,
fissures, prolapsed hemorrhoids, skin tags, incontinence, and overzealous cleansing.
✔✔What are some differential diagnoses for perianal pruritus? - ✔✔Contact dermatitis,
atopic dermatitis, bacterial infections, candidal infections, STIs, and other skin
conditions.
✔✔What dietary items should be avoided in cases of perianal pruritus? - ✔✔Spicy
foods, coffee, chocolate, and tomatoes.
✔✔What is Barrett's esophagus? - ✔✔A condition where the squamous epithelium of
the esophagus is replaced by metaplastic columnar epithelium containing goblet and
columnar cells.
✔✔What causes Barrett's esophagus? - ✔✔Chronic reflux-induced injury to the
esophageal squamous epithelium, increased in patients with truncal obesity.
✔✔How is Barrett's esophagus diagnosed? - ✔✔Endoscopy shows orange, gastric-type
epithelium extending upward more than 1 cm from the gastroesophageal junction;
biopsies confirm diagnosis.
✔✔What is a significant complication of Barrett's esophagus? - ✔✔Esophageal
adenocarcinoma with a risk of 0.2-0.5% per year.
✔✔What are the recommendations for endoscopic screenings in Barrett's esophagus? -
✔✔Adults with weekly GERD symptoms for 5 or more years and three or more risk
factors should undergo screenings.
