,NR 545 Exam 3 – Pharm, Phys Assess & Pathophys –
Q&A (2026) PDF | Chamberlain
1. A 6‑year‑old child presents with fever, ear pain, and a bulging, erythematous
tympanic membrane with decreased mobility on pneumatic otoscopy. The
nurse practitioner diagnoses acute otitis media. Which pathogen is the most
common bacterial cause?
A) Streptococcus pneumoniae
B) Pseudomonas aeruginosa
C) Moraxella catarrhalis
D) Haemophilus influenzae
Correct Answer: A) Streptococcus pneumoniae
Rationale: S. pneumoniae is the leading bacterial cause of AOM, followed by
non‑typeable H. influenzae and M. catarrhalis. Pseudomonas is more common
in chronic otitis externa or in immunocompromised patients. Bulging TM is the
hallmark of AOM.
2. A patient with Crohn’s disease asks why her inflammation can occur
anywhere from mouth to anus. The nurse practitioner explains that Crohn’s
disease is characterized by:
A) Continuous mucosal inflammation starting in the rectum
B) Skip lesions with transmural inflammation
C) Superficial ulceration limited to the colon
D) Inflammation confined to the terminal ileum
,Correct Answer: B) Skip lesions with transmural inflammation
Rationale: Crohn’s disease is transmural and patchy (skip lesions), potentially
involving any GI segment. Ulcerative colitis is continuous, mucosal, and begins
in the rectum. This distinction guides treatment and prognosis.
3. The nurse practitioner is evaluating a patient with suspected peptic ulcer
disease. The most common etiologic agent is:
A) Helicobacter pylori
B) Long‑term acetaminophen use
C) Spicy food consumption
D) Emotional stress
Correct Answer: A) Helicobacter pylori
Rationale: H. pylori infection causes the majority of duodenal and gastric ulcers.
NSAIDs are the second most common cause. Acetaminophen is not ulcerogenic,
and diet/stress are not primary causes. Eradication therapy heals ulcers and
prevents recurrence.
4. A patient with ulcerative colitis reports a persistent, painful urge to defecate
even though the bowel is empty. This symptom is known as:
A) Hematochezia
B) Steatorrhea
C) Tenesmus
D) Obstipation
, Correct Answer: C) Tenesmus
Rationale: Tenesmus is the feeling of incomplete evacuation with constant urge,
characteristic of UC due to rectal inflammation. Hematochezia is bloody stools;
steatorrhea is fatty stools; obstipation is severe constipation.
5. The nurse practitioner suspects acute appendicitis in a patient with
periumbilical pain that has migrated to the right lower quadrant. Which physical
exam finding supports this diagnosis?
A) Murphy’s sign
B) Rovsing’s sign
C) McBurney’s point tenderness
D) Grey Turner’s sign
Correct Answer: C) McBurney’s point tenderness
Rationale: McBurney’s point is located midway between the umbilicus and the
anterior superior iliac spine; maximal tenderness there is classic for
appendicitis. Murphy’s sign is for cholecystitis; Rovsing’s is also appendicitis but
McBurney’s is the specific point.
6. A patient with diverticulitis presents with left lower quadrant pain, fever, and
leukocytosis. The nurse practitioner’s initial management includes:
A) High‑fiber diet and increased fluids
B) Bowel rest and broad‑spectrum antibiotics
C) Immediate surgical resection
Q&A (2026) PDF | Chamberlain
1. A 6‑year‑old child presents with fever, ear pain, and a bulging, erythematous
tympanic membrane with decreased mobility on pneumatic otoscopy. The
nurse practitioner diagnoses acute otitis media. Which pathogen is the most
common bacterial cause?
A) Streptococcus pneumoniae
B) Pseudomonas aeruginosa
C) Moraxella catarrhalis
D) Haemophilus influenzae
Correct Answer: A) Streptococcus pneumoniae
Rationale: S. pneumoniae is the leading bacterial cause of AOM, followed by
non‑typeable H. influenzae and M. catarrhalis. Pseudomonas is more common
in chronic otitis externa or in immunocompromised patients. Bulging TM is the
hallmark of AOM.
2. A patient with Crohn’s disease asks why her inflammation can occur
anywhere from mouth to anus. The nurse practitioner explains that Crohn’s
disease is characterized by:
A) Continuous mucosal inflammation starting in the rectum
B) Skip lesions with transmural inflammation
C) Superficial ulceration limited to the colon
D) Inflammation confined to the terminal ileum
,Correct Answer: B) Skip lesions with transmural inflammation
Rationale: Crohn’s disease is transmural and patchy (skip lesions), potentially
involving any GI segment. Ulcerative colitis is continuous, mucosal, and begins
in the rectum. This distinction guides treatment and prognosis.
3. The nurse practitioner is evaluating a patient with suspected peptic ulcer
disease. The most common etiologic agent is:
A) Helicobacter pylori
B) Long‑term acetaminophen use
C) Spicy food consumption
D) Emotional stress
Correct Answer: A) Helicobacter pylori
Rationale: H. pylori infection causes the majority of duodenal and gastric ulcers.
NSAIDs are the second most common cause. Acetaminophen is not ulcerogenic,
and diet/stress are not primary causes. Eradication therapy heals ulcers and
prevents recurrence.
4. A patient with ulcerative colitis reports a persistent, painful urge to defecate
even though the bowel is empty. This symptom is known as:
A) Hematochezia
B) Steatorrhea
C) Tenesmus
D) Obstipation
, Correct Answer: C) Tenesmus
Rationale: Tenesmus is the feeling of incomplete evacuation with constant urge,
characteristic of UC due to rectal inflammation. Hematochezia is bloody stools;
steatorrhea is fatty stools; obstipation is severe constipation.
5. The nurse practitioner suspects acute appendicitis in a patient with
periumbilical pain that has migrated to the right lower quadrant. Which physical
exam finding supports this diagnosis?
A) Murphy’s sign
B) Rovsing’s sign
C) McBurney’s point tenderness
D) Grey Turner’s sign
Correct Answer: C) McBurney’s point tenderness
Rationale: McBurney’s point is located midway between the umbilicus and the
anterior superior iliac spine; maximal tenderness there is classic for
appendicitis. Murphy’s sign is for cholecystitis; Rovsing’s is also appendicitis but
McBurney’s is the specific point.
6. A patient with diverticulitis presents with left lower quadrant pain, fever, and
leukocytosis. The nurse practitioner’s initial management includes:
A) High‑fiber diet and increased fluids
B) Bowel rest and broad‑spectrum antibiotics
C) Immediate surgical resection
