NR 511 COMPREHENSIVE EXAM
REVIEW QUESTIONS WITH VERIFIED
ANSWERS.NEW UPDATE. JUST
RELEASED
1. A 45-year-old male presents with a sudden onset of excruciating pain in his right big toe.
The joint is swollen, red, and warm. Which of the following is the gold standard for
diagnosing this condition?
A. Serum uric acid level
B. X-ray of the foot
C. Joint aspiration and synovial fluid analysis
D. Clinical presentation alone
Answer: C
Conceptual Explanation: Synovial fluid analysis showing negatively birefringent needle-
shaped crystals is the gold standard for diagnosing gout. Serum uric acid can be normal
during an acute attack.
2. According to the Centor criteria, which of the following patients is most likely to require
testing for Group A Streptococcus?
A. A 20-year-old with cough, rhinorrhea, and sore throat
,B. A 65-year-old with a low-grade fever and hoarseness
C. A 10-year-old with fever, tonsillar exudates, and anterior cervical lymphadenopathy
D. A 30-year-old with a sore throat but no fever or lymphadenopathy
Answer: C
Conceptual Explanation: The Centor criteria include fever, tonsillar exudates, absence of
cough, and tender anterior cervical lymphadenopathy. The 10-year-old meets multiple
criteria.
3. A 62-year-old female presents with a ‘curtain dropping’ sensation over her left eye. She
denies pain but reports seeing flashes of light previously. What is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Cataract progression
D. Macular degeneration
Answer: B
Conceptual Explanation: Painless vision loss described as a ‘curtain’ or ‘shade’ coming
down, often preceded by floaters or flashes, is classic for retinal detachment.
4. Which of the following physical exam findings is most suggestive of a meniscus tear?
A. McMurray test with a palpable ‘clunk’
B. Lachman test positivity
, C. Positive Anterior Drawer test
D. Valgus stress test laxity
Answer: A
Conceptual Explanation: The McMurray test is specifically used to evaluate for meniscal
tears, while Lachman and Anterior Drawer test the ACL.
5. A 28-year-old female presents with a malar rash, joint pain, and photosensitivity. Which
laboratory test is the best initial screening for Systemic Lupus Erythematosus (SLE)?
A. Anti-dsDNA
B. Anti-Smith antibody
C. Antinuclear antibody (ANA)
D. C-reactive protein (CRP)
Answer: C
Conceptual Explanation: ANA is the most sensitive screening test for SLE, although it is
not specific. Anti-dsDNA and Anti-Smith are more specific.
6. In a patient presenting with acute cholecystitis, which physical exam sign is most likely to
be positive?
A. McBurney’s sign
B. Psoas sign
C. Rovsing’s sign
REVIEW QUESTIONS WITH VERIFIED
ANSWERS.NEW UPDATE. JUST
RELEASED
1. A 45-year-old male presents with a sudden onset of excruciating pain in his right big toe.
The joint is swollen, red, and warm. Which of the following is the gold standard for
diagnosing this condition?
A. Serum uric acid level
B. X-ray of the foot
C. Joint aspiration and synovial fluid analysis
D. Clinical presentation alone
Answer: C
Conceptual Explanation: Synovial fluid analysis showing negatively birefringent needle-
shaped crystals is the gold standard for diagnosing gout. Serum uric acid can be normal
during an acute attack.
2. According to the Centor criteria, which of the following patients is most likely to require
testing for Group A Streptococcus?
A. A 20-year-old with cough, rhinorrhea, and sore throat
,B. A 65-year-old with a low-grade fever and hoarseness
C. A 10-year-old with fever, tonsillar exudates, and anterior cervical lymphadenopathy
D. A 30-year-old with a sore throat but no fever or lymphadenopathy
Answer: C
Conceptual Explanation: The Centor criteria include fever, tonsillar exudates, absence of
cough, and tender anterior cervical lymphadenopathy. The 10-year-old meets multiple
criteria.
3. A 62-year-old female presents with a ‘curtain dropping’ sensation over her left eye. She
denies pain but reports seeing flashes of light previously. What is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Cataract progression
D. Macular degeneration
Answer: B
Conceptual Explanation: Painless vision loss described as a ‘curtain’ or ‘shade’ coming
down, often preceded by floaters or flashes, is classic for retinal detachment.
4. Which of the following physical exam findings is most suggestive of a meniscus tear?
A. McMurray test with a palpable ‘clunk’
B. Lachman test positivity
, C. Positive Anterior Drawer test
D. Valgus stress test laxity
Answer: A
Conceptual Explanation: The McMurray test is specifically used to evaluate for meniscal
tears, while Lachman and Anterior Drawer test the ACL.
5. A 28-year-old female presents with a malar rash, joint pain, and photosensitivity. Which
laboratory test is the best initial screening for Systemic Lupus Erythematosus (SLE)?
A. Anti-dsDNA
B. Anti-Smith antibody
C. Antinuclear antibody (ANA)
D. C-reactive protein (CRP)
Answer: C
Conceptual Explanation: ANA is the most sensitive screening test for SLE, although it is
not specific. Anti-dsDNA and Anti-Smith are more specific.
6. In a patient presenting with acute cholecystitis, which physical exam sign is most likely to
be positive?
A. McBurney’s sign
B. Psoas sign
C. Rovsing’s sign
