NUR 504 EXAM 3 QUESTIONS & ANSWERS| GRADE A| 100% CORRECT
(VERIFIED SOLUTIONS)
1. A patient presents to the primary care clinic reporting several months of
progressive fatigue, exertional dyspnea, and occasional palpitations. The
nurse practitioner notes pale conjunctivae and asks about dietary intake,
gastrointestinal symptoms, menstrual history, and possible blood loss.
Which additional finding would most strongly support iron-deficiency
anemia as the underlying cause?
A. Elevated mean corpuscular volume with hypersegmented neutrophils
B. Low serum ferritin with microcytosis and hypochromia
C. Elevated reticulocyte count with increased bilirubin
D. Normal hemoglobin with isolated leukocytosis
Answer: B
2. A patient reports persistent fatigue, numbness and tingling of both feet,
difficulty maintaining balance, and a sore tongue. Laboratory testing
demonstrates macrocytosis. Which deficiency should the clinician strongly
consider?
A. Vitamin B12 deficiency
B. Vitamin C deficiency
C. Iron deficiency
D. Vitamin K deficiency
Answer: A
3. A patient with chronic alcohol use presents with confusion, gait instability,
and abnormal eye movements. The symptoms developed in the setting of
poor nutritional intake. Which deficiency-related condition should be
suspected?
A. Vitamin B12 deficiency
B. Thiamine deficiency
C. Vitamin D deficiency
D. Folate excess
pg. 1
,Answer: B
4. A patient with chronic kidney disease develops increasing fatigue and
exercise intolerance. Laboratory studies show a normocytic anemia with
reduced erythropoietin production. Which mechanism best explains the
anemia?
A. Excessive intestinal iron absorption
B. Reduced renal production of erythropoietin
C. Increased vitamin B12 synthesis
D. Excessive destruction of platelets
Answer: B
5. A patient presents with fatigue, fever, night sweats, and unexplained weight
loss. Examination reveals painless cervical lymphadenopathy. Which clinical
approach is most appropriate?
A. Assume uncomplicated viral infection and provide no follow-up
B. Evaluate for significant systemic disease, including malignancy and
chronic infection
C. Diagnose seasonal allergies based only on the lymphadenopathy
D. Reassure the patient that painless nodes are always benign
Answer: B
6. A patient presents with acute onset of facial drooping, right arm weakness,
and difficulty speaking. The symptoms began approximately 30 minutes
earlier. What is the most appropriate immediate priority?
A. Schedule a routine neurologic consultation
B. Initiate emergency stroke evaluation
C. Encourage oral hydration and reassess tomorrow
D. Treat for tension headache
Answer: B
7. A patient reports recurrent episodes of unilateral weakness and difficulty
speaking that completely resolve within several minutes. Which condition
should be considered even though the symptoms have resolved?
pg. 2
, A. Transient ischemic attack
B. Chronic tension headache
C. Benign positional vertigo
D. Peripheral neuropathy
Answer: A
8. A patient develops sudden severe headache that reaches maximal intensity
within seconds and describes it as the worst headache ever experienced.
Which diagnosis requires urgent consideration?
A. Migraine without aura
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinus headache
Answer: C
9. A patient reports recurrent unilateral throbbing headaches associated with
nausea, photophobia, and occasional visual symptoms preceding the
headache. Which diagnosis is most consistent with this presentation?
A. Migraine with aura
B. Cluster headache
C. Tension-type headache
D. Temporal arteritis
Answer: A
10. A patient reports severe unilateral orbital pain occurring in repeated
episodes at approximately the same time each night, accompanied by
tearing and nasal congestion on the affected side. Which diagnosis is most
consistent?
A. Migraine
B. Cluster headache
C. Tension headache
D. Sinusitis
Answer: B
pg. 3
, 11. An older adult reports a new persistent unilateral temporal headache
associated with scalp tenderness and jaw pain while chewing. Which
additional laboratory test would be particularly relevant?
A. Erythrocyte sedimentation rate and C-reactive protein
B. Serum amylase only
C. Troponin only
D. Serum potassium only
Answer: A
12. A patient presents with dizziness described as a sensation that the room is
spinning, particularly when turning the head. Which symptom description
most strongly supports vertigo?
A. A feeling of impending fainting without movement
B. A sensation of environmental spinning or movement
C. Generalized weakness after exercise
D. Isolated fatigue without balance disturbance
Answer: B
13. A patient develops brief episodes of intense spinning when rolling over in
bed, with each episode lasting less than one minute. Which condition
should be considered?
A. Benign paroxysmal positional vertigo
B. Cerebrovascular accident in every case
C. Orthostatic hypotension
D. Peripheral neuropathy
Answer: A
14. A patient reports dizziness immediately after standing from a seated
position. Which assessment would best help determine whether orthostatic
hypotension is contributing?
A. Measure blood pressure and pulse in appropriate supine and standing
positions
B. Perform only a hearing examination
pg. 4
(VERIFIED SOLUTIONS)
1. A patient presents to the primary care clinic reporting several months of
progressive fatigue, exertional dyspnea, and occasional palpitations. The
nurse practitioner notes pale conjunctivae and asks about dietary intake,
gastrointestinal symptoms, menstrual history, and possible blood loss.
Which additional finding would most strongly support iron-deficiency
anemia as the underlying cause?
A. Elevated mean corpuscular volume with hypersegmented neutrophils
B. Low serum ferritin with microcytosis and hypochromia
C. Elevated reticulocyte count with increased bilirubin
D. Normal hemoglobin with isolated leukocytosis
Answer: B
2. A patient reports persistent fatigue, numbness and tingling of both feet,
difficulty maintaining balance, and a sore tongue. Laboratory testing
demonstrates macrocytosis. Which deficiency should the clinician strongly
consider?
A. Vitamin B12 deficiency
B. Vitamin C deficiency
C. Iron deficiency
D. Vitamin K deficiency
Answer: A
3. A patient with chronic alcohol use presents with confusion, gait instability,
and abnormal eye movements. The symptoms developed in the setting of
poor nutritional intake. Which deficiency-related condition should be
suspected?
A. Vitamin B12 deficiency
B. Thiamine deficiency
C. Vitamin D deficiency
D. Folate excess
pg. 1
,Answer: B
4. A patient with chronic kidney disease develops increasing fatigue and
exercise intolerance. Laboratory studies show a normocytic anemia with
reduced erythropoietin production. Which mechanism best explains the
anemia?
A. Excessive intestinal iron absorption
B. Reduced renal production of erythropoietin
C. Increased vitamin B12 synthesis
D. Excessive destruction of platelets
Answer: B
5. A patient presents with fatigue, fever, night sweats, and unexplained weight
loss. Examination reveals painless cervical lymphadenopathy. Which clinical
approach is most appropriate?
A. Assume uncomplicated viral infection and provide no follow-up
B. Evaluate for significant systemic disease, including malignancy and
chronic infection
C. Diagnose seasonal allergies based only on the lymphadenopathy
D. Reassure the patient that painless nodes are always benign
Answer: B
6. A patient presents with acute onset of facial drooping, right arm weakness,
and difficulty speaking. The symptoms began approximately 30 minutes
earlier. What is the most appropriate immediate priority?
A. Schedule a routine neurologic consultation
B. Initiate emergency stroke evaluation
C. Encourage oral hydration and reassess tomorrow
D. Treat for tension headache
Answer: B
7. A patient reports recurrent episodes of unilateral weakness and difficulty
speaking that completely resolve within several minutes. Which condition
should be considered even though the symptoms have resolved?
pg. 2
, A. Transient ischemic attack
B. Chronic tension headache
C. Benign positional vertigo
D. Peripheral neuropathy
Answer: A
8. A patient develops sudden severe headache that reaches maximal intensity
within seconds and describes it as the worst headache ever experienced.
Which diagnosis requires urgent consideration?
A. Migraine without aura
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinus headache
Answer: C
9. A patient reports recurrent unilateral throbbing headaches associated with
nausea, photophobia, and occasional visual symptoms preceding the
headache. Which diagnosis is most consistent with this presentation?
A. Migraine with aura
B. Cluster headache
C. Tension-type headache
D. Temporal arteritis
Answer: A
10. A patient reports severe unilateral orbital pain occurring in repeated
episodes at approximately the same time each night, accompanied by
tearing and nasal congestion on the affected side. Which diagnosis is most
consistent?
A. Migraine
B. Cluster headache
C. Tension headache
D. Sinusitis
Answer: B
pg. 3
, 11. An older adult reports a new persistent unilateral temporal headache
associated with scalp tenderness and jaw pain while chewing. Which
additional laboratory test would be particularly relevant?
A. Erythrocyte sedimentation rate and C-reactive protein
B. Serum amylase only
C. Troponin only
D. Serum potassium only
Answer: A
12. A patient presents with dizziness described as a sensation that the room is
spinning, particularly when turning the head. Which symptom description
most strongly supports vertigo?
A. A feeling of impending fainting without movement
B. A sensation of environmental spinning or movement
C. Generalized weakness after exercise
D. Isolated fatigue without balance disturbance
Answer: B
13. A patient develops brief episodes of intense spinning when rolling over in
bed, with each episode lasting less than one minute. Which condition
should be considered?
A. Benign paroxysmal positional vertigo
B. Cerebrovascular accident in every case
C. Orthostatic hypotension
D. Peripheral neuropathy
Answer: A
14. A patient reports dizziness immediately after standing from a seated
position. Which assessment would best help determine whether orthostatic
hypotension is contributing?
A. Measure blood pressure and pulse in appropriate supine and standing
positions
B. Perform only a hearing examination
pg. 4
