NR667
NR667 Exit Exam ,Clinical Medicine Board Review: 150 High-
Yield Questions with Answers and Rationales
Gradegurus
This exam contains:
❖NR667 Exit Exam ,Clinical Medicine Board Review
❖150 High-Yield Questions with Answers and Rationales
,Correct Answers and Rationales with Multiple Choice
Options
.
Page 1
1. Your 51-year-old female patient has been diagnosed with a "new murmur" during a
near syncopal episode workup. In evaluating this patient, during which phase of the
cardiac cycle would you anticipate auscultation of an S1 heart sound?
A. Diastole
B. Systole
C. Isovolumetric relaxation
D. Atrial kick
Correct: B. Systole
Rationale: S1 ("lub") is the closure of the mitral and tricuspid valves at the onset of
ventricular systole. It marks the beginning of systole.
2. The initial workup for a patient with a new chief complaint of palpitations should
include which of the following tests first?
A. Basic metabolic profile
, B. Echocardiogram
C. Holter monitor
D. Cardiac stress test
Correct: A. Basic metabolic profile
Rationale: Palpitations may be triggered by electrolyte abnormalities (e.g., hypokalemia,
hypomagnesemia), anemia, or thyroid dysfunction. A BMP is a rapid, low-cost first-line
test.
3. Which of the following locations is most commonly described as the best location to
identify the aortic valve in a healthy adult?
A. 2nd intercostal space, right sternal border
B. 2nd intercostal space, left sternal border
C. 4th intercostal space, left sternal border
D. 5th intercostal space, midclavicular line
Correct: A. 2nd intercostal space, right sternal border
Rationale: The aortic valve is best heard at the right 2nd intercostal space (aortic area).
The pulmonic valve is at the left 2nd ICS; tricuspid at left 4th ICS; mitral at the apex (5th
ICS, MCL).
4. Jason, a 63-year-old male who had a cardiac drug-eluting stent placed and had an
elevated troponin of 1.6, asks how long he will need to be on aspirin plus clopidogrel
(Plavix). How long should Jason be on dual antiplatelet therapy after his stent?
A. 1 month
B. 3 months
C. 6 months
D. 12 months minimum
, Correct: D. 12 months minimum
Rationale: Current guidelines recommend dual antiplatelet therapy (DAPT) for at least 12
months after drug-eluting stent placement in patients without high bleeding risk.
5. What illness or diagnosis would localized egophony on auscultation over the left
lower lobe most likely imply?
A. Consolidation (pneumonia)
B. Pleural effusion
C. Pneumothorax
D. Atelectasis
Correct: A. Consolidation (pneumonia)
Rationale: Egophony ("E-to-A" change) is classically heard over consolidated lung
tissue, as in lobar pneumonia.
6. While assessing a 15-year-old patient for a new onset of cough, how does
performing percussion of the thorax assist the provider during the physical
examination?
A. To identify if underlying tissues are air-filled, fluid-filled, or consolidated
B. To measure lung volumes
C. To assess vocal fremitus
D. To evaluate diaphragmatic excursion
Correct: A. To identify if underlying tissues are air-filled, fluid-filled, or consolidated
Rationale: Percussion helps distinguish resonance (normal air-filled lung), dullness
(fluid/consolidation), and hyperresonance (air trapping/pneumothorax).
7. Which of the following patients would you expect to show a less-than-expected
forced vital capacity (FVC) on pulmonary function testing?
NR667 Exit Exam ,Clinical Medicine Board Review: 150 High-
Yield Questions with Answers and Rationales
Gradegurus
This exam contains:
❖NR667 Exit Exam ,Clinical Medicine Board Review
❖150 High-Yield Questions with Answers and Rationales
,Correct Answers and Rationales with Multiple Choice
Options
.
Page 1
1. Your 51-year-old female patient has been diagnosed with a "new murmur" during a
near syncopal episode workup. In evaluating this patient, during which phase of the
cardiac cycle would you anticipate auscultation of an S1 heart sound?
A. Diastole
B. Systole
C. Isovolumetric relaxation
D. Atrial kick
Correct: B. Systole
Rationale: S1 ("lub") is the closure of the mitral and tricuspid valves at the onset of
ventricular systole. It marks the beginning of systole.
2. The initial workup for a patient with a new chief complaint of palpitations should
include which of the following tests first?
A. Basic metabolic profile
, B. Echocardiogram
C. Holter monitor
D. Cardiac stress test
Correct: A. Basic metabolic profile
Rationale: Palpitations may be triggered by electrolyte abnormalities (e.g., hypokalemia,
hypomagnesemia), anemia, or thyroid dysfunction. A BMP is a rapid, low-cost first-line
test.
3. Which of the following locations is most commonly described as the best location to
identify the aortic valve in a healthy adult?
A. 2nd intercostal space, right sternal border
B. 2nd intercostal space, left sternal border
C. 4th intercostal space, left sternal border
D. 5th intercostal space, midclavicular line
Correct: A. 2nd intercostal space, right sternal border
Rationale: The aortic valve is best heard at the right 2nd intercostal space (aortic area).
The pulmonic valve is at the left 2nd ICS; tricuspid at left 4th ICS; mitral at the apex (5th
ICS, MCL).
4. Jason, a 63-year-old male who had a cardiac drug-eluting stent placed and had an
elevated troponin of 1.6, asks how long he will need to be on aspirin plus clopidogrel
(Plavix). How long should Jason be on dual antiplatelet therapy after his stent?
A. 1 month
B. 3 months
C. 6 months
D. 12 months minimum
, Correct: D. 12 months minimum
Rationale: Current guidelines recommend dual antiplatelet therapy (DAPT) for at least 12
months after drug-eluting stent placement in patients without high bleeding risk.
5. What illness or diagnosis would localized egophony on auscultation over the left
lower lobe most likely imply?
A. Consolidation (pneumonia)
B. Pleural effusion
C. Pneumothorax
D. Atelectasis
Correct: A. Consolidation (pneumonia)
Rationale: Egophony ("E-to-A" change) is classically heard over consolidated lung
tissue, as in lobar pneumonia.
6. While assessing a 15-year-old patient for a new onset of cough, how does
performing percussion of the thorax assist the provider during the physical
examination?
A. To identify if underlying tissues are air-filled, fluid-filled, or consolidated
B. To measure lung volumes
C. To assess vocal fremitus
D. To evaluate diaphragmatic excursion
Correct: A. To identify if underlying tissues are air-filled, fluid-filled, or consolidated
Rationale: Percussion helps distinguish resonance (normal air-filled lung), dullness
(fluid/consolidation), and hyperresonance (air trapping/pneumothorax).
7. Which of the following patients would you expect to show a less-than-expected
forced vital capacity (FVC) on pulmonary function testing?
