NR571/ NR 571 MIDTERM EXAM
NEWEST
ACTUAL EXAM WITH
COMPLETE 80 QUESTIONS
AND RATIONALIZED ANSWERS
Mr. C is a 75-year-old male with a recent history of an ischemic
stroke. He is being cared for at home and has home health
assistance. Residual effects of his stroke include dysphasia and
right-sided weakness. He presents today for evaluation
secondary to fever, chills, and productive cough. His CXR
demonstrates the following: What is the most likely cause of
this finding?
A. COPD
B. bacterial pneumonia
C. viral pneumonia
D. aspiration pneumonia
D. aspiration pneumonia
Rationale: This patient has aspiration pneumonia. That is
evident by the collection in the right base of the lung. With
his past medical history significant for ischemic stroke in
,dysphasia, aspiration has to be high on the differential list
for this patient.
A 72-year-old male with a past history of CAD, HTN, HLD,
tobacco use, and Type 2 DM presents to the ED with complaints
of sudden onset of severe pain to his left lower leg that started
about two hours earlier. Vital signs are as follows: BP 148/92,
HR 105, T 99.1 F. Lab work is notable for lactic acid of 3.4 and
CBC with WBC count of 14,000. Physical exam reveals cool,
pale LLE that is hairless and smooth. Pedal pulses are absent
with doppler ultrasound. The patient does not have any
sensation in his toes or his calf. Which of the following is the
suspected diagnosis?
A. deep vein thrombosis.
B. peripheral artery disease.
C. diabetic neuropathy.
D. acute limb ischemia.
D. acute limb ischemia.
Rationale: The patient has evidence of a cold leg without
sensation that occurred after severe acute pain of the leg
,before admission. He has lactic acidosis and a lack of
peripheral pulses on doppler ultrasound. This represents
acute limb ischemia.
Which of the following is the first step in the management of
Acute Limb Ischemia patient?
A. initiate a heparin drip.
B. obtain immediate vascular surgery consultation.
C. administer pain medication.
D. start broad-spectrum antibiotics.
B. obtain immediate vascular surgery consultation.
Rationale: In a patient with acute limb ischemia, the first
course of action should be to obtain STAT vascular surgery
consultation to revascularize the leg or perform amputation
if
, necessary. Heparin drip should be initiated as the second
course of action.
A 58-year-old man is seen in the ED for syncope. His spouse
reports being in the kitchen and hearing him fall on the living
room floor. The patient recalls feeling very light-headed but
remembers nothing more. Upon further questioning, he recalls
feeling dizzy on several occasions over the past few months. He
has a history of hypertension and a myocardial infarction 10
years earlier. He has since been well and exercises on a daily
basis. In the ED, he has a blood pressure (BP) of 95/55 mmHg
and a heart rate of 30 beats/min. An EKG is obtained (see
below). What is the most important initial step in managing this
patient?
A.Administer dopamine
B.Admit for further monitoring
C.Place a temporary pacemaker
NEWEST
ACTUAL EXAM WITH
COMPLETE 80 QUESTIONS
AND RATIONALIZED ANSWERS
Mr. C is a 75-year-old male with a recent history of an ischemic
stroke. He is being cared for at home and has home health
assistance. Residual effects of his stroke include dysphasia and
right-sided weakness. He presents today for evaluation
secondary to fever, chills, and productive cough. His CXR
demonstrates the following: What is the most likely cause of
this finding?
A. COPD
B. bacterial pneumonia
C. viral pneumonia
D. aspiration pneumonia
D. aspiration pneumonia
Rationale: This patient has aspiration pneumonia. That is
evident by the collection in the right base of the lung. With
his past medical history significant for ischemic stroke in
,dysphasia, aspiration has to be high on the differential list
for this patient.
A 72-year-old male with a past history of CAD, HTN, HLD,
tobacco use, and Type 2 DM presents to the ED with complaints
of sudden onset of severe pain to his left lower leg that started
about two hours earlier. Vital signs are as follows: BP 148/92,
HR 105, T 99.1 F. Lab work is notable for lactic acid of 3.4 and
CBC with WBC count of 14,000. Physical exam reveals cool,
pale LLE that is hairless and smooth. Pedal pulses are absent
with doppler ultrasound. The patient does not have any
sensation in his toes or his calf. Which of the following is the
suspected diagnosis?
A. deep vein thrombosis.
B. peripheral artery disease.
C. diabetic neuropathy.
D. acute limb ischemia.
D. acute limb ischemia.
Rationale: The patient has evidence of a cold leg without
sensation that occurred after severe acute pain of the leg
,before admission. He has lactic acidosis and a lack of
peripheral pulses on doppler ultrasound. This represents
acute limb ischemia.
Which of the following is the first step in the management of
Acute Limb Ischemia patient?
A. initiate a heparin drip.
B. obtain immediate vascular surgery consultation.
C. administer pain medication.
D. start broad-spectrum antibiotics.
B. obtain immediate vascular surgery consultation.
Rationale: In a patient with acute limb ischemia, the first
course of action should be to obtain STAT vascular surgery
consultation to revascularize the leg or perform amputation
if
, necessary. Heparin drip should be initiated as the second
course of action.
A 58-year-old man is seen in the ED for syncope. His spouse
reports being in the kitchen and hearing him fall on the living
room floor. The patient recalls feeling very light-headed but
remembers nothing more. Upon further questioning, he recalls
feeling dizzy on several occasions over the past few months. He
has a history of hypertension and a myocardial infarction 10
years earlier. He has since been well and exercises on a daily
basis. In the ED, he has a blood pressure (BP) of 95/55 mmHg
and a heart rate of 30 beats/min. An EKG is obtained (see
below). What is the most important initial step in managing this
patient?
A.Administer dopamine
B.Admit for further monitoring
C.Place a temporary pacemaker
