NBME CBSE REAL EXAM 200 VERIFIED QUESTIONS AND ANSWERS LATEST 2025, Exams of Nursing

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NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS

LATEST 2025

70yo M dies in a motor vehicle collision. Was undergoing evaluation for

occult blood in the stool. Photo of transverse colon shown. Dx? -

ANSWER- Tubular adenoma

38yo M with 1-week hx of watery, itchy eyes and a runny nose. Physical

shows inflamed nasal mucosa. No congestion in lower lung.

Pharmacotherapy? - ANSWER- Loratadine

agglutination? - ANSWER- IgM

24yo M with small tender blisters on his penis 3 days after unprotected sex. Photograph shown. Causal agent? - ANSWER- HSV-

42yo F with 3-year hx of an intermittent facial rash, including the forehead, eyelids, nose, and cheeks. Rash seems to be getting worse since she moved from New York to Florida last year. Spicy foods

precipitate a flushing reaction that seems to exacerbate the rash. PE shows erythema over the nose and cheeks, with scattered telangiectasias and a few papules. Dx? - ANSWER- Rosacea

postconception (in days)? - ANSWER- 15 to 40

64yo M in ED 3 hours after SOB with exertion and extreme fatigue. Has ischemic heart disease. P 125/min, BP 105/60. ECG shows atrial fibrillation. Intravenous ibutilide is administered. Ten minutes later, ECG shows normal sinus rhythm. Risk for which drug effect in the next

65yo F with 20-year hx of osteoarthritis of the hands now has pain radiating down the distal anterior thigh, knee, medial leg, and food. Bony outgrowth of vertebrae compressing one of the spinal nerves is suspected. Nerve root in which intervertebral foramina is effected? - ANSWER- L3 to L

38yo M with 3-year hx of T2DM. Taking an oral antihyperglycemic agent, he has tried diet and exercise. BMI 32. PE normal. Hb A1c is 10%. Physician recommends initiation of insulin injections. Responds, "I know that insulin would help control my blood sugar. But a lot of people in my family have diabetes, and insulin made them really sick at times. Patient is at which stage of change? - ANSWER- contemplation

edematous, erythematous rash with linear vesicles. Cause is activation of which cell types? - ANSWER- T lymphocytes

70yo M from china with poorly differentiated monoclonal carcinoma of

the nasopharynx. DNA probes of neoplastic cells are most likely to

detect genome of which virus? - ANSWER- EBV

Epidemiologic study of aniline dye, 500 workers with bladder cancer and 200 workers without. Exposed to aniline dyes/Have Bladder cancer:

ANSWER- 3

Compound is taken up by bacterial cells. No energy is necessary for uptake, and the compound is not concentrated in the cell. Which describes this mechanism of transport? - ANSWER- carrier-mediated diffusion

Newborn has male genital ducts but female external genitalia.

Study designed to evaluate the efficacy of coenzyme Q10 in improving

cardiac output in patients with CHF. Sixty patients with CHF are

recruited. Each assigned by coin toss to one of two groups. Design? -

ANSWER- randomized clinical trial

12yo boy immersed up to his neck in 60F water for 20 minutes. Physiological changes? - ANSWER- Central blood volume INCREASED, ADH (vasopressin) DECREASED, Atrial Natriuretic Peptide INCREASED? C (block3, q23)

Randomized controlled study of 2000 patients with insomnia is

conducted to evaluate the efficacy of a new medication to treat this

condition. Ten subjects from both the control and treatment groups do

not complete the study are not included in the analysis. Treatment group

able to fall asleep 5 minutes faster than control (p=0.001). Neither group report an improvement in quality of life. Conclude that new med is efficacious in treating

specificity of 60%. Based on the results of the ESR testing, most appropriate next step? - ANSWER- Additional testing to confirm the diagnosis of TA

Sequence surrounding the first two exons of the human beta-globin gene

shown, with exons in bold. Translation start codon is underlined. A

mutation from G-->A at position 355 is most likely to lead to beta-

thalassemia by which mechanism? - ANSWER- Disruption of normal

splicing by creation of a new 3' splice site?

42yo M in ED because of a 10-day history of progressive fever, SOB,

at that time. PE shows enlarged uterus, beta-hCG markedly increased. Ultrasonagraphy of pelvis shows material within the endometrial cavity and no intrauterine pregnancy. CT scan shows a necrotic intrauterine mass and metastatic nodules in the lungs. Site of Origin? - ANSWER- trophoblastic tissue

65yo M emigrated from Brazil with 8-month history of shortness of breath and fatigue, edema of lower ext. CXR shows cardiomegaly. endomyocardial biopsy specimen shows myofiber necrosis with a mixed inflammatory infiltrate of PMNs, T lymphos, m.phages, and eosinophils. Causal org? - ANSWER- Trypanosoma cruzi

40yo F with mole on her back that has increased in size during past 4 months. PE shows raised irregular lesion with variegated black-tan pigmentation and ill- defined margins. Pleomorphic, hyperchromatic cells within clear islands that tend to collapse. Extends from epidermis into papillary dermis. Dx? - ANSWER- melanoma

30yo F training for a marathon, running 20 miles/day. Fasting glucose is

Male newborn at 28 weeks'. Given ventilatory support with up to 80% oxygen for the next 72 hours, but dies of resp. failure. Cause is inadequate secretion from which labeled cell types? - ANSWER- D. type II pneumocyte (produces surfactant)

9yo girl with poor growth during the past year. < 3rd %ile for height and at 10th percentile for weight. PE normal. Visual field testing shows bitemporal hemianopia. Labs show GH deficiency. MRI shows calcified

cystic mass in suprasellar region. Tumor derived from? - ANSWER- Diverticulum of the roof of the embryonic oral cavity

28yo F G1P1 with 2-day history of a painful mass in her right breast. Delivered healthy female newborn 3 weeks ago, and been breast-feeding since. T 37C, PE shows 3-cm tender mass surrounded by an area of erythema beneath the right areola. Causal org? - ANSWER- staph aureus

27yo F with fever, malaise, abdominal pain, and vaginal d/c for 4 days. LMP 5 days ago. Had ectopic 1 year ago. T 38.3 C, bilateral lower quadrant tenderness with rebound and guarding. Pelvic exam with cervical motion tenderness and bilateral adnexal tenderness WBC 18k. Pregnancy test neg. Dx? - ANSWER- Gonorrhea (PID)

20M with 3-month hx of progressive thirst (drinking a lot of fluids) and urinary frequency during past 3 days. U/A shows specific gravity less than 1.006. Most likely has dysfunction of which endocrine structure? - ANSWER- posterior pituitary gland (ADH)

28yo M in ED 30 minutes after SOB. 3-year hx of cocaine abuse. T 38.1, P 100/min, BP 150/45. PE: diminished pulses in left upper extremity.

Crackles heard over all lung fields. 2/6 diastolic murmur at left sternal border. CXr shows a widened aortic arch. Dx? - ANSWER- Dissecting aneurysm

1-week-old girl. screening showed a possible defect in fatty acid oxidation. PE normal. Next step? - ANSWER- Measurement of serum acylcarnitine concentrations

79yoM 30 minutes after LOC for 30 seconds. Alert, but dizzy. No urinary or fecal incontinence. Pulse 40/min, BP 92/56. PE shows no tongue biting. Lungs clear, Variable intensity S1. Oriented X3. ECG

55yo M with chronic bronchitis in ED after being unresponsive. Found bottles of albuterol, ampicillin, codeine, and theophylline bedside. T

37.2 C, p 112/min, respirations are 6/min, BP 95/60. Acute Rx should include? - ANSWER- naloxone

50yo man has persistent cough for 2 months. He has had a 5 kg (11 lb) weight loss. He is a farmer and on itraconazole 4 weeks for histoplasmosis from chicken coops. Medications: hydrochlorothiazide, enalapril, atenolol, omeprazole, and metoclopramide for hypertension and gastroesophageal reflux. Thin. Physical exam otherwise normal.

Itraconazole interacts with which drug and account for lack of effect of itraconazole? - ANSWER- omeprazole

20yo man with 6-hour difficulty breathing and vomiting. 10-year history of type 1 diabetes on insulin. Pulse 90, respirations 30 and deep, bp 90/60. Physical shows dehydration. Labs: Na+ 130, K+ 6.5, HCO3 5, glucose 500, pH 7.2, pCO2 25 mm Hg. Which compound stimulated hormone-sensitive lipase in adipocytes causing accumulation of metabolites causing acidosis? - ANSWER- epinephrine

Physician sad to inform patient of progression of carcinoma to the terminal phase. Physician's face makes patient cry and ask, "It's bad news, isn't it?" Which is best response? - ANSWER- "Yes, it is."

4yo boy two bacterial urinary tract infections past year. Physical exam normal. Radiologic studies show dilation of left ureter and renal pelvis, minimal left-sided renal function. Left nephrectomy done. Photo: dilated renal pelvis and ureter. Which is cause of renal disease? - ANSWER- congenital urethral obstruction

45yo man poorly controlled type 2 diabetes 1-month low-grade fever. Getting hemodialysis for end-stage renal disease. T 37 C (98.6 F), pulse 72, bp 144/92. Physical subclavian catheter below right clavicle. Lungs clear. Cardiac exam no murmurs. Blood cultures grow nonhemolytic, catalase-negative, gram-positive cocci in pairs and chains. Which organism? - ANSWER- Enterococcus faecalis

3yo boy sickle cell disease with fever and pain over left foot 3 weeks.

Hematocrit stable. Leukocyte count 15,000 predominance of neutrophils. Which is most likely explanation for findings? - ANSWER- osteomyelitis

10yo girl well-child examination. No menstrual period. 50th percentile height and weight. Physical exam absence of breast bud development and no pubic or

27yo woman 12-hour history of fever and abdominal pain. History of recurrent urinary tract infections. Temperature is 39 C (102.2 F).

Physical exam tenderness of right flank. Abdominal xrays bilateral

48yo nulligravid woman with excessive uterine bleeding for 3 months. Bleeding during menses and at irregular intervals. Menses were regular before. BMI 27. Pelvic exam: adnexae are nonpalpable. Endometrial curettage shows abundant tissue. Which is cause of symptoms? - ANSWER- Endometrial hyperplasia

65yo woman surgical repair of aneurysm right internal carotid artery in cavernous sinus. Three days later on physical exam, right pupil larger than left pupil. Weakness of eye movement. Diagram of coronal section through middle cranial fossa shown. Which nerve is damaged? - ANSWER- A (CN III)

55yo woman 6-week history low energy, irritability, crying spells, difficulty falling asleep, wakes up during night, cannot focus. Taking lorazepam for 15y for generalized anxiety disorder. Taking estrogen

"testy." Speech is slowed. No psychosis. Wishes she wouldn't wake up but doesn't plan to harm herself. Cause of symptoms? - ANSWER- Major depressive disorder

10yrs after total gastrectomy, 60yo man difficulty walking. Diffuse spasticity in arms and legs, impaired proprioception in his feet, increased

muscle stretch reflexes in arms and knees, absence of muscle stretch

reflexes in ankles, bilateral extensor plantar responses. Which vitamin is deficient? - ANSWER- B12 (cobalamin)

80yo man type 2 diabetes 2-month history severe constipation. Laxatives haven't relieved symptoms. Abdominal exam shows distention.

Colonoscopy shows no abnormalities. Patient has dysfunction of which nerve? - ANSWER- Pelvic splanchnic

34yo man lightheaded after running 12 miles of marathon hot day. Pulse 130 bp 80/60. Which changes to autonomic nervous system occurred? - ANSWER- B. Sympathetic efferent activity increased, parasympathetic efferent activity decreased

40yo woman hx of 6 month episodic sinusitis with 2-week intermittent headaches, fatigue, and generalized joint pain, worsening cough productive of blood-tinged sputum. Failed antibiotics, decongestants and nasal corticosteroids. Physical exam: erythema in nasal mucosa, two small ulceration. Lungs scattered crackles. X-ray patchy bilateral

antineutrophil cytoplasmic antibody increased. Dx? - ANSWER- Wegener granulomatosis

25yo woman 6-month history of joint pain poorly responsive to aspirin.

metacarpophalangeal joints, and wrists; weakness of grasp. Small nodules palpated beneath skin around joints of fingers. Dx? - ANSWER- Rheumatoid arthritis

ANSWER- Inhibition of osteoclast-mediated bone resorption

Female newborn at 36 weeks gestation has respiratory distress. Apgar 3 and 5 at 1 and 5 minutes. Physical shows cyanosis. Endotracheal and NG tubes placed. Xray shows nasogastric tube in left hemithorax,

mediastinum displacement to right, absence bowel gas in abdomen.

Which embryological event led to these findings? - ANSWER- Incomplete formation of pleuroperitoneal membrane

65yo women progressive vulva itching past 2 months; miconazole for yeast infections ineffective. Exam: atrophy of labia minora and thin, parchment-like skin over vulva and anus. Dx? - ANSWER- Lichen sclerosus

75yo man 2-day ear ringing, nausea, fatigue. Temp 37 C (98.6 F), pulse

100, respirations 24, bp 140/85. Physical: mild epigastic tenderness.

ABG: pH=7.42 pCO2=30 pO2=95 HCO3=19. Dx? - ANSWER-

Salicylate poisoning

15yo girl 1-day hx redness and painful skin following sunbathing. She used sunblock. No medications. Physical exam: severe erythema of back and extremities, no blisters. Dx? - ANSWER- First-degree burn

58yo man supraventricular tachyarrhythmia refractory to pharmacotherapy gets ablation of accessory excitatory pathway in atrial endocardium. Which area should be avoided to leave sinoatrial (pacemaker) node intact? - ANSWER- The junction of the superior vena cava and the right atrium

81yo woman massive pulmonary embolism from deep venous thrombosis. Platelet count 160,000. Appropriate pharmacotherapy is started. One week later, platelets 55,000. Thrombocytopenia most likely caused by a drug with which of the following mechanism of action? - ANSWER- Potentiates the action of antithrombin III

59yo man has total thyroidectomy for 4-cm follicular carcinoma of thyroid. Twelve hours after procedure, has paresthesias of hands and feet. Vitals stable, carpal spasm on inflammation of bp cuff. Lab

symptoms? - ANSWER- Albuterol

14yo boy daily headaches for 2 months. Headaches are bilateral aching in temples. "Has not been himself" for months. Confused, forgetting names, dates, places, clumsy, frequent falls. School performance declined. Physical exam: broad-based ataxic gait. Slow to answer questions. Chronic abuse of which substance? - ANSWER- Inhaled glue

40yo African American woman 2-week hx fever, malaise, dyspnea. Temperature 36.7 C (98 F), respirations 20. Physical exam: erythema nodosum, parotid enlargement, hepatosplenomegaly. Calcium 16. CT chest bilateral hilar adenopathy. Increase of which in serum? - ANSWER- 1,25- Dihydroxycholecalciferol

56yo woman with restrictive cardiomyopathy, proteinuria, renal failure. 35-year history of rheumatoid arthritis. Renal biopsy shows glomerular deposition of eosinophilic hyaline material. Congo red stain: birefringent pattern under polarized light. Structure of material? - ANSWER- betapleated sheet structure

63yo man 3-month hx difficulty sleeping. Sleeps better upright. HR 90, bp 110/60. Physical exam: increased jugular venous pressure, mild ankle edema. Cause of edema? - ANSWER- Increased capillary hydrostatic pressure

14yo boy come to ER 1 hour after colliding with teammate playing

soccer. Physical exam: edematous tissues of left eye, mild depression of

left zygomatic bone. Skin between eye and upper lip numb. Double

vision look upward. Nerve damaged causing sensory loss? - ANSWER-

Maxillary division of trigeminal nerve

35yo man becomes increasingly depressed, impulsive and difficult over

past year. Grimaces intermittently with rapid, jerking, purposeless

movements of fingers. Historical factor relevant in dx? - ANSWER-

Family history of a similar illness