1
Chamberlain NR511 Actual Exam
Questions and Answers with Rationales
2026/2027 | Differential Diagnosis &
Primary Care Final Exam | FNP
Practicum Assessment | Pass Guarantee
Q001: A 34-year-old woman presents with 3 weeks of polyuria, nocturia, and
blurred vision; BMI 24, BP 118/76, HR 78. UA shows 2+ glucose, negative
ketones, negative nitrites; random plasma glucose 198 mg/dL, HbA1c 7.4 %.
Which is the most likely diagnosis and first-line management?
Options:
A. Type 1 diabetes mellitus; initiate basal-bolus insulin
B. Type 2 diabetes mellitus; start metformin 500 mg BID, lifestyle counseling, 3-
month f/u
C. Diabetes insipidus; prescribe desmopressin
D. Early chronic kidney disease; order renal ultrasound and ACE inhibitor
ANSWER: B
Q002: A 56-year-old man with HTN and 35-pack-year smoking history complains
of exertional chest tightness for 2 months, now occurring while walking one block.
Vital signs stable; ECG shows sinus rhythm, mild LVH. Which is the next best
diagnostic step?
Options:
A. Coronary CT angiography
B. Stress echocardiography
, 2
C. Cardiac catheterization immediately
D. Chest X-ray and D-dimer
ANSWER: B
Q003: A 29-year-old man presents with 4 days of dysuria, frequency, and right
flank pain; temperature 38.2 °C, CVA tenderness positive. UA shows 50 WBCs,
positive leukocyte esterase, negative nitrites. Which is the most appropriate initial
management?
Options:
A. Oral cephalexin for 5 days with early recheck
B. Ceftriaxone 1 g IV now, then transition to oral based on culture
C. Trimethoprim-sulfamethoxazole BID × 3 days
D. Phenazopyridine only and increased fluids
ANSWER: B
Q004: A 42-year-old woman with chronic sinusitis and nasal polyps reports 10
days of worsening facial pain, purulent rhinorrhea, and fever 38.5 °C. Which is the
most appropriate initial antibiotic choice?
Options:
A. Amoxicillin 500 mg TID × 5 days
B. Amoxicillin-clavulanate 875/125 mg BID × 10 days
C. Doxycycline 100 mg BID × 5 days
D. Intranasal corticosteroid spray only
ANSWER: B
Q005: A 67-year-old man with COPD (FEV1 55 % predicted) reports increased
dyspnea, sputum volume, and purulence for 48 hours; O2 sat 90 % on room air, no
fever. Which is the best outpatient management?
Options:
, 3
A. Prednisone 40 mg PO daily × 5 days, albuterol-ipratropium nebulizer, and oral
doxycycline
B. Immediate intubation and ICU admission
C. High-flow nasal cannula oxygen only
D. Azithromycin single 1 g dose
ANSWER: A
Q006: A 24-year-old woman with asthma presents with 2 days of wheezing, chest
tightness, and nighttime awakenings; peak flow 65 % of personal best. Which step-
up therapy is most appropriate?
Options:
A. Continue SABA PRN only
B. Initiate ICS 250 mcg BID and SABA, provide written action plan
C. Oral prednisone 60 mg now and discharge
D. Nebulized magnesium sulfate only
ANSWER: B
Q007: A 50-year-old man with HTN and gout has BP 148/92 mmHg on lisinopril
10 mg daily and colchicine PRN. Which is the best next antihypertensive choice?
Options:
A. Add amlodipine 5 mg daily
B. Increase lisinopril to 20 mg daily
C. Add hydrochlorothiazide 12.5 mg daily
D. Switch to carvedilol 6.25 mg BID
ANSWER: A
Q008: A 19-year-old college student presents with 1 week of fatigue, pharyngitis,
and cervical lymphadenopathy; rapid strep negative, heterophile antibody positive.
Which is the best management?
Chamberlain NR511 Actual Exam
Questions and Answers with Rationales
2026/2027 | Differential Diagnosis &
Primary Care Final Exam | FNP
Practicum Assessment | Pass Guarantee
Q001: A 34-year-old woman presents with 3 weeks of polyuria, nocturia, and
blurred vision; BMI 24, BP 118/76, HR 78. UA shows 2+ glucose, negative
ketones, negative nitrites; random plasma glucose 198 mg/dL, HbA1c 7.4 %.
Which is the most likely diagnosis and first-line management?
Options:
A. Type 1 diabetes mellitus; initiate basal-bolus insulin
B. Type 2 diabetes mellitus; start metformin 500 mg BID, lifestyle counseling, 3-
month f/u
C. Diabetes insipidus; prescribe desmopressin
D. Early chronic kidney disease; order renal ultrasound and ACE inhibitor
ANSWER: B
Q002: A 56-year-old man with HTN and 35-pack-year smoking history complains
of exertional chest tightness for 2 months, now occurring while walking one block.
Vital signs stable; ECG shows sinus rhythm, mild LVH. Which is the next best
diagnostic step?
Options:
A. Coronary CT angiography
B. Stress echocardiography
, 2
C. Cardiac catheterization immediately
D. Chest X-ray and D-dimer
ANSWER: B
Q003: A 29-year-old man presents with 4 days of dysuria, frequency, and right
flank pain; temperature 38.2 °C, CVA tenderness positive. UA shows 50 WBCs,
positive leukocyte esterase, negative nitrites. Which is the most appropriate initial
management?
Options:
A. Oral cephalexin for 5 days with early recheck
B. Ceftriaxone 1 g IV now, then transition to oral based on culture
C. Trimethoprim-sulfamethoxazole BID × 3 days
D. Phenazopyridine only and increased fluids
ANSWER: B
Q004: A 42-year-old woman with chronic sinusitis and nasal polyps reports 10
days of worsening facial pain, purulent rhinorrhea, and fever 38.5 °C. Which is the
most appropriate initial antibiotic choice?
Options:
A. Amoxicillin 500 mg TID × 5 days
B. Amoxicillin-clavulanate 875/125 mg BID × 10 days
C. Doxycycline 100 mg BID × 5 days
D. Intranasal corticosteroid spray only
ANSWER: B
Q005: A 67-year-old man with COPD (FEV1 55 % predicted) reports increased
dyspnea, sputum volume, and purulence for 48 hours; O2 sat 90 % on room air, no
fever. Which is the best outpatient management?
Options:
, 3
A. Prednisone 40 mg PO daily × 5 days, albuterol-ipratropium nebulizer, and oral
doxycycline
B. Immediate intubation and ICU admission
C. High-flow nasal cannula oxygen only
D. Azithromycin single 1 g dose
ANSWER: A
Q006: A 24-year-old woman with asthma presents with 2 days of wheezing, chest
tightness, and nighttime awakenings; peak flow 65 % of personal best. Which step-
up therapy is most appropriate?
Options:
A. Continue SABA PRN only
B. Initiate ICS 250 mcg BID and SABA, provide written action plan
C. Oral prednisone 60 mg now and discharge
D. Nebulized magnesium sulfate only
ANSWER: B
Q007: A 50-year-old man with HTN and gout has BP 148/92 mmHg on lisinopril
10 mg daily and colchicine PRN. Which is the best next antihypertensive choice?
Options:
A. Add amlodipine 5 mg daily
B. Increase lisinopril to 20 mg daily
C. Add hydrochlorothiazide 12.5 mg daily
D. Switch to carvedilol 6.25 mg BID
ANSWER: A
Q008: A 19-year-old college student presents with 1 week of fatigue, pharyngitis,
and cervical lymphadenopathy; rapid strep negative, heterophile antibody positive.
Which is the best management?
