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NR 511 / NR511 Final Exam Actual Exam
2026/2027 | Differential Diagnosis &
Primary Care Practicum | Chamberlain |
Questions with Verified Answers | 100%
Correct | Pass Guaranteed
Q001: A 34-year-old woman presents with 3 days of low-grade fever, dysuria, and
left-flank pain; vitals show BP 96/60, HR 110, temp 38.2 °C; urinalysis reveals 50
WBC/hpf, positive leukocyte esterase and nitrites, and 10 RBC/hpf. Point-of-care
renal ultrasound shows no hydronephrosis. Which is the most appropriate next
step?
Options:
A. Oral cephalexin 500 mg q6h × 3 days with early follow-up
B. Ceftriaxone 1 g IV daily plus oral macrocrystalline nitrofurantoin
C. Hospital admission for IV ceftriaxone and blood cultures
D. Outpatient ciprofloxacin 500 mg PO BID × 7 days with repeat UA in 1 week
ANSWER: C
Q002: A 48-year-old man with HTN notes intermittent chest tightness for 2 weeks,
occurring with yard work and resolving with rest; today he reports 20 minutes of
midsternal pressure while seated. ECG shows 1 mm ST depression in leads V4-V6,
troponin I 0.06 ng/mL (URL 0.04). BP 150/90, HR 88. Which is the most
appropriate immediate management?
Options:
A. Start metoprolol 50 mg PO and arrange outpatient stress test within 1 week
, 2
B. Administer aspirin 325 mg, ticagrelor 180 mg, enoxaparin 1 mg/kg SQ, and
admit for observation
C. Give sublingual nitroglycerin 0.4 mg and discharge with ranolazine prescription
D. Schedule coronary CT angiography as outpatient and start atorvastatin 20 mg
ANSWER: B
Q003: A 29-year-old man complains of 4 weeks of fatigue, 5-kg weight loss, and
nocturnal fevers; exam reveals 1.5 cm rubbery, non-tender cervical lymph nodes
and 0.5 cm axillary nodes; CBC shows WBC 14 × 10⁹/L with 45 % lymphocytes,
Hgb 110 g/L, platelets 180 × 10⁹/L; LDH 420 U/L (upper limit 250). CXR is
normal. Which is the most appropriate next test?
Options:
A. Reassure and repeat CBC in 3 months
B. Empiric amoxicillin-clavulanate for 10 days
C. Excisional biopsy of the largest cervical node
D. Quantiferon-TB Gold and EBV serologies
ANSWER: C
Q004: A 56-year-old postmenopausal woman reports 3 months of vague abdominal
bloating and early satiety; exam reveals mild ascites and a firm, irregular pelvic
mass; CA-125 is 450 U/mL (normal <35). Transvaginal ultrasound shows a 10 cm
complex mass with solid and cystic components. Which is the most appropriate
next step?
Options:
A. Schedule repeat ultrasound and CA-125 in 6 weeks
B. Order CT chest/abdomen/pelvis and refer to gynecologic oncology
C. Start empiric antibiotics for pelvic inflammatory disease
D. Perform paracentesis for cytology only
ANSWER: B
, 3
Q005: A 24-year-old woman presents with 2 days of right-lower-quadrant pain,
nausea, and fever 38 °C; last menstrual period 6 weeks ago; urine hCG negative;
WBC 13 × 10⁹/L, CRP 45 mg/L; bimanual exam shows cervical motion tenderness
and right adnexal tenderness. Urinalysis is normal. Which is the most appropriate
initial management?
Options:
A. Outpatient ceftriaxone 250 mg IM plus doxycycline 100 mg PO BID × 14 days
with early follow-up
B. Hospitalization for IV ceftriaxone and doxycycline with surgical consultation
C. Discharge with naproxen for pain and follow-up in 1 week
D. Start metronidazole 500 mg PO BID × 7 days and reevaluate
ANSWER: B
Q006: A 45-year-old man with DM type 2 presents with 2 weeks of polyuria,
polydipsia, and 4-kg weight loss; random glucose 28 mmol/L (504 mg/dL), serum
ketones 4.5 mmol/L, pH 7.25, HCO₃ 16 mmol/L, K⁺ 4.8 mEq/L. Urinalysis shows
4+ glucose and 3+ ketones. Which is the most appropriate initial management?
Options:
A. Start subcutaneous insulin sliding scale and discharge with follow-up
B. Admit to ICU for IV insulin infusion and aggressive hydration
C. Give 5 units regular insulin IV push and discharge on metformin
D. Start basal-bolus subcutaneous insulin and oral hydration
ANSWER: B
Q007: A 40-year-old man notes increasing dyspnea on exertion and occasional
chest tightness for 3 months; he smokes 1 ppd × 20 years; spirometry shows
FEV₁/FVC 0.65, FEV₁ 65 % predicted, improvement 180 mL post-bronchodilator.
CXR shows hyperinflation. Which is the most appropriate initial
pharmacotherapy?
Options:
NR 511 / NR511 Final Exam Actual Exam
2026/2027 | Differential Diagnosis &
Primary Care Practicum | Chamberlain |
Questions with Verified Answers | 100%
Correct | Pass Guaranteed
Q001: A 34-year-old woman presents with 3 days of low-grade fever, dysuria, and
left-flank pain; vitals show BP 96/60, HR 110, temp 38.2 °C; urinalysis reveals 50
WBC/hpf, positive leukocyte esterase and nitrites, and 10 RBC/hpf. Point-of-care
renal ultrasound shows no hydronephrosis. Which is the most appropriate next
step?
Options:
A. Oral cephalexin 500 mg q6h × 3 days with early follow-up
B. Ceftriaxone 1 g IV daily plus oral macrocrystalline nitrofurantoin
C. Hospital admission for IV ceftriaxone and blood cultures
D. Outpatient ciprofloxacin 500 mg PO BID × 7 days with repeat UA in 1 week
ANSWER: C
Q002: A 48-year-old man with HTN notes intermittent chest tightness for 2 weeks,
occurring with yard work and resolving with rest; today he reports 20 minutes of
midsternal pressure while seated. ECG shows 1 mm ST depression in leads V4-V6,
troponin I 0.06 ng/mL (URL 0.04). BP 150/90, HR 88. Which is the most
appropriate immediate management?
Options:
A. Start metoprolol 50 mg PO and arrange outpatient stress test within 1 week
, 2
B. Administer aspirin 325 mg, ticagrelor 180 mg, enoxaparin 1 mg/kg SQ, and
admit for observation
C. Give sublingual nitroglycerin 0.4 mg and discharge with ranolazine prescription
D. Schedule coronary CT angiography as outpatient and start atorvastatin 20 mg
ANSWER: B
Q003: A 29-year-old man complains of 4 weeks of fatigue, 5-kg weight loss, and
nocturnal fevers; exam reveals 1.5 cm rubbery, non-tender cervical lymph nodes
and 0.5 cm axillary nodes; CBC shows WBC 14 × 10⁹/L with 45 % lymphocytes,
Hgb 110 g/L, platelets 180 × 10⁹/L; LDH 420 U/L (upper limit 250). CXR is
normal. Which is the most appropriate next test?
Options:
A. Reassure and repeat CBC in 3 months
B. Empiric amoxicillin-clavulanate for 10 days
C. Excisional biopsy of the largest cervical node
D. Quantiferon-TB Gold and EBV serologies
ANSWER: C
Q004: A 56-year-old postmenopausal woman reports 3 months of vague abdominal
bloating and early satiety; exam reveals mild ascites and a firm, irregular pelvic
mass; CA-125 is 450 U/mL (normal <35). Transvaginal ultrasound shows a 10 cm
complex mass with solid and cystic components. Which is the most appropriate
next step?
Options:
A. Schedule repeat ultrasound and CA-125 in 6 weeks
B. Order CT chest/abdomen/pelvis and refer to gynecologic oncology
C. Start empiric antibiotics for pelvic inflammatory disease
D. Perform paracentesis for cytology only
ANSWER: B
, 3
Q005: A 24-year-old woman presents with 2 days of right-lower-quadrant pain,
nausea, and fever 38 °C; last menstrual period 6 weeks ago; urine hCG negative;
WBC 13 × 10⁹/L, CRP 45 mg/L; bimanual exam shows cervical motion tenderness
and right adnexal tenderness. Urinalysis is normal. Which is the most appropriate
initial management?
Options:
A. Outpatient ceftriaxone 250 mg IM plus doxycycline 100 mg PO BID × 14 days
with early follow-up
B. Hospitalization for IV ceftriaxone and doxycycline with surgical consultation
C. Discharge with naproxen for pain and follow-up in 1 week
D. Start metronidazole 500 mg PO BID × 7 days and reevaluate
ANSWER: B
Q006: A 45-year-old man with DM type 2 presents with 2 weeks of polyuria,
polydipsia, and 4-kg weight loss; random glucose 28 mmol/L (504 mg/dL), serum
ketones 4.5 mmol/L, pH 7.25, HCO₃ 16 mmol/L, K⁺ 4.8 mEq/L. Urinalysis shows
4+ glucose and 3+ ketones. Which is the most appropriate initial management?
Options:
A. Start subcutaneous insulin sliding scale and discharge with follow-up
B. Admit to ICU for IV insulin infusion and aggressive hydration
C. Give 5 units regular insulin IV push and discharge on metformin
D. Start basal-bolus subcutaneous insulin and oral hydration
ANSWER: B
Q007: A 40-year-old man notes increasing dyspnea on exertion and occasional
chest tightness for 3 months; he smokes 1 ppd × 20 years; spirometry shows
FEV₁/FVC 0.65, FEV₁ 65 % predicted, improvement 180 mL post-bronchodilator.
CXR shows hyperinflation. Which is the most appropriate initial
pharmacotherapy?
Options:
