1
NR 511 Differential Diagnosis and Primary Care
Exam 2026/2027 Chamberlain University complete
exam
SECTION 1: GENERAL PRINCIPLES & DIAGNOSTIC TESTING
1. The remodeling of a scar can take how long?
A. 2 weeks
B. 1 month
C. 3 months
D. 6 months
✔✔ Correct Answer ✔✔ D. 6 months
Rationale: Scar remodeling is a dynamic process that can continue for up to 6 months or longer, during
which collagen fibers reorganize to improve tensile strength and appearance .
2. The most cost-effective screening test for determining HIV status is:
A. Western blot
B. Enzyme-linked immunosorbent assay (ELISA)
C. Polymerase chain reaction (PCR)
D. Viral load testing
✔✔ Correct Answer ✔✔ B. Enzyme-linked immunosorbent assay (ELISA)
Rationale: ELISA is the most cost-effective initial screening test for HIV due to its high sensitivity and
relatively low cost. Positive results must be confirmed with Western blot or immunofluorescence
assays .
3. Which blood test is a nonspecific method most helpful for evaluating the severity and course of an
inflammatory process?
A. Erythrocyte sedimentation rate (ESR)
B. C-reactive protein (CRP)
C. Rheumatoid factor (RF)
D. Antinuclear antibody (ANA)
✔✔ Correct Answer ✔✔ B. C-reactive protein (CRP)
Rationale: CRP is an acute-phase reactant that rises rapidly in response to inflammation and infection,
,2
making it valuable for monitoring disease activity and treatment response. Unlike ESR, it is not affected
by anemia or age .
SECTION 2: DERMATOLOGY
4. A 22-year-old African American female presents with nonpalpable patches of skin loss and
blanching on her forehead, hands, and feet that developed over 6 months. What is the most likely
diagnosis?
A. Tinea versicolor
B. Vitiligo
C. Pityriasis alba
D. Post-inflammatory hypopigmentation
✔✔ Correct Answer ✔✔ B. Vitiligo
Rationale: Vitiligo presents as well-demarcated, non-scaly, depigmented macules and patches with a
characteristic distribution (face, hands, feet). There is no history of preceding inflammation .
5. A 22-year-old college student presents with a rash on her buttocks after using a hot tub daily during
spring break. Exam reveals multiple 1–2 mm erythematous pustules. What is the most likely
pathogen?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Candida albicans
D. Herpes simplex virus
✔✔ Correct Answer ✔✔ B. Pseudomonas aeruginosa
Rationale: Hot tub folliculitis is caused by Pseudomonas aeruginosa and presents with pruritic or tender
erythematous papules and pustules within hours to days of exposure .
6. A 27-year-old female presents with perioral burning followed by a group of vesicles with
erythematous bases. What test would confirm her diagnosis?
A. Viral culture
B. Tzanck smear
C. Direct fluorescent antibody (DFA)
D. Serology for HSV antibodies
✔✔ Correct Answer ✔✔ B. Tzanck smear
Rationale: A Tzanck smear can detect multinucleated giant cells, confirming herpes simplex or
varicella-zoster infection. However, it does not distinguish between HSV-1, HSV-2, or VZV .
,3
7. A 3-year-old presents with 3 small, superficial, honey-colored vesicles on the perioral area. She is
afebrile and active. How should this be treated?
A. Oral cephalexin for 7 days
B. Local debridement and mupirocin for 5 days
C. Topical clotrimazole
D. Oral acyclovir
✔✔ Correct Answer ✔✔ B. Local debridement and mupirocin for 5 days
Rationale: This describes impetigo, typically caused by Staphylococcus aureus or Streptococcus
pyogenes. Topical mupirocin is first-line for localized, non-bullous impetigo .
8. A 4-year-old presents with an itchy rash between his fingers, with multiple 1–2 mm red papules in
sets of 3, along with excoriations. What is the treatment?
A. Permethrin lotion for the patient only
B. Permethrin lotion for the patient and all family members
C. Oral ivermectin
D. Topical corticosteroids
✔✔ Correct Answer ✔✔ B. Permethrin lotion for the patient and all family members
Rationale: This is scabies. Permethrin 5% cream is first-line, and all close contacts should be treated
simultaneously to prevent reinfestation .
9. A 44-year-old banker presents with sudden flares of pain, swelling, and redness of the toes. He
takes hydrochlorothiazide for hypertension. What is the most likely diagnosis?
A. Septic arthritis
B. Gout
C. Rheumatoid arthritis
D. Charcot neuro-osteoarthropathy
✔✔ Correct Answer ✔✔ B. Gout
Rationale: Thiazide diuretics (HCTZ) can precipitate gout by reducing uric acid excretion. Acute gout
presents with sudden onset of severe pain, erythema, and swelling of a single joint, most commonly the
first metatarsophalangeal joint .
10. Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure
to UV-B?
A. Actinic keratosis
B. Basal cell carcinoma
C. Verruca
D. Seborrheic dermatitis
, 4
✔✔ Correct Answer ✔✔ A. Actinic keratosis
Rationale: Actinic keratoses are rough, scaly patches on sun-exposed skin that represent premalignant
dysplasia and can progress to squamous cell carcinoma. UV-B radiation causes keratinocyte atypia .
SECTION 3: MUSCULOSKELETAL & RHEUMATOLOGY
11. A 13-year-old obese boy reports low-grade left knee pain for 2 months, now unable to bear
weight. Exam shows decreased internal rotation and abduction of the left hip with external rotation
when the knee is flexed. What should the NP suspect?
A. Left meniscal tear
B. Left ACL tear
C. Slipped capital femoral epiphysis (SCFE)
D. Osgood-Schlatter disease
✔✔ Correct Answer ✔✔ C. Slipped capital femoral epiphysis (SCFE)
Rationale: SCFE typically occurs in obese adolescents and presents with referred pain to the knee. Hip
exam reveals decreased internal rotation and abduction, often with obligatory external rotation when
the hip is flexed .
12. In assessing skeletal muscles, turning the patient's forearm so the palm is up is called:
A. Supination
B. Pronation
C. Abduction
D. Eversion
✔✔ Correct Answer ✔✔ A. Supination
Rationale: Supination is the movement of rotating the forearm so the palm faces upward. Pronation
rotates the palm downward .
13. The valgus stress test, varus stress test, Lachman test, and thumb sign assess knee ligaments.
Which test is most specific for the anterior cruciate ligament (ACL)?
A. Valgus stress test
B. Varus stress test
C. Lachman test
D. Thumb sign
✔✔ Correct Answer ✔✔ C. Lachman test
Rationale: The Lachman test is the most sensitive and specific physical examination maneuver for
diagnosing ACL injury. It assesses anterior translation of the tibia relative to the femur with the knee
flexed 20–30 degrees .
NR 511 Differential Diagnosis and Primary Care
Exam 2026/2027 Chamberlain University complete
exam
SECTION 1: GENERAL PRINCIPLES & DIAGNOSTIC TESTING
1. The remodeling of a scar can take how long?
A. 2 weeks
B. 1 month
C. 3 months
D. 6 months
✔✔ Correct Answer ✔✔ D. 6 months
Rationale: Scar remodeling is a dynamic process that can continue for up to 6 months or longer, during
which collagen fibers reorganize to improve tensile strength and appearance .
2. The most cost-effective screening test for determining HIV status is:
A. Western blot
B. Enzyme-linked immunosorbent assay (ELISA)
C. Polymerase chain reaction (PCR)
D. Viral load testing
✔✔ Correct Answer ✔✔ B. Enzyme-linked immunosorbent assay (ELISA)
Rationale: ELISA is the most cost-effective initial screening test for HIV due to its high sensitivity and
relatively low cost. Positive results must be confirmed with Western blot or immunofluorescence
assays .
3. Which blood test is a nonspecific method most helpful for evaluating the severity and course of an
inflammatory process?
A. Erythrocyte sedimentation rate (ESR)
B. C-reactive protein (CRP)
C. Rheumatoid factor (RF)
D. Antinuclear antibody (ANA)
✔✔ Correct Answer ✔✔ B. C-reactive protein (CRP)
Rationale: CRP is an acute-phase reactant that rises rapidly in response to inflammation and infection,
,2
making it valuable for monitoring disease activity and treatment response. Unlike ESR, it is not affected
by anemia or age .
SECTION 2: DERMATOLOGY
4. A 22-year-old African American female presents with nonpalpable patches of skin loss and
blanching on her forehead, hands, and feet that developed over 6 months. What is the most likely
diagnosis?
A. Tinea versicolor
B. Vitiligo
C. Pityriasis alba
D. Post-inflammatory hypopigmentation
✔✔ Correct Answer ✔✔ B. Vitiligo
Rationale: Vitiligo presents as well-demarcated, non-scaly, depigmented macules and patches with a
characteristic distribution (face, hands, feet). There is no history of preceding inflammation .
5. A 22-year-old college student presents with a rash on her buttocks after using a hot tub daily during
spring break. Exam reveals multiple 1–2 mm erythematous pustules. What is the most likely
pathogen?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Candida albicans
D. Herpes simplex virus
✔✔ Correct Answer ✔✔ B. Pseudomonas aeruginosa
Rationale: Hot tub folliculitis is caused by Pseudomonas aeruginosa and presents with pruritic or tender
erythematous papules and pustules within hours to days of exposure .
6. A 27-year-old female presents with perioral burning followed by a group of vesicles with
erythematous bases. What test would confirm her diagnosis?
A. Viral culture
B. Tzanck smear
C. Direct fluorescent antibody (DFA)
D. Serology for HSV antibodies
✔✔ Correct Answer ✔✔ B. Tzanck smear
Rationale: A Tzanck smear can detect multinucleated giant cells, confirming herpes simplex or
varicella-zoster infection. However, it does not distinguish between HSV-1, HSV-2, or VZV .
,3
7. A 3-year-old presents with 3 small, superficial, honey-colored vesicles on the perioral area. She is
afebrile and active. How should this be treated?
A. Oral cephalexin for 7 days
B. Local debridement and mupirocin for 5 days
C. Topical clotrimazole
D. Oral acyclovir
✔✔ Correct Answer ✔✔ B. Local debridement and mupirocin for 5 days
Rationale: This describes impetigo, typically caused by Staphylococcus aureus or Streptococcus
pyogenes. Topical mupirocin is first-line for localized, non-bullous impetigo .
8. A 4-year-old presents with an itchy rash between his fingers, with multiple 1–2 mm red papules in
sets of 3, along with excoriations. What is the treatment?
A. Permethrin lotion for the patient only
B. Permethrin lotion for the patient and all family members
C. Oral ivermectin
D. Topical corticosteroids
✔✔ Correct Answer ✔✔ B. Permethrin lotion for the patient and all family members
Rationale: This is scabies. Permethrin 5% cream is first-line, and all close contacts should be treated
simultaneously to prevent reinfestation .
9. A 44-year-old banker presents with sudden flares of pain, swelling, and redness of the toes. He
takes hydrochlorothiazide for hypertension. What is the most likely diagnosis?
A. Septic arthritis
B. Gout
C. Rheumatoid arthritis
D. Charcot neuro-osteoarthropathy
✔✔ Correct Answer ✔✔ B. Gout
Rationale: Thiazide diuretics (HCTZ) can precipitate gout by reducing uric acid excretion. Acute gout
presents with sudden onset of severe pain, erythema, and swelling of a single joint, most commonly the
first metatarsophalangeal joint .
10. Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure
to UV-B?
A. Actinic keratosis
B. Basal cell carcinoma
C. Verruca
D. Seborrheic dermatitis
, 4
✔✔ Correct Answer ✔✔ A. Actinic keratosis
Rationale: Actinic keratoses are rough, scaly patches on sun-exposed skin that represent premalignant
dysplasia and can progress to squamous cell carcinoma. UV-B radiation causes keratinocyte atypia .
SECTION 3: MUSCULOSKELETAL & RHEUMATOLOGY
11. A 13-year-old obese boy reports low-grade left knee pain for 2 months, now unable to bear
weight. Exam shows decreased internal rotation and abduction of the left hip with external rotation
when the knee is flexed. What should the NP suspect?
A. Left meniscal tear
B. Left ACL tear
C. Slipped capital femoral epiphysis (SCFE)
D. Osgood-Schlatter disease
✔✔ Correct Answer ✔✔ C. Slipped capital femoral epiphysis (SCFE)
Rationale: SCFE typically occurs in obese adolescents and presents with referred pain to the knee. Hip
exam reveals decreased internal rotation and abduction, often with obligatory external rotation when
the hip is flexed .
12. In assessing skeletal muscles, turning the patient's forearm so the palm is up is called:
A. Supination
B. Pronation
C. Abduction
D. Eversion
✔✔ Correct Answer ✔✔ A. Supination
Rationale: Supination is the movement of rotating the forearm so the palm faces upward. Pronation
rotates the palm downward .
13. The valgus stress test, varus stress test, Lachman test, and thumb sign assess knee ligaments.
Which test is most specific for the anterior cruciate ligament (ACL)?
A. Valgus stress test
B. Varus stress test
C. Lachman test
D. Thumb sign
✔✔ Correct Answer ✔✔ C. Lachman test
Rationale: The Lachman test is the most sensitive and specific physical examination maneuver for
diagnosing ACL injury. It assesses anterior translation of the tibia relative to the femur with the knee
flexed 20–30 degrees .
