Advanced Clinical Diagnosis - NR 603 Comprehensive Practice Exam
2026/2027 Chamberlain
1. A 55-year-old male presents with a blood pressure of 145/92 mmHg on two
separate occasions. According to the ACC/AHA guidelines, how should this be
classified?
A. Elevated
B. Stage 1 Hypertension
C. Hypertensive Crisis
D. Stage 2 Hypertension
Answer: D
Rationale: Stage 2 Hypertension is defined as a systolic BP of at least 140 mmHg or a
diastolic BP of at least 90 mmHg.
2. Which of the following physical exam findings is most characteristic of a
patient with right-sided heart failure?
A. Pulmonary crackles
B. Paroxysmal nocturnal dyspnea
C. Jugular venous distention
D. S3 gallop at the apex
Answer: C
Rationale: Right-sided heart failure leads to systemic congestion, manifesting as JVD,
peripheral edema, and hepatomegaly.
,3. An 8-year-old child presents with a ‘barking’ cough and inspiratory stridor.
What is the most likely diagnosis?
A. Pertussis
B. Epiglottitis
C. Bronchiolitis
D. Croup
Answer: D
Rationale: Croup (laryngotracheobronchitis) typically presents with a barking cough and
stridor in young children.
4. Which laboratory value is the most sensitive indicator for diagnosing primary
hypothyroidism?
A. Serum TSH
B. Free T4
C. Total T3
D. Thyroid antibodies
Answer: A
Rationale: TSH is the most sensitive screening and diagnostic test for primary thyroid
disorders.
5. A patient presents with a ‘herald patch’ followed by a Christmas tree pattern
of smaller lesions on the trunk. What is the diagnosis?
A. Tinea corporis
B. Psoriasis
C. Pityriasis rosea
D. Eczema
Answer: C
Rationale: Pityriasis rosea begins with a herald patch and progresses to a Christmas tree
distribution of salmon-colored plaques.
, 6. What is the first-line treatment for a patient diagnosed with mild persistent
asthma?
A. Low-dose Inhaled Corticosteroid (ICS)
B. SABA PRN
C. Long-acting Beta Agonist (LABA)
D. Oral Prednisone
Answer: A
Rationale: Inhaled corticosteroids are the mainstay for persistent asthma to reduce
underlying airway inflammation.
7. Which type of anemia is characterized by a high Mean Corpuscular Volume
(MCV)?
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Thalassemia
D. Anemia of chronic disease
Answer: B
Rationale: Vitamin B12 and folate deficiencies cause macrocytic anemia, which is indicated
by an elevated MCV.
8. In a patient with Community-Acquired Pneumonia (CAP) and no
comorbidities, which is the preferred first-line outpatient antibiotic?
A. Amoxicillin
B. Levofloxacin
C. Ceftriaxone
D. Vancomycin
Answer: A
Rationale: For healthy outpatients with CAP, Amoxicillin or Doxycycline are often
recommended first-line treatments.
2026/2027 Chamberlain
1. A 55-year-old male presents with a blood pressure of 145/92 mmHg on two
separate occasions. According to the ACC/AHA guidelines, how should this be
classified?
A. Elevated
B. Stage 1 Hypertension
C. Hypertensive Crisis
D. Stage 2 Hypertension
Answer: D
Rationale: Stage 2 Hypertension is defined as a systolic BP of at least 140 mmHg or a
diastolic BP of at least 90 mmHg.
2. Which of the following physical exam findings is most characteristic of a
patient with right-sided heart failure?
A. Pulmonary crackles
B. Paroxysmal nocturnal dyspnea
C. Jugular venous distention
D. S3 gallop at the apex
Answer: C
Rationale: Right-sided heart failure leads to systemic congestion, manifesting as JVD,
peripheral edema, and hepatomegaly.
,3. An 8-year-old child presents with a ‘barking’ cough and inspiratory stridor.
What is the most likely diagnosis?
A. Pertussis
B. Epiglottitis
C. Bronchiolitis
D. Croup
Answer: D
Rationale: Croup (laryngotracheobronchitis) typically presents with a barking cough and
stridor in young children.
4. Which laboratory value is the most sensitive indicator for diagnosing primary
hypothyroidism?
A. Serum TSH
B. Free T4
C. Total T3
D. Thyroid antibodies
Answer: A
Rationale: TSH is the most sensitive screening and diagnostic test for primary thyroid
disorders.
5. A patient presents with a ‘herald patch’ followed by a Christmas tree pattern
of smaller lesions on the trunk. What is the diagnosis?
A. Tinea corporis
B. Psoriasis
C. Pityriasis rosea
D. Eczema
Answer: C
Rationale: Pityriasis rosea begins with a herald patch and progresses to a Christmas tree
distribution of salmon-colored plaques.
, 6. What is the first-line treatment for a patient diagnosed with mild persistent
asthma?
A. Low-dose Inhaled Corticosteroid (ICS)
B. SABA PRN
C. Long-acting Beta Agonist (LABA)
D. Oral Prednisone
Answer: A
Rationale: Inhaled corticosteroids are the mainstay for persistent asthma to reduce
underlying airway inflammation.
7. Which type of anemia is characterized by a high Mean Corpuscular Volume
(MCV)?
A. Iron deficiency anemia
B. Vitamin B12 deficiency
C. Thalassemia
D. Anemia of chronic disease
Answer: B
Rationale: Vitamin B12 and folate deficiencies cause macrocytic anemia, which is indicated
by an elevated MCV.
8. In a patient with Community-Acquired Pneumonia (CAP) and no
comorbidities, which is the preferred first-line outpatient antibiotic?
A. Amoxicillin
B. Levofloxacin
C. Ceftriaxone
D. Vancomycin
Answer: A
Rationale: For healthy outpatients with CAP, Amoxicillin or Doxycycline are often
recommended first-line treatments.
