NR511 Week 2 CEA Exam Due 15th
March 2026 Complete Questions 1-
150 Actual Exam Screenshots NR511
FNP Pre-Clinical Diagnostic Online
Exam Requires Respondus Lockdown
Browser + Webcam NR511
Differential Diagnosis & Primary Care
Practicum Exam Questions
Topic 1: Clinical Reasoning & Differential Diagnosis (1–15)
Question 1
A 45-year-old woman presents with episodic right upper quadrant pain that occurs
30-60 minutes after fatty meals. The pain is sharp, lasts 1-2 hours, and radiates to
the right shoulder. Vital signs normal. What is the most likely diagnosis?
A) Acute cholecystitis
B) Biliary colic
C) Peptic ulcer disease
D) Acute pancreatitis
Correct ,,answer,,,,: B
Rationale: Biliary colic is intermittent, postprandial (especially after fatty foods),
and self-limiting. Acute cholecystitis causes constant pain, fever, and tenderness.
,Peptic ulcer pain is epigastric, often relieved by food. Pancreatitis is severe,
constant epigastric pain radiating to the back.
Question 2
A 28-year-old runner reports lateral knee pain that worsens when running
downhill. On exam, tenderness over the lateral femoral condyle. What is the most
likely diagnosis?
A) Patellofemoral syndrome
B) Iliotibial band syndrome
C) Medial meniscus tear
D) Prepatellar bursitis
Correct ,,answer,,,,: B
Rationale: Iliotibial band syndrome causes lateral knee pain, often in runners,
exacerbated by downhill running. Patellofemoral pain is anterior. Meniscus tear
causes catching/locking. Prepatellar bursitis is anterior swelling from kneeling.
Question 3
A 62-year-old with hypertension reports a sudden onset of “worst headache of my
life” that peaked within seconds. Neurologic exam is non-focal. What is the most
critical diagnosis to exclude?
A) Migraine with aura
B) Tension headache
C) Subarachnoid hemorrhage
D) Giant cell arteritis
Correct ,,answer,,,,: C
Rationale: “Thunderclap headache” (sudden, severe, peaking within 60 seconds) is
a classic presentation of subarachnoid hemorrhage until proven otherwise.
Migraine is recurrent with gradual onset. Tension headache is mild to moderate.
GCA causes scalp tenderness, jaw claudication, and elevated ESR.
,Question 4
A 55-year-old smoker with COPD presents with worsening dyspnea, purulent
sputum, and fever for 3 days. Lung exam shows diffuse wheezing. Chest X-ray is
clear. What is the most likely diagnosis?
A) Community-acquired pneumonia
B) Acute exacerbation of COPD
C) Pulmonary embolism
D) Heart failure exacerbation
Correct ,,answer,,,,: B
Rationale: Increased dyspnea, sputum purulence, and sputum volume define an
acute COPD exacerbation. Pneumonia would show infiltrate on CXR. PE typically
has sudden dyspnea without fever/purulence. HF would have crackles, not clear
CXR in this context.
Question 5
A 35-year-old presents with dysuria, frequency, and suprapubic discomfort. She
has no vaginal discharge or irritation. Urinalysis shows positive leukocyte esterase
and nitrites. What is the most likely diagnosis?
A) Vaginal candidiasis
B) Chlamydia trachomatis cervicitis
C) Uncomplicated cystitis
D) Interstitial cystitis
Correct ,,answer,,,,: C
Rationale: Classic symptoms of cystitis with positive leukocyte esterase and
nitrites (indicative of Gram-negative bacteria) are highly specific for
uncomplicated UTI. Vaginal candidiasis causes itching, discharge, no dysuria.
Chlamydia often asymptomatic or mucopurulent discharge. Interstitial cystitis has
chronic pain with negative UA.
, Question 6
A 70-year-old with diabetes presents with painless hematuria. He denies trauma,
stones, or infection. What is the most concerning diagnosis?
A) Urinary tract infection
B) Benign prostatic hyperplasia
C) Bladder cancer
D) Kidney stone
Correct ,,answer,,,,: C
Rationale: Painless hematuria in an older adult (especially with smoking history or
occupational exposures) is bladder cancer until proven otherwise. UTI typically
has dysuria/fever. BPH causes obstructive symptoms, not isolated painless
hematuria. Stones cause pain.
Question 7
A 25-year-old presents with sore throat, fever, and tender anterior cervical
lymphadenopathy. No cough. On exam, pharyngeal erythema and tonsillar
exudate. What is the best next step to determine if this is group A streptococcus?
A) Prescribe amoxicillin empirically
B) Rapid antigen detection test (RADT) or throat culture
C) Monospot test
D) Complete blood count
Correct ,,answer,,,,: B
Rationale: Centor criteria suggest possible strep pharyngitis. Rapid strep test (or
culture if rapid negative in children) is indicated to guide antibiotic therapy.
Empiric antibiotics are not recommended without testing. Monospot for EBV
(cough, fatigue). CBC non-specific.
Question 8
A 32-year-old presents with gradual onset of fatigue, weight gain, cold intolerance,
and constipation. On exam: bradycardia, dry skin, delayed relaxation of deep
March 2026 Complete Questions 1-
150 Actual Exam Screenshots NR511
FNP Pre-Clinical Diagnostic Online
Exam Requires Respondus Lockdown
Browser + Webcam NR511
Differential Diagnosis & Primary Care
Practicum Exam Questions
Topic 1: Clinical Reasoning & Differential Diagnosis (1–15)
Question 1
A 45-year-old woman presents with episodic right upper quadrant pain that occurs
30-60 minutes after fatty meals. The pain is sharp, lasts 1-2 hours, and radiates to
the right shoulder. Vital signs normal. What is the most likely diagnosis?
A) Acute cholecystitis
B) Biliary colic
C) Peptic ulcer disease
D) Acute pancreatitis
Correct ,,answer,,,,: B
Rationale: Biliary colic is intermittent, postprandial (especially after fatty foods),
and self-limiting. Acute cholecystitis causes constant pain, fever, and tenderness.
,Peptic ulcer pain is epigastric, often relieved by food. Pancreatitis is severe,
constant epigastric pain radiating to the back.
Question 2
A 28-year-old runner reports lateral knee pain that worsens when running
downhill. On exam, tenderness over the lateral femoral condyle. What is the most
likely diagnosis?
A) Patellofemoral syndrome
B) Iliotibial band syndrome
C) Medial meniscus tear
D) Prepatellar bursitis
Correct ,,answer,,,,: B
Rationale: Iliotibial band syndrome causes lateral knee pain, often in runners,
exacerbated by downhill running. Patellofemoral pain is anterior. Meniscus tear
causes catching/locking. Prepatellar bursitis is anterior swelling from kneeling.
Question 3
A 62-year-old with hypertension reports a sudden onset of “worst headache of my
life” that peaked within seconds. Neurologic exam is non-focal. What is the most
critical diagnosis to exclude?
A) Migraine with aura
B) Tension headache
C) Subarachnoid hemorrhage
D) Giant cell arteritis
Correct ,,answer,,,,: C
Rationale: “Thunderclap headache” (sudden, severe, peaking within 60 seconds) is
a classic presentation of subarachnoid hemorrhage until proven otherwise.
Migraine is recurrent with gradual onset. Tension headache is mild to moderate.
GCA causes scalp tenderness, jaw claudication, and elevated ESR.
,Question 4
A 55-year-old smoker with COPD presents with worsening dyspnea, purulent
sputum, and fever for 3 days. Lung exam shows diffuse wheezing. Chest X-ray is
clear. What is the most likely diagnosis?
A) Community-acquired pneumonia
B) Acute exacerbation of COPD
C) Pulmonary embolism
D) Heart failure exacerbation
Correct ,,answer,,,,: B
Rationale: Increased dyspnea, sputum purulence, and sputum volume define an
acute COPD exacerbation. Pneumonia would show infiltrate on CXR. PE typically
has sudden dyspnea without fever/purulence. HF would have crackles, not clear
CXR in this context.
Question 5
A 35-year-old presents with dysuria, frequency, and suprapubic discomfort. She
has no vaginal discharge or irritation. Urinalysis shows positive leukocyte esterase
and nitrites. What is the most likely diagnosis?
A) Vaginal candidiasis
B) Chlamydia trachomatis cervicitis
C) Uncomplicated cystitis
D) Interstitial cystitis
Correct ,,answer,,,,: C
Rationale: Classic symptoms of cystitis with positive leukocyte esterase and
nitrites (indicative of Gram-negative bacteria) are highly specific for
uncomplicated UTI. Vaginal candidiasis causes itching, discharge, no dysuria.
Chlamydia often asymptomatic or mucopurulent discharge. Interstitial cystitis has
chronic pain with negative UA.
, Question 6
A 70-year-old with diabetes presents with painless hematuria. He denies trauma,
stones, or infection. What is the most concerning diagnosis?
A) Urinary tract infection
B) Benign prostatic hyperplasia
C) Bladder cancer
D) Kidney stone
Correct ,,answer,,,,: C
Rationale: Painless hematuria in an older adult (especially with smoking history or
occupational exposures) is bladder cancer until proven otherwise. UTI typically
has dysuria/fever. BPH causes obstructive symptoms, not isolated painless
hematuria. Stones cause pain.
Question 7
A 25-year-old presents with sore throat, fever, and tender anterior cervical
lymphadenopathy. No cough. On exam, pharyngeal erythema and tonsillar
exudate. What is the best next step to determine if this is group A streptococcus?
A) Prescribe amoxicillin empirically
B) Rapid antigen detection test (RADT) or throat culture
C) Monospot test
D) Complete blood count
Correct ,,answer,,,,: B
Rationale: Centor criteria suggest possible strep pharyngitis. Rapid strep test (or
culture if rapid negative in children) is indicated to guide antibiotic therapy.
Empiric antibiotics are not recommended without testing. Monospot for EBV
(cough, fatigue). CBC non-specific.
Question 8
A 32-year-old presents with gradual onset of fatigue, weight gain, cold intolerance,
and constipation. On exam: bradycardia, dry skin, delayed relaxation of deep
