NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential
Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
OBJECTIVE ASSESSMENT - EXAM
NR511 / NR 511 Midterm Exam
Study Guide |Week 1 - 4| (Latest
2026/2027): Differential
Diagnosis & Primary Care
Practicum - Chamberlain
2026/2027
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Differential Diagnosis & Clinical Reasoning Musculoskeletal & Neurological Disorders
Cardiovascular & Respiratory Disorders Diagnostic Testing & Interpretation
Gastrointestinal & Genitourinary Conditions Evidence-Based Clinical Decision Making
COVER PAGE - 1
, SECTION 1 | Differential Diagnosis & Clinical Reasoning | Q1-Q15 | NR511 / NR 511 Midterm Exam Study Guide |Week
1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027 2026/2027
Q1 Question 1 of 75
A 34-year-old teacher presents with a 3-day history of sore throat, low-grade fever, and nasal congestion. She
reports that several students in her class have been sick with similar symptoms. On examination, her pharynx
is erythematous without exudates, and she has clear nasal discharge.
A. Acute viral pharyngitis, supportive care only
B. Group A streptococcal pharyngitis, start amoxicillin
C. Allergic rhinitis, prescribe intranasal corticosteroids
D. Infectious mononucleosis, obtain monospot testing
Correct Answer: A
Rationale:
The constellation of nasal congestion, clear discharge, low-grade fever, and sick contacts strongly suggests viral
pharyngitis, which is self-limiting and managed conservatively. Group A strep typically presents with sudden onset sore
throat, tonsillar exudates, and absence of cough (Centor criteria), making antibiotic therapy unnecessary in this case.
Q2 Question 2 of 75
A 58-year-old construction worker reports substernal chest pressure that began 20 minutes ago while lifting
heavy materials. The pain radiates to his left arm and is associated with diaphoresis and shortness of breath.
He has a history of hypertension and type 2 diabetes.
A. Costochondritis, recommend rest and NSAIDs
B. Musculoskeletal strain, apply heat and schedule follow-up
C. Gastroesophageal reflux disease, prescribe PPI therapy
D. Acute coronary syndrome, activate emergency protocol
Correct Answer: D
Rationale:
This patient exhibits classic red flags for acute coronary syndrome including substernal pressure with radiation to the left
arm, diaphoresis, and dyspnea in a patient with multiple cardiovascular risk factors. Costochondritis and GERD lack the
systemic symptoms seen here, and delaying treatment for musculoskeletal strain would be dangerous given the
high-risk presentation.
NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
- 2026/2027 | Passing Score: 80% | Page 1 of 40
, Q3 Question 3 of 75
A 45-year-old woman presents with a chronic cough lasting 8 weeks. She does not smoke and takes lisinopril
for hypertension. The cough is dry, worse at night, and has not improved with over-the-counter cough
suppressants. Physical examination is unremarkable.
A. Initiate empiric antibiotics for bronchitis
B. Order chest CT to evaluate for malignancy
C. Switch lisinopril to amlodipine and reassess
D. Prescribe inhaled albuterol for suspected asthma
Correct Answer: C
Rationale:
ACE inhibitor-induced cough occurs in up to 20% of patients and should be suspected when a chronic dry cough
develops after starting these medications. Switching to an ARB or a different antihypertensive class typically resolves
the cough within 1-4 weeks. Empiric antibiotics are inappropriate without evidence of infection, and imaging or
bronchodilators should be considered only after medication change fails.
Q4 Question 4 of 75
A 28-year-old graduate student comes to the clinic with a severe unilateral headache that started abruptly 2
hours ago. She describes the pain as "the worst headache of my life" with associated neck stiffness and
photophobia. She has no prior headache history.
A. Prescribe sumatriptan for migraine and schedule follow-up
B. Refer to neurology for tension headache management
C. Recommend rest, hydration, and over-the-counter analgesics
D. Order non-contrast head CT immediately to evaluate for subarachnoid hemorrhage
Correct Answer: D
Rationale:
A sudden-onset "thunderclap" headache described as the worst of one's life, especially with neck stiffness and
photophobia, is a sentinel presentation requiring emergent evaluation for subarachnoid hemorrhage. Migraine typically
builds gradually and rarely presents as a first-time severe headache, while tension headaches lack the acute severity
and associated meningeal signs.
NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
- 2026/2027 | Passing Score: 80% | Page 2 of 40
, Q5 Question 5 of 75
A 22-year-old soccer player sustained an inversion injury to her right ankle during a game 1 hour ago. She is
unable to bear weight and has significant swelling over the lateral malleolus. The Ottawa Ankle Rules
assessment reveals bony tenderness at the posterior edge of the lateral malleolus.
A. Apply a compression wrap and recommend RICE therapy at home
B. Obtain an MRI to assess for ligamentous injury
C. Prescribe an oral NSAID and refer to physical therapy
D. Order ankle radiographs to evaluate for fracture
Correct Answer: D
Rationale:
The Ottawa Ankle Rules indicate that bony tenderness at the posterior edge of the lateral malleolus meets criteria for
radiographic imaging. These clinical decision rules have high sensitivity for detecting ankle fractures and help avoid
unnecessary imaging. RICE therapy alone would be inappropriate without first ruling out fracture given the positive
Ottawa criteria.
Q6 Question 6 of 75
A 52-year-old woman presents with persistent fatigue, weight gain, cold intolerance, and constipation over the
past 3 months. Her skin is dry, and her reflexes show delayed relaxation. Her TSH is elevated at 12.4 mIU/L
with a low free T4.
A. Major depressive disorder, initiate SSRI therapy
B. Iron deficiency anemia, order ferritin and CBC
C. Primary hypothyroidism, start levothyroxine replacement
D. Chronic fatigue syndrome, recommend cognitive behavioral therapy
Correct Answer: C
Rationale:
The combination of fatigue, weight gain, cold intolerance, constipation, dry skin, and delayed reflex relaxation with
elevated TSH and low free T4 is diagnostic of primary hypothyroidism. While depression and anemia can cause fatigue,
they do not explain the full constellation of metabolic symptoms or the abnormal thyroid function tests.
NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
- 2026/2027 | Passing Score: 80% | Page 3 of 40
Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
OBJECTIVE ASSESSMENT - EXAM
NR511 / NR 511 Midterm Exam
Study Guide |Week 1 - 4| (Latest
2026/2027): Differential
Diagnosis & Primary Care
Practicum - Chamberlain
2026/2027
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Differential Diagnosis & Clinical Reasoning Musculoskeletal & Neurological Disorders
Cardiovascular & Respiratory Disorders Diagnostic Testing & Interpretation
Gastrointestinal & Genitourinary Conditions Evidence-Based Clinical Decision Making
COVER PAGE - 1
, SECTION 1 | Differential Diagnosis & Clinical Reasoning | Q1-Q15 | NR511 / NR 511 Midterm Exam Study Guide |Week
1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027 2026/2027
Q1 Question 1 of 75
A 34-year-old teacher presents with a 3-day history of sore throat, low-grade fever, and nasal congestion. She
reports that several students in her class have been sick with similar symptoms. On examination, her pharynx
is erythematous without exudates, and she has clear nasal discharge.
A. Acute viral pharyngitis, supportive care only
B. Group A streptococcal pharyngitis, start amoxicillin
C. Allergic rhinitis, prescribe intranasal corticosteroids
D. Infectious mononucleosis, obtain monospot testing
Correct Answer: A
Rationale:
The constellation of nasal congestion, clear discharge, low-grade fever, and sick contacts strongly suggests viral
pharyngitis, which is self-limiting and managed conservatively. Group A strep typically presents with sudden onset sore
throat, tonsillar exudates, and absence of cough (Centor criteria), making antibiotic therapy unnecessary in this case.
Q2 Question 2 of 75
A 58-year-old construction worker reports substernal chest pressure that began 20 minutes ago while lifting
heavy materials. The pain radiates to his left arm and is associated with diaphoresis and shortness of breath.
He has a history of hypertension and type 2 diabetes.
A. Costochondritis, recommend rest and NSAIDs
B. Musculoskeletal strain, apply heat and schedule follow-up
C. Gastroesophageal reflux disease, prescribe PPI therapy
D. Acute coronary syndrome, activate emergency protocol
Correct Answer: D
Rationale:
This patient exhibits classic red flags for acute coronary syndrome including substernal pressure with radiation to the left
arm, diaphoresis, and dyspnea in a patient with multiple cardiovascular risk factors. Costochondritis and GERD lack the
systemic symptoms seen here, and delaying treatment for musculoskeletal strain would be dangerous given the
high-risk presentation.
NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
- 2026/2027 | Passing Score: 80% | Page 1 of 40
, Q3 Question 3 of 75
A 45-year-old woman presents with a chronic cough lasting 8 weeks. She does not smoke and takes lisinopril
for hypertension. The cough is dry, worse at night, and has not improved with over-the-counter cough
suppressants. Physical examination is unremarkable.
A. Initiate empiric antibiotics for bronchitis
B. Order chest CT to evaluate for malignancy
C. Switch lisinopril to amlodipine and reassess
D. Prescribe inhaled albuterol for suspected asthma
Correct Answer: C
Rationale:
ACE inhibitor-induced cough occurs in up to 20% of patients and should be suspected when a chronic dry cough
develops after starting these medications. Switching to an ARB or a different antihypertensive class typically resolves
the cough within 1-4 weeks. Empiric antibiotics are inappropriate without evidence of infection, and imaging or
bronchodilators should be considered only after medication change fails.
Q4 Question 4 of 75
A 28-year-old graduate student comes to the clinic with a severe unilateral headache that started abruptly 2
hours ago. She describes the pain as "the worst headache of my life" with associated neck stiffness and
photophobia. She has no prior headache history.
A. Prescribe sumatriptan for migraine and schedule follow-up
B. Refer to neurology for tension headache management
C. Recommend rest, hydration, and over-the-counter analgesics
D. Order non-contrast head CT immediately to evaluate for subarachnoid hemorrhage
Correct Answer: D
Rationale:
A sudden-onset "thunderclap" headache described as the worst of one's life, especially with neck stiffness and
photophobia, is a sentinel presentation requiring emergent evaluation for subarachnoid hemorrhage. Migraine typically
builds gradually and rarely presents as a first-time severe headache, while tension headaches lack the acute severity
and associated meningeal signs.
NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
- 2026/2027 | Passing Score: 80% | Page 2 of 40
, Q5 Question 5 of 75
A 22-year-old soccer player sustained an inversion injury to her right ankle during a game 1 hour ago. She is
unable to bear weight and has significant swelling over the lateral malleolus. The Ottawa Ankle Rules
assessment reveals bony tenderness at the posterior edge of the lateral malleolus.
A. Apply a compression wrap and recommend RICE therapy at home
B. Obtain an MRI to assess for ligamentous injury
C. Prescribe an oral NSAID and refer to physical therapy
D. Order ankle radiographs to evaluate for fracture
Correct Answer: D
Rationale:
The Ottawa Ankle Rules indicate that bony tenderness at the posterior edge of the lateral malleolus meets criteria for
radiographic imaging. These clinical decision rules have high sensitivity for detecting ankle fractures and help avoid
unnecessary imaging. RICE therapy alone would be inappropriate without first ruling out fracture given the positive
Ottawa criteria.
Q6 Question 6 of 75
A 52-year-old woman presents with persistent fatigue, weight gain, cold intolerance, and constipation over the
past 3 months. Her skin is dry, and her reflexes show delayed relaxation. Her TSH is elevated at 12.4 mIU/L
with a low free T4.
A. Major depressive disorder, initiate SSRI therapy
B. Iron deficiency anemia, order ferritin and CBC
C. Primary hypothyroidism, start levothyroxine replacement
D. Chronic fatigue syndrome, recommend cognitive behavioral therapy
Correct Answer: C
Rationale:
The combination of fatigue, weight gain, cold intolerance, constipation, dry skin, and delayed reflex relaxation with
elevated TSH and low free T4 is diagnostic of primary hypothyroidism. While depression and anemia can cause fatigue,
they do not explain the full constellation of metabolic symptoms or the abnormal thyroid function tests.
NR511 / NR 511 Midterm Exam Study Guide |Week 1 - 4| (Latest 2026/2027): Differential Diagnosis & Primary Care Practicum - Chamberlain 2026/2027
- 2026/2027 | Passing Score: 80% | Page 3 of 40
