1
NR 511 CEA Exam Prep 2026: Comprehensive 250-
Question Practice Test with Answers and Rationales
for Chamberlain Differential Diagnosis and Primary
Care Practicum
Section 1: Clinical Decision-Making and Differential Diagnosis (Questions 1-30)
1. A 45-year-old male presents with chest pain that is pressure-like, radiating to the left arm,
associated with diaphoresis and nausea. The pain started 30 minutes ago while shoveling
snow. What is the most appropriate initial action?
A. Obtain a detailed cardiac history
B. Administer aspirin 324 mg PO
C. Activate EMS for immediate transport
D. Perform an EKG in the office
Correct Answer: C. Activate EMS for immediate transport
Rationale: This patient has symptoms concerning for acute coronary syndrome (ACS). The most
appropriate initial action is to activate EMS for immediate transport to an emergency
,2
department. While aspirin and EKG are important, they should not delay emergency transport.
The "golden hour" for myocardial salvage is critical.
2. A 65-year-old female presents with acute onset of severe, tearing chest pain radiating to
the back. Blood pressure is 160/90 mmHg in the right arm and 100/60 mmHg in the left arm.
What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale: Aortic dissection presents with severe, tearing chest pain that radiates to the back
and can cause discrepancies in blood pressure between arms. This clinical picture is classic for
aortic dissection, which is a medical emergency requiring immediate imaging and surgical
consultation.
,3
3. What is the primary purpose of creating a differential diagnosis list?
A. To list all possible diseases that could explain a patient's symptoms, ranked from most to
least likely
B. To provide a definitive diagnosis before any testing is done
C. To satisfy insurance requirements for reimbursement
D. To document only the most serious condition regardless of likelihood
Correct Answer: A. To list all possible diseases that could explain a patient's symptoms,
ranked from most to least likely
Rationale: A differential diagnosis list is a systematic method to identify and rank potential
causes of a patient's presenting symptoms. This process ensures comprehensive clinical
reasoning, prevents premature closure, and guides appropriate diagnostic testing.
4. A 55-year-old male presents with fatigue, unintentional weight loss, and low-grade fever
for 3 weeks. What is the most appropriate initial approach?
A. Reassure the patient and schedule follow-up in 3 months
B. Order a comprehensive metabolic panel, CBC with differential, and ESR/CRP
, 4
C. Prescribe antibiotics for presumed infection
D. Refer immediately to oncology
Correct Answer: B. Order a comprehensive metabolic panel, CBC with differential, and
ESR/CRP
Rationale: Unexplained weight loss with constitutional symptoms (fever, night sweats, fatigue)
warrants initial laboratory evaluation to screen for infection, chronic inflammation, or
malignancy. Empirical treatment or immediate oncology referral without further workup is
premature.
5. Which of the following is a key component of the "5 A's" model for behavioral counseling
in primary care?
A. Ask, Advise, Assess, Assist, Arrange
B. Assess, Advise, Agree, Assist, Arrange
C. Admit, Advise, Agree, Assist, Arrange
D. Assess, Advise, Administer, Arrange, Adhere
Correct Answer: B. Assess, Advise, Agree, Assist, Arrange
NR 511 CEA Exam Prep 2026: Comprehensive 250-
Question Practice Test with Answers and Rationales
for Chamberlain Differential Diagnosis and Primary
Care Practicum
Section 1: Clinical Decision-Making and Differential Diagnosis (Questions 1-30)
1. A 45-year-old male presents with chest pain that is pressure-like, radiating to the left arm,
associated with diaphoresis and nausea. The pain started 30 minutes ago while shoveling
snow. What is the most appropriate initial action?
A. Obtain a detailed cardiac history
B. Administer aspirin 324 mg PO
C. Activate EMS for immediate transport
D. Perform an EKG in the office
Correct Answer: C. Activate EMS for immediate transport
Rationale: This patient has symptoms concerning for acute coronary syndrome (ACS). The most
appropriate initial action is to activate EMS for immediate transport to an emergency
,2
department. While aspirin and EKG are important, they should not delay emergency transport.
The "golden hour" for myocardial salvage is critical.
2. A 65-year-old female presents with acute onset of severe, tearing chest pain radiating to
the back. Blood pressure is 160/90 mmHg in the right arm and 100/60 mmHg in the left arm.
What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C. Aortic dissection
Rationale: Aortic dissection presents with severe, tearing chest pain that radiates to the back
and can cause discrepancies in blood pressure between arms. This clinical picture is classic for
aortic dissection, which is a medical emergency requiring immediate imaging and surgical
consultation.
,3
3. What is the primary purpose of creating a differential diagnosis list?
A. To list all possible diseases that could explain a patient's symptoms, ranked from most to
least likely
B. To provide a definitive diagnosis before any testing is done
C. To satisfy insurance requirements for reimbursement
D. To document only the most serious condition regardless of likelihood
Correct Answer: A. To list all possible diseases that could explain a patient's symptoms,
ranked from most to least likely
Rationale: A differential diagnosis list is a systematic method to identify and rank potential
causes of a patient's presenting symptoms. This process ensures comprehensive clinical
reasoning, prevents premature closure, and guides appropriate diagnostic testing.
4. A 55-year-old male presents with fatigue, unintentional weight loss, and low-grade fever
for 3 weeks. What is the most appropriate initial approach?
A. Reassure the patient and schedule follow-up in 3 months
B. Order a comprehensive metabolic panel, CBC with differential, and ESR/CRP
, 4
C. Prescribe antibiotics for presumed infection
D. Refer immediately to oncology
Correct Answer: B. Order a comprehensive metabolic panel, CBC with differential, and
ESR/CRP
Rationale: Unexplained weight loss with constitutional symptoms (fever, night sweats, fatigue)
warrants initial laboratory evaluation to screen for infection, chronic inflammation, or
malignancy. Empirical treatment or immediate oncology referral without further workup is
premature.
5. Which of the following is a key component of the "5 A's" model for behavioral counseling
in primary care?
A. Ask, Advise, Assess, Assist, Arrange
B. Assess, Advise, Agree, Assist, Arrange
C. Admit, Advise, Agree, Assist, Arrange
D. Assess, Advise, Administer, Arrange, Adhere
Correct Answer: B. Assess, Advise, Agree, Assist, Arrange
