NR 575 PRIMARY CARE PRACTICUM FINAL EXAM
CHAMBERLAIN UNIVERSITY QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A 67-year-old man presents with increasing fatigue, dyspnea on exertion, and
bilateral ankle swelling over the past 2 weeks. His history includes hypertension,
type 2 diabetes mellitus, and myocardial infarction 4 years ago. Blood pressure is
146/88 mmHg, pulse 96/min, respirations 20/min, oxygen saturation 95% on room
air. Physical examination reveals jugular venous distention, bibasilar crackles, and
2+ pitting edema.
Which diagnosis best explains the patient's presentation?
A. Community-acquired pneumonia
B. Acute decompensated heart failure
C. Nephrotic syndrome
D. Pulmonary embolism
Answer: B
Rationale: Progressive dyspnea, peripheral edema, elevated JVP, and pulmonary
crackles are classic findings of acute decompensated heart failure. Although
nephrotic syndrome may produce edema, pulmonary congestion and elevated JVP
strongly indicate cardiac volume overload.
,Question 2
A 29-year-old woman reports urinary frequency, urgency, and dysuria for 24
hours. She denies fever, flank pain, vaginal discharge, or pregnancy. Urinalysis
demonstrates positive leukocyte esterase and nitrites.
What is the most appropriate initial management?
A. Begin empiric treatment for uncomplicated cystitis
B. Obtain CT abdomen and pelvis
C. Refer immediately to urology
D. Begin intravenous antibiotics
Answer: A
Rationale: Healthy nonpregnant women with classic symptoms and supportive
urinalysis findings can be treated empirically for uncomplicated cystitis. Imaging
and specialty referral are unnecessary unless complicated infection is suspected.
Question 3
A 54-year-old woman with obesity presents for evaluation of fatigue. Laboratory
studies reveal:
TSH: 9.4 mIU/L
Free T4: Low
Which diagnosis is most likely?
A. Secondary hypothyroidism
B. Primary hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: B
,Rationale: Elevated TSH with low free T4 indicates primary thyroid gland failure.
Secondary hypothyroidism presents with an inappropriately low or normal TSH.
Question 4
A 62-year-old smoker develops sudden left arm weakness and slurred speech that
began 45 minutes ago.
What is the priority action?
A. Administer aspirin immediately
B. Obtain emergent noncontrast CT of the head
C. Schedule outpatient MRI
D. Begin heparin infusion
Answer: B
Rationale: Suspected acute stroke requires immediate neuroimaging to distinguish
ischemic from hemorrhagic stroke before thrombolytic therapy or antiplatelet
medications are considered.
Question 5
A 38-year-old man with poorly controlled hypertension is found to have persistent
hypokalemia despite potassium supplementation.
Which condition should be strongly suspected?
A. Cushing syndrome
B. Primary hyperaldosteronism
C. Hypothyroidism
D. Addison disease
Answer: B
, Rationale: Resistant hypertension with unexplained hypokalemia strongly
suggests excess aldosterone production, most commonly primary
hyperaldosteronism.
Question 6
A 71-year-old woman reports progressive forgetfulness over 3 years. Family
members describe impaired medication management and repeated questions.
Neurologic examination is otherwise normal.
Which diagnosis is most likely?
A. Delirium
B. Alzheimer's disease
C. Major depression
D. Normal aging
Answer: B
Rationale: Gradual cognitive decline affecting memory and instrumental activities
of daily living is characteristic of Alzheimer's disease.
Question 7
A 46-year-old patient with type 2 diabetes has an A1C of 9.1% despite adherence
to maximum tolerated metformin therapy. Kidney function is normal.
Which medication provides glycemic improvement with demonstrated
cardiovascular benefit?
A. Glyburide
B. Pioglitazone
C. Empagliflozin
D. Acarbose
CHAMBERLAIN UNIVERSITY QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A 67-year-old man presents with increasing fatigue, dyspnea on exertion, and
bilateral ankle swelling over the past 2 weeks. His history includes hypertension,
type 2 diabetes mellitus, and myocardial infarction 4 years ago. Blood pressure is
146/88 mmHg, pulse 96/min, respirations 20/min, oxygen saturation 95% on room
air. Physical examination reveals jugular venous distention, bibasilar crackles, and
2+ pitting edema.
Which diagnosis best explains the patient's presentation?
A. Community-acquired pneumonia
B. Acute decompensated heart failure
C. Nephrotic syndrome
D. Pulmonary embolism
Answer: B
Rationale: Progressive dyspnea, peripheral edema, elevated JVP, and pulmonary
crackles are classic findings of acute decompensated heart failure. Although
nephrotic syndrome may produce edema, pulmonary congestion and elevated JVP
strongly indicate cardiac volume overload.
,Question 2
A 29-year-old woman reports urinary frequency, urgency, and dysuria for 24
hours. She denies fever, flank pain, vaginal discharge, or pregnancy. Urinalysis
demonstrates positive leukocyte esterase and nitrites.
What is the most appropriate initial management?
A. Begin empiric treatment for uncomplicated cystitis
B. Obtain CT abdomen and pelvis
C. Refer immediately to urology
D. Begin intravenous antibiotics
Answer: A
Rationale: Healthy nonpregnant women with classic symptoms and supportive
urinalysis findings can be treated empirically for uncomplicated cystitis. Imaging
and specialty referral are unnecessary unless complicated infection is suspected.
Question 3
A 54-year-old woman with obesity presents for evaluation of fatigue. Laboratory
studies reveal:
TSH: 9.4 mIU/L
Free T4: Low
Which diagnosis is most likely?
A. Secondary hypothyroidism
B. Primary hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: B
,Rationale: Elevated TSH with low free T4 indicates primary thyroid gland failure.
Secondary hypothyroidism presents with an inappropriately low or normal TSH.
Question 4
A 62-year-old smoker develops sudden left arm weakness and slurred speech that
began 45 minutes ago.
What is the priority action?
A. Administer aspirin immediately
B. Obtain emergent noncontrast CT of the head
C. Schedule outpatient MRI
D. Begin heparin infusion
Answer: B
Rationale: Suspected acute stroke requires immediate neuroimaging to distinguish
ischemic from hemorrhagic stroke before thrombolytic therapy or antiplatelet
medications are considered.
Question 5
A 38-year-old man with poorly controlled hypertension is found to have persistent
hypokalemia despite potassium supplementation.
Which condition should be strongly suspected?
A. Cushing syndrome
B. Primary hyperaldosteronism
C. Hypothyroidism
D. Addison disease
Answer: B
, Rationale: Resistant hypertension with unexplained hypokalemia strongly
suggests excess aldosterone production, most commonly primary
hyperaldosteronism.
Question 6
A 71-year-old woman reports progressive forgetfulness over 3 years. Family
members describe impaired medication management and repeated questions.
Neurologic examination is otherwise normal.
Which diagnosis is most likely?
A. Delirium
B. Alzheimer's disease
C. Major depression
D. Normal aging
Answer: B
Rationale: Gradual cognitive decline affecting memory and instrumental activities
of daily living is characteristic of Alzheimer's disease.
Question 7
A 46-year-old patient with type 2 diabetes has an A1C of 9.1% despite adherence
to maximum tolerated metformin therapy. Kidney function is normal.
Which medication provides glycemic improvement with demonstrated
cardiovascular benefit?
A. Glyburide
B. Pioglitazone
C. Empagliflozin
D. Acarbose
