NR 511 FINAL EXAM TEST DIFFERENTIAL DIAGNOSIS & PRIMARY CARE PRACTICUM QUESTIONS &
ANSWERS WITH RATIONALES 2026 UPDATED(CHAMBERLAIN) 100% GUARANTEE PASS
Question 1:
Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level
of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
Correct Answer: d. paresthesia of the perineum and buttocks
Options:
a. gastrocnemius weakness
b. reduced or absent ankle reflexes
c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks
Rationale: Cauda equina compression presents with saddle anesthesia (paresthesia of the
perineum and buttocks), bowel/bladder dysfunction, and bilateral lower extremity weakness. The
other options are more consistent with nerve root compression at specific levels.
Question 2:
The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In order
to plan care, the clinician understands that this criteria score has which of the following
meanings?
Correct Answer: a. a high mortality rate
Options:
a. a high mortality rate
b. an increased chance of recurrence
c. 7% chance of the disease becoming chronic
d. all of the above
Rationale: Ranson's criteria are used to assess severity and prognosis in acute pancreatitis. A
score of 7 or more indicates severe pancreatitis with a high mortality rate (approximately 50-60%).
,Question 3:
Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral
load. What does this indicate?
Correct Answer: a. a favorable diagnostic trend
Options:
a. a favorable diagnostic trend
b. disease progression
c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV
Rationale: A falling viral load in HIV indicates that the antiretroviral therapy is working
effectively and the patient's immune system is responding favorably. It does not mean HIV is
eradicated.
Question 4:
Which is the differentiating symptom between labyrinthitis and vestibular neuritis?
Correct Answer: d. hearing loss may be associated with labyrinthitis, but not with vestibular
neuritis
Options:
a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the
onset is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis
c. symptoms with labyrinthitis are usually acute in onset, whereas with vestibular neuritis the
onset is more gradual
d. hearing loss may be associated with labyrinthitis, but not with vestibular neuritis
Rationale: Labyrinthitis involves both vestibular and cochlear branches of CN VIII, causing
vertigo AND hearing loss/tinnitus. Vestibular neuritis only affects the vestibular branch, so hearing
is preserved.
Question 5:
,A 27 year old female presents with a chief complaint of burning and pain on urination. She has no
previous history of urinary tract infection. What are some additional symptoms consistent with a
diagnosis of lower UTI?
Correct Answer: c. blood in urine and frequency
Options:
a. back and abdominal pain
b. fever, chills, costovertebral angle (CVA) tenderness
c. blood in urine and frequency
d. foul-smelling discharge, perineal itch
Rationale: Lower UTI symptoms include dysuria, frequency, urgency, and hematuria.
Back/abdominal pain, fever, and CVA tenderness suggest pyelonephritis (upper UTI).
Question 6:
The differential diagnosis for vertigo can be classified into which of the following categories:
Correct Answer: d. all of the above
Options:
a. peripheral vestibular disease
b. CNS disorders
c. Systemic disorders
d. all of the above
Rationale: Vertigo can be caused by peripheral vestibular disorders (e.g., BPPV, labyrinthitis),
central nervous system disorders (e.g., stroke, MS), and systemic disorders (e.g., hypotension,
anemia).
, Question 7:
Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of
localized low back pain and muscle spasm along with a normal neurological examination. As the
clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following
symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or
ruptured disc?
Correct Answer: b. unilateral radicular pain symptoms that extend below the knee and are equal to
or greater than the back pain
Options:
a. morning stiffness and limited mobility of the lumbar spine
b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than
the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. pathologic fractures, severe night pain, weight loss and fatigue
Rationale: Radicular pain that extends below the knee suggests nerve root compression from a
herniated disc. Pain radiating below the knee is more concerning than isolated back pain.
Question 8:
Preceptors must always see the patients that the students see in the clinical setting.
Correct Answer: a. true
Options:
ANSWERS WITH RATIONALES 2026 UPDATED(CHAMBERLAIN) 100% GUARANTEE PASS
Question 1:
Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level
of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
Correct Answer: d. paresthesia of the perineum and buttocks
Options:
a. gastrocnemius weakness
b. reduced or absent ankle reflexes
c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks
Rationale: Cauda equina compression presents with saddle anesthesia (paresthesia of the
perineum and buttocks), bowel/bladder dysfunction, and bilateral lower extremity weakness. The
other options are more consistent with nerve root compression at specific levels.
Question 2:
The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In order
to plan care, the clinician understands that this criteria score has which of the following
meanings?
Correct Answer: a. a high mortality rate
Options:
a. a high mortality rate
b. an increased chance of recurrence
c. 7% chance of the disease becoming chronic
d. all of the above
Rationale: Ranson's criteria are used to assess severity and prognosis in acute pancreatitis. A
score of 7 or more indicates severe pancreatitis with a high mortality rate (approximately 50-60%).
,Question 3:
Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral
load. What does this indicate?
Correct Answer: a. a favorable diagnostic trend
Options:
a. a favorable diagnostic trend
b. disease progression
c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV
Rationale: A falling viral load in HIV indicates that the antiretroviral therapy is working
effectively and the patient's immune system is responding favorably. It does not mean HIV is
eradicated.
Question 4:
Which is the differentiating symptom between labyrinthitis and vestibular neuritis?
Correct Answer: d. hearing loss may be associated with labyrinthitis, but not with vestibular
neuritis
Options:
a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the
onset is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis
c. symptoms with labyrinthitis are usually acute in onset, whereas with vestibular neuritis the
onset is more gradual
d. hearing loss may be associated with labyrinthitis, but not with vestibular neuritis
Rationale: Labyrinthitis involves both vestibular and cochlear branches of CN VIII, causing
vertigo AND hearing loss/tinnitus. Vestibular neuritis only affects the vestibular branch, so hearing
is preserved.
Question 5:
,A 27 year old female presents with a chief complaint of burning and pain on urination. She has no
previous history of urinary tract infection. What are some additional symptoms consistent with a
diagnosis of lower UTI?
Correct Answer: c. blood in urine and frequency
Options:
a. back and abdominal pain
b. fever, chills, costovertebral angle (CVA) tenderness
c. blood in urine and frequency
d. foul-smelling discharge, perineal itch
Rationale: Lower UTI symptoms include dysuria, frequency, urgency, and hematuria.
Back/abdominal pain, fever, and CVA tenderness suggest pyelonephritis (upper UTI).
Question 6:
The differential diagnosis for vertigo can be classified into which of the following categories:
Correct Answer: d. all of the above
Options:
a. peripheral vestibular disease
b. CNS disorders
c. Systemic disorders
d. all of the above
Rationale: Vertigo can be caused by peripheral vestibular disorders (e.g., BPPV, labyrinthitis),
central nervous system disorders (e.g., stroke, MS), and systemic disorders (e.g., hypotension,
anemia).
, Question 7:
Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of
localized low back pain and muscle spasm along with a normal neurological examination. As the
clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following
symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or
ruptured disc?
Correct Answer: b. unilateral radicular pain symptoms that extend below the knee and are equal to
or greater than the back pain
Options:
a. morning stiffness and limited mobility of the lumbar spine
b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than
the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. pathologic fractures, severe night pain, weight loss and fatigue
Rationale: Radicular pain that extends below the knee suggests nerve root compression from a
herniated disc. Pain radiating below the knee is more concerning than isolated back pain.
Question 8:
Preceptors must always see the patients that the students see in the clinical setting.
Correct Answer: a. true
Options:
