NR 569 Midterm Exam 2026/2027 – Differential
Diagnosis in Acute Care Practicum Review
(Chamberlain)
Practice Multiple-Choice Questions, Answers,
and Rationales Guaranteed Pass
Question 1
A 24-year-old female presents with dysuria, urinary frequency, and
urgency for 2 days. She denies flank pain and fever. What is the most
likely diagnosis?
A. Acute pyelonephritis
B. Interstitial cystitis
C. Uncomplicated urinary tract infection (UTI)
D. Nephrolithiasis
Answer: C. Uncomplicated urinary tract infection (UTI)
Rationale: Dysuria, urgency, and frequency without systemic symptoms
such as fever or flank pain are classic findings of an uncomplicated
lower urinary tract infection.
Question 2
A patient presents with unilateral facial drooping involving both the
forehead and lower face. Which diagnosis is most likely?
A. Bell's palsy
B. Ischemic stroke
C. Trigeminal neuralgia
D. Temporal arteritis
,Answer: A. Bell's palsy
Rationale: Bell's palsy causes peripheral facial nerve paralysis affecting
the entire side of the face, including the forehead. Stroke typically spares
the forehead.
Question 3
A 67-year-old smoker reports chronic cough with sputum production for
more than 3 months per year for the last 2 years. What is the most likely
diagnosis?
A. Asthma
B. Chronic bronchitis
C. Pneumonia
D. Lung cancer
Answer: B. Chronic bronchitis
Rationale: Chronic bronchitis is defined as productive cough lasting at
least 3 months per year for 2 consecutive years.
Question 4
Which symptom is most suggestive of acute bacterial sinusitis?
A. Nasal congestion lasting 3 days
B. Symptoms improving after 5 days
C. Symptoms persisting longer than 10 days without improvement
D. Clear nasal discharge only
Answer: C. Symptoms persisting longer than 10 days without
improvement
,Rationale: Acute bacterial sinusitis is suspected when symptoms persist
beyond 10 days or worsen after initial improvement.
Question 5
A patient reports sudden severe chest pain radiating to the back. Which
diagnosis should be ruled out first?
A. Gastroesophageal reflux disease
B. Costochondritis
C. Aortic dissection
D. Anxiety disorder
Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back is a hallmark
sign of aortic dissection and requires immediate evaluation.
Question 6
A positive McBurney's point tenderness is most associated with:
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Diverticulitis
Answer: B. Appendicitis
Rationale: McBurney's point tenderness is a classic physical
examination finding in acute appendicitis.
Question 7
Which finding is most characteristic of heart failure?
, A. Hemoptysis
B. Orthopnea
C. Wheezing only
D. Pleuritic chest pain
Answer: B. Orthopnea
Rationale: Orthopnea and paroxysmal nocturnal dyspnea are classic
symptoms of heart failure due to pulmonary congestion.
Question 8
A patient presents with fever, productive cough, and localized crackles.
What is the most likely diagnosis?
A. Asthma
B. Viral bronchitis
C. Pneumonia
D. Pulmonary embolism
Answer: C. Pneumonia
Rationale: Fever, productive cough, and focal lung findings are strongly
suggestive of pneumonia.
Question 9
Which headache presentation is most consistent with migraine?
A. Bilateral pressure-like headache
B. Unilateral throbbing headache with nausea
C. Sudden worst headache of life
D. Headache associated with jaw claudication
Answer: B. Unilateral throbbing headache with nausea
Diagnosis in Acute Care Practicum Review
(Chamberlain)
Practice Multiple-Choice Questions, Answers,
and Rationales Guaranteed Pass
Question 1
A 24-year-old female presents with dysuria, urinary frequency, and
urgency for 2 days. She denies flank pain and fever. What is the most
likely diagnosis?
A. Acute pyelonephritis
B. Interstitial cystitis
C. Uncomplicated urinary tract infection (UTI)
D. Nephrolithiasis
Answer: C. Uncomplicated urinary tract infection (UTI)
Rationale: Dysuria, urgency, and frequency without systemic symptoms
such as fever or flank pain are classic findings of an uncomplicated
lower urinary tract infection.
Question 2
A patient presents with unilateral facial drooping involving both the
forehead and lower face. Which diagnosis is most likely?
A. Bell's palsy
B. Ischemic stroke
C. Trigeminal neuralgia
D. Temporal arteritis
,Answer: A. Bell's palsy
Rationale: Bell's palsy causes peripheral facial nerve paralysis affecting
the entire side of the face, including the forehead. Stroke typically spares
the forehead.
Question 3
A 67-year-old smoker reports chronic cough with sputum production for
more than 3 months per year for the last 2 years. What is the most likely
diagnosis?
A. Asthma
B. Chronic bronchitis
C. Pneumonia
D. Lung cancer
Answer: B. Chronic bronchitis
Rationale: Chronic bronchitis is defined as productive cough lasting at
least 3 months per year for 2 consecutive years.
Question 4
Which symptom is most suggestive of acute bacterial sinusitis?
A. Nasal congestion lasting 3 days
B. Symptoms improving after 5 days
C. Symptoms persisting longer than 10 days without improvement
D. Clear nasal discharge only
Answer: C. Symptoms persisting longer than 10 days without
improvement
,Rationale: Acute bacterial sinusitis is suspected when symptoms persist
beyond 10 days or worsen after initial improvement.
Question 5
A patient reports sudden severe chest pain radiating to the back. Which
diagnosis should be ruled out first?
A. Gastroesophageal reflux disease
B. Costochondritis
C. Aortic dissection
D. Anxiety disorder
Answer: C. Aortic dissection
Rationale: Sudden tearing chest pain radiating to the back is a hallmark
sign of aortic dissection and requires immediate evaluation.
Question 6
A positive McBurney's point tenderness is most associated with:
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Diverticulitis
Answer: B. Appendicitis
Rationale: McBurney's point tenderness is a classic physical
examination finding in acute appendicitis.
Question 7
Which finding is most characteristic of heart failure?
, A. Hemoptysis
B. Orthopnea
C. Wheezing only
D. Pleuritic chest pain
Answer: B. Orthopnea
Rationale: Orthopnea and paroxysmal nocturnal dyspnea are classic
symptoms of heart failure due to pulmonary congestion.
Question 8
A patient presents with fever, productive cough, and localized crackles.
What is the most likely diagnosis?
A. Asthma
B. Viral bronchitis
C. Pneumonia
D. Pulmonary embolism
Answer: C. Pneumonia
Rationale: Fever, productive cough, and focal lung findings are strongly
suggestive of pneumonia.
Question 9
Which headache presentation is most consistent with migraine?
A. Bilateral pressure-like headache
B. Unilateral throbbing headache with nausea
C. Sudden worst headache of life
D. Headache associated with jaw claudication
Answer: B. Unilateral throbbing headache with nausea
