NR 511 | Final Exam Practice Page 1
, NR 511 FINAL EXAM
Differential Diagnosis & Primary Care Practicum
Chamberlain University
100-Question Original Practice Examination
2026/2027 Edition
1. A 58-year-old develops central chest pressure with diaphoresis and nausea at rest. What is the priority?
A) Diagnose reflux from symptoms alone
B) Schedule a routine lipid panel next month
C) Activate emergency evaluation for possible acute coronary syndrome
D) Advise observation at home until morning
Correct Answer: Activate emergency evaluation for possible acute coronary syndrome
Rationale: Ischemic chest symptoms with autonomic signs require time-sensitive emergency assessment including ECG and
appropriate testing.
2. A patient reports sharp chest pain and severe dyspnea that started suddenly after prolonged immobility. Which
diagnosis must be urgently considered?
A) Seasonal allergic rhinitis
B) Uncomplicated gastritis
C) Pulmonary embolism
D) Otitis externa
Correct Answer: Pulmonary embolism
Rationale: Sudden dyspnea with pleuritic pain and thrombotic risk factors raises concern for pulmonary embolism.
3. A patient has abrupt tearing chest pain radiating to the back and unequal arm pulses. What is the best next
step?
A) Reassure the patient about muscle strain
B) Empiric antacid trial only
C) Routine outpatient chest radiograph in six weeks
D) Emergency evaluation for acute aortic syndrome
Correct Answer: Emergency evaluation for acute aortic syndrome
Rationale: Acute severe pain and pulse asymmetry are warning signs of aortic dissection or related emergencies.
4. A patient has exertional substernal discomfort that resolves with rest in minutes. Which diagnosis is plausible?
A) Stable angina from myocardial ischemia
B) Cellulitis
C) Acute appendicitis
NR 511 | Final Exam Practice Page 2
, D) Acute otitis media
Correct Answer: Stable angina from myocardial ischemia
Rationale: Predictable exertional discomfort relieved by rest suggests an ischemic pattern requiring cardiovascular evaluation.
5. Which feature most increases concern about syncope?
A) Symptoms occurring only during a painful procedure
B) Clear prodrome in a hot room
C) Syncope during exertion with palpitations
D) Brief lightheadedness after standing quickly
Correct Answer: Syncope during exertion with palpitations
Rationale: Exertional syncope or palpitations may signal a dangerous arrhythmia or structural heart disorder.
6. A patient reports progressively worse dyspnea, orthopnea, and ankle edema. Which syndrome is a leading
possibility?
A) Cystitis
B) Uncomplicated sinusitis
C) Migraine without aura
D) Heart failure
Correct Answer: Heart failure
Rationale: Orthopnea and fluid retention together support consideration of cardiac dysfunction.
7. Which combination suggests possible infective endocarditis in a patient with injection drug use?
A) Normal vital signs with dry skin
B) Fever and a new heart murmur
C) Intermittent hiccups
D) Isolated sneezing
Correct Answer: Fever and a new heart murmur
Rationale: Fever with a new murmur and risk factors warrants prompt evaluation for bloodstream and valvular infection.
8. A patient presents with a new irregularly irregular pulse. Which test best establishes the rhythm?
A) Plain abdominal radiograph
B) 12-lead electrocardiogram
C) Stool occult blood test
D) Visual acuity chart
Correct Answer: 12-lead electrocardiogram
Rationale: ECG is needed to characterize atrial fibrillation and other arrhythmias accurately.
NR 511 | Final Exam Practice Page 3
, NR 511 FINAL EXAM
Differential Diagnosis & Primary Care Practicum
Chamberlain University
100-Question Original Practice Examination
2026/2027 Edition
1. A 58-year-old develops central chest pressure with diaphoresis and nausea at rest. What is the priority?
A) Diagnose reflux from symptoms alone
B) Schedule a routine lipid panel next month
C) Activate emergency evaluation for possible acute coronary syndrome
D) Advise observation at home until morning
Correct Answer: Activate emergency evaluation for possible acute coronary syndrome
Rationale: Ischemic chest symptoms with autonomic signs require time-sensitive emergency assessment including ECG and
appropriate testing.
2. A patient reports sharp chest pain and severe dyspnea that started suddenly after prolonged immobility. Which
diagnosis must be urgently considered?
A) Seasonal allergic rhinitis
B) Uncomplicated gastritis
C) Pulmonary embolism
D) Otitis externa
Correct Answer: Pulmonary embolism
Rationale: Sudden dyspnea with pleuritic pain and thrombotic risk factors raises concern for pulmonary embolism.
3. A patient has abrupt tearing chest pain radiating to the back and unequal arm pulses. What is the best next
step?
A) Reassure the patient about muscle strain
B) Empiric antacid trial only
C) Routine outpatient chest radiograph in six weeks
D) Emergency evaluation for acute aortic syndrome
Correct Answer: Emergency evaluation for acute aortic syndrome
Rationale: Acute severe pain and pulse asymmetry are warning signs of aortic dissection or related emergencies.
4. A patient has exertional substernal discomfort that resolves with rest in minutes. Which diagnosis is plausible?
A) Stable angina from myocardial ischemia
B) Cellulitis
C) Acute appendicitis
NR 511 | Final Exam Practice Page 2
, D) Acute otitis media
Correct Answer: Stable angina from myocardial ischemia
Rationale: Predictable exertional discomfort relieved by rest suggests an ischemic pattern requiring cardiovascular evaluation.
5. Which feature most increases concern about syncope?
A) Symptoms occurring only during a painful procedure
B) Clear prodrome in a hot room
C) Syncope during exertion with palpitations
D) Brief lightheadedness after standing quickly
Correct Answer: Syncope during exertion with palpitations
Rationale: Exertional syncope or palpitations may signal a dangerous arrhythmia or structural heart disorder.
6. A patient reports progressively worse dyspnea, orthopnea, and ankle edema. Which syndrome is a leading
possibility?
A) Cystitis
B) Uncomplicated sinusitis
C) Migraine without aura
D) Heart failure
Correct Answer: Heart failure
Rationale: Orthopnea and fluid retention together support consideration of cardiac dysfunction.
7. Which combination suggests possible infective endocarditis in a patient with injection drug use?
A) Normal vital signs with dry skin
B) Fever and a new heart murmur
C) Intermittent hiccups
D) Isolated sneezing
Correct Answer: Fever and a new heart murmur
Rationale: Fever with a new murmur and risk factors warrants prompt evaluation for bloodstream and valvular infection.
8. A patient presents with a new irregularly irregular pulse. Which test best establishes the rhythm?
A) Plain abdominal radiograph
B) 12-lead electrocardiogram
C) Stool occult blood test
D) Visual acuity chart
Correct Answer: 12-lead electrocardiogram
Rationale: ECG is needed to characterize atrial fibrillation and other arrhythmias accurately.
NR 511 | Final Exam Practice Page 3
