NR569 Differential Diagnosis in Acute Care
Midterm 2025- 2026 Exam 71 Questions with
Verified Answers
Comprehensive Patient Assessment
- Appropriate for new patients in the office or hospital.
- Provides fundamental and personalized knowledge about
patient.
- Strengthens the clinician-patient relationship.
- Helps identify or rule out physical causes related to patient
concerns.
- Provides a baseline for future assessments.
- Creates a platform for health promotion through education
and counseling.
- Develops proficiency in the skills of physical assessment.
Focused Patient Assessment
- Appropriate for established patients, especially during routine
or urgent care visits.
,- Addresses focused concerns or symptoms.
- Assesses symptoms restricted to a specific body system.
- Applies examination methods relevant to assessing the
concern or problem as thoroughly and carefully as possible.
Subjective Information
- The clinical record from the Chief Complaint (CC) through the
Review of Systems (ROS) is considered SUBJECTIVE information.
- Includes symptoms which are health concerns the patient tells
the provider.
- Includes feelings, perceptions, and concerns obtained from the
clinical interview.
- Examples: complaints of sore throat, headache, or pain.
Objective Information
- All physical examination, laboratory information and test data
are objective data.
Components of Comprehensive Adult Health History
- Initial information (Identifying patient
information/source/reliability)
- Chief Complaint(s)
- History of Present Illness
- Past Medical History
- Family History
- Personal/Social History
- Review of Systems (ROS)
,SNAPPS method
- Summarize the history and findings.
- Narrow the differential diagnosis to two to three possibilities.
- Analyze the differential by comparing and contrasting the
possibilities.
- Probe the preceptor by asking questions about alternative
approaches or uncertainties.
- Plan the management of the patient's health issues.
- Select an issue from the case for self-directed learning.
Creating a Differential Diagnosis
Hoofbeats = Horses NOT Zebras
- The differential diagnosis process involves using clinical
reasoning to distinguish between two or more conditions that
share similar signs and symptoms. Based on the CC the NP
gathers information through PMH (subjective data) and physical
examination (objective data) to establish a broad list of common
& uncommon diagnosis. As the provider collects more data,
competing hypotheses are either confirmed, disproved, or their
priority changes.
Steps for Creating a Differential Diagnosis
1. Initially start with a broad list of diagnoses until further
information or data is obtained.
, 2. List your top diagnosis FIRST followed by other potential
diagnoses for a specific problem *but keep it problem oriented
until you have an actual diagnosis.*
3. Aggressively prioritize work up of the most likely and most
harmful (ie, life threatening) diagnoses under consideration.
4. Prioritize the work up of ACUTE and REVERSIBLE diseases
followed by CHRONIC and IRREVERSIBLE (eg, delirium r/t a
medical cause vs. chronic, progressive dementia).
5. As information or data that effectively rules out a particular
diagnosis for a chief complaint becomes available, remove that
diagnosis from your list & focus your attention on remaining
possibilities.
6. Once a diagnosis has been confirmed, the problem list should
be diagnosis-oriented rather than problem-oriented.
Pertinent Positive
- Symptoms or signs that are present that you would expect to
find if a possible cause for for a patient's problem were true,
which then supports the diagnosis.
Pertinent Negative
Expected symptoms or signs that are not present, facts that you
would expect to find if a possible cause for a patient's problem
were true, which then weaken this diagnosis by their absence.
Principles of Good Documentation
*Checklist to Ensure a Quality Clinical Record.*
Midterm 2025- 2026 Exam 71 Questions with
Verified Answers
Comprehensive Patient Assessment
- Appropriate for new patients in the office or hospital.
- Provides fundamental and personalized knowledge about
patient.
- Strengthens the clinician-patient relationship.
- Helps identify or rule out physical causes related to patient
concerns.
- Provides a baseline for future assessments.
- Creates a platform for health promotion through education
and counseling.
- Develops proficiency in the skills of physical assessment.
Focused Patient Assessment
- Appropriate for established patients, especially during routine
or urgent care visits.
,- Addresses focused concerns or symptoms.
- Assesses symptoms restricted to a specific body system.
- Applies examination methods relevant to assessing the
concern or problem as thoroughly and carefully as possible.
Subjective Information
- The clinical record from the Chief Complaint (CC) through the
Review of Systems (ROS) is considered SUBJECTIVE information.
- Includes symptoms which are health concerns the patient tells
the provider.
- Includes feelings, perceptions, and concerns obtained from the
clinical interview.
- Examples: complaints of sore throat, headache, or pain.
Objective Information
- All physical examination, laboratory information and test data
are objective data.
Components of Comprehensive Adult Health History
- Initial information (Identifying patient
information/source/reliability)
- Chief Complaint(s)
- History of Present Illness
- Past Medical History
- Family History
- Personal/Social History
- Review of Systems (ROS)
,SNAPPS method
- Summarize the history and findings.
- Narrow the differential diagnosis to two to three possibilities.
- Analyze the differential by comparing and contrasting the
possibilities.
- Probe the preceptor by asking questions about alternative
approaches or uncertainties.
- Plan the management of the patient's health issues.
- Select an issue from the case for self-directed learning.
Creating a Differential Diagnosis
Hoofbeats = Horses NOT Zebras
- The differential diagnosis process involves using clinical
reasoning to distinguish between two or more conditions that
share similar signs and symptoms. Based on the CC the NP
gathers information through PMH (subjective data) and physical
examination (objective data) to establish a broad list of common
& uncommon diagnosis. As the provider collects more data,
competing hypotheses are either confirmed, disproved, or their
priority changes.
Steps for Creating a Differential Diagnosis
1. Initially start with a broad list of diagnoses until further
information or data is obtained.
, 2. List your top diagnosis FIRST followed by other potential
diagnoses for a specific problem *but keep it problem oriented
until you have an actual diagnosis.*
3. Aggressively prioritize work up of the most likely and most
harmful (ie, life threatening) diagnoses under consideration.
4. Prioritize the work up of ACUTE and REVERSIBLE diseases
followed by CHRONIC and IRREVERSIBLE (eg, delirium r/t a
medical cause vs. chronic, progressive dementia).
5. As information or data that effectively rules out a particular
diagnosis for a chief complaint becomes available, remove that
diagnosis from your list & focus your attention on remaining
possibilities.
6. Once a diagnosis has been confirmed, the problem list should
be diagnosis-oriented rather than problem-oriented.
Pertinent Positive
- Symptoms or signs that are present that you would expect to
find if a possible cause for for a patient's problem were true,
which then supports the diagnosis.
Pertinent Negative
Expected symptoms or signs that are not present, facts that you
would expect to find if a possible cause for a patient's problem
were true, which then weaken this diagnosis by their absence.
Principles of Good Documentation
*Checklist to Ensure a Quality Clinical Record.*
