1
NR569 / NR 569 Midterm & Final Exams
(Latest 2024/2025 Study Bundle):
Differential Diagnosis in Acute Care
Practicum – Chamberlain | Verified
Questions & Answers | A+ Graded
Question Bank
1. What is the primary purpose of rapid antigen detection testing (RADT) in patients
with suspected pharyngitis?
A) Confirm viral infection
B) Detect streptococcal antigens
C) Assess thyroid function
D) Evaluate for esophageal reflux
Rationale: RADT is used to detect group A streptococcal antigens in patients with
pharyngitis symptoms. A throat culture is not necessary unless the RADT is negative in
children, symptoms persist, or there is no response to antibiotics.
2. A patient presents with a sore throat worsened by swallowing and a normal
oropharynx on exam. What condition should the clinician suspect?
A) Streptococcal pharyngitis
B) Allergic rhinitis
C) Thyroiditis
D) GERD
Rationale: Thyroiditis can present with a sore throat exacerbated by swallowing and a
normal oropharynx, prompting thyroid palpation for swelling or pain.
3. What physical exam finding is most consistent with an auricle hematoma?
A) Erythema of the ear canal
B) Contour irregularity with fluctuant swelling
C) Vesicles on the earlobe
D) Purulent ear drainage
Rationale: An auricle hematoma presents with contour irregularity, swelling, and a
fluctuant area over the ear’s cartilaginous portions, often with pain and ecchymosis.
4. What is a potential complication of untreated auricle hematoma?
A) Hearing loss
B) Cauliflower ear
C) Meningitis
D) Facial palsy
Rationale: Untreated auricle hematoma can lead to permanent cartilage deformity,
, 2
known as “cauliflower ear,” requiring urgent ENT or plastic surgery referral if present for
over 7 days.
5. A patient with Ramsay Hunt syndrome is likely to present with which classic triad?
A) Fever, cough, and rash
B) Otalgia, vesicles, and facial palsy
C) Dysphagia, heartburn, and regurgitation
D) Tinnitus, vertigo, and nystagmus
Rationale: Ramsay Hunt syndrome, caused by varicella-zoster virus reactivation,
presents with otalgia, vesicles in the ear or mouth, and ipsilateral facial palsy.
6. What is the first-line treatment for acute otitis media in a child with no antibiotic
allergies?
A) Azithromycin
B) Amoxicillin
C) Ceftriaxone
D) Levofloxacin
Rationale: Amoxicillin is the first-line antibiotic for acute otitis media in children due to
its efficacy against common pathogens like Streptococcus pneumoniae, per AAP
guidelines.
7. A patient with acute otitis media reports purulent ear drainage. What does this
suggest?
A) Viral infection
B) Tympanic membrane perforation
C) Allergic reaction
D) Cerumen impaction
Rationale: Purulent ear drainage in acute otitis media indicates a likely tympanic
membrane perforation, requiring antibiotic therapy and otolaryngology referral.
8. What diagnostic tool is essential for confirming acute otitis media?
A) Audiometry
B) Otoscopy
C) Tympanometry
D) CT scan
Rationale: Otoscopy is essential for diagnosing acute otitis media, revealing tympanic
membrane erythema, bulging, or effusion, combined with clinical symptoms.
9. A patient with allergic rhinitis reports sneezing and runny nose. What is a common
trigger?
A) Hypotension
B) Pollen exposure
C) Hypoglycemia
D) Dehydration
Rationale: Allergic rhinitis is commonly triggered by environmental allergens like
pollen, causing symptoms such as sneezing, runny nose, and itching.
10. What is a key physical exam finding in allergic pharyngitis?
A) Exudates on tonsils
B) Postnasal drip
C) Thyroid tenderness
D) Cervical lymphadenopathy
, 3
Rationale: Allergic pharyngitis is often associated with postnasal drip from chronic
sinusitis, causing minor pharyngeal irritation and inflammation.
11. A patient with persistent nausea and vomiting four days after general anesthesia
requires what?
A) Immediate surgery
B) Diagnostic evaluation
C) Increased fluid intake
D) Antacid therapy
Rationale: Persistent nausea and vomiting beyond the expected postoperative period
indicate a need for diagnostic evaluation beyond supportive care.
12. What is a primary treatment goal for nausea and vomiting?
A) Increase gastric motility
B) Correct fluid and electrolyte imbalance
C) Reduce oral intake
D) Administer analgesics
Rationale: Correcting fluid and electrolyte imbalances is a primary goal in managing
nausea and vomiting to prevent dehydration and metabolic disturbances.
13. A patient with chronic nausea and vomiting is at risk for what complication?
A) Hypertension
B) Malnutrition
C) Hyperglycemia
D) Osteoporosis
Rationale: Chronic nausea and vomiting can lead to inadequate caloric intake, resulting
in malnutrition, requiring nutritional support.
14. What should be considered if a patient cannot tolerate oral intake after five days of
vomiting?
A) Intravenous antibiotics
B) Enteral or parenteral feeding
C) Increased oral hydration
D) Antiemetic dose reduction
Rationale: Enteral or parenteral feeding is indicated for patients unable to tolerate oral
intake after five days to prevent malnutrition, with enteral feeding preferred.
15. What are the two main categories of antiemetic agents?
A) Antihistamines and anticholinergics
B) Central antiemetics and peripheral prokinetics
C) Opioids and benzodiazepines
D) NSAIDs and corticosteroids
Rationale: Antiemetics are classified as central (e.g., ondansetron) and peripheral
prokinetics (e.g., metoclopramide), targeting different nausea pathways.
16. A patient with erosive esophagitis reports dysphagia and substernal pain. What is a
common cause?
A) Hypertension
B) Prolonged GERD
C) Peptic ulcer disease
D) Hiatal hernia
NR569 / NR 569 Midterm & Final Exams
(Latest 2024/2025 Study Bundle):
Differential Diagnosis in Acute Care
Practicum – Chamberlain | Verified
Questions & Answers | A+ Graded
Question Bank
1. What is the primary purpose of rapid antigen detection testing (RADT) in patients
with suspected pharyngitis?
A) Confirm viral infection
B) Detect streptococcal antigens
C) Assess thyroid function
D) Evaluate for esophageal reflux
Rationale: RADT is used to detect group A streptococcal antigens in patients with
pharyngitis symptoms. A throat culture is not necessary unless the RADT is negative in
children, symptoms persist, or there is no response to antibiotics.
2. A patient presents with a sore throat worsened by swallowing and a normal
oropharynx on exam. What condition should the clinician suspect?
A) Streptococcal pharyngitis
B) Allergic rhinitis
C) Thyroiditis
D) GERD
Rationale: Thyroiditis can present with a sore throat exacerbated by swallowing and a
normal oropharynx, prompting thyroid palpation for swelling or pain.
3. What physical exam finding is most consistent with an auricle hematoma?
A) Erythema of the ear canal
B) Contour irregularity with fluctuant swelling
C) Vesicles on the earlobe
D) Purulent ear drainage
Rationale: An auricle hematoma presents with contour irregularity, swelling, and a
fluctuant area over the ear’s cartilaginous portions, often with pain and ecchymosis.
4. What is a potential complication of untreated auricle hematoma?
A) Hearing loss
B) Cauliflower ear
C) Meningitis
D) Facial palsy
Rationale: Untreated auricle hematoma can lead to permanent cartilage deformity,
, 2
known as “cauliflower ear,” requiring urgent ENT or plastic surgery referral if present for
over 7 days.
5. A patient with Ramsay Hunt syndrome is likely to present with which classic triad?
A) Fever, cough, and rash
B) Otalgia, vesicles, and facial palsy
C) Dysphagia, heartburn, and regurgitation
D) Tinnitus, vertigo, and nystagmus
Rationale: Ramsay Hunt syndrome, caused by varicella-zoster virus reactivation,
presents with otalgia, vesicles in the ear or mouth, and ipsilateral facial palsy.
6. What is the first-line treatment for acute otitis media in a child with no antibiotic
allergies?
A) Azithromycin
B) Amoxicillin
C) Ceftriaxone
D) Levofloxacin
Rationale: Amoxicillin is the first-line antibiotic for acute otitis media in children due to
its efficacy against common pathogens like Streptococcus pneumoniae, per AAP
guidelines.
7. A patient with acute otitis media reports purulent ear drainage. What does this
suggest?
A) Viral infection
B) Tympanic membrane perforation
C) Allergic reaction
D) Cerumen impaction
Rationale: Purulent ear drainage in acute otitis media indicates a likely tympanic
membrane perforation, requiring antibiotic therapy and otolaryngology referral.
8. What diagnostic tool is essential for confirming acute otitis media?
A) Audiometry
B) Otoscopy
C) Tympanometry
D) CT scan
Rationale: Otoscopy is essential for diagnosing acute otitis media, revealing tympanic
membrane erythema, bulging, or effusion, combined with clinical symptoms.
9. A patient with allergic rhinitis reports sneezing and runny nose. What is a common
trigger?
A) Hypotension
B) Pollen exposure
C) Hypoglycemia
D) Dehydration
Rationale: Allergic rhinitis is commonly triggered by environmental allergens like
pollen, causing symptoms such as sneezing, runny nose, and itching.
10. What is a key physical exam finding in allergic pharyngitis?
A) Exudates on tonsils
B) Postnasal drip
C) Thyroid tenderness
D) Cervical lymphadenopathy
, 3
Rationale: Allergic pharyngitis is often associated with postnasal drip from chronic
sinusitis, causing minor pharyngeal irritation and inflammation.
11. A patient with persistent nausea and vomiting four days after general anesthesia
requires what?
A) Immediate surgery
B) Diagnostic evaluation
C) Increased fluid intake
D) Antacid therapy
Rationale: Persistent nausea and vomiting beyond the expected postoperative period
indicate a need for diagnostic evaluation beyond supportive care.
12. What is a primary treatment goal for nausea and vomiting?
A) Increase gastric motility
B) Correct fluid and electrolyte imbalance
C) Reduce oral intake
D) Administer analgesics
Rationale: Correcting fluid and electrolyte imbalances is a primary goal in managing
nausea and vomiting to prevent dehydration and metabolic disturbances.
13. A patient with chronic nausea and vomiting is at risk for what complication?
A) Hypertension
B) Malnutrition
C) Hyperglycemia
D) Osteoporosis
Rationale: Chronic nausea and vomiting can lead to inadequate caloric intake, resulting
in malnutrition, requiring nutritional support.
14. What should be considered if a patient cannot tolerate oral intake after five days of
vomiting?
A) Intravenous antibiotics
B) Enteral or parenteral feeding
C) Increased oral hydration
D) Antiemetic dose reduction
Rationale: Enteral or parenteral feeding is indicated for patients unable to tolerate oral
intake after five days to prevent malnutrition, with enteral feeding preferred.
15. What are the two main categories of antiemetic agents?
A) Antihistamines and anticholinergics
B) Central antiemetics and peripheral prokinetics
C) Opioids and benzodiazepines
D) NSAIDs and corticosteroids
Rationale: Antiemetics are classified as central (e.g., ondansetron) and peripheral
prokinetics (e.g., metoclopramide), targeting different nausea pathways.
16. A patient with erosive esophagitis reports dysphagia and substernal pain. What is a
common cause?
A) Hypertension
B) Prolonged GERD
C) Peptic ulcer disease
D) Hiatal hernia
