NR 569 / NR569 (Latest Update )
Differential Diagnosis in Acute Care Practicum 2025-
2026 100 Questions & Correct Detailed Answers
(Verified Answers) |Already Graded A+||Brand New
Version!!
1. A 68-year-old patient presents with sudden onset chest pain radiating to
the left arm. Which diagnostic test is most appropriate to rule out acute
myocardial infarction?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Echocardiogram
D. CT scan of the chest
Rationale: ECG is the first-line test for diagnosing acute myocardial
infarction due to its ability to detect ischemic changes immediately.
2. A patient presents with severe shortness of breath and wheezing. Which
medication should be administered first in acute management?
A. Corticosteroids orally
B. Short-acting beta-agonist (SABA) inhaler
C. Long-acting beta-agonist
D. Antihistamine
Rationale: SABAs provide rapid bronchodilation and are the first-line
treatment for acute asthma exacerbations.
3. A 45-year-old patient presents with acute onset right lower quadrant
abdominal pain and nausea. Which condition is most likely?
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Peptic ulcer disease
, Rationale: Sudden right lower quadrant pain with nausea and anorexia is
classic for acute appendicitis.
4. Which laboratory finding is most indicative of bacterial meningitis?
A. Normal cerebrospinal fluid (CSF) glucose
B. Lymphocytic predominance in CSF
C. Elevated CSF neutrophils and low glucose
D. Negative CSF culture
Rationale: Bacterial meningitis typically shows high neutrophils, low
glucose, and elevated protein in CSF.
5. A patient presents with unilateral facial droop, inability to close the eye,
and loss of forehead wrinkling. What is the most likely diagnosis?
A. Stroke
B. Bell’s palsy
C. Peripheral facial nerve palsy
D. Myasthenia gravis
Rationale: Peripheral facial nerve (Bell’s) palsy affects both upper and lower
parts of the face, unlike central lesions from stroke.
6. A patient with chronic kidney disease presents with confusion, nausea, and
asterixis. Which electrolyte abnormality is most likely?
A. Hypercalcemia
B. Hypokalemia
C. Hyperammonemia
D. Hyponatremia
Rationale: Accumulation of nitrogenous waste in kidney failure leads to
hyperammonemia, causing encephalopathy and asterixis.
7. Which ECG finding is characteristic of acute pericarditis?
A. ST depression in V1-V3
B. Diffuse ST-segment elevation with PR depression
C. Pathologic Q waves
D. T-wave inversion only in inferior leads
, Rationale: Acute pericarditis often presents with diffuse ST elevation and PR
depression, differentiating it from MI.
8. A patient presents with sudden-onset severe headache described as “worst
headache of my life.” What is the priority diagnostic test?
A. MRI of the brain
B. CT scan without contrast
C. Lumbar puncture first
D. EEG
Rationale: Non-contrast CT is the fastest and most sensitive initial test to
detect subarachnoid hemorrhage.
9. Which of the following is the most appropriate first-line treatment for acute
decompensated heart failure with pulmonary edema?
A. Oral beta-blocker
B. IV loop diuretic
C. ACE inhibitor orally
D. Oral digoxin
Rationale: IV loop diuretics rapidly reduce fluid overload and relieve
pulmonary edema in acute heart failure exacerbations.
10.A patient presents with sudden-onset left-sided weakness and slurred
speech. Which is the priority intervention?
A. Start oral antihypertensive
B. Activate stroke protocol for thrombolysis assessment
C. Order an echocardiogram
D. Administer IV antibiotics
Rationale: Rapid recognition and intervention in ischemic stroke is critical
for thrombolytic therapy within the therapeutic window.
I’ve drafted the first 10 questions as a sample to ensure the format and level of
detail match your expectations.
Differential Diagnosis in Acute Care Practicum 2025-
2026 100 Questions & Correct Detailed Answers
(Verified Answers) |Already Graded A+||Brand New
Version!!
1. A 68-year-old patient presents with sudden onset chest pain radiating to
the left arm. Which diagnostic test is most appropriate to rule out acute
myocardial infarction?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Echocardiogram
D. CT scan of the chest
Rationale: ECG is the first-line test for diagnosing acute myocardial
infarction due to its ability to detect ischemic changes immediately.
2. A patient presents with severe shortness of breath and wheezing. Which
medication should be administered first in acute management?
A. Corticosteroids orally
B. Short-acting beta-agonist (SABA) inhaler
C. Long-acting beta-agonist
D. Antihistamine
Rationale: SABAs provide rapid bronchodilation and are the first-line
treatment for acute asthma exacerbations.
3. A 45-year-old patient presents with acute onset right lower quadrant
abdominal pain and nausea. Which condition is most likely?
A. Cholecystitis
B. Appendicitis
C. Pancreatitis
D. Peptic ulcer disease
, Rationale: Sudden right lower quadrant pain with nausea and anorexia is
classic for acute appendicitis.
4. Which laboratory finding is most indicative of bacterial meningitis?
A. Normal cerebrospinal fluid (CSF) glucose
B. Lymphocytic predominance in CSF
C. Elevated CSF neutrophils and low glucose
D. Negative CSF culture
Rationale: Bacterial meningitis typically shows high neutrophils, low
glucose, and elevated protein in CSF.
5. A patient presents with unilateral facial droop, inability to close the eye,
and loss of forehead wrinkling. What is the most likely diagnosis?
A. Stroke
B. Bell’s palsy
C. Peripheral facial nerve palsy
D. Myasthenia gravis
Rationale: Peripheral facial nerve (Bell’s) palsy affects both upper and lower
parts of the face, unlike central lesions from stroke.
6. A patient with chronic kidney disease presents with confusion, nausea, and
asterixis. Which electrolyte abnormality is most likely?
A. Hypercalcemia
B. Hypokalemia
C. Hyperammonemia
D. Hyponatremia
Rationale: Accumulation of nitrogenous waste in kidney failure leads to
hyperammonemia, causing encephalopathy and asterixis.
7. Which ECG finding is characteristic of acute pericarditis?
A. ST depression in V1-V3
B. Diffuse ST-segment elevation with PR depression
C. Pathologic Q waves
D. T-wave inversion only in inferior leads
, Rationale: Acute pericarditis often presents with diffuse ST elevation and PR
depression, differentiating it from MI.
8. A patient presents with sudden-onset severe headache described as “worst
headache of my life.” What is the priority diagnostic test?
A. MRI of the brain
B. CT scan without contrast
C. Lumbar puncture first
D. EEG
Rationale: Non-contrast CT is the fastest and most sensitive initial test to
detect subarachnoid hemorrhage.
9. Which of the following is the most appropriate first-line treatment for acute
decompensated heart failure with pulmonary edema?
A. Oral beta-blocker
B. IV loop diuretic
C. ACE inhibitor orally
D. Oral digoxin
Rationale: IV loop diuretics rapidly reduce fluid overload and relieve
pulmonary edema in acute heart failure exacerbations.
10.A patient presents with sudden-onset left-sided weakness and slurred
speech. Which is the priority intervention?
A. Start oral antihypertensive
B. Activate stroke protocol for thrombolysis assessment
C. Order an echocardiogram
D. Administer IV antibiotics
Rationale: Rapid recognition and intervention in ischemic stroke is critical
for thrombolytic therapy within the therapeutic window.
I’ve drafted the first 10 questions as a sample to ensure the format and level of
detail match your expectations.
