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Chamberlain NR511 Actual Exam
Questions and Answers with Rationales
2026/2027 | Differential Diagnosis &
Primary Care Final Exam | FNP
Practicum Assessment | Pass Guarantee
Q001: A 42-year-old woman presents with 3 weeks of low-back pain that radiates
to the left buttock, worsened by sitting and relieved with standing. She denies
fever, bowel/bladder dysfunction, and has no history of trauma. On exam, there is
tenderness over the left sciatic notch and a positive straight-leg raise at 45°. DTRs
are normal. Which is the most appropriate next step?
Options:
A. Order lumbosacral MRI immediately
B. Prescribe oxycodone/acetaminophen for 1 week
C. Initiate naproxen + PT + patient education on core-strengthening exercises -
CORRECT
D. Refer for emergent neurosurgical evaluation
ANSWER: C
Q002: A 28-year-old man complains of 10 days of nasal congestion, purulent
anterior discharge, maxillary tooth pain, and fatigue. He has no fever, asthma, or
prior sinus surgery. On exam, there is tenderness over the left maxillary sinus and
decreased transillumination. Which is the best initial management?
Options:
A. Obtain CT sinuses and ENT referral
, 2
B. Prescribe amoxicillin-clavulanate for 5 days
C. Recommend intranasal fluticasone + saline irrigation + watchful waiting for 7
more days - CORRECT
D. Start oral prednisone 40 mg x 5 days
ANSWER: C
Q003: A 55-year-old man with HTN and 40 pack-year history reports 4 weeks of
dry cough worse at night and with exercise, no wheeze, no fever. He takes
lisinopril 10 mg daily. CXR and SpO₂ are normal. Which is the most likely
diagnosis and next step?
Options:
A. Asthma—order spirometry with bronchodilator
B. ACE-inhibitor cough—substitute ARB and re-evaluate in 2 weeks - CORRECT
C. GERD—start omeprazole 20 mg BID
D. Chronic bronchitis—prescribe albuterol MDI
ANSWER: B
Q004: A 34-year-old woman has had 6 weeks of intermittent palpitations, heat
intolerance, and 8-lb weight loss. HR 102 regular, BP 118/70, no tremor. TSH 0.02
mIU/L (nl 0.4-4.0), free T₄ 2.1 ng/dL (nl 0.8-1.8). Which is the most appropriate
initial action?
Options:
A. Start methimazole 20 mg daily and check TSI
B. Order thyroid uptake and scan
C. Prescribe propranolol 20 mg TID and refer to endocrinology within 2 weeks -
CORRECT
D. Repeat TSH in 6 weeks
ANSWER: C
, 3
Q005: A 48-year-old man describes 3 months of burning epigastric pain relieved by
food and antacids; pain awakens him at night. He denies weight loss, vomiting, or
NSAID use. Exam benign. Which is the best initial management?
Options:
A. Order upper endoscopy immediately
B. Test and treat H. pylori, start omeprazole 20 mg daily for 4 weeks - CORRECT
C. Prescribe sucralfate 1 g QID
D. Schedule barium upper GI series
ANSWER: B
Q006: A 24-year-old woman has had 2 days of dysuria, frequency, and suprapubic
pain; no fever or flank pain. Urinalysis shows 15 WBC/hpf, positive leukocyte
esterase, negative nitrite. Which is the best initial management?
Options:
A. Send urine culture and start nitrofurantoin 100 mg BID x 5 days - CORRECT
B. Prescribe phenazopyridine only and fluids
C. Start ceftriaxone 1 g IM single dose
D. Recommend cranberry juice and follow-up in 1 week
ANSWER: A
Q007: A 16-year-old male athlete has 2 weeks of right knee pain after increasing
running mileage; pain improves with rest. Exam shows tenderness at the tibial
tubercle and pain with resisted knee extension. Radiographs are normal. Which is
the most likely diagnosis and management?
Options:
A. Osgood-Schlatter disease—recommend rest, ice, NSAIDs, quadriceps stretching
- CORRECT
B. Patellar tendon rupture—urgent orthopedic referral
C. Osteochondritis dissecans—order MRI knee
Chamberlain NR511 Actual Exam
Questions and Answers with Rationales
2026/2027 | Differential Diagnosis &
Primary Care Final Exam | FNP
Practicum Assessment | Pass Guarantee
Q001: A 42-year-old woman presents with 3 weeks of low-back pain that radiates
to the left buttock, worsened by sitting and relieved with standing. She denies
fever, bowel/bladder dysfunction, and has no history of trauma. On exam, there is
tenderness over the left sciatic notch and a positive straight-leg raise at 45°. DTRs
are normal. Which is the most appropriate next step?
Options:
A. Order lumbosacral MRI immediately
B. Prescribe oxycodone/acetaminophen for 1 week
C. Initiate naproxen + PT + patient education on core-strengthening exercises -
CORRECT
D. Refer for emergent neurosurgical evaluation
ANSWER: C
Q002: A 28-year-old man complains of 10 days of nasal congestion, purulent
anterior discharge, maxillary tooth pain, and fatigue. He has no fever, asthma, or
prior sinus surgery. On exam, there is tenderness over the left maxillary sinus and
decreased transillumination. Which is the best initial management?
Options:
A. Obtain CT sinuses and ENT referral
, 2
B. Prescribe amoxicillin-clavulanate for 5 days
C. Recommend intranasal fluticasone + saline irrigation + watchful waiting for 7
more days - CORRECT
D. Start oral prednisone 40 mg x 5 days
ANSWER: C
Q003: A 55-year-old man with HTN and 40 pack-year history reports 4 weeks of
dry cough worse at night and with exercise, no wheeze, no fever. He takes
lisinopril 10 mg daily. CXR and SpO₂ are normal. Which is the most likely
diagnosis and next step?
Options:
A. Asthma—order spirometry with bronchodilator
B. ACE-inhibitor cough—substitute ARB and re-evaluate in 2 weeks - CORRECT
C. GERD—start omeprazole 20 mg BID
D. Chronic bronchitis—prescribe albuterol MDI
ANSWER: B
Q004: A 34-year-old woman has had 6 weeks of intermittent palpitations, heat
intolerance, and 8-lb weight loss. HR 102 regular, BP 118/70, no tremor. TSH 0.02
mIU/L (nl 0.4-4.0), free T₄ 2.1 ng/dL (nl 0.8-1.8). Which is the most appropriate
initial action?
Options:
A. Start methimazole 20 mg daily and check TSI
B. Order thyroid uptake and scan
C. Prescribe propranolol 20 mg TID and refer to endocrinology within 2 weeks -
CORRECT
D. Repeat TSH in 6 weeks
ANSWER: C
, 3
Q005: A 48-year-old man describes 3 months of burning epigastric pain relieved by
food and antacids; pain awakens him at night. He denies weight loss, vomiting, or
NSAID use. Exam benign. Which is the best initial management?
Options:
A. Order upper endoscopy immediately
B. Test and treat H. pylori, start omeprazole 20 mg daily for 4 weeks - CORRECT
C. Prescribe sucralfate 1 g QID
D. Schedule barium upper GI series
ANSWER: B
Q006: A 24-year-old woman has had 2 days of dysuria, frequency, and suprapubic
pain; no fever or flank pain. Urinalysis shows 15 WBC/hpf, positive leukocyte
esterase, negative nitrite. Which is the best initial management?
Options:
A. Send urine culture and start nitrofurantoin 100 mg BID x 5 days - CORRECT
B. Prescribe phenazopyridine only and fluids
C. Start ceftriaxone 1 g IM single dose
D. Recommend cranberry juice and follow-up in 1 week
ANSWER: A
Q007: A 16-year-old male athlete has 2 weeks of right knee pain after increasing
running mileage; pain improves with rest. Exam shows tenderness at the tibial
tubercle and pain with resisted knee extension. Radiographs are normal. Which is
the most likely diagnosis and management?
Options:
A. Osgood-Schlatter disease—recommend rest, ice, NSAIDs, quadriceps stretching
- CORRECT
B. Patellar tendon rupture—urgent orthopedic referral
C. Osteochondritis dissecans—order MRI knee
