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NR 511 / NR511 Midterm Exam Actual Exam
2026/2027 | Differential Diagnosis and
Primary Care Practicum | Chamberlain |
Questions with Verified Answers | 100%
Correct | Pass Guaranteed
Q001: A 28-year-old female presents with a 3-day history of dysuria, frequency,
and suprapubic discomfort. She is afebrile and has no flank pain. Urinalysis shows
positive nitrites, leukocyte esterase, and 15–20 WBCs/hpf. Which is the most
appropriate first-line outpatient management?
Options:
A. Oral cephalexin 500 mg QID × 3 days
B. Trimethoprim-sulfamethoxazole DS BID × 3 days
C. Ciprofloxacin 250 mg BID × 3 days
D. Observation only with increased fluids
ANSWER: B
Q002: A 45-year-old male smoker reports a 2-week history of productive cough,
low-grade fever, and pleuritic chest pain. Chest X-ray shows right lower-lobe
consolidation and air bronchograms. He is hemodynamically stable and afebrile
today. Which is the most appropriate initial outpatient antibiotic choice?
Options:
A. Amoxicillin 500 mg TID × 5 days
B. Azithromycin 500 mg day 1 then 250 mg × 4 days
C. Doxycycline 100 mg BID × 5 days
, 2
D. Levofloxacin 750 mg daily × 5 days
ANSWER: B
Q003: A 34-year-old woman presents with a 4-week history of fatigue, weight
gain, cold intolerance, and constipation. TSH is 9.8 mIU/L (normal 0.4–4.0) and
free T4 is 0.8 ng/dL (normal 0.9–1.7). Which is the most appropriate initial
treatment and patient education?
Options:
A. Start levothyroxine 1.6 µg/kg daily and counsel on lifelong therapy
B. Repeat TSH in 6 weeks; no medication yet
C. Start liothyronine 25 µg BID
D. Refer immediately to endocrinology for further work-up
ANSWER: A
Q004: A 50-year-old male presents with acute onset of retrosternal chest pain that
improves when sitting up and worsens when lying flat. He has a friction rub on
auscultation and diffuse ST elevations on ECG. Troponin is mildly elevated. Which
is the most appropriate initial management?
Options:
A. Aspirin 325 mg, colchicine 0.5 mg BID, and NSAID therapy
B. Immediate cardiac catheterization
C. High-dose heparin infusion
D. IV thrombolysis
ANSWER: A
Q005: A 25-year-old man reports 3 days of severe right lower-quadrant pain,
anorexia, and low-grade fever. McBurney point tenderness and rebound are
present. WBC is 15 000/µL. Which is the most appropriate next step?
Options:
A. Abdominal ultrasound
, 3
B. CT abdomen/pelvis with contrast
C. Urgent surgical consult
D. Empiric antibiotics and discharge
ANSWER: B
Q006: A 40-year-old woman presents with a 2-week history of epigastric pain
relieved by food and nighttime awakening. She is otherwise healthy. Stool H.
pylori antigen is positive. Which is the most appropriate initial management?
Options:
A. Omeprazole alone for 4 weeks
B. Triple therapy: PPI + clarithromycin + amoxicillin × 14 days
C. Sucralfate suspension QID
D. Immediate endoscopy
ANSWER: B
Q007: A 30-year-old woman presents with a 1-week history of watery diarrhea,
cramping, and low-grade fever after a picnic. Stool PCR is positive for
Campylobacter. Which antibiotic and duration is first-line?
Options:
A. Ciprofloxacin 500 mg BID × 3 days
B. Azithromycin 500 mg daily × 3 days
C. TMP-SMX DS BID × 3 days
D. No antibiotics needed
ANSWER: B
Q008: A 55-year-old woman presents with a 3-month history of bilateral hand
stiffness > 45 min, swelling at MCP joints, and positive anti-CCP. RF is 60 IU/mL.
Which is the most appropriate initial management?
Options:
NR 511 / NR511 Midterm Exam Actual Exam
2026/2027 | Differential Diagnosis and
Primary Care Practicum | Chamberlain |
Questions with Verified Answers | 100%
Correct | Pass Guaranteed
Q001: A 28-year-old female presents with a 3-day history of dysuria, frequency,
and suprapubic discomfort. She is afebrile and has no flank pain. Urinalysis shows
positive nitrites, leukocyte esterase, and 15–20 WBCs/hpf. Which is the most
appropriate first-line outpatient management?
Options:
A. Oral cephalexin 500 mg QID × 3 days
B. Trimethoprim-sulfamethoxazole DS BID × 3 days
C. Ciprofloxacin 250 mg BID × 3 days
D. Observation only with increased fluids
ANSWER: B
Q002: A 45-year-old male smoker reports a 2-week history of productive cough,
low-grade fever, and pleuritic chest pain. Chest X-ray shows right lower-lobe
consolidation and air bronchograms. He is hemodynamically stable and afebrile
today. Which is the most appropriate initial outpatient antibiotic choice?
Options:
A. Amoxicillin 500 mg TID × 5 days
B. Azithromycin 500 mg day 1 then 250 mg × 4 days
C. Doxycycline 100 mg BID × 5 days
, 2
D. Levofloxacin 750 mg daily × 5 days
ANSWER: B
Q003: A 34-year-old woman presents with a 4-week history of fatigue, weight
gain, cold intolerance, and constipation. TSH is 9.8 mIU/L (normal 0.4–4.0) and
free T4 is 0.8 ng/dL (normal 0.9–1.7). Which is the most appropriate initial
treatment and patient education?
Options:
A. Start levothyroxine 1.6 µg/kg daily and counsel on lifelong therapy
B. Repeat TSH in 6 weeks; no medication yet
C. Start liothyronine 25 µg BID
D. Refer immediately to endocrinology for further work-up
ANSWER: A
Q004: A 50-year-old male presents with acute onset of retrosternal chest pain that
improves when sitting up and worsens when lying flat. He has a friction rub on
auscultation and diffuse ST elevations on ECG. Troponin is mildly elevated. Which
is the most appropriate initial management?
Options:
A. Aspirin 325 mg, colchicine 0.5 mg BID, and NSAID therapy
B. Immediate cardiac catheterization
C. High-dose heparin infusion
D. IV thrombolysis
ANSWER: A
Q005: A 25-year-old man reports 3 days of severe right lower-quadrant pain,
anorexia, and low-grade fever. McBurney point tenderness and rebound are
present. WBC is 15 000/µL. Which is the most appropriate next step?
Options:
A. Abdominal ultrasound
, 3
B. CT abdomen/pelvis with contrast
C. Urgent surgical consult
D. Empiric antibiotics and discharge
ANSWER: B
Q006: A 40-year-old woman presents with a 2-week history of epigastric pain
relieved by food and nighttime awakening. She is otherwise healthy. Stool H.
pylori antigen is positive. Which is the most appropriate initial management?
Options:
A. Omeprazole alone for 4 weeks
B. Triple therapy: PPI + clarithromycin + amoxicillin × 14 days
C. Sucralfate suspension QID
D. Immediate endoscopy
ANSWER: B
Q007: A 30-year-old woman presents with a 1-week history of watery diarrhea,
cramping, and low-grade fever after a picnic. Stool PCR is positive for
Campylobacter. Which antibiotic and duration is first-line?
Options:
A. Ciprofloxacin 500 mg BID × 3 days
B. Azithromycin 500 mg daily × 3 days
C. TMP-SMX DS BID × 3 days
D. No antibiotics needed
ANSWER: B
Q008: A 55-year-old woman presents with a 3-month history of bilateral hand
stiffness > 45 min, swelling at MCP joints, and positive anti-CCP. RF is 60 IU/mL.
Which is the most appropriate initial management?
Options:
