NR 511 / NR511 Midterm Exam Week 1-4
Actual Exam 2026/2027 | Differential
Diagnosis & Primary Care Practicum |
Chamberlain | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
Q001: A 24-year-old female presents with 3 days of dysuria, frequency, and
suprapubic discomfort. Urinalysis shows >10 WBC/hpf, positive leukocyte
esterase, and negative nitrites. She is afebrile and has no flank pain. Which is the
most appropriate first-line empiric therapy for an uncomplicated UTI in a non-
pregnant patient?
Options:
A. Trimethoprim-sulfamethoxazole DS BID × 3 days
B. Ciprofloxacin 250 mg PO BID × 3 days
C. Nitrofurantoin 100 mg PO BID × 5 days - CORRECT
D. Amoxicillin 500 mg PO TID × 7 days
ANSWER: C
Q002: A 35-year-old man complains of 4 weeks of persistent dry cough worse at
night and with exercise. He denies fever, wheeze, or sputum. CXR is normal and
spirometry shows FEV₁/FVC 0.68 with 15% improvement after albuterol. He
vapes daily. Which is the preferred initial pharmacologic therapy?
Options:
A. Oral corticosteroid burst
B. Inhaled corticosteroid/LABA combination - CORRECT
C. Macrolide antibiotic for atypical pneumonia
D. Antihistamine for post-nasal drip
ANSWER: B
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Q003: A 28-year-old woman has 6 weeks of fatigue, weight gain, and cold
intolerance. TSH is 6.8 mIU/L (0.4–4.0) and free T4 is low. She is not pregnant.
Which initial prescription and counselling is correct?
Options:
A. Levothyroxine 25 µg daily with breakfast
B. Levothyroxine 1.6 µg/kg/day taken 30–60 min before breakfast - CORRECT
C. Repeat TSH in 3 months; treat only if TSH >10
D. Liothyronine 5 µg BID for rapid relief
ANSWER: B
Q004: A 45-year-old woman with T2DM (HbA1c 9.1%) has burning feet worse at
night; monofilament shows decreased sensation. Strength is 5/5 and renal function
is normal. Which first-line medication is appropriate for neuropathic pain?
Options:
A. Gabapentin 300 mg TID
B. Duloxetine 30 mg daily and optimise glycaemic control - CORRECT
C. Tramadol 50 mg QID PRN
D. Topical lidocaine patches only
ANSWER: B
Q005: A 22-year-old athlete has 1 week of right shin pain after increasing mileage;
X-ray shows faint cortical lucency, no fever, normal WBC. Which initial
management is best?
Options:
A. Immediate MRI to rule out tumour
B. Oral antibiotics for osteomyelitis
C. Rest, ice, acetaminophen, gradual return 4–6 weeks - CORRECT
D. Long-leg casting for 6 weeks
ANSWER: C
Q006: A 30-year-old woman has 3 weeks of low mood, anhedonia, PHQ-9 16, no
suicidal ideation, first episode. Which initial primary-care plan is appropriate?
Options:
A. Immediate psychiatry referral for admission
B. Sertraline 50 mg daily, psychoeducation, 2-week follow-up - CORRECT
C. Trial of St. John’s wort and counselling only
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D. Order TSH and B12 before any treatment
ANSWER: B
Q007: A 38-year-old woman has 4 days of right anterolateral leg pain and swelling
after a long flight. D-dimer is 1200 ng/mL and proximal DVT is confirmed on
ultrasound. She is hemodynamically stable. Which initial anticoagulation is
appropriate?
Options:
A. Aspirin 325 mg daily
B. Apixaban 10 mg PO BID × 7 days then 5 mg BID ≥3 months - CORRECT
C. Enoxaparin 40 mg SC daily
D. IV heparin only and discharge without oral agent
ANSWER: B
Q008: A 42-year-old man reports 4 weeks of burning epigastric pain relieved by
food and antacids; he takes OTC ibuprofen 4–6 tablets daily. Stool antigen H.
pylori is positive. Which empiric therapy is first-line?
Options:
A. High-dose PPI for 8 weeks only
B. Stop NSAIDs, start pantoprazole 40 mg BID, and bismuth quadruple therapy ×
14 days - CORRECT
C. Immediate endoscopy to rule out malignancy
D. Amoxicillin alone for 7 days
ANSWER: B
Q009: A 50-year-old woman has 4 months of bilateral hand pain and morning
stiffness >1 h; MCP/PIP swelling. RF is 42 IU/mL and anti-CCP positive. X-rays
are normal. Which initial DMARD is preferred?
Options:
A. Hydroxychloroquine 400 mg daily
B. Methotrexate 15 mg weekly with folic acid - CORRECT
C. Prednisone 20 mg daily bridge
D. NSAID only; rheumatology referral in 6 months
ANSWER: B
Q010: A 29-year-old man has 2 days of dysuria and meatal itching; UA: 15
WBC/hpf, no bacteria, no fever. Which management is most appropriate today?