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NR 511 / NR511 Final Exam Actual
Exam 2026/2027 | Differential
Diagnosis & Primary Care Practicum |
Chamberlain | Questions with Verified
Answers | 100% Correct | Pass
Guaranteed
Q001: A 34-year-old woman presents to primary care with 3 weeks of diffuse joint
pain, bilateral hand stiffness lasting >1 hour, and swelling at the MCP joints; she
denies fever, rash, or back pain. RF is 42 IU/mL (nl <14), anti-CCP is 62 U/mL (nl
<20), ESR 48 mm/h, CRP 2.8 mg/dL. Which is the most likely diagnosis?
A. Systemic lupus erythematosus
B. Rheumatoid arthritis
C. Osteoarthritis
D. Parvovirus B19 arthropathy
ANSWER: B
Q002: A 45-year-old man with HTN and 40 pack-year smoking history reports 4
weeks of productive cough, 15-lb weight loss, and hemoptysis; CXR shows a 3.5
cm spiculated right upper lobe mass. Which diagnostic test should be ordered next?
A. Sputum cytology
B. CT chest with contrast and PET-CT
C. PPD skin test
D. Spirometry
ANSWER: B
Q003: A 28-year-old man complains of 2 days of burning pain with urination and a
yellow-green penile discharge; Gram stain of discharge shows intracellular gram-
negative diplococci. Which is the preferred outpatient treatment?
A. Doxycycline 100 mg BID x 7 days
, 2
B. Ceftriaxone 500 mg IM single dose plus azithromycin 1 g PO single dose
C. Ciprofloxacin 500 mg PO single dose
D. Amoxicillin 1 g PO single dose
ANSWER: B
Q004: A 52-year-old woman with DM and HTN presents with 2 weeks of fatigue,
bilateral lower-extremity edema, and foamy urine; urinalysis shows 3+ protein, no
blood, 24-h urine 4.8 g protein, albumin 2.1 g/dL, Cr 1.3 mg/dL. Which is the most
likely diagnosis?
A. Acute glomerulonephritis
B. Nephrotic syndrome
C. Urinary tract infection
D. Heart failure
ANSWER: B
Q005: A 19-year-old college student presents with sore throat, fever 38.9 °C,
tonsillar exudate, and tender anterior cervical nodes; rapid antigen detection test is
positive. Which is the first-line therapy?
A. Amoxicillin 500 mg PO BID x 5 days
B. Penicillin V 500 mg PO BID x 10 days
C. Azithromycin 500 mg PO x 3 days
D. Supportive care only
ANSWER: B
Q006: A 38-year-old woman reports 6 weeks of intermittent burning retrosternal
chest pain after meals and when supine, with acidic taste; no dysphagia or weight
loss. Which initial lifestyle modification is most appropriate?
A. Elevate head of bed 6-8 inches and avoid eating 3 h before lying down
B. Start daily NSAID use
C. Increase caffeine intake
D. Begin high-fat diet
ANSWER: A
Q007: A 42-year-old man with HTN presents for BP follow-up; home logs average
152/96 mmHg on lisinopril 10 mg daily. Which is the next best action?
A. Add amlodipine 5 mg daily and recheck in 4 weeks
B. Increase lisinopril to 20 mg daily
, 3
C. Discontinue lisinopril and start losartan
D. Order renal artery duplex only
ANSWER: A
Q008: A 30-year-old woman with asthma reports using albuterol 4×/week and
waking 1×/week with cough; peak flow 82% personal best. Which step-up therapy
is indicated?
A. Add ICS/LABA combination inhaler daily
B. Increase albuterol to 2 puffs QID scheduled
C. Start oral prednisone 40 mg daily
D. Add montelukast 10 mg BID
ANSWER: A
Q009: A 26-year-old woman presents with 3 days of dysuria, frequency, and
suprapubic pain; urine dipstick shows positive nitrites and leukocyte esterase, no
blood. Which is first-line outpatient therapy?
A. Nitrofurantoin 100 mg BID x 5 days
B. Ciprofloxacin 500 mg BID x 3 days
C. Amoxicillin 500 mg TID x 7 days
D. TMP-SMX DS BID x 3 days (if local resistance <20%)
ANSWER: A
Q010: A 50-year-old man with 30 pack-year smoking history reports 4 weeks of
dry cough, 12-lb weight loss, and night sweats; CXR shows right upper lobe
cavitary lesion. Which initial test is indicated?
A. Sputum acid-fast bacilli smear and culture
B. CT chest with contrast
C. PET-CT whole body
D. PPD skin test
ANSWER: A
Q011: A 33-year-old woman presents with 4 weeks of fatigue, weight gain, cold
intolerance, and constipation; TSH 8.5 mIU/L (nl 0.4-4.0), free T4 0.8 ng/dL (nl
0.8-1.8). Which is the most likely diagnosis?
A. Subacute thyroiditis
B. Primary hypothyroidism
C. Secondary hypothyroidism
NR 511 / NR511 Final Exam Actual
Exam 2026/2027 | Differential
Diagnosis & Primary Care Practicum |
Chamberlain | Questions with Verified
Answers | 100% Correct | Pass
Guaranteed
Q001: A 34-year-old woman presents to primary care with 3 weeks of diffuse joint
pain, bilateral hand stiffness lasting >1 hour, and swelling at the MCP joints; she
denies fever, rash, or back pain. RF is 42 IU/mL (nl <14), anti-CCP is 62 U/mL (nl
<20), ESR 48 mm/h, CRP 2.8 mg/dL. Which is the most likely diagnosis?
A. Systemic lupus erythematosus
B. Rheumatoid arthritis
C. Osteoarthritis
D. Parvovirus B19 arthropathy
ANSWER: B
Q002: A 45-year-old man with HTN and 40 pack-year smoking history reports 4
weeks of productive cough, 15-lb weight loss, and hemoptysis; CXR shows a 3.5
cm spiculated right upper lobe mass. Which diagnostic test should be ordered next?
A. Sputum cytology
B. CT chest with contrast and PET-CT
C. PPD skin test
D. Spirometry
ANSWER: B
Q003: A 28-year-old man complains of 2 days of burning pain with urination and a
yellow-green penile discharge; Gram stain of discharge shows intracellular gram-
negative diplococci. Which is the preferred outpatient treatment?
A. Doxycycline 100 mg BID x 7 days
, 2
B. Ceftriaxone 500 mg IM single dose plus azithromycin 1 g PO single dose
C. Ciprofloxacin 500 mg PO single dose
D. Amoxicillin 1 g PO single dose
ANSWER: B
Q004: A 52-year-old woman with DM and HTN presents with 2 weeks of fatigue,
bilateral lower-extremity edema, and foamy urine; urinalysis shows 3+ protein, no
blood, 24-h urine 4.8 g protein, albumin 2.1 g/dL, Cr 1.3 mg/dL. Which is the most
likely diagnosis?
A. Acute glomerulonephritis
B. Nephrotic syndrome
C. Urinary tract infection
D. Heart failure
ANSWER: B
Q005: A 19-year-old college student presents with sore throat, fever 38.9 °C,
tonsillar exudate, and tender anterior cervical nodes; rapid antigen detection test is
positive. Which is the first-line therapy?
A. Amoxicillin 500 mg PO BID x 5 days
B. Penicillin V 500 mg PO BID x 10 days
C. Azithromycin 500 mg PO x 3 days
D. Supportive care only
ANSWER: B
Q006: A 38-year-old woman reports 6 weeks of intermittent burning retrosternal
chest pain after meals and when supine, with acidic taste; no dysphagia or weight
loss. Which initial lifestyle modification is most appropriate?
A. Elevate head of bed 6-8 inches and avoid eating 3 h before lying down
B. Start daily NSAID use
C. Increase caffeine intake
D. Begin high-fat diet
ANSWER: A
Q007: A 42-year-old man with HTN presents for BP follow-up; home logs average
152/96 mmHg on lisinopril 10 mg daily. Which is the next best action?
A. Add amlodipine 5 mg daily and recheck in 4 weeks
B. Increase lisinopril to 20 mg daily
, 3
C. Discontinue lisinopril and start losartan
D. Order renal artery duplex only
ANSWER: A
Q008: A 30-year-old woman with asthma reports using albuterol 4×/week and
waking 1×/week with cough; peak flow 82% personal best. Which step-up therapy
is indicated?
A. Add ICS/LABA combination inhaler daily
B. Increase albuterol to 2 puffs QID scheduled
C. Start oral prednisone 40 mg daily
D. Add montelukast 10 mg BID
ANSWER: A
Q009: A 26-year-old woman presents with 3 days of dysuria, frequency, and
suprapubic pain; urine dipstick shows positive nitrites and leukocyte esterase, no
blood. Which is first-line outpatient therapy?
A. Nitrofurantoin 100 mg BID x 5 days
B. Ciprofloxacin 500 mg BID x 3 days
C. Amoxicillin 500 mg TID x 7 days
D. TMP-SMX DS BID x 3 days (if local resistance <20%)
ANSWER: A
Q010: A 50-year-old man with 30 pack-year smoking history reports 4 weeks of
dry cough, 12-lb weight loss, and night sweats; CXR shows right upper lobe
cavitary lesion. Which initial test is indicated?
A. Sputum acid-fast bacilli smear and culture
B. CT chest with contrast
C. PET-CT whole body
D. PPD skin test
ANSWER: A
Q011: A 33-year-old woman presents with 4 weeks of fatigue, weight gain, cold
intolerance, and constipation; TSH 8.5 mIU/L (nl 0.4-4.0), free T4 0.8 ng/dL (nl
0.8-1.8). Which is the most likely diagnosis?
A. Subacute thyroiditis
B. Primary hypothyroidism
C. Secondary hypothyroidism
