NR511 Week 8 Final Exam – Best 100 Practice
Questions with Answers & Rationales – Differential
Diagnosis & Primary Care Practicum – Chamberlain
University – 2026 Updated
INTRO:
*This comprehensive study resource is designed for students preparing for the NR511
Week 8 Final Exam at Chamberlain University. The exam is noncumulative, covers Weeks
5-8 content, consists of 100 multiple-choice questions, and is administered via Examplify
with 120 minutes allotted . Topics include gastrointestinal disorders, genitourinary
conditions, musculoskeletal and spinal disorders, endocrine and metabolic problems, bites
and lacerations, and men's/women's health. Answers are in bold italic * with explanations
in italic at the end of each question.
SECTION 1: GASTROINTESTINAL DISORDERS (Questions 1-25)
1. A patient with GERD should be instructed to eliminate which activity?
A) Walking after meals
B) Elevating the head of the bed
C) Weight lifting
D) Drinking water between meals
Weight lifting increases intra-abdominal pressure, which can worsen GERD by promoting
reflux of gastric contents. Lifestyle modifications for GERD include avoiding heavy lifting,
eating smaller meals, remaining upright after eating, and elevating the head of the bed .
2. A patient is seen with a sudden onset of flank pain accompanied by nausea,
vomiting, and diaphoresis. In addition to nephrolithiasis, which conditions should be
included in the differential diagnosis?
A) Pancreatitis
B) Peptic ulcer disease
C) Diverticulitis
D) All of the above
,Flank pain with nausea, vomiting, and diaphoresis can present with multiple conditions.
Pancreatitis, peptic ulcer disease, and diverticulitis can all cause referred pain to the flank or
back and must be included in the differential diagnosis when evaluating a patient with acute
abdominal/flank symptoms .
3. A 45-year-old patient with GERD presents with a burning sensation in the chest
after meals, worse when lying down. Antacids provide minimal relief. What is the
most appropriate initial pharmacotherapy?
A) H2 blocker PRN
B) Metoclopramide
C) Sucralfate
D) Proton pump inhibitor daily
PPIs are the most effective medication class for GERD and should be taken daily before
meals. They provide superior acid suppression compared to H2 blockers and are the first-
line pharmacologic therapy for moderate-to-severe GERD symptoms .
4. A patient is diagnosed with Giardia after a backpacking trip. Which treatment is
appropriate?
A) Ciprofloxacin
B) Metronidazole
C) Amoxicillin
D) Doxycycline
Metronidazole is the treatment of choice for Giardia lamblia infection. Giardia is a protozoan
parasite commonly acquired from contaminated water during outdoor activities such as
backpacking .
5. A 30-year-old patient presents with intermittent burning midepigastric pain that
improves with food. She has no alarm symptoms. What is the most likely diagnosis?
A) Gastric cancer
B) Duodenal ulcer
C) GERD
D) Biliary colic
Epigastric pain relieved by food is classic for duodenal ulcer. Gastric ulcer pain typically
worsens with food intake. Duodenal ulcers are commonly caused by H. pylori infection or
NSAID use .
6. Episodes of prolonged inflammation with repeated or inadequately treated acute
infection lasting greater than 12 weeks is defined as:
, A) Acute sinusitis
B) Chronic sinusitis
C) Recurrent sinusitis
D) Subacute sinusitis
Chronic sinusitis is defined as inflammation lasting greater than 12 weeks, often with
repeated or inadequately treated acute infections. Treatment may require longer courses of
antibiotics or referral to ENT .
7. A patient with acute pancreatitis is most likely to present with:
A) Right upper quadrant pain
B) Epigastric pain radiating to the back
C) Left lower quadrant pain
D) Diffuse abdominal pain
Epigastric pain radiating to the back is classic for acute pancreatitis. The pain is often
severe and may be accompanied by nausea and vomiting. Common causes include
gallstones and alcohol use .
8. The patient with acute cholelithiasis and RUQ pain radiating to the middle of the
back would most likely have which laboratory finding?
A) Elevated amylase
B) Elevated alkaline phosphatase
C) Elevated lipase
D) Elevated liver transaminases
Elevated alkaline phosphatase is a classic finding in biliary obstruction from cholelithiasis. It
may be accompanied by elevated bilirubin and GGT. RUQ pain radiating to the back
suggests biliary colic .
9. A 55-year-old man with a 40-pack-year smoking history presents with new onset
hemoptysis, weight loss, and persistent cough. What is the most appropriate initial
imaging study?
A) CT chest with contrast
B) MRI chest
C) Chest X-ray
D) PET scan
Chest X-ray is the initial imaging study of choice for suspected lung cancer. Suspicious
findings on CXR prompt further evaluation with CT. Risk factors include smoking history,
weight loss, and hemoptysis .
Questions with Answers & Rationales – Differential
Diagnosis & Primary Care Practicum – Chamberlain
University – 2026 Updated
INTRO:
*This comprehensive study resource is designed for students preparing for the NR511
Week 8 Final Exam at Chamberlain University. The exam is noncumulative, covers Weeks
5-8 content, consists of 100 multiple-choice questions, and is administered via Examplify
with 120 minutes allotted . Topics include gastrointestinal disorders, genitourinary
conditions, musculoskeletal and spinal disorders, endocrine and metabolic problems, bites
and lacerations, and men's/women's health. Answers are in bold italic * with explanations
in italic at the end of each question.
SECTION 1: GASTROINTESTINAL DISORDERS (Questions 1-25)
1. A patient with GERD should be instructed to eliminate which activity?
A) Walking after meals
B) Elevating the head of the bed
C) Weight lifting
D) Drinking water between meals
Weight lifting increases intra-abdominal pressure, which can worsen GERD by promoting
reflux of gastric contents. Lifestyle modifications for GERD include avoiding heavy lifting,
eating smaller meals, remaining upright after eating, and elevating the head of the bed .
2. A patient is seen with a sudden onset of flank pain accompanied by nausea,
vomiting, and diaphoresis. In addition to nephrolithiasis, which conditions should be
included in the differential diagnosis?
A) Pancreatitis
B) Peptic ulcer disease
C) Diverticulitis
D) All of the above
,Flank pain with nausea, vomiting, and diaphoresis can present with multiple conditions.
Pancreatitis, peptic ulcer disease, and diverticulitis can all cause referred pain to the flank or
back and must be included in the differential diagnosis when evaluating a patient with acute
abdominal/flank symptoms .
3. A 45-year-old patient with GERD presents with a burning sensation in the chest
after meals, worse when lying down. Antacids provide minimal relief. What is the
most appropriate initial pharmacotherapy?
A) H2 blocker PRN
B) Metoclopramide
C) Sucralfate
D) Proton pump inhibitor daily
PPIs are the most effective medication class for GERD and should be taken daily before
meals. They provide superior acid suppression compared to H2 blockers and are the first-
line pharmacologic therapy for moderate-to-severe GERD symptoms .
4. A patient is diagnosed with Giardia after a backpacking trip. Which treatment is
appropriate?
A) Ciprofloxacin
B) Metronidazole
C) Amoxicillin
D) Doxycycline
Metronidazole is the treatment of choice for Giardia lamblia infection. Giardia is a protozoan
parasite commonly acquired from contaminated water during outdoor activities such as
backpacking .
5. A 30-year-old patient presents with intermittent burning midepigastric pain that
improves with food. She has no alarm symptoms. What is the most likely diagnosis?
A) Gastric cancer
B) Duodenal ulcer
C) GERD
D) Biliary colic
Epigastric pain relieved by food is classic for duodenal ulcer. Gastric ulcer pain typically
worsens with food intake. Duodenal ulcers are commonly caused by H. pylori infection or
NSAID use .
6. Episodes of prolonged inflammation with repeated or inadequately treated acute
infection lasting greater than 12 weeks is defined as:
, A) Acute sinusitis
B) Chronic sinusitis
C) Recurrent sinusitis
D) Subacute sinusitis
Chronic sinusitis is defined as inflammation lasting greater than 12 weeks, often with
repeated or inadequately treated acute infections. Treatment may require longer courses of
antibiotics or referral to ENT .
7. A patient with acute pancreatitis is most likely to present with:
A) Right upper quadrant pain
B) Epigastric pain radiating to the back
C) Left lower quadrant pain
D) Diffuse abdominal pain
Epigastric pain radiating to the back is classic for acute pancreatitis. The pain is often
severe and may be accompanied by nausea and vomiting. Common causes include
gallstones and alcohol use .
8. The patient with acute cholelithiasis and RUQ pain radiating to the middle of the
back would most likely have which laboratory finding?
A) Elevated amylase
B) Elevated alkaline phosphatase
C) Elevated lipase
D) Elevated liver transaminases
Elevated alkaline phosphatase is a classic finding in biliary obstruction from cholelithiasis. It
may be accompanied by elevated bilirubin and GGT. RUQ pain radiating to the back
suggests biliary colic .
9. A 55-year-old man with a 40-pack-year smoking history presents with new onset
hemoptysis, weight loss, and persistent cough. What is the most appropriate initial
imaging study?
A) CT chest with contrast
B) MRI chest
C) Chest X-ray
D) PET scan
Chest X-ray is the initial imaging study of choice for suspected lung cancer. Suspicious
findings on CXR prompt further evaluation with CT. Risk factors include smoking history,
weight loss, and hemoptysis .
