Pass NR607 PRE-DIAGNOSTIC EXAM
(Chamberlain) NEWEST 2025/ 2026
ACTUAL EXAM| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED
CORRECT ANSWS (VERIFIED CORRECT
ANSWS) GRADED A+ (BRAND NEW!!)
Question 1
A 58-year-old male with a history of hypertension and hyperlipidemia presents with substernal
chest pressure radiating to the left arm. An ECG shows ST-segment elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
• A) Left anterior descending
• B) Left circumflex
• C) Right coronary artery
• D) Left main coronary artery
Correct answ: C) Right coronary artery
Rationale: Leads II, III, and aVF reflect the inferior wall of the left ventricle, which is supplied by
the right coronary artery (RCA) in most right-dominant circulations. Inferior STEMI = RCA
occlusion. The LAD supplies the anterior wall and septum (leads V1–V4), while the LCx supplies
the lateral wall (leads I, aVL, V5–V6).
,Question 2
A 65-year-old woman with diabetes presents with progressive dyspnea, orthopnea, and bilateral
crackles. A chest X-ray shows pulmonary edema with cardiomegaly. Which pathophysiological
process is most likely responsible?
• A) Left-sided heart failure
• B) Right-sided heart failure
• C) Pulmonary embolism
• D) Chronic obstructive pulmonary disease
Correct answ: A) Left-sided heart failure
Rationale: Left-sided heart failure leads to increased pulmonary capillary pressure, resulting in
pulmonary congestion, dyspnea, orthopnea, and crackles on auscultation. Cardiomegaly on CXR
reflects chronic volume overload. Right-sided failure would present with peripheral edema and
JVD.
Question 3
What happens in the brain during a potentially traumatic event?
• A) The prefrontal cortex initiates an immediate cognitive appraisal
• B) The brain stem is critical in fast, defensive responses
• C) The hippocampus shuts down all memory formation
• D) The occipital lobe processes threat before the brain stem
Correct answ: B) The brain stem is critical in fast, defensive responses
Rationale: The brain stem is directly connected with the retina; visual information is sent to the
brain stem immediately before higher brain levels are even aware of the threat. If a predator
moves closer, the periaqueductal gray initiates fight-or-flight response by activating the
sympathetic nervous system.
,Question 4
A patient presents with sudden onset of severe headache, neck stiffness, and photophobia. A
lumbar puncture reveals xanthochromia. What is the most likely diagnosis?
• A) Migraine headache
• B) Meningitis
• C) Subarachnoid hemorrhage
• D) Brain tumor
Correct answ: C) Subarachnoid hemorrhage
Rationale: The classic triad of subarachnoid hemorrhage includes sudden severe headache
("worst headache of life"), neck stiffness, and photophobia. Xanthochromia (yellowish CSF)
indicates breakdown of red blood cells, confirming prior bleeding into the subarachnoid space.
Question 5
A patient with chronic liver disease develops confusion, asterixis, and elevated ammonia levels.
This condition is best described as:
• A) Hepatic encephalopathy
• B) Portal hypertension
• C) Esophageal varices
• D) Ascites
Correct answ: A) Hepatic encephalopathy
Rationale: Hepatic encephalopathy results from the liver's inability to detoxify ammonia and
other neurotoxins, leading to altered mental status, confusion, and asterixis (liver flap). Elevated
ammonia levels confirm the diagnosis.
, Question 6
Which structure of the mind deals with reality testing and the thinking process?
• A) Superego
• B) Defense mechanisms
• C) Id
• D) Ego
Correct answ: D) Ego
Rationale: The ego operates on the reality principle and is responsible for reality testing, logical
thinking, and mediating between the id's impulses and the superego's moral constraints. Anxiety
can arise from intrapsychic conflict among these structures.
Question 7
A patient with type 2 diabetes presents with a foot ulcer that is deep, painless, and surrounded by
callus. Which pathophysiological mechanism is most likely contributing to this presentation?
• A) Peripheral neuropathy
• B) Peripheral artery disease
• C) Venous insufficiency
• D) Autoimmune vasculitis
Correct answ: A) Peripheral neuropathy
Rationale: Diabetic peripheral neuropathy causes loss of protective sensation, leading to
painless ulcers that often go unnoticed. The deep nature and callus formation are characteristic
of neuropathic ulcers, typically located on pressure points of the foot.
(Chamberlain) NEWEST 2025/ 2026
ACTUAL EXAM| COMPLETE REAL EXAM
QUESTIONS AND CORRECT DETAILED
CORRECT ANSWS (VERIFIED CORRECT
ANSWS) GRADED A+ (BRAND NEW!!)
Question 1
A 58-year-old male with a history of hypertension and hyperlipidemia presents with substernal
chest pressure radiating to the left arm. An ECG shows ST-segment elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
• A) Left anterior descending
• B) Left circumflex
• C) Right coronary artery
• D) Left main coronary artery
Correct answ: C) Right coronary artery
Rationale: Leads II, III, and aVF reflect the inferior wall of the left ventricle, which is supplied by
the right coronary artery (RCA) in most right-dominant circulations. Inferior STEMI = RCA
occlusion. The LAD supplies the anterior wall and septum (leads V1–V4), while the LCx supplies
the lateral wall (leads I, aVL, V5–V6).
,Question 2
A 65-year-old woman with diabetes presents with progressive dyspnea, orthopnea, and bilateral
crackles. A chest X-ray shows pulmonary edema with cardiomegaly. Which pathophysiological
process is most likely responsible?
• A) Left-sided heart failure
• B) Right-sided heart failure
• C) Pulmonary embolism
• D) Chronic obstructive pulmonary disease
Correct answ: A) Left-sided heart failure
Rationale: Left-sided heart failure leads to increased pulmonary capillary pressure, resulting in
pulmonary congestion, dyspnea, orthopnea, and crackles on auscultation. Cardiomegaly on CXR
reflects chronic volume overload. Right-sided failure would present with peripheral edema and
JVD.
Question 3
What happens in the brain during a potentially traumatic event?
• A) The prefrontal cortex initiates an immediate cognitive appraisal
• B) The brain stem is critical in fast, defensive responses
• C) The hippocampus shuts down all memory formation
• D) The occipital lobe processes threat before the brain stem
Correct answ: B) The brain stem is critical in fast, defensive responses
Rationale: The brain stem is directly connected with the retina; visual information is sent to the
brain stem immediately before higher brain levels are even aware of the threat. If a predator
moves closer, the periaqueductal gray initiates fight-or-flight response by activating the
sympathetic nervous system.
,Question 4
A patient presents with sudden onset of severe headache, neck stiffness, and photophobia. A
lumbar puncture reveals xanthochromia. What is the most likely diagnosis?
• A) Migraine headache
• B) Meningitis
• C) Subarachnoid hemorrhage
• D) Brain tumor
Correct answ: C) Subarachnoid hemorrhage
Rationale: The classic triad of subarachnoid hemorrhage includes sudden severe headache
("worst headache of life"), neck stiffness, and photophobia. Xanthochromia (yellowish CSF)
indicates breakdown of red blood cells, confirming prior bleeding into the subarachnoid space.
Question 5
A patient with chronic liver disease develops confusion, asterixis, and elevated ammonia levels.
This condition is best described as:
• A) Hepatic encephalopathy
• B) Portal hypertension
• C) Esophageal varices
• D) Ascites
Correct answ: A) Hepatic encephalopathy
Rationale: Hepatic encephalopathy results from the liver's inability to detoxify ammonia and
other neurotoxins, leading to altered mental status, confusion, and asterixis (liver flap). Elevated
ammonia levels confirm the diagnosis.
, Question 6
Which structure of the mind deals with reality testing and the thinking process?
• A) Superego
• B) Defense mechanisms
• C) Id
• D) Ego
Correct answ: D) Ego
Rationale: The ego operates on the reality principle and is responsible for reality testing, logical
thinking, and mediating between the id's impulses and the superego's moral constraints. Anxiety
can arise from intrapsychic conflict among these structures.
Question 7
A patient with type 2 diabetes presents with a foot ulcer that is deep, painless, and surrounded by
callus. Which pathophysiological mechanism is most likely contributing to this presentation?
• A) Peripheral neuropathy
• B) Peripheral artery disease
• C) Venous insufficiency
• D) Autoimmune vasculitis
Correct answ: A) Peripheral neuropathy
Rationale: Diabetic peripheral neuropathy causes loss of protective sensation, leading to
painless ulcers that often go unnoticed. The deep nature and callus formation are characteristic
of neuropathic ulcers, typically located on pressure points of the foot.
