NR-511DIFFERENTIAL DIAGNOSIS FINAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026
Q&A |LATEST EXAM UPDATE 2026/2027 CHAMBERLAIN
UNIVERSITY..
Core Domains
* Diagnostic Reasoning Process
* Evidence-Based Clinical Decision Making
* Advanced Physical Assessment and Pathophysiology
* Legal and Ethical Standards in Primary Care
* Pharmacotherapeutics and Management Planning
* Culturally Competent Health Promotion
Introduction
*The purpose of this examination is to evaluate the student's mastery of the differential diagnosis process within the primary car
SECTION ONE: QUESTIONS 1–100
A 45-year-old patient presents with sudden onset of severe, stabbing chest pain radiating to the back. Physical exam reveals a blood
pressure discrepancy between the left and right arms. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
🟢 C. Aortic dissection
🔴 RATIONALE: The combination of sudden, tearing chest pain radiating to the back and a blood pressure differential between limbs is
classic for aortic dissection, requiring immediate stabilization.
A 24-year-old female presents with dysuria, frequency, and suprapubic pain. Urinalysis shows positive nitrites and leukocyte esterase.
Which treatment is the gold standard for an uncomplicated urinary tract infection in this patient?
,A. Nitrofurantoin
B. Amoxicillin
C. Azithromycin
D. Ciprofloxacin
🟢 A. Nitrofurantoin
🔴 RATIONALE: Nitrofurantoin is a first-line treatment for uncomplicated lower urinary tract infections due to its high concentration in the
bladder and low resistance profile.
Which of the following laboratory markers is most specific for diagnosing Rheumatoid Arthritis?
A. Elevated ESR
B. Anti-cyclic citrullinated peptide (anti-CCP)
C. Positive ANA
D. Elevated C-reactive protein
🟢 B. Anti-cyclic citrullinated peptide (anti-CCP)
🔴 RATIONALE: Anti-CCP antibodies are highly specific for rheumatoid arthritis and often appear before clinical symptoms manifest.
A patient presents with a painless, indurated ulcer on the genitalia. The patient reports unprotected intercourse 3 weeks ago. What is
the most appropriate initial diagnostic test?
A. Gram stain
B. RPR or VDRL
C. HSV PCR
D. Tzanck smear
🟢 B. RPR or VDRL
🔴 RATIONALE: A painless, indurated ulcer is a primary chancre suggestive of syphilis. Initial screening involves nontreponemal tests like
RPR or VDRL.
When performing a physical exam on a patient with suspected appendicitis, which finding is consistent with Psoas sign?
A. Pain in the RLQ with internal rotation of the right hip
B. Pain in the RLQ with extension of the right hip
C. Pain in the RLQ upon palpation of the LLQ
D. Pain in the RLQ upon release of pressure
🟢 B. Pain in the RLQ with extension of the right hip
🔴 RATIONALE: The Psoas sign is elicited by extending the patient's right hip, causing irritation of the psoas muscle by an inflamed
appendix.
Which medication class is contraindicated in patients with a history of angioedema?
A. Beta-blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Thiazide diuretics
, 🟢 C. ACE inhibitors
🔴 RATIONALE: ACE inhibitors are strongly associated with the development of angioedema and are contraindicated in patients with a
history of this condition.
A 60-year-old male with a history of hypertension presents with new-onset resting tremor, bradykinesia, and masked facies. What is the
most likely diagnosis?
A. Essential tremor
B. Parkinson’s disease
C. Multiple sclerosis
D. Huntington’s disease
🟢 B. Parkinson’s disease
🔴 RATIONALE: The triad of resting tremor, bradykinesia, and rigidity (masked facies) is characteristic of Parkinson’s disease.
Which guideline best dictates the legal scope of practice for an Advanced Practice Registered Nurse (APRN)?
A. Hospital bylaws
B. State Nurse Practice Act
C. American Nurses Association (ANA) guidelines
D. Agency for Healthcare Research and Quality (AHRQ)
🟢 B. State Nurse Practice Act
🔴 RATIONALE: The State Nurse Practice Act is the legal framework that defines the scope of practice and prescriptive authority for nurses
within a specific jurisdiction.
A patient presents with a "bulls-eye" rash following a hiking trip. Which pathogen is the causative agent?
A. Rickettsia rickettsii
B. Borrelia burgdorferi
C. Treponema pallidum
D. Bartonella henselae
🟢 B. Borrelia burgdorferi
🔴 RATIONALE: The erythema migrans rash (bulls-eye) is pathognomonic for Lyme disease, caused by the spirochete Borrelia burgdorferi.
What is the most common cause of community-acquired pneumonia in adults?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Legionella pneumophila
🟢 B. Streptococcus pneumoniae
🔴 RATIONALE: Streptococcus pneumoniae remains the most frequent causative pathogen for community-acquired pneumonia.
A 30-year-old female presents with fatigue, weight gain, cold intolerance, and dry skin. Labs show elevated TSH and low T4. What is
the diagnosis?
2026
Q&A |LATEST EXAM UPDATE 2026/2027 CHAMBERLAIN
UNIVERSITY..
Core Domains
* Diagnostic Reasoning Process
* Evidence-Based Clinical Decision Making
* Advanced Physical Assessment and Pathophysiology
* Legal and Ethical Standards in Primary Care
* Pharmacotherapeutics and Management Planning
* Culturally Competent Health Promotion
Introduction
*The purpose of this examination is to evaluate the student's mastery of the differential diagnosis process within the primary car
SECTION ONE: QUESTIONS 1–100
A 45-year-old patient presents with sudden onset of severe, stabbing chest pain radiating to the back. Physical exam reveals a blood
pressure discrepancy between the left and right arms. What is the most likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
🟢 C. Aortic dissection
🔴 RATIONALE: The combination of sudden, tearing chest pain radiating to the back and a blood pressure differential between limbs is
classic for aortic dissection, requiring immediate stabilization.
A 24-year-old female presents with dysuria, frequency, and suprapubic pain. Urinalysis shows positive nitrites and leukocyte esterase.
Which treatment is the gold standard for an uncomplicated urinary tract infection in this patient?
,A. Nitrofurantoin
B. Amoxicillin
C. Azithromycin
D. Ciprofloxacin
🟢 A. Nitrofurantoin
🔴 RATIONALE: Nitrofurantoin is a first-line treatment for uncomplicated lower urinary tract infections due to its high concentration in the
bladder and low resistance profile.
Which of the following laboratory markers is most specific for diagnosing Rheumatoid Arthritis?
A. Elevated ESR
B. Anti-cyclic citrullinated peptide (anti-CCP)
C. Positive ANA
D. Elevated C-reactive protein
🟢 B. Anti-cyclic citrullinated peptide (anti-CCP)
🔴 RATIONALE: Anti-CCP antibodies are highly specific for rheumatoid arthritis and often appear before clinical symptoms manifest.
A patient presents with a painless, indurated ulcer on the genitalia. The patient reports unprotected intercourse 3 weeks ago. What is
the most appropriate initial diagnostic test?
A. Gram stain
B. RPR or VDRL
C. HSV PCR
D. Tzanck smear
🟢 B. RPR or VDRL
🔴 RATIONALE: A painless, indurated ulcer is a primary chancre suggestive of syphilis. Initial screening involves nontreponemal tests like
RPR or VDRL.
When performing a physical exam on a patient with suspected appendicitis, which finding is consistent with Psoas sign?
A. Pain in the RLQ with internal rotation of the right hip
B. Pain in the RLQ with extension of the right hip
C. Pain in the RLQ upon palpation of the LLQ
D. Pain in the RLQ upon release of pressure
🟢 B. Pain in the RLQ with extension of the right hip
🔴 RATIONALE: The Psoas sign is elicited by extending the patient's right hip, causing irritation of the psoas muscle by an inflamed
appendix.
Which medication class is contraindicated in patients with a history of angioedema?
A. Beta-blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Thiazide diuretics
, 🟢 C. ACE inhibitors
🔴 RATIONALE: ACE inhibitors are strongly associated with the development of angioedema and are contraindicated in patients with a
history of this condition.
A 60-year-old male with a history of hypertension presents with new-onset resting tremor, bradykinesia, and masked facies. What is the
most likely diagnosis?
A. Essential tremor
B. Parkinson’s disease
C. Multiple sclerosis
D. Huntington’s disease
🟢 B. Parkinson’s disease
🔴 RATIONALE: The triad of resting tremor, bradykinesia, and rigidity (masked facies) is characteristic of Parkinson’s disease.
Which guideline best dictates the legal scope of practice for an Advanced Practice Registered Nurse (APRN)?
A. Hospital bylaws
B. State Nurse Practice Act
C. American Nurses Association (ANA) guidelines
D. Agency for Healthcare Research and Quality (AHRQ)
🟢 B. State Nurse Practice Act
🔴 RATIONALE: The State Nurse Practice Act is the legal framework that defines the scope of practice and prescriptive authority for nurses
within a specific jurisdiction.
A patient presents with a "bulls-eye" rash following a hiking trip. Which pathogen is the causative agent?
A. Rickettsia rickettsii
B. Borrelia burgdorferi
C. Treponema pallidum
D. Bartonella henselae
🟢 B. Borrelia burgdorferi
🔴 RATIONALE: The erythema migrans rash (bulls-eye) is pathognomonic for Lyme disease, caused by the spirochete Borrelia burgdorferi.
What is the most common cause of community-acquired pneumonia in adults?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Legionella pneumophila
🟢 B. Streptococcus pneumoniae
🔴 RATIONALE: Streptococcus pneumoniae remains the most frequent causative pathogen for community-acquired pneumonia.
A 30-year-old female presents with fatigue, weight gain, cold intolerance, and dry skin. Labs show elevated TSH and low T4. What is
the diagnosis?
