NR576 / NR 576 Final Exam (2026/2027 Newly Updated)
OBJECTIVE ASSESSMENT - EXAM
NR576 / NR 576 Final Exam (2026/2027 Newly
Updated): Differential Diagnosis in
Adult-Gerontology Primary Care | Guide with
Verified Answers - Chamberlain 2026/2027
75 VERIFIED 2026/2027 80%
QUESTIONS ANSWERS EDITION PASSING SCORE
TOPICS COVERED
• Hypertension & Heart Failure • Stroke & Seizure Disorders
• Coronary Artery Disease • Parkinson & MS
• Arrhythmias & Valvular Disease • Low Back Pain & Arthritis
• COPD & Asthma • GERD & Peptic Ulcer
• Pulmonary Embolism • IBD & Diverticulitis
• Diabetes Mellitus & DKA • CKD & BPH
• Thyroid Disorders • Melanoma & Skin Cancers
• Adrenal & Pituitary Disorders • Anemia & Hematologic Cancers
COVER PAGE - 1
,Section 1: Cardiovascular & Respiratory Differential Diagnosis
A 68-year-old male presents with progressive dyspnea on exertion, orthopnea, and bilateral
Q1
lower extremity edema. His jugular venous pressure is elevated, and an S3 gallop is
auscultated. He has a history of poorly controlled hypertension and type 2 diabetes.
A. Chronic obstructive pulmonary disease
B. Acute decompensated heart failure
C. Pulmonary embolism
D. Community-acquired pneumonia
Correct Answer: B
Rationale: Acute decompensated heart failure presents with dyspnea, orthopnea, JVD, S3 gallop, and peripheral edema.
COPD lacks JVD and S3. PE typically presents with acute pleuritic chest pain and tachypnea without chronic volume overload
signs.
A 72-year-old female with a 40 pack-year smoking history presents with chronic cough,
Q2
wheezing, and progressive dyspnea. Spirometry reveals an FEV1/FVC ratio of 0.62 with
minimal bronchodilator response. Her chest X-ray shows hyperinflation and flattened
diaphragms.
A. Chronic obstructive pulmonary disease
B. Asthma with fixed airway obstruction
C. Interstitial lung disease
D. Congestive heart failure
Correct Answer: A
Rationale: COPD is characterized by irreversible airflow limitation (FEV1/FVC < 0.70), smoking history, hyperinflation, and
minimal bronchodilator response. Asthma typically shows significant reversibility. ILD presents with restrictive, not obstructive,
patterns.
, A 55-year-old male presents with sudden onset of pleuritic chest pain, dyspnea, and
Q3
tachycardia after a 10-hour flight. He is diaphoretic and has a blood pressure of 94/62 mmHg.
D-dimer is markedly elevated.
A. Acute myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Spontaneous pneumothorax
Correct Answer: C
Rationale: Pulmonary embolism classically presents with pleuritic chest pain, dyspnea, tachycardia, and hypotension after
prolonged immobilization. The elevated D-dimer and clinical context strongly support PE over MI, which typically presents with
crushing substernal pain.
A 64-year-old female with a history of atrial fibrillation presents with acute left-sided weakness,
Q4
facial droop, and slurred speech. Her NIHSS score is 8, and CT head shows no hemorrhage.
A. Intracerebral hemorrhage
B. Subarachnoid hemorrhage
C. Transient ischemic attack
D. Cardioembolic ischemic stroke
Correct Answer: D
Rationale: Atrial fibrillation is a major risk factor for cardioembolic stroke. The acute focal neurologic deficits with negative CT
for hemorrhage strongly suggest ischemic stroke. TIA symptoms resolve within 24 hours, and SAH presents with thunderclap
headache.
A 70-year-old male presents with exertional chest pressure radiating to his left arm, relieved by
Q5
rest. He has a history of hyperlipidemia and hypertension. An ECG during symptoms shows 2
mm ST-segment depression in leads V4-V6.
A. Acute pericarditis
B. Stable angina pectoris
C. Variant (Prinzmetal) angina
D. Myocarditis
Correct Answer: B
Rationale: Stable angina presents with exertional chest pressure relieved by rest, with transient ST depression indicating
subendocardial ischemia. Pericarditis causes diffuse ST elevation and positional pain. Variant angina causes ST elevation at
rest, not with exertion.
, A 58-year-old male with a history of hypertension presents with a tearing chest pain radiating
Q6
to his back. His blood pressure is 190/110 mmHg in the right arm and 140/90 mmHg in the left
arm. Chest CT with contrast reveals an intimal flap.
A. Aortic dissection
B. Acute coronary syndrome
C. Pulmonary embolism
D. Esophageal rupture
Correct Answer: A
Rationale: Aortic dissection classically presents with tearing chest pain radiating to the back, blood pressure differential
between arms, and an intimal flap on CT. ACS typically causes pressure-like pain without pulse deficits or intimal flaps.
A 45-year-old female presents with sharp, positional chest pain that worsens when lying flat
Q7
and improves when leaning forward. She had a viral upper respiratory infection two weeks ago.
ECG shows diffuse ST-segment elevation and PR-segment depression.
A. Acute myocardial infarction
B. Pulmonary embolism
C. Acute pericarditis
D. Costochondritis
Correct Answer: C
Rationale: Acute pericarditis presents with positional pleuritic chest pain, friction rub, diffuse ST elevation, and PR depression
following a viral prodrome. MI causes localized ST elevation in a coronary distribution, not diffuse changes.
A 76-year-old female presents with progressive dyspnea, fatigue, and syncope on exertion.
Q8
Physical exam reveals a harsh crescendo-decrescendo systolic murmur at the right upper
sternal border radiating to the carotids.
A. Mitral regurgitation
B. Tricuspid regurgitation
C. Mitral stenosis
D. Aortic stenosis
Correct Answer: D
Rationale: Aortic stenosis presents with exertional dyspnea, syncope, and a harsh crescendo-decrescendo systolic murmur
radiating to the carotids in elderly patients. Mitral regurgitation causes a holosystolic murmur at the apex.
OBJECTIVE ASSESSMENT - EXAM
NR576 / NR 576 Final Exam (2026/2027 Newly
Updated): Differential Diagnosis in
Adult-Gerontology Primary Care | Guide with
Verified Answers - Chamberlain 2026/2027
75 VERIFIED 2026/2027 80%
QUESTIONS ANSWERS EDITION PASSING SCORE
TOPICS COVERED
• Hypertension & Heart Failure • Stroke & Seizure Disorders
• Coronary Artery Disease • Parkinson & MS
• Arrhythmias & Valvular Disease • Low Back Pain & Arthritis
• COPD & Asthma • GERD & Peptic Ulcer
• Pulmonary Embolism • IBD & Diverticulitis
• Diabetes Mellitus & DKA • CKD & BPH
• Thyroid Disorders • Melanoma & Skin Cancers
• Adrenal & Pituitary Disorders • Anemia & Hematologic Cancers
COVER PAGE - 1
,Section 1: Cardiovascular & Respiratory Differential Diagnosis
A 68-year-old male presents with progressive dyspnea on exertion, orthopnea, and bilateral
Q1
lower extremity edema. His jugular venous pressure is elevated, and an S3 gallop is
auscultated. He has a history of poorly controlled hypertension and type 2 diabetes.
A. Chronic obstructive pulmonary disease
B. Acute decompensated heart failure
C. Pulmonary embolism
D. Community-acquired pneumonia
Correct Answer: B
Rationale: Acute decompensated heart failure presents with dyspnea, orthopnea, JVD, S3 gallop, and peripheral edema.
COPD lacks JVD and S3. PE typically presents with acute pleuritic chest pain and tachypnea without chronic volume overload
signs.
A 72-year-old female with a 40 pack-year smoking history presents with chronic cough,
Q2
wheezing, and progressive dyspnea. Spirometry reveals an FEV1/FVC ratio of 0.62 with
minimal bronchodilator response. Her chest X-ray shows hyperinflation and flattened
diaphragms.
A. Chronic obstructive pulmonary disease
B. Asthma with fixed airway obstruction
C. Interstitial lung disease
D. Congestive heart failure
Correct Answer: A
Rationale: COPD is characterized by irreversible airflow limitation (FEV1/FVC < 0.70), smoking history, hyperinflation, and
minimal bronchodilator response. Asthma typically shows significant reversibility. ILD presents with restrictive, not obstructive,
patterns.
, A 55-year-old male presents with sudden onset of pleuritic chest pain, dyspnea, and
Q3
tachycardia after a 10-hour flight. He is diaphoretic and has a blood pressure of 94/62 mmHg.
D-dimer is markedly elevated.
A. Acute myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Spontaneous pneumothorax
Correct Answer: C
Rationale: Pulmonary embolism classically presents with pleuritic chest pain, dyspnea, tachycardia, and hypotension after
prolonged immobilization. The elevated D-dimer and clinical context strongly support PE over MI, which typically presents with
crushing substernal pain.
A 64-year-old female with a history of atrial fibrillation presents with acute left-sided weakness,
Q4
facial droop, and slurred speech. Her NIHSS score is 8, and CT head shows no hemorrhage.
A. Intracerebral hemorrhage
B. Subarachnoid hemorrhage
C. Transient ischemic attack
D. Cardioembolic ischemic stroke
Correct Answer: D
Rationale: Atrial fibrillation is a major risk factor for cardioembolic stroke. The acute focal neurologic deficits with negative CT
for hemorrhage strongly suggest ischemic stroke. TIA symptoms resolve within 24 hours, and SAH presents with thunderclap
headache.
A 70-year-old male presents with exertional chest pressure radiating to his left arm, relieved by
Q5
rest. He has a history of hyperlipidemia and hypertension. An ECG during symptoms shows 2
mm ST-segment depression in leads V4-V6.
A. Acute pericarditis
B. Stable angina pectoris
C. Variant (Prinzmetal) angina
D. Myocarditis
Correct Answer: B
Rationale: Stable angina presents with exertional chest pressure relieved by rest, with transient ST depression indicating
subendocardial ischemia. Pericarditis causes diffuse ST elevation and positional pain. Variant angina causes ST elevation at
rest, not with exertion.
, A 58-year-old male with a history of hypertension presents with a tearing chest pain radiating
Q6
to his back. His blood pressure is 190/110 mmHg in the right arm and 140/90 mmHg in the left
arm. Chest CT with contrast reveals an intimal flap.
A. Aortic dissection
B. Acute coronary syndrome
C. Pulmonary embolism
D. Esophageal rupture
Correct Answer: A
Rationale: Aortic dissection classically presents with tearing chest pain radiating to the back, blood pressure differential
between arms, and an intimal flap on CT. ACS typically causes pressure-like pain without pulse deficits or intimal flaps.
A 45-year-old female presents with sharp, positional chest pain that worsens when lying flat
Q7
and improves when leaning forward. She had a viral upper respiratory infection two weeks ago.
ECG shows diffuse ST-segment elevation and PR-segment depression.
A. Acute myocardial infarction
B. Pulmonary embolism
C. Acute pericarditis
D. Costochondritis
Correct Answer: C
Rationale: Acute pericarditis presents with positional pleuritic chest pain, friction rub, diffuse ST elevation, and PR depression
following a viral prodrome. MI causes localized ST elevation in a coronary distribution, not diffuse changes.
A 76-year-old female presents with progressive dyspnea, fatigue, and syncope on exertion.
Q8
Physical exam reveals a harsh crescendo-decrescendo systolic murmur at the right upper
sternal border radiating to the carotids.
A. Mitral regurgitation
B. Tricuspid regurgitation
C. Mitral stenosis
D. Aortic stenosis
Correct Answer: D
Rationale: Aortic stenosis presents with exertional dyspnea, syncope, and a harsh crescendo-decrescendo systolic murmur
radiating to the carotids in elderly patients. Mitral regurgitation causes a holosystolic murmur at the apex.
