2026/2027 EDITION
NR 569 Midterm Exam: Differential Diagnosis
in Acute Care Practicum
Weeks 1-4 | Questions and Verified Answers | 75 Questions
Chamberlain University | 100% Correct • A+ Graded
Total Questions Cognitive Levels
75 Multiple Choice 25% Recall • 50% Application • 25% Analysis
Sections Format
7 Content Areas + Integrated Scenarios 4-Option MCQ • One Correct Answer
,NR 569 Midterm Exam | Differential Diagnosis in Acute Care | Chamberlain University 2026/2027
NR 569 Midterm Exam: Differential Diagnosis in
Acute Care Practicum
Weeks 1-4 | 2026/2027 Edition
Chamberlain University | Questions and Verified Answers | 75 Questions | 100% Correct
Cognitive Levels: 25% Recall | 50% Application | 25% Analysis
Sections: 7 Content Areas + Integrated Scenarios Format: 4-Option MCQ, One Correct Answer
Question Style: 75% Scenario-Based | 15% Direct Recall | 10%
Clinical Reasoning Content: NR 569 Weeks 1-4 Differential Diagnosis Blueprint
Section Content Area Questions
Section 1 Clinical Reasoning and Diagnostic Frameworks Q1-15
Section 2 Comprehensive Patient Assessment, History Taking, and Documentation Q16-25
Section 3 Respiratory System Differential Diagnosis Q26-40
Section 4 Cardiovascular System Differential Diagnosis Q41-55
Section 5 Gastrointestinal and Abdominal Differential Diagnosis Q56-65
Section 6 Infectious Diseases, Systemic Conditions, and Fever Evaluation Q66-72
Section 7 Integrated Clinical Scenarios and Diagnostic Decision-Making Q73-75
Section 1: Clinical Reasoning and Diagnostic Frameworks (SNAPPS,
OLDCARTS, Diagnostic Accuracy) (Q1-Q15)
Q1: A nurse practitioner student is presenting a patient case using the SNAPPS method. After summarizing the
case, the student narrows the differential to two diagnoses. Which step of the SNAPPS method should the student
perform next?
A. Plan the management
B. Analyze the differential by comparing and contrasting the diagnoses [CORRECT]
C. Probe the preceptor with questions
D. Select a learning issue for self-directed study
Correct Answer: B
Rationale: The SNAPPS method follows the sequence: Summarize, Narrow, Analyze, Probe, Plan, Select. After narrowing the
differential, the next step is to Analyze the differential by comparing and contrasting the diagnoses, explaining how the
clinical findings support or rule out each possibility. This step demonstrates clinical reasoning by articulating the diagnostic
thought process. Planning and selecting learning issues come after the analysis and probing steps.
Page 1
, NR 569 Midterm Exam | Differential Diagnosis in Acute Care | Chamberlain University 2026/2027
Q2: A patient presents with chest pain. Using the OLDCARTS mnemonic, which component is being assessed when
the nurse practitioner asks, 'Does anything make the pain worse or better?'
A. Onset and Duration
B. Character and Timing
C. Aggravating and Relieving factors [CORRECT]
D. Location and Severity
Correct Answer: C
Rationale: The OLDCARTS mnemonic stands for Onset, Location/Radiation, Duration, Character, Aggravating factors,
Relieving factors, Timing, and Severity. Asking about factors that worsen or improve the pain assesses both Aggravating and
Relieving factors. This information is critical for differential diagnosis because certain conditions have characteristic
aggravating and relieving patterns; for example, pericarditis pain worsens with lying flat and improves with sitting forward.
Q3: A diagnostic test has a sensitivity of 98% for detecting pulmonary embolism. Using the SnNout principle, how
should the clinician interpret a negative result on this test?
A. The negative result rules in the diagnosis of PE
B. The negative result effectively rules out the diagnosis of PE [CORRECT]
C. The negative result is inconclusive and requires further testing
D. The negative result has no diagnostic value
Correct Answer: B
Rationale: The SnNout principle states that when a test has high Sensitivity, a Negative result rules OUT the disease. A
sensitivity of 98% means the test correctly identifies 98% of patients who have the disease, so a negative result on a highly
sensitive test effectively rules out the condition. This is the opposite of the SpPin principle, where a highly specific test with a
positive result rules IN the disease. Understanding these principles guides efficient diagnostic testing.
Q4: A nurse practitioner is evaluating a patient with suspected acute coronary syndrome. A highly sensitive
troponin test has a specificity of 90%. If the test result is positive, which principle supports the clinician's confidence
in ruling in the diagnosis?
A. SnNout
B. SpPin [CORRECT]
C. Positive likelihood ratio
D. Negative predictive value
Correct Answer: B
Rationale: The SpPin principle states that when a test has high Specificity, a Positive result rules IN the disease. A specificity
of 90% means the test correctly identifies 90% of patients who do not have the disease, making false positives unlikely. A
positive result on a highly specific test provides strong evidence that the disease is present. This is the opposite of the
SnNout principle, where a highly sensitive test with a negative result rules out the disease.
Q5: A diagnostic test for deep vein thrombosis has a positive likelihood ratio (LR+) of 10. How should the clinician
interpret this value?
A. The test provides no meaningful change in posttest probability
B. A positive result moderately increases the probability of DVT
C. A positive result significantly increases the probability of DVT [CORRECT]
D. A positive result decreases the probability of DVT
Page 2
NR 569 Midterm Exam: Differential Diagnosis
in Acute Care Practicum
Weeks 1-4 | Questions and Verified Answers | 75 Questions
Chamberlain University | 100% Correct • A+ Graded
Total Questions Cognitive Levels
75 Multiple Choice 25% Recall • 50% Application • 25% Analysis
Sections Format
7 Content Areas + Integrated Scenarios 4-Option MCQ • One Correct Answer
,NR 569 Midterm Exam | Differential Diagnosis in Acute Care | Chamberlain University 2026/2027
NR 569 Midterm Exam: Differential Diagnosis in
Acute Care Practicum
Weeks 1-4 | 2026/2027 Edition
Chamberlain University | Questions and Verified Answers | 75 Questions | 100% Correct
Cognitive Levels: 25% Recall | 50% Application | 25% Analysis
Sections: 7 Content Areas + Integrated Scenarios Format: 4-Option MCQ, One Correct Answer
Question Style: 75% Scenario-Based | 15% Direct Recall | 10%
Clinical Reasoning Content: NR 569 Weeks 1-4 Differential Diagnosis Blueprint
Section Content Area Questions
Section 1 Clinical Reasoning and Diagnostic Frameworks Q1-15
Section 2 Comprehensive Patient Assessment, History Taking, and Documentation Q16-25
Section 3 Respiratory System Differential Diagnosis Q26-40
Section 4 Cardiovascular System Differential Diagnosis Q41-55
Section 5 Gastrointestinal and Abdominal Differential Diagnosis Q56-65
Section 6 Infectious Diseases, Systemic Conditions, and Fever Evaluation Q66-72
Section 7 Integrated Clinical Scenarios and Diagnostic Decision-Making Q73-75
Section 1: Clinical Reasoning and Diagnostic Frameworks (SNAPPS,
OLDCARTS, Diagnostic Accuracy) (Q1-Q15)
Q1: A nurse practitioner student is presenting a patient case using the SNAPPS method. After summarizing the
case, the student narrows the differential to two diagnoses. Which step of the SNAPPS method should the student
perform next?
A. Plan the management
B. Analyze the differential by comparing and contrasting the diagnoses [CORRECT]
C. Probe the preceptor with questions
D. Select a learning issue for self-directed study
Correct Answer: B
Rationale: The SNAPPS method follows the sequence: Summarize, Narrow, Analyze, Probe, Plan, Select. After narrowing the
differential, the next step is to Analyze the differential by comparing and contrasting the diagnoses, explaining how the
clinical findings support or rule out each possibility. This step demonstrates clinical reasoning by articulating the diagnostic
thought process. Planning and selecting learning issues come after the analysis and probing steps.
Page 1
, NR 569 Midterm Exam | Differential Diagnosis in Acute Care | Chamberlain University 2026/2027
Q2: A patient presents with chest pain. Using the OLDCARTS mnemonic, which component is being assessed when
the nurse practitioner asks, 'Does anything make the pain worse or better?'
A. Onset and Duration
B. Character and Timing
C. Aggravating and Relieving factors [CORRECT]
D. Location and Severity
Correct Answer: C
Rationale: The OLDCARTS mnemonic stands for Onset, Location/Radiation, Duration, Character, Aggravating factors,
Relieving factors, Timing, and Severity. Asking about factors that worsen or improve the pain assesses both Aggravating and
Relieving factors. This information is critical for differential diagnosis because certain conditions have characteristic
aggravating and relieving patterns; for example, pericarditis pain worsens with lying flat and improves with sitting forward.
Q3: A diagnostic test has a sensitivity of 98% for detecting pulmonary embolism. Using the SnNout principle, how
should the clinician interpret a negative result on this test?
A. The negative result rules in the diagnosis of PE
B. The negative result effectively rules out the diagnosis of PE [CORRECT]
C. The negative result is inconclusive and requires further testing
D. The negative result has no diagnostic value
Correct Answer: B
Rationale: The SnNout principle states that when a test has high Sensitivity, a Negative result rules OUT the disease. A
sensitivity of 98% means the test correctly identifies 98% of patients who have the disease, so a negative result on a highly
sensitive test effectively rules out the condition. This is the opposite of the SpPin principle, where a highly specific test with a
positive result rules IN the disease. Understanding these principles guides efficient diagnostic testing.
Q4: A nurse practitioner is evaluating a patient with suspected acute coronary syndrome. A highly sensitive
troponin test has a specificity of 90%. If the test result is positive, which principle supports the clinician's confidence
in ruling in the diagnosis?
A. SnNout
B. SpPin [CORRECT]
C. Positive likelihood ratio
D. Negative predictive value
Correct Answer: B
Rationale: The SpPin principle states that when a test has high Specificity, a Positive result rules IN the disease. A specificity
of 90% means the test correctly identifies 90% of patients who do not have the disease, making false positives unlikely. A
positive result on a highly specific test provides strong evidence that the disease is present. This is the opposite of the
SnNout principle, where a highly sensitive test with a negative result rules out the disease.
Q5: A diagnostic test for deep vein thrombosis has a positive likelihood ratio (LR+) of 10. How should the clinician
interpret this value?
A. The test provides no meaningful change in posttest probability
B. A positive result moderately increases the probability of DVT
C. A positive result significantly increases the probability of DVT [CORRECT]
D. A positive result decreases the probability of DVT
Page 2
