NR 511 Chamberlain University | Complete Package
Bundle (Midterm & Final Exams) | Differential Diagnosis
& Primary Care | Updated 2026/2027
PART 1: NR 511 Midterm Exam (25 Questions)
1. A 24-year-old female presents with a 3-day history of nasal
congestion, purulent rhinorrhea, and facial pressure. She is
afebrile. Which of the following is the most appropriate initial
management?
A) Prescribe amoxicillin-clavulanate for 10 days.
B) Recommend supportive care with intranasal saline and
decongestants.
C) Prescribe azithromycin for 5 days.
D) Order a CT scan of the sinuses.
Answer: B
Rationale: Acute bacterial rhinosinusitis is suspected when
symptoms persist beyond 10 days, worsen after initial
improvement ("double sickening"), or present with severe
symptoms (fever >39°C, purulent discharge for 3+ days). At day
3 of typical symptoms, viral rhinosinusitis is most likely, and
supportive care is the standard of care.
,2. A 45-year-old male presents with sudden onset of severe,
excruciating throat pain, odynophagia, and muffled "hot
potato" voice. On examination, he is drooling and leaning
forward. What is the most likely diagnosis?
A) Acute streptococcal pharyngitis
B) Epiglottitis
C) Peritonsillar abscess
D) Infectious mononucleosis
Answer: B
Rationale: Epiglottitis presents with the "3 Ds" (Drooling,
Dysphagia, Distress) along with a muffled voice and tripod
positioning. It is a medical emergency requiring immediate
airway management. Peritonsillar abscess presents with
unilateral tonsillar swelling and uvular deviation.
3. Which of the following is a mandatory criterion for
diagnosing acute rheumatic fever (ARF) following Group A Strep
pharyngitis?
A) Elevated antistreptolysin O (ASO) titer
B) Migratory polyarthritis
C) Carditis
,D) Erythema marginatum
Answer: A
Rationale: According to the Jones criteria, evidence of
preceding Group A Strep infection (positive throat culture, rapid
strep test, or elevated/rising streptococcal antibody titer like
ASO) is a mandatory criterion. The other options are major or
minor criteria, but cannot be used to diagnose ARF without
evidence of the preceding infection.
4. A 30-year-old presents with a unilateral red eye, severe pain,
photophobia, and blurred vision. The pupil is irregular and mid-
dilated. What is the priority action?
A) Prescribe antibiotic eye drops and follow up in 3 days.
B) Instruct the patient to use warm compresses and artificial
tears.
C) Refer immediately to ophthalmology for evaluation of acute
angle-closure glaucoma or iritis.
D) Prescribe antiviral therapy for HSV keratitis.
Answer: C
Rationale: A red eye with severe pain, photophobia, blurred
vision, and an irregular pupil is a red flag for a sight-threatening
, condition such as acute angle-closure glaucoma, iritis, or
corneal ulcer. This requires immediate ophthalmologic referral.
5. A 52-year-old male presents with severe vertigo that started
this morning, lasting for several minutes whenever he rolls over
in bed. He has no hearing loss, tinnitus, or focal neurological
deficits. What is the most likely diagnosis?
A) Ménière’s disease
B) Vestibular neuritis
C) Benign paroxysmal positional vertigo (BPPV)
D) Vertebrobasilar insufficiency
Answer: C
Rationale: BPPV is characterized by brief episodes of vertigo
(lasting <1 minute) triggered by changes in head position (like
rolling over in bed). There is no hearing loss or neurological
symptoms. Ménière's involves vertigo, hearing loss, and
tinnitus. Vestibular neuritis causes continuous vertigo for days.
6. A 6-month-old infant is brought in with a barking cough,
stridor at rest, and retractions. The parents report a low-grade
fever. What is the first-line treatment?
A) Oral amoxicillin
Bundle (Midterm & Final Exams) | Differential Diagnosis
& Primary Care | Updated 2026/2027
PART 1: NR 511 Midterm Exam (25 Questions)
1. A 24-year-old female presents with a 3-day history of nasal
congestion, purulent rhinorrhea, and facial pressure. She is
afebrile. Which of the following is the most appropriate initial
management?
A) Prescribe amoxicillin-clavulanate for 10 days.
B) Recommend supportive care with intranasal saline and
decongestants.
C) Prescribe azithromycin for 5 days.
D) Order a CT scan of the sinuses.
Answer: B
Rationale: Acute bacterial rhinosinusitis is suspected when
symptoms persist beyond 10 days, worsen after initial
improvement ("double sickening"), or present with severe
symptoms (fever >39°C, purulent discharge for 3+ days). At day
3 of typical symptoms, viral rhinosinusitis is most likely, and
supportive care is the standard of care.
,2. A 45-year-old male presents with sudden onset of severe,
excruciating throat pain, odynophagia, and muffled "hot
potato" voice. On examination, he is drooling and leaning
forward. What is the most likely diagnosis?
A) Acute streptococcal pharyngitis
B) Epiglottitis
C) Peritonsillar abscess
D) Infectious mononucleosis
Answer: B
Rationale: Epiglottitis presents with the "3 Ds" (Drooling,
Dysphagia, Distress) along with a muffled voice and tripod
positioning. It is a medical emergency requiring immediate
airway management. Peritonsillar abscess presents with
unilateral tonsillar swelling and uvular deviation.
3. Which of the following is a mandatory criterion for
diagnosing acute rheumatic fever (ARF) following Group A Strep
pharyngitis?
A) Elevated antistreptolysin O (ASO) titer
B) Migratory polyarthritis
C) Carditis
,D) Erythema marginatum
Answer: A
Rationale: According to the Jones criteria, evidence of
preceding Group A Strep infection (positive throat culture, rapid
strep test, or elevated/rising streptococcal antibody titer like
ASO) is a mandatory criterion. The other options are major or
minor criteria, but cannot be used to diagnose ARF without
evidence of the preceding infection.
4. A 30-year-old presents with a unilateral red eye, severe pain,
photophobia, and blurred vision. The pupil is irregular and mid-
dilated. What is the priority action?
A) Prescribe antibiotic eye drops and follow up in 3 days.
B) Instruct the patient to use warm compresses and artificial
tears.
C) Refer immediately to ophthalmology for evaluation of acute
angle-closure glaucoma or iritis.
D) Prescribe antiviral therapy for HSV keratitis.
Answer: C
Rationale: A red eye with severe pain, photophobia, blurred
vision, and an irregular pupil is a red flag for a sight-threatening
, condition such as acute angle-closure glaucoma, iritis, or
corneal ulcer. This requires immediate ophthalmologic referral.
5. A 52-year-old male presents with severe vertigo that started
this morning, lasting for several minutes whenever he rolls over
in bed. He has no hearing loss, tinnitus, or focal neurological
deficits. What is the most likely diagnosis?
A) Ménière’s disease
B) Vestibular neuritis
C) Benign paroxysmal positional vertigo (BPPV)
D) Vertebrobasilar insufficiency
Answer: C
Rationale: BPPV is characterized by brief episodes of vertigo
(lasting <1 minute) triggered by changes in head position (like
rolling over in bed). There is no hearing loss or neurological
symptoms. Ménière's involves vertigo, hearing loss, and
tinnitus. Vestibular neuritis causes continuous vertigo for days.
6. A 6-month-old infant is brought in with a barking cough,
stridor at rest, and retractions. The parents report a low-grade
fever. What is the first-line treatment?
A) Oral amoxicillin
