NR 511 FINAL EXAM PREP:
DIFFERENTIAL DIAGNOSIS AND
PRIMARY CARE PRACTICUM REVIEW
1. A 45-year-old male presents with a sudden onset of severe eye pain, blurred vision, and
seeing halos around lights. On examination, the eye is red and the pupil is mid-dilated and
non-reactive. What is the most likely diagnosis?
A. Uveitis
B. Bacterial Conjunctivitis
C. Corneal Abrasion
D. Acute Angle-Closure Glaucoma
Answer: D
Conceptual Explanation: Acute angle-closure glaucoma is a medical emergency
characterized by sudden eye pain, halos around lights, and a mid-dilated non-reactive
pupil. Redness and blurred vision are also hallmark signs.
,2. When evaluating a patient for chronic obstructive pulmonary disease (COPD), which of the
following is the gold standard for diagnosis according to the GOLD guidelines?
A. Chest X-ray showing hyperinflation
B. Peak expiratory flow rate measurement
C. Post-bronchodilator spirometry (FEV1/FVC < 0.70)
D. High-resolution CT scan of the chest
Answer: C
Conceptual Explanation: The GOLD guidelines state that post-bronchodilator spirometry
demonstrating an FEV1/FVC ratio of less than 0.70 is required to confirm the diagnosis of
persistent airflow limitation (COPD).
3. A 28-year-old female presents with fatigue and a sore throat. Physical exam reveals
posterior cervical lymphadenopathy and splenomegaly. What is the most appropriate
diagnostic test to confirm the suspected diagnosis?
A. Rapid Strep Antigen Test
B. Complete Blood Count (CBC) only
C. Throat Culture
D. Monospot (Heterophile antibody test)
Answer: D
, Conceptual Explanation: Posterior cervical lymphadenopathy and splenomegaly are
classic for infectious mononucleosis. The Monospot test is the primary diagnostic tool,
although it may be negative early in the disease.
4. In the context of evidence-based medicine, what does ‘sensitivity’ refer to in a diagnostic
test?
A. The ability of the test to correctly identify those with the disease (True Positive Rate).
B. The probability that a patient with a positive test actually has the disease.
C. The ability of the test to correctly identify those without the disease.
D. The consistency of the test results when repeated.
Answer: A
Conceptual Explanation: Sensitivity (SnNout) measures the proportion of actual positives
that are correctly identified as such. High sensitivity is useful for ruling out a disease.
5. A patient presents with a ‘curtain dropping’ sensation over their vision in one eye,
associated with new-onset floaters. This is characteristic of:
A. Cataracts
B. Macular Degeneration
C. Retinal Detachment
D. Optic Neuritis
Answer: C
DIFFERENTIAL DIAGNOSIS AND
PRIMARY CARE PRACTICUM REVIEW
1. A 45-year-old male presents with a sudden onset of severe eye pain, blurred vision, and
seeing halos around lights. On examination, the eye is red and the pupil is mid-dilated and
non-reactive. What is the most likely diagnosis?
A. Uveitis
B. Bacterial Conjunctivitis
C. Corneal Abrasion
D. Acute Angle-Closure Glaucoma
Answer: D
Conceptual Explanation: Acute angle-closure glaucoma is a medical emergency
characterized by sudden eye pain, halos around lights, and a mid-dilated non-reactive
pupil. Redness and blurred vision are also hallmark signs.
,2. When evaluating a patient for chronic obstructive pulmonary disease (COPD), which of the
following is the gold standard for diagnosis according to the GOLD guidelines?
A. Chest X-ray showing hyperinflation
B. Peak expiratory flow rate measurement
C. Post-bronchodilator spirometry (FEV1/FVC < 0.70)
D. High-resolution CT scan of the chest
Answer: C
Conceptual Explanation: The GOLD guidelines state that post-bronchodilator spirometry
demonstrating an FEV1/FVC ratio of less than 0.70 is required to confirm the diagnosis of
persistent airflow limitation (COPD).
3. A 28-year-old female presents with fatigue and a sore throat. Physical exam reveals
posterior cervical lymphadenopathy and splenomegaly. What is the most appropriate
diagnostic test to confirm the suspected diagnosis?
A. Rapid Strep Antigen Test
B. Complete Blood Count (CBC) only
C. Throat Culture
D. Monospot (Heterophile antibody test)
Answer: D
, Conceptual Explanation: Posterior cervical lymphadenopathy and splenomegaly are
classic for infectious mononucleosis. The Monospot test is the primary diagnostic tool,
although it may be negative early in the disease.
4. In the context of evidence-based medicine, what does ‘sensitivity’ refer to in a diagnostic
test?
A. The ability of the test to correctly identify those with the disease (True Positive Rate).
B. The probability that a patient with a positive test actually has the disease.
C. The ability of the test to correctly identify those without the disease.
D. The consistency of the test results when repeated.
Answer: A
Conceptual Explanation: Sensitivity (SnNout) measures the proportion of actual positives
that are correctly identified as such. High sensitivity is useful for ruling out a disease.
5. A patient presents with a ‘curtain dropping’ sensation over their vision in one eye,
associated with new-onset floaters. This is characteristic of:
A. Cataracts
B. Macular Degeneration
C. Retinal Detachment
D. Optic Neuritis
Answer: C
