NR 511
Midterm Exams
(3 Full Set Exams)
(Week’s 1 – 4 Covered)
(Differential Diagnosis & Primary Care Practicum)
Exam-Style Qs that mirror the actual Exam
Chamberlain
,Table of Contents
NR 511 MIDTERM EXAM SET 1 ......................................... 2
NR 511 MIDTERM EXAM SET 2 ....................................... 48
NR 511 MIDTERM EXAM SET 3 ....................................... 94
NR 511 MIDTERM EXAM SET 1
Question 1:
A 48-year-old man presents with intermittent epigastric pain for 3 months.
You begin the visit by asking him when the pain started, where he feels it, how
long each episode lasts, and what makes it better or worse using OLDCARTS.
Which part of the diagnostic reasoning process are you performing?
A. Review of systems
B. History of present illness
C. Functional health patterns
D. Problem list formulation
Answer: B. History of present illness
Expert Explanation: The HPI is a focused, detailed breakdown of the chief
complaint using OLDCARTS (onset, location, duration, characteristics,
aggravating/relieving factors, treatments, severity), which is exactly what is being
gathered in this scenario.
Question 2:
A 67-year-old woman tells you she has had “aching all over” for weeks and
feels “exhausted.” You note her blood pressure, heart rate, and gait as she
,walks to the exam table. Which information collected during this encounter is
OBJECTIVE data?
A. “Aching all over”
B. “Exhausted”
C. Blood pressure 158/92 mm Hg
D. “Can’t sleep at night”
Answer: C. Blood pressure 158/92 mm Hg
Expert Explanation: Objective data are what the clinician can see, hear, or
measure, including vitals and exam findings, whereas the patient’s reported
symptoms are subjective data.
Question 3:
A 35-year-old man with abdominal pain is being evaluated. After gathering his
history and exam, you generate a list of five possible diagnoses ordered from
most to least likely. What is the primary purpose of this list?
A. To determine insurance eligibility
B. To create a problem list for future visits only
C. To establish a working set of diagnostic possibilities to guide testing and
management
D. To justify prescribing medications
Answer: C. To establish a working set of diagnostic possibilities to guide testing and
management
Expert Explanation: A differential diagnosis is a prioritized working list of
potential diagnoses linked to the chief complaint that guides targeted testing and
safe, evidence-based management.
Question 4:
A student writes a SOAP note and places “acute sinusitis” under the Plan
, section instead of where it belongs. In which section should the diagnosis be
documented?
A. Subjective
B. Objective
C. Assessment
D. Plan
Answer: C. Assessment
Expert Explanation: The diagnosis and differentials belong in the Assessment
section, which contains the clinician’s synthesis and interpretation of subjective and
objective findings.
Question 5:
A 50-year-old man with chest pain undergoes a highly sensitive troponin test
that returns negative. How is this result best interpreted?
A. The disease is ruled in
B. The disease is likely ruled out
C. The disease prevalence is high
D. The test is unreliable
Answer: B. The disease is likely ruled out
Expert Explanation: A highly sensitive test has few false negatives; therefore, a
negative result makes the presence of disease unlikely (SNOUT: Sensitive test, when
Negative, rules OUT disease).
Question 6:
A 42-year-old woman is being tested for a rare autoimmune condition with
very low prevalence. Even with a good test, what impact does the low
prevalence have on the test’s positive predictive value (PPV)?
A. PPV increases
Midterm Exams
(3 Full Set Exams)
(Week’s 1 – 4 Covered)
(Differential Diagnosis & Primary Care Practicum)
Exam-Style Qs that mirror the actual Exam
Chamberlain
,Table of Contents
NR 511 MIDTERM EXAM SET 1 ......................................... 2
NR 511 MIDTERM EXAM SET 2 ....................................... 48
NR 511 MIDTERM EXAM SET 3 ....................................... 94
NR 511 MIDTERM EXAM SET 1
Question 1:
A 48-year-old man presents with intermittent epigastric pain for 3 months.
You begin the visit by asking him when the pain started, where he feels it, how
long each episode lasts, and what makes it better or worse using OLDCARTS.
Which part of the diagnostic reasoning process are you performing?
A. Review of systems
B. History of present illness
C. Functional health patterns
D. Problem list formulation
Answer: B. History of present illness
Expert Explanation: The HPI is a focused, detailed breakdown of the chief
complaint using OLDCARTS (onset, location, duration, characteristics,
aggravating/relieving factors, treatments, severity), which is exactly what is being
gathered in this scenario.
Question 2:
A 67-year-old woman tells you she has had “aching all over” for weeks and
feels “exhausted.” You note her blood pressure, heart rate, and gait as she
,walks to the exam table. Which information collected during this encounter is
OBJECTIVE data?
A. “Aching all over”
B. “Exhausted”
C. Blood pressure 158/92 mm Hg
D. “Can’t sleep at night”
Answer: C. Blood pressure 158/92 mm Hg
Expert Explanation: Objective data are what the clinician can see, hear, or
measure, including vitals and exam findings, whereas the patient’s reported
symptoms are subjective data.
Question 3:
A 35-year-old man with abdominal pain is being evaluated. After gathering his
history and exam, you generate a list of five possible diagnoses ordered from
most to least likely. What is the primary purpose of this list?
A. To determine insurance eligibility
B. To create a problem list for future visits only
C. To establish a working set of diagnostic possibilities to guide testing and
management
D. To justify prescribing medications
Answer: C. To establish a working set of diagnostic possibilities to guide testing and
management
Expert Explanation: A differential diagnosis is a prioritized working list of
potential diagnoses linked to the chief complaint that guides targeted testing and
safe, evidence-based management.
Question 4:
A student writes a SOAP note and places “acute sinusitis” under the Plan
, section instead of where it belongs. In which section should the diagnosis be
documented?
A. Subjective
B. Objective
C. Assessment
D. Plan
Answer: C. Assessment
Expert Explanation: The diagnosis and differentials belong in the Assessment
section, which contains the clinician’s synthesis and interpretation of subjective and
objective findings.
Question 5:
A 50-year-old man with chest pain undergoes a highly sensitive troponin test
that returns negative. How is this result best interpreted?
A. The disease is ruled in
B. The disease is likely ruled out
C. The disease prevalence is high
D. The test is unreliable
Answer: B. The disease is likely ruled out
Expert Explanation: A highly sensitive test has few false negatives; therefore, a
negative result makes the presence of disease unlikely (SNOUT: Sensitive test, when
Negative, rules OUT disease).
Question 6:
A 42-year-old woman is being tested for a rare autoimmune condition with
very low prevalence. Even with a good test, what impact does the low
prevalence have on the test’s positive predictive value (PPV)?
A. PPV increases
