NR 569 FINAL EXAM ACTUAL 2026/2027 |
DIFFERENTIAL DIAGNOSIS ACUTE CARE
PRACTICUM | WEEKS 4-8 VERIFIED Q&A |
CHAMBERLAIN | PASS GUARANTEED - A+
GRADED QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Advanced Diagnostic Reasoning and Clinical Decision-Making
Cardiovascular System Differentials
Respiratory System Differentials
Gastrointestinal and Hepatobiliary Differentials
Neurological and Musculoskeletal Differentials
Endocrine and Metabolic Differentials
Renal and Genitourinary Differentials
Hematologic and Oncologic Differentials
Infectious Disease and Sepsis Evaluation
Integrated Acute Care Case Scenarios
Introduction
The NR 569 Final Exam assesses the acute care nurse practitioner student's
mastery of advanced differential diagnosis across weeks 4-8 of the practicum.
The exam evaluates clinical reasoning, diagnostic test interpretation, and
evidence-based decision-making for complex acute care presentations.
Multiple-choice questions emphasize cardiovascular, respiratory,
gastrointestinal, neurological, endocrine, renal, and hematologic differentials.
Mastery ensures the provision of safe, effective, and high-quality advanced
practice nursing care in acute care settings.
,Section One: Questions 1–100
1. A 68-year-old male presents with acute onset of severe chest pain
radiating to the back, with a blood pressure differential of 20 mm Hg
between arms. Which diagnostic test should be ordered first?
A. ECG
B. Chest X-ray
C. CT angiography of the chest
D. Transthoracic echocardiogram
Correct answer: C
RATIONALE: CT angiography is the gold standard for diagnosing aortic
dissection, which is suggested by severe chest pain radiating to the back and
unequal arm blood pressures. ECG and echocardiogram may be supportive
but CT angiography is definitive.
2. A 55-year-old female with a history of heart failure presents with
worsening dyspnea and orthopnea. Which finding on physical exam is
most specific for acute decompensated heart failure?
A. Bibasilar crackles
B. Peripheral edema
C. S3 gallop
D. Jugular venous distension
Correct answer: C
RATIONALE: An S3 gallop is highly specific for acute decompensated
heart failure. While crackles, edema, and JVD are consistent, they are less
specific and can occur in other conditions.
3. A 30-year-old male presents with sudden onset of pleuritic chest pain
and dyspnea after a long flight. Which diagnostic test should be
ordered first if he is hemodynamically stable?
,A. D-dimer
B. CT pulmonary angiography
C. Chest X-ray
D. Lower extremity venous duplex
Correct answer: A
RATIONALE: In hemodynamically stable patients with suspected
pulmonary embolism and low/intermediate pretest probability, D-dimer is
the first-line test. If negative, PE can be excluded.
4. A 72-year-old female presents with new-onset atrial fibrillation.
Which complication is most concerning and requires immediate
anticoagulation assessment?
A. Heart failure
B. Thromboembolic stroke
C. Myocardial infarction
D. Hypertension
Correct answer: B
RATIONALE: Atrial fibrillation significantly increases the risk of
thromboembolic stroke due to stasis in the left atrium. Anticoagulation is a
key management strategy.
5. A 45-year-old male with a history of alcohol use disorder presents
with severe epigastric pain radiating to the back. Which laboratory
finding is most consistent with acute pancreatitis?
A. Elevated lipase
B. Elevated AST/ALT
C. Elevated troponin
D. Elevated BNP
Correct answer: A
, RATIONALE: Elevated lipase is the most sensitive and specific marker for
acute pancreatitis. AST/ALT elevation suggests liver injury, troponin suggests
myocardial injury, and BNP suggests heart failure.
6. A 60-year-old female presents with jaundice, right upper quadrant
pain, and fever. Which diagnosis is most likely?
A. Cholecystitis
B. Cholangitis
C. Hepatitis
D. Pancreatitis
Correct answer: B
RATIONALE: The Charcot triad of jaundice, RUQ pain, and fever is classic
for ascending cholangitis, which requires urgent intervention.
7. A 35-year-old female presents with a new onset of severe headache
described as "the worst headache of my life." Which diagnostic test
should be ordered first?
A. Lumbar puncture
B. Non-contrast CT of the head
C. MRI of the brain
D. EEG
Correct answer: B
RATIONALE: Non-contrast CT is the initial test of choice to rule out
subarachnoid hemorrhage in a patient with thunderclap headache. Lumbar
puncture is performed if CT is negative but suspicion remains high.
8. A 28-year-old male presents with polyuria, polydipsia, and weight
loss. Which diagnosis is most likely?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
DIFFERENTIAL DIAGNOSIS ACUTE CARE
PRACTICUM | WEEKS 4-8 VERIFIED Q&A |
CHAMBERLAIN | PASS GUARANTEED - A+
GRADED QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Advanced Diagnostic Reasoning and Clinical Decision-Making
Cardiovascular System Differentials
Respiratory System Differentials
Gastrointestinal and Hepatobiliary Differentials
Neurological and Musculoskeletal Differentials
Endocrine and Metabolic Differentials
Renal and Genitourinary Differentials
Hematologic and Oncologic Differentials
Infectious Disease and Sepsis Evaluation
Integrated Acute Care Case Scenarios
Introduction
The NR 569 Final Exam assesses the acute care nurse practitioner student's
mastery of advanced differential diagnosis across weeks 4-8 of the practicum.
The exam evaluates clinical reasoning, diagnostic test interpretation, and
evidence-based decision-making for complex acute care presentations.
Multiple-choice questions emphasize cardiovascular, respiratory,
gastrointestinal, neurological, endocrine, renal, and hematologic differentials.
Mastery ensures the provision of safe, effective, and high-quality advanced
practice nursing care in acute care settings.
,Section One: Questions 1–100
1. A 68-year-old male presents with acute onset of severe chest pain
radiating to the back, with a blood pressure differential of 20 mm Hg
between arms. Which diagnostic test should be ordered first?
A. ECG
B. Chest X-ray
C. CT angiography of the chest
D. Transthoracic echocardiogram
Correct answer: C
RATIONALE: CT angiography is the gold standard for diagnosing aortic
dissection, which is suggested by severe chest pain radiating to the back and
unequal arm blood pressures. ECG and echocardiogram may be supportive
but CT angiography is definitive.
2. A 55-year-old female with a history of heart failure presents with
worsening dyspnea and orthopnea. Which finding on physical exam is
most specific for acute decompensated heart failure?
A. Bibasilar crackles
B. Peripheral edema
C. S3 gallop
D. Jugular venous distension
Correct answer: C
RATIONALE: An S3 gallop is highly specific for acute decompensated
heart failure. While crackles, edema, and JVD are consistent, they are less
specific and can occur in other conditions.
3. A 30-year-old male presents with sudden onset of pleuritic chest pain
and dyspnea after a long flight. Which diagnostic test should be
ordered first if he is hemodynamically stable?
,A. D-dimer
B. CT pulmonary angiography
C. Chest X-ray
D. Lower extremity venous duplex
Correct answer: A
RATIONALE: In hemodynamically stable patients with suspected
pulmonary embolism and low/intermediate pretest probability, D-dimer is
the first-line test. If negative, PE can be excluded.
4. A 72-year-old female presents with new-onset atrial fibrillation.
Which complication is most concerning and requires immediate
anticoagulation assessment?
A. Heart failure
B. Thromboembolic stroke
C. Myocardial infarction
D. Hypertension
Correct answer: B
RATIONALE: Atrial fibrillation significantly increases the risk of
thromboembolic stroke due to stasis in the left atrium. Anticoagulation is a
key management strategy.
5. A 45-year-old male with a history of alcohol use disorder presents
with severe epigastric pain radiating to the back. Which laboratory
finding is most consistent with acute pancreatitis?
A. Elevated lipase
B. Elevated AST/ALT
C. Elevated troponin
D. Elevated BNP
Correct answer: A
, RATIONALE: Elevated lipase is the most sensitive and specific marker for
acute pancreatitis. AST/ALT elevation suggests liver injury, troponin suggests
myocardial injury, and BNP suggests heart failure.
6. A 60-year-old female presents with jaundice, right upper quadrant
pain, and fever. Which diagnosis is most likely?
A. Cholecystitis
B. Cholangitis
C. Hepatitis
D. Pancreatitis
Correct answer: B
RATIONALE: The Charcot triad of jaundice, RUQ pain, and fever is classic
for ascending cholangitis, which requires urgent intervention.
7. A 35-year-old female presents with a new onset of severe headache
described as "the worst headache of my life." Which diagnostic test
should be ordered first?
A. Lumbar puncture
B. Non-contrast CT of the head
C. MRI of the brain
D. EEG
Correct answer: B
RATIONALE: Non-contrast CT is the initial test of choice to rule out
subarachnoid hemorrhage in a patient with thunderclap headache. Lumbar
puncture is performed if CT is negative but suspicion remains high.
8. A 28-year-old male presents with polyuria, polydipsia, and weight
loss. Which diagnosis is most likely?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
