NR 511 Final Exam (PDF) | (2026)
Differential Diagnosis | 96 Questions
THIS DOCUMENT CONTAINS:
NR 511
NR 511 Final Exam
NR 511/ NR511
Chamberlain College Of Nursing
Differential Diagnosis
,Janet is a 30 year old woman who has been recently diagnosed with a herniated disc
at the level of L5-S1. She is currently in the emergency room with suspicion of cauda
equina compression. Which of the following is a sign or symptom of cauda equina
compression?
a. Gastrocnemius weakness
b. Reduced or absent ankle reflexes
c. Numbness of the lateral foot
d. Paresthesia of the perineum and buttocks
Correct Answer: d. Paresthesia of the perineum and buttocks
Expert Rationale: Cauda equina syndrome is a surgical emergency characterized by
compression of the lumbosacral nerve roots below the conus medullaris. The hallmark
finding is saddle anesthesia (paresthesia/anesthesia in the perineal, buttock, and inner
thigh regions), which reflects compression of the sacral nerve roots (S2-S4). Other
associated symptoms include urinary retention or incontinence, fecal incontinence, and
bilateral lower extremity weakness. While gastrocnemius weakness (S1-S2), reduced
ankle reflexes (S1), and lateral foot numbness (S1) can occur with L5-S1 disc herniation,
these are not specific to cauda equina syndrome. The perineal/buttock paresthesia is the
sentinel finding that distinguishes cauda equina compression from a simple
radiculopathy and mandates emergent surgical evaluation.
Question 2
The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's
Criteria. In order to plan care, the clinician understands that this criteria score has
which of the following meanings?
a. A high mortality rate
b. An increased chance of recurrence
,c. 7% chance of the disease becoming chronic
d. All of the above
Correct Answer: a. A high mortality rate
Expert Rationale: Ranson's Criteria is a prognostic scoring system used to assess the
severity and predict mortality in acute pancreatitis. The score is calculated at admission
(age, WBC, glucose, AST, LDH) and at 48 hours (fall in hematocrit, rise in BUN,
calcium, PaO2, base deficit, fluid sequestration). A score of 0-2 carries approximately
1% mortality; 3-4 carries 15% mortality; 5-6 carries 40% mortality; and 7-8 carries nearly
100% mortality. Therefore, a score of 7 indicates an extremely high mortality rate.
Ranson's Criteria does not predict recurrence or chronicity. The clinician must recognize
this score as indicating critical illness requiring intensive monitoring and aggressive
supportive care.
Question 3
Reuben, age 24, has HIV and just had a routine viral load test done. The results show
a falling viral load. What does this indicate?
a. A favorable diagnostic trend
b. Disease progression
c. The need to be more aggressive with Reuben's medications
d. The eradication of the HIV
Correct Answer: a. A favorable diagnostic trend
Expert Rationale: HIV viral load measures the number of copies of HIV RNA per
milliliter of blood. A falling viral load indicates that antiretroviral therapy (ART) is
effectively suppressing viral replication. The goal of ART is to achieve an undetectable
viral load (<50 copies/mL), which is associated with improved CD4 counts, reduced
opportunistic infections, and decreased transmission risk. A falling viral load is a
favorable trend, not disease progression. It does not indicate eradication of HIV, as the
, virus persists in latent reservoirs. The current regimen should be continued unless there
are other reasons to change therapy.
Question 4
Which is the differentiating symptom between labyrinthitis and vestibular neuritis?
a. Symptoms with vestibular neuritis are usually acute in onset, whereas with
labyrinthitis the onset is more gradual
b. Hearing loss may be associated with vestibular neuritis, but not with labyrinthitis
c. Symptoms with labyrinthitis are usually acute in onset, whereas with vestibular
neuritis the onset is more gradual
d. Hearing loss may be associated with labyrinthitis, but not with vestibular neuritis
Correct Answer: d. Hearing loss may be associated with labyrinthitis, but not with
vestibular neuritis
Expert Rationale: Both labyrinthitis and vestibular neuritis present with acute onset of
vertigo, nausea, vomiting, and nystagmus. The key differentiating feature is the
involvement of hearing. The labyrinth contains both the vestibular apparatus
(semicircular canals, utricle, saccule) and the cochlea. Labyrinthitis involves
inflammation of both the vestibular and cochlear portions of the inner ear, resulting in
vertigo plus hearing loss and/or tinnitus. Vestibular neuritis involves inflammation of
only the vestibular portion of the eighth cranial nerve, sparing hearing. Both conditions
typically have acute onset, so onset timing is not a differentiating factor.
Question 5
A 27 year old female presents with a chief complaint of burning and pain on
urination. She has no previous history of urinary tract infection. What are some
additional symptoms consistent with a diagnosis of lower UTI?
Differential Diagnosis | 96 Questions
THIS DOCUMENT CONTAINS:
NR 511
NR 511 Final Exam
NR 511/ NR511
Chamberlain College Of Nursing
Differential Diagnosis
,Janet is a 30 year old woman who has been recently diagnosed with a herniated disc
at the level of L5-S1. She is currently in the emergency room with suspicion of cauda
equina compression. Which of the following is a sign or symptom of cauda equina
compression?
a. Gastrocnemius weakness
b. Reduced or absent ankle reflexes
c. Numbness of the lateral foot
d. Paresthesia of the perineum and buttocks
Correct Answer: d. Paresthesia of the perineum and buttocks
Expert Rationale: Cauda equina syndrome is a surgical emergency characterized by
compression of the lumbosacral nerve roots below the conus medullaris. The hallmark
finding is saddle anesthesia (paresthesia/anesthesia in the perineal, buttock, and inner
thigh regions), which reflects compression of the sacral nerve roots (S2-S4). Other
associated symptoms include urinary retention or incontinence, fecal incontinence, and
bilateral lower extremity weakness. While gastrocnemius weakness (S1-S2), reduced
ankle reflexes (S1), and lateral foot numbness (S1) can occur with L5-S1 disc herniation,
these are not specific to cauda equina syndrome. The perineal/buttock paresthesia is the
sentinel finding that distinguishes cauda equina compression from a simple
radiculopathy and mandates emergent surgical evaluation.
Question 2
The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's
Criteria. In order to plan care, the clinician understands that this criteria score has
which of the following meanings?
a. A high mortality rate
b. An increased chance of recurrence
,c. 7% chance of the disease becoming chronic
d. All of the above
Correct Answer: a. A high mortality rate
Expert Rationale: Ranson's Criteria is a prognostic scoring system used to assess the
severity and predict mortality in acute pancreatitis. The score is calculated at admission
(age, WBC, glucose, AST, LDH) and at 48 hours (fall in hematocrit, rise in BUN,
calcium, PaO2, base deficit, fluid sequestration). A score of 0-2 carries approximately
1% mortality; 3-4 carries 15% mortality; 5-6 carries 40% mortality; and 7-8 carries nearly
100% mortality. Therefore, a score of 7 indicates an extremely high mortality rate.
Ranson's Criteria does not predict recurrence or chronicity. The clinician must recognize
this score as indicating critical illness requiring intensive monitoring and aggressive
supportive care.
Question 3
Reuben, age 24, has HIV and just had a routine viral load test done. The results show
a falling viral load. What does this indicate?
a. A favorable diagnostic trend
b. Disease progression
c. The need to be more aggressive with Reuben's medications
d. The eradication of the HIV
Correct Answer: a. A favorable diagnostic trend
Expert Rationale: HIV viral load measures the number of copies of HIV RNA per
milliliter of blood. A falling viral load indicates that antiretroviral therapy (ART) is
effectively suppressing viral replication. The goal of ART is to achieve an undetectable
viral load (<50 copies/mL), which is associated with improved CD4 counts, reduced
opportunistic infections, and decreased transmission risk. A falling viral load is a
favorable trend, not disease progression. It does not indicate eradication of HIV, as the
, virus persists in latent reservoirs. The current regimen should be continued unless there
are other reasons to change therapy.
Question 4
Which is the differentiating symptom between labyrinthitis and vestibular neuritis?
a. Symptoms with vestibular neuritis are usually acute in onset, whereas with
labyrinthitis the onset is more gradual
b. Hearing loss may be associated with vestibular neuritis, but not with labyrinthitis
c. Symptoms with labyrinthitis are usually acute in onset, whereas with vestibular
neuritis the onset is more gradual
d. Hearing loss may be associated with labyrinthitis, but not with vestibular neuritis
Correct Answer: d. Hearing loss may be associated with labyrinthitis, but not with
vestibular neuritis
Expert Rationale: Both labyrinthitis and vestibular neuritis present with acute onset of
vertigo, nausea, vomiting, and nystagmus. The key differentiating feature is the
involvement of hearing. The labyrinth contains both the vestibular apparatus
(semicircular canals, utricle, saccule) and the cochlea. Labyrinthitis involves
inflammation of both the vestibular and cochlear portions of the inner ear, resulting in
vertigo plus hearing loss and/or tinnitus. Vestibular neuritis involves inflammation of
only the vestibular portion of the eighth cranial nerve, sparing hearing. Both conditions
typically have acute onset, so onset timing is not a differentiating factor.
Question 5
A 27 year old female presents with a chief complaint of burning and pain on
urination. She has no previous history of urinary tract infection. What are some
additional symptoms consistent with a diagnosis of lower UTI?
