NR511 Final Exam Latest 2025/ 2026
Update Differential Diagnosis & Primary
Care Practicum|Sure to Pass|Actual
Exam Questions And Answers |Graded
A+.
1. Mr. Johnson, age 69, has had Meniere disease for several years. He has some
hearing loss but now has persistent vertigo. What treatment might be instituted
to relieve the vertigo?
1.A labyrinthectomy.
2.Pharmacological therapy.
3.A vestibular neurectomy.
4.Wearing an earplug in the ear that has the most hearing loss.
- ANSWER 3. A vestibular neurectomy.
2. Treatment for achalasia may include:
1. Balloon dilation of the lower esophageal sphincter.
2. Beta blockers.
3. A fundoplication.
4. An esophagogastrectomy. - ANSWER 1. Balloon dilation of the LES
3. Which oral medication might be used to treat a client with chronic cholelithiasis
who is a poor candidate for surgery?
1.Ursodiol (Actigall).
2.Ibuprofen (Advil).
3.Prednisone (Deltasone).
4.Surgery is the only answer. - ANSWER 1. Ursodiol (Actigall)
4. A low pretest probability of disease may lead to which of the following? -
ANSWER Low positive predictive value and more false-positive results
1
,5. Positive predictive value increases with prevalence; thus, low prevalence value
yields a low positive predictive value and implies a high false-positive rate.
Negative predictive value decreases with prevalence, and sensitivity/specificity
do not vary.
6. If you strongly suspect that a client is positive for a specific condition but tests
negative, the negative result may be: - ANSWER False-negative test results due
to a low negative predictive value.
7. Your clinical suspicion is equivalent to pre-test probability and high prevalence
of a population. Negative predictive value is inversely correlated with
prevalence. Your clinical suspicion is a low negative predictive value,
suggesting a false-negative.
8. A client has a positive rapid strep test. Knowing nothing else, how likely is it
that the client has strep pharyngitis? - ANSWER Cannot be determined from
this information.
9. Without a pre-test probability the test result cannot be interpreted accurately.
10.Which test(s) provide data relevant to the chief complaint: Fever - ANSWER
CBC
11.Which test(s) provide data relevant to the chief complaint: Unexplained
bruising - ANSWER CBC
12.hich test(s) provide data relevant to the chief complaint: Fatigue - ANSWER
CBC, CMP
2
,13.Which test(s) provide data relevant to the chief complaint: Cardiac
dysrhythmias - ANSWER CMP, electrolyte abnormalities
14.Which test(s) provide data relevant to the chief complaint: Unexplained weight
loss - ANSWER CBC, CMP
15.Check WBC for inflammation or possible cancer, CMP for glucose, liver or
kidney abnormalities
16.Which test(s) provide data relevant to the chief complaint: Edema - ANSWER
CMP
17.SNAPPS - ANSWER Summarize the history and findings
18.Narrow the differential diagnosis to two or three possibilities
19.Analyze the differential by comparing and contrasting the possibilities
20.Probe the preceptor by asking questions about alternative approaches or
uncertainties
21.Plan the management of the client's health issues
22.Select an issue from the case for self-directed learning
23.Pruritis - ANSWER -Pruritus is the sensation of itching accompanied by the
urge to scratch and can be considered as acute or chronic. It can be a symptom
of an actual dermatological issue or it can be a symptom of another disease or
drug reaction. In persons older than 65, pruritis is the most common skin
complaint encountered in primary care.
24.-Pruritis is caused from a localized reaction, as in the case of an insect bite or it
can be caused from a systemic response. A systemic cause of pruritis is in
hyperbilirubinemia where bile salts deposit in the skin creating the discomfort.
Pruritis can exist with or without a rash.
25.rash - ANSWER A rash is a clinical manifestation of inflammation that can
have multiple etiologies, including autoimmune, parasitic, viral, and bacterial
3
, origins. A thorough and careful history is an important step in the evaluation of
pruritis and rashes
26.Third-party payers - ANSWER 7 categories: Medicare/ Medicaid, VA,
workman's comp, indemnity insurance, managed care corp,
27.auto liability
28.Payment of NPs by Centers for Medicare and Medicaid Services (CMS): -
ANSWER 85% of physicians fee
29.Medicare Part A and B (what each pays): - ANSWER o A: Inpatient hospital
stay, skilled nursing care, hospice, home care
• B: Outpatient services, provider visits, surgery, lab, medical equipment,
preventative exams.
30.The purpose of Medicare Advantage Plans - ANSWER Benefits of Medicare
and additional with lower copays
31.Assessment and diagnosis of herpes zoster - ANSWER -Painful rash with
blisters (unilateral vesicular rash along dermatome) most commonly a thoracic
or
32.lumbar dermatome
- May present with unexplained pain
33.Assessment and diagnosis of common skin complaints - ANSWER Sexual
history (STD), social history (Occupational exposure, travel, hobbies, pets,
drugs), Medications,
34.Medical history (recent illness)
4
Update Differential Diagnosis & Primary
Care Practicum|Sure to Pass|Actual
Exam Questions And Answers |Graded
A+.
1. Mr. Johnson, age 69, has had Meniere disease for several years. He has some
hearing loss but now has persistent vertigo. What treatment might be instituted
to relieve the vertigo?
1.A labyrinthectomy.
2.Pharmacological therapy.
3.A vestibular neurectomy.
4.Wearing an earplug in the ear that has the most hearing loss.
- ANSWER 3. A vestibular neurectomy.
2. Treatment for achalasia may include:
1. Balloon dilation of the lower esophageal sphincter.
2. Beta blockers.
3. A fundoplication.
4. An esophagogastrectomy. - ANSWER 1. Balloon dilation of the LES
3. Which oral medication might be used to treat a client with chronic cholelithiasis
who is a poor candidate for surgery?
1.Ursodiol (Actigall).
2.Ibuprofen (Advil).
3.Prednisone (Deltasone).
4.Surgery is the only answer. - ANSWER 1. Ursodiol (Actigall)
4. A low pretest probability of disease may lead to which of the following? -
ANSWER Low positive predictive value and more false-positive results
1
,5. Positive predictive value increases with prevalence; thus, low prevalence value
yields a low positive predictive value and implies a high false-positive rate.
Negative predictive value decreases with prevalence, and sensitivity/specificity
do not vary.
6. If you strongly suspect that a client is positive for a specific condition but tests
negative, the negative result may be: - ANSWER False-negative test results due
to a low negative predictive value.
7. Your clinical suspicion is equivalent to pre-test probability and high prevalence
of a population. Negative predictive value is inversely correlated with
prevalence. Your clinical suspicion is a low negative predictive value,
suggesting a false-negative.
8. A client has a positive rapid strep test. Knowing nothing else, how likely is it
that the client has strep pharyngitis? - ANSWER Cannot be determined from
this information.
9. Without a pre-test probability the test result cannot be interpreted accurately.
10.Which test(s) provide data relevant to the chief complaint: Fever - ANSWER
CBC
11.Which test(s) provide data relevant to the chief complaint: Unexplained
bruising - ANSWER CBC
12.hich test(s) provide data relevant to the chief complaint: Fatigue - ANSWER
CBC, CMP
2
,13.Which test(s) provide data relevant to the chief complaint: Cardiac
dysrhythmias - ANSWER CMP, electrolyte abnormalities
14.Which test(s) provide data relevant to the chief complaint: Unexplained weight
loss - ANSWER CBC, CMP
15.Check WBC for inflammation or possible cancer, CMP for glucose, liver or
kidney abnormalities
16.Which test(s) provide data relevant to the chief complaint: Edema - ANSWER
CMP
17.SNAPPS - ANSWER Summarize the history and findings
18.Narrow the differential diagnosis to two or three possibilities
19.Analyze the differential by comparing and contrasting the possibilities
20.Probe the preceptor by asking questions about alternative approaches or
uncertainties
21.Plan the management of the client's health issues
22.Select an issue from the case for self-directed learning
23.Pruritis - ANSWER -Pruritus is the sensation of itching accompanied by the
urge to scratch and can be considered as acute or chronic. It can be a symptom
of an actual dermatological issue or it can be a symptom of another disease or
drug reaction. In persons older than 65, pruritis is the most common skin
complaint encountered in primary care.
24.-Pruritis is caused from a localized reaction, as in the case of an insect bite or it
can be caused from a systemic response. A systemic cause of pruritis is in
hyperbilirubinemia where bile salts deposit in the skin creating the discomfort.
Pruritis can exist with or without a rash.
25.rash - ANSWER A rash is a clinical manifestation of inflammation that can
have multiple etiologies, including autoimmune, parasitic, viral, and bacterial
3
, origins. A thorough and careful history is an important step in the evaluation of
pruritis and rashes
26.Third-party payers - ANSWER 7 categories: Medicare/ Medicaid, VA,
workman's comp, indemnity insurance, managed care corp,
27.auto liability
28.Payment of NPs by Centers for Medicare and Medicaid Services (CMS): -
ANSWER 85% of physicians fee
29.Medicare Part A and B (what each pays): - ANSWER o A: Inpatient hospital
stay, skilled nursing care, hospice, home care
• B: Outpatient services, provider visits, surgery, lab, medical equipment,
preventative exams.
30.The purpose of Medicare Advantage Plans - ANSWER Benefits of Medicare
and additional with lower copays
31.Assessment and diagnosis of herpes zoster - ANSWER -Painful rash with
blisters (unilateral vesicular rash along dermatome) most commonly a thoracic
or
32.lumbar dermatome
- May present with unexplained pain
33.Assessment and diagnosis of common skin complaints - ANSWER Sexual
history (STD), social history (Occupational exposure, travel, hobbies, pets,
drugs), Medications,
34.Medical history (recent illness)
4
