NR 511: Differential Diagnosis & Primary Care Practicum
Comprehensive Review of Differential Diagnosis,
Screening, and Management in Primary Care: NR
511 (2026 Midterm and Final Combined) Actual
Exam tests Graded A+
,NR 511: DIFFERENTIAL DIAGNOSIS & PRIMARY
CARE PRACTICUM MIDTERM EXAM STUDY
GUIDE & PRACTICE QUESTIONS WITH
QUESTIONS AND CORRECT ANSWERS
GRADED A+
1. A 45-year-old male presents for wellness visit. He smokes 1
PPD × 20 years, BP 128/78, BMI 29. Most appropriate next
screening test?
a. Low-dose CT chest for lung cancer
b. Fasting lipid panel
c. Colonoscopy
d. PSA
Correct Answer b. Fasting lipid panel
Rationale USPSTF recommends lipid screening in men 35–75
years; smoking + overweight = elevated CVD risk.
2. A 28-year-old female G1P0 at 8 weeks gestation reports
nausea and vomiting. First-line pharmacologic management?
a. Vitamin B6 (pyridoxine) + doxylamine
b. Ondansetron
c. Metoclopramide
d. Promethazine
,Correct Answer a. Vitamin B6 (pyridoxine) + doxylamine
Rationale First-line for nausea/vomiting of pregnancy (NVP);
safe and effective per ACOG.
3. A 62-year-old female with fatigue, weight gain, cold intolerance.
TSH 8.2 mIU/L, free T4 low. Diagnosis?
a. Primary hypothyroidism
b. Subclinical hypothyroidism
c. Secondary hypothyroidism
d. Hyperthyroidism
Correct Answer a. Primary hypothyroidism
Rationale Elevated TSH + low free T4 = primary
hypothyroidism (most commonly Hashimoto’s).
4. A 19-year-old female with acute onset sore throat, fever 101°F,
tonsillar exudates, tender cervical nodes, no cough. Centor score
= 4. Next step?
a. Rapid strep test or throat culture
b. Start empiric amoxicillin
c. Supportive care only
d. Start prednisone
Correct Answer a. Rapid strep test or throat culture
Rationale Centor 4 = high likelihood of group A strep;
confirmatory test required before antibiotics.
, 5. A 55-year-old male with HTN and type 2 DM. Most appropriate
initial antihypertensive?
a. ACE inhibitor (lisinopril)
b. Thiazide diuretic
c. Beta-blocker
d. Calcium channel blocker
Correct Answer a. ACE inhibitor (lisinopril)
Rationale ACEI/ARB first-line in DM + HTN due to renal
protective effects.
6. A 32-year-old female with 3-day history of dysuria, frequency,
urgency, no fever or flank pain. Most likely diagnosis?
a. Uncomplicated cystitis
b. Pyelonephritis
c. Urethritis
d. Vaginitis
Correct Answer a. Uncomplicated cystitis
Rationale Classic symptoms of lower UTI in young female; no
systemic signs.
7. First-line empiric treatment for uncomplicated cystitis in non-
pregnant female is:
Comprehensive Review of Differential Diagnosis,
Screening, and Management in Primary Care: NR
511 (2026 Midterm and Final Combined) Actual
Exam tests Graded A+
,NR 511: DIFFERENTIAL DIAGNOSIS & PRIMARY
CARE PRACTICUM MIDTERM EXAM STUDY
GUIDE & PRACTICE QUESTIONS WITH
QUESTIONS AND CORRECT ANSWERS
GRADED A+
1. A 45-year-old male presents for wellness visit. He smokes 1
PPD × 20 years, BP 128/78, BMI 29. Most appropriate next
screening test?
a. Low-dose CT chest for lung cancer
b. Fasting lipid panel
c. Colonoscopy
d. PSA
Correct Answer b. Fasting lipid panel
Rationale USPSTF recommends lipid screening in men 35–75
years; smoking + overweight = elevated CVD risk.
2. A 28-year-old female G1P0 at 8 weeks gestation reports
nausea and vomiting. First-line pharmacologic management?
a. Vitamin B6 (pyridoxine) + doxylamine
b. Ondansetron
c. Metoclopramide
d. Promethazine
,Correct Answer a. Vitamin B6 (pyridoxine) + doxylamine
Rationale First-line for nausea/vomiting of pregnancy (NVP);
safe and effective per ACOG.
3. A 62-year-old female with fatigue, weight gain, cold intolerance.
TSH 8.2 mIU/L, free T4 low. Diagnosis?
a. Primary hypothyroidism
b. Subclinical hypothyroidism
c. Secondary hypothyroidism
d. Hyperthyroidism
Correct Answer a. Primary hypothyroidism
Rationale Elevated TSH + low free T4 = primary
hypothyroidism (most commonly Hashimoto’s).
4. A 19-year-old female with acute onset sore throat, fever 101°F,
tonsillar exudates, tender cervical nodes, no cough. Centor score
= 4. Next step?
a. Rapid strep test or throat culture
b. Start empiric amoxicillin
c. Supportive care only
d. Start prednisone
Correct Answer a. Rapid strep test or throat culture
Rationale Centor 4 = high likelihood of group A strep;
confirmatory test required before antibiotics.
, 5. A 55-year-old male with HTN and type 2 DM. Most appropriate
initial antihypertensive?
a. ACE inhibitor (lisinopril)
b. Thiazide diuretic
c. Beta-blocker
d. Calcium channel blocker
Correct Answer a. ACE inhibitor (lisinopril)
Rationale ACEI/ARB first-line in DM + HTN due to renal
protective effects.
6. A 32-year-old female with 3-day history of dysuria, frequency,
urgency, no fever or flank pain. Most likely diagnosis?
a. Uncomplicated cystitis
b. Pyelonephritis
c. Urethritis
d. Vaginitis
Correct Answer a. Uncomplicated cystitis
Rationale Classic symptoms of lower UTI in young female; no
systemic signs.
7. First-line empiric treatment for uncomplicated cystitis in non-
pregnant female is:
