NR511 Week 8 Final Exam – 200 Practice Questions
Differential Diagnosis & Primary Care Practicum
Complete with Answers, Rationales, and Explanations
Question 1
A 45yearold male presents with chest pain for 2 hours. What is the most urgent initial step?
A) Order a chest Xray
B) Perform a 12lead ECG
C) Prescribe antacids
D) Refer to a cardiologist
Answer: B) Perform a 12lead ECG
Rationale: An ECG is critical to rapidly assess for myocardial infarction, a life threatening condition. ECG
should be obtained within 10 minutes of arrival for patients with chest pain.
Question 2
Which of the following is the most important factor in determining anticoagulation therapy for a patient
with atrial fibrillation?
A) Patient's age
B) CHA₂DS₂VASc score
C) Blood pressure
D) Heart rate
Answer: B) CHA₂DS₂VASc score
,Rationale: The CHA₂DS₂VASc score is the primary tool used to assess stroke risk in atrial fibrillation
patients and guides anticoagulation decisions.
Question 3
A patient with hypertension and diabetes should have their blood pressure treated to what target?
A) <140/90 mmHg
B) <130/80 mmHg
C) <150/90 mmHg
D) <120/80 mmHg
Answer: B) <130/80 mmHg
Rationale: For patients with diabetes or chronic kidney disease, the recommended blood pressure target
is <130/80 mmHg to reduce cardiovascular and renal complications.
Question 4
A 62yearold male with a history of smoking presents with exertional chest pain that resolves with rest.
What is the most likely diagnosis?
A) Stable angina
B) Unstable angina
C) Myocardial infarction
D) Pericarditis
Answer: A) Stable angina
,Rationale: Stable angina is characterized by chest pain that occurs with exertion and resolves with rest.
It is typically caused by fixed coronary artery obstruction.
Question 5
What is the firstline pharmacologic therapy for heart failure with reduced ejection fraction (HFrEF)?
A) Betablockers alone
B) ACE inhibitors or ARBs
C) Calcium channel blockers
D) Digoxin
Answer: B) ACE inhibitors or ARBs
Rationale: ACE inhibitors or ARBs are firstline therapy for HFrEF as they reduce afterload, preload, and
mortality. Betablockers are also indicated but typically added after ACE inhibitor initiation.
Question 6
Which ECG finding is most characteristic of acute pericarditis?
A) STsegment elevation in all leads
B) Diffuse STsegment elevation with PR depression
C) Q waves in contiguous leads
D) Twave inversions
Answer: B) Diffuse STsegment elevation with PR depression
Rationale: Pericarditis typically shows diffuse STsegment elevation (not localized) and PRsegment
depression across multiple leads.
, Question 7
A patient presents with suddenonset severe headache, neck stiffness, and photophobia. What is the
most appropriate next step?
A) CT scan of the head without contrast
B) MRI of the brain
C) Lumbar puncture
D) Both CT scan and lumbar puncture if CT is negative
Answer: D) Both CT scan and lumbar puncture if CT is negative
Rationale: Suspected subarachnoid hemorrhage requires a noncontrast CT head first. If CT is negative,
lumbar puncture is needed to rule out blood in the CSF.
Question 8
What is the most costeffective screening test for determining HIV status?
A) Western blot
B) Enzymelinked immunosorbent assay (ELISA)
C) Polymerase chain reaction (PCR)
D) Viral load testing
Answer: B) Enzymelinked immunosorbent assay (ELISA)
Rationale: ELISA is the most costeffective screening test for HIV. Positive results are confirmed with
Western blot or other confirmatory tests.
Differential Diagnosis & Primary Care Practicum
Complete with Answers, Rationales, and Explanations
Question 1
A 45yearold male presents with chest pain for 2 hours. What is the most urgent initial step?
A) Order a chest Xray
B) Perform a 12lead ECG
C) Prescribe antacids
D) Refer to a cardiologist
Answer: B) Perform a 12lead ECG
Rationale: An ECG is critical to rapidly assess for myocardial infarction, a life threatening condition. ECG
should be obtained within 10 minutes of arrival for patients with chest pain.
Question 2
Which of the following is the most important factor in determining anticoagulation therapy for a patient
with atrial fibrillation?
A) Patient's age
B) CHA₂DS₂VASc score
C) Blood pressure
D) Heart rate
Answer: B) CHA₂DS₂VASc score
,Rationale: The CHA₂DS₂VASc score is the primary tool used to assess stroke risk in atrial fibrillation
patients and guides anticoagulation decisions.
Question 3
A patient with hypertension and diabetes should have their blood pressure treated to what target?
A) <140/90 mmHg
B) <130/80 mmHg
C) <150/90 mmHg
D) <120/80 mmHg
Answer: B) <130/80 mmHg
Rationale: For patients with diabetes or chronic kidney disease, the recommended blood pressure target
is <130/80 mmHg to reduce cardiovascular and renal complications.
Question 4
A 62yearold male with a history of smoking presents with exertional chest pain that resolves with rest.
What is the most likely diagnosis?
A) Stable angina
B) Unstable angina
C) Myocardial infarction
D) Pericarditis
Answer: A) Stable angina
,Rationale: Stable angina is characterized by chest pain that occurs with exertion and resolves with rest.
It is typically caused by fixed coronary artery obstruction.
Question 5
What is the firstline pharmacologic therapy for heart failure with reduced ejection fraction (HFrEF)?
A) Betablockers alone
B) ACE inhibitors or ARBs
C) Calcium channel blockers
D) Digoxin
Answer: B) ACE inhibitors or ARBs
Rationale: ACE inhibitors or ARBs are firstline therapy for HFrEF as they reduce afterload, preload, and
mortality. Betablockers are also indicated but typically added after ACE inhibitor initiation.
Question 6
Which ECG finding is most characteristic of acute pericarditis?
A) STsegment elevation in all leads
B) Diffuse STsegment elevation with PR depression
C) Q waves in contiguous leads
D) Twave inversions
Answer: B) Diffuse STsegment elevation with PR depression
Rationale: Pericarditis typically shows diffuse STsegment elevation (not localized) and PRsegment
depression across multiple leads.
, Question 7
A patient presents with suddenonset severe headache, neck stiffness, and photophobia. What is the
most appropriate next step?
A) CT scan of the head without contrast
B) MRI of the brain
C) Lumbar puncture
D) Both CT scan and lumbar puncture if CT is negative
Answer: D) Both CT scan and lumbar puncture if CT is negative
Rationale: Suspected subarachnoid hemorrhage requires a noncontrast CT head first. If CT is negative,
lumbar puncture is needed to rule out blood in the CSF.
Question 8
What is the most costeffective screening test for determining HIV status?
A) Western blot
B) Enzymelinked immunosorbent assay (ELISA)
C) Polymerase chain reaction (PCR)
D) Viral load testing
Answer: B) Enzymelinked immunosorbent assay (ELISA)
Rationale: ELISA is the most costeffective screening test for HIV. Positive results are confirmed with
Western blot or other confirmatory tests.
