NR 511 FINAL EXAM - ADVANCED
PRIMARY CARE CLINICAL PRACTICE
QUESTIONS & VERIFIED ANSWERS
2026/2027 UPDATE
1. A 55-year-old male presents with a sudden onset of severe right big toe pain, redness, and
swelling. He reports consuming a large steak and several beers the night before. What is the
most likely diagnosis?
A. Gouty Arthritis
B. Rheumatoid Arthritis
C. Septic Arthritis
D. Osteoarthritis
Answer: A
Conceptual Explanation: Gouty arthritis often presents as podagra (involvement of the
first metatarsophalangeal joint) and is frequently triggered by high-purine foods like red
meat and alcohol.
,2. Which of the following physical exam maneuvers is most specific for assessing an anterior
cruciate ligament (ACL) injury?
A. McMurray test
B. Lachman test
C. Phalen’s sign
D. Empty can test
Answer: B
Conceptual Explanation: The Lachman test is considered the most sensitive and specific
physical exam maneuver for detecting an ACL tear.
3. A 32-year-old female presents with a ‘curtain-like’ shadow over her vision in the left eye,
along with floaters and flashes of light. What is the priority intervention?
A. Prescribe antibiotic eye drops
B. Refer immediately to ophthalmology for suspected retinal detachment
C. Perform a tonometry test for glaucoma
D. Apply a warm compress and reassess in 24 hours
Answer: B
Conceptual Explanation: Flashes, floaters, and a ‘curtain’ over the visual field are classic
signs of retinal detachment, a medical emergency requiring immediate specialist referral.
, 4. When interpreting a Weber test, if the sound lateralizes to the affected ear (the ‘bad’ ear),
what type of hearing loss is suggested?
A. Sensorineural hearing loss
B. Conductive hearing loss
C. Central hearing loss
D. Normal hearing
Answer: B
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the affected
ear because the sound is not muffled by room noise. In sensorineural loss, it lateralizes to
the good ear.
5. A patient presents with a ‘bulls-eye’ rash (erythema migrans) after a hiking trip in the
Northeast. Which organism is most likely responsible?
A. Borrelia burgdorferi
B. Rickettsia rickettsii
C. Staphylococcus aureus
D. Treponema pallidum
Answer: A
Conceptual Explanation: Borrelia burgdorferi is the causative agent of Lyme disease,
which typically presents with an erythema migrans rash.
PRIMARY CARE CLINICAL PRACTICE
QUESTIONS & VERIFIED ANSWERS
2026/2027 UPDATE
1. A 55-year-old male presents with a sudden onset of severe right big toe pain, redness, and
swelling. He reports consuming a large steak and several beers the night before. What is the
most likely diagnosis?
A. Gouty Arthritis
B. Rheumatoid Arthritis
C. Septic Arthritis
D. Osteoarthritis
Answer: A
Conceptual Explanation: Gouty arthritis often presents as podagra (involvement of the
first metatarsophalangeal joint) and is frequently triggered by high-purine foods like red
meat and alcohol.
,2. Which of the following physical exam maneuvers is most specific for assessing an anterior
cruciate ligament (ACL) injury?
A. McMurray test
B. Lachman test
C. Phalen’s sign
D. Empty can test
Answer: B
Conceptual Explanation: The Lachman test is considered the most sensitive and specific
physical exam maneuver for detecting an ACL tear.
3. A 32-year-old female presents with a ‘curtain-like’ shadow over her vision in the left eye,
along with floaters and flashes of light. What is the priority intervention?
A. Prescribe antibiotic eye drops
B. Refer immediately to ophthalmology for suspected retinal detachment
C. Perform a tonometry test for glaucoma
D. Apply a warm compress and reassess in 24 hours
Answer: B
Conceptual Explanation: Flashes, floaters, and a ‘curtain’ over the visual field are classic
signs of retinal detachment, a medical emergency requiring immediate specialist referral.
, 4. When interpreting a Weber test, if the sound lateralizes to the affected ear (the ‘bad’ ear),
what type of hearing loss is suggested?
A. Sensorineural hearing loss
B. Conductive hearing loss
C. Central hearing loss
D. Normal hearing
Answer: B
Conceptual Explanation: In conductive hearing loss, the sound lateralizes to the affected
ear because the sound is not muffled by room noise. In sensorineural loss, it lateralizes to
the good ear.
5. A patient presents with a ‘bulls-eye’ rash (erythema migrans) after a hiking trip in the
Northeast. Which organism is most likely responsible?
A. Borrelia burgdorferi
B. Rickettsia rickettsii
C. Staphylococcus aureus
D. Treponema pallidum
Answer: A
Conceptual Explanation: Borrelia burgdorferi is the causative agent of Lyme disease,
which typically presents with an erythema migrans rash.
