NR-511 NR 511 NR511 Differential Diagnoses (FNP
Track) – Final Exam Questions And Correct
Answers (Verified Answers) Plus Rationales 2025
1. A 45-year-old male presents with epigastric pain that worsens after meals. He
reports frequent belching and early satiety. What is the most likely diagnosis?
A. Acute pancreatitis
B. Acute cholecystitis
C. Peptic ulcer disease
D. Gastroenteritis
Peptic ulcer disease commonly presents with epigastric pain,
especially after meals, and is often associated with belching, early
satiety, and a history of NSAID use or H. pylori infection.
2. A 19-year-old college student presents with sore throat, fever, and posterior
cervical lymphadenopathy. A rapid strep test is negative. What is the most likely
diagnosis?
A. Group A Streptococcal pharyngitis
B. Infectious mononucleosis
C. Peritonsillar abscess
D. Viral pharyngitis
Infectious mononucleosis presents with fever, sore throat, fatigue,
,and posterior cervical lymphadenopathy. Negative strep test and age
group are additional clues.
3. A 67-year-old man with a history of smoking presents with hematuria and no
other symptoms. Which of the following is the most likely diagnosis?
A. Nephrolithiasis
B. Bladder cancer
C. Glomerulonephritis
D. Benign prostatic hyperplasia
Painless hematuria in an older male with a history of smoking is highly
suggestive of bladder cancer.
4. A 28-year-old woman presents with sudden onset of right lower quadrant
pain and a positive urine pregnancy test. What is the most urgent diagnosis to
rule out?
A. Appendicitis
B. Ectopic pregnancy
C. Ovarian cyst
D. Pelvic inflammatory disease
Ectopic pregnancy is a medical emergency and should be ruled out in
any pregnant woman with abdominal pain, particularly in the lower
quadrants.
,5. A 55-year-old male reports persistent heartburn, chronic cough, and
hoarseness. Which condition is most likely?
A. Asthma
B. Bronchitis
C. Gastroesophageal reflux disease (GERD)
D. Laryngitis
GERD can cause not only heartburn but also extra-esophageal
symptoms like chronic cough, hoarseness, and throat irritation due to
acid reflux.
6. A 30-year-old woman presents with fatigue, cold intolerance, and weight
gain. Her TSH is elevated. What is the most likely diagnosis?
A. Graves' disease
B. Hashimoto’s thyroiditis
C. Subacute thyroiditis
D. Euthyroid sick syndrome
Hashimoto’s thyroiditis is the most common cause of hypothyroidism
and typically presents with elevated TSH and low free T4.
7. Which physical exam finding is most associated with appendicitis?
A. Cullen’s sign
B. McBurney’s point tenderness
C. Murphy’s sign
, D. Rovsing’s sign
McBurney’s point tenderness is a classic finding in appendicitis,
located 1/3 of the distance from the anterior superior iliac spine to the
umbilicus.
8. A patient with a long-standing history of alcohol use presents with epigastric
pain radiating to the back, elevated amylase, and lipase. What is the most likely
diagnosis?
A. Gastritis
B. Cholecystitis
C. Acute pancreatitis
D. Peptic ulcer disease
Acute pancreatitis presents with upper abdominal pain radiating to
the back, often with elevated pancreatic enzymes and history of
alcohol use.
9. A 34-year-old female presents with fatigue, joint pain, and a malar rash. What
is the most likely diagnosis?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus (SLE)
C. Psoriatic arthritis
D. Fibromyalgia
Track) – Final Exam Questions And Correct
Answers (Verified Answers) Plus Rationales 2025
1. A 45-year-old male presents with epigastric pain that worsens after meals. He
reports frequent belching and early satiety. What is the most likely diagnosis?
A. Acute pancreatitis
B. Acute cholecystitis
C. Peptic ulcer disease
D. Gastroenteritis
Peptic ulcer disease commonly presents with epigastric pain,
especially after meals, and is often associated with belching, early
satiety, and a history of NSAID use or H. pylori infection.
2. A 19-year-old college student presents with sore throat, fever, and posterior
cervical lymphadenopathy. A rapid strep test is negative. What is the most likely
diagnosis?
A. Group A Streptococcal pharyngitis
B. Infectious mononucleosis
C. Peritonsillar abscess
D. Viral pharyngitis
Infectious mononucleosis presents with fever, sore throat, fatigue,
,and posterior cervical lymphadenopathy. Negative strep test and age
group are additional clues.
3. A 67-year-old man with a history of smoking presents with hematuria and no
other symptoms. Which of the following is the most likely diagnosis?
A. Nephrolithiasis
B. Bladder cancer
C. Glomerulonephritis
D. Benign prostatic hyperplasia
Painless hematuria in an older male with a history of smoking is highly
suggestive of bladder cancer.
4. A 28-year-old woman presents with sudden onset of right lower quadrant
pain and a positive urine pregnancy test. What is the most urgent diagnosis to
rule out?
A. Appendicitis
B. Ectopic pregnancy
C. Ovarian cyst
D. Pelvic inflammatory disease
Ectopic pregnancy is a medical emergency and should be ruled out in
any pregnant woman with abdominal pain, particularly in the lower
quadrants.
,5. A 55-year-old male reports persistent heartburn, chronic cough, and
hoarseness. Which condition is most likely?
A. Asthma
B. Bronchitis
C. Gastroesophageal reflux disease (GERD)
D. Laryngitis
GERD can cause not only heartburn but also extra-esophageal
symptoms like chronic cough, hoarseness, and throat irritation due to
acid reflux.
6. A 30-year-old woman presents with fatigue, cold intolerance, and weight
gain. Her TSH is elevated. What is the most likely diagnosis?
A. Graves' disease
B. Hashimoto’s thyroiditis
C. Subacute thyroiditis
D. Euthyroid sick syndrome
Hashimoto’s thyroiditis is the most common cause of hypothyroidism
and typically presents with elevated TSH and low free T4.
7. Which physical exam finding is most associated with appendicitis?
A. Cullen’s sign
B. McBurney’s point tenderness
C. Murphy’s sign
, D. Rovsing’s sign
McBurney’s point tenderness is a classic finding in appendicitis,
located 1/3 of the distance from the anterior superior iliac spine to the
umbilicus.
8. A patient with a long-standing history of alcohol use presents with epigastric
pain radiating to the back, elevated amylase, and lipase. What is the most likely
diagnosis?
A. Gastritis
B. Cholecystitis
C. Acute pancreatitis
D. Peptic ulcer disease
Acute pancreatitis presents with upper abdominal pain radiating to
the back, often with elevated pancreatic enzymes and history of
alcohol use.
9. A 34-year-old female presents with fatigue, joint pain, and a malar rash. What
is the most likely diagnosis?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus (SLE)
C. Psoriatic arthritis
D. Fibromyalgia
