NR 511 Case Study Week 3 Part 1 | 2026/2027 Final Exam
Study Guide – Detailed, Correct Responses
This guide focuses on NR 511’s Week 3 Case Study, offering
detailed responses to ensure students understand and master
the material for the final exam.
Key Words: NR 511, Case Study, Week 3, Study Guide, Final
Exam
NR 511 Week 3 Study Guide: 100 Q&A
Section 1: Differential Diagnosis & Clinical Reasoning (20 Questions)
1. What is the single most critical step in the diagnostic process?
A. Ordering laboratory tests
B. Obtaining a detailed history ✓
C. Performing a physical exam
D. Reviewing prior records
2. A patient presents with acute-onset sharp chest pain that worsens with inspiration and is
relieved by leaning forward. The lung sounds are clear. What is the MOST likely diagnosis?
A. Myocardial Infarction (MI)
B. Pulmonary Embolism (PE)
C. Acute Pericarditis ✓
D. Pneumothorax
3. Which symptom is a "red flag" for a serious cause of headache?
A. Gradual onset over hours
B. Bilateral, pressure-like pain
,C. Headache awakening patient from sleep ✓
D. Association with stress
4. The classic triad for diagnosing meningitis includes all EXCEPT:
A. Fever
B. Headache
C. Nuchal rigidity
D. Photophobia ✓ (Note: Classic triad is fever, headache, nuchal rigidity. Photophobia is a
common associated symptom but not part of the classic triad.)
5. When formulating a differential diagnosis, you should list possibilities in order of:
A. Alphabetical order
B. Most common to least common
C. Most serious to least serious
D. Most likely to least likely, considering prevalence and patient-specific factors ✓
6. A patient with gastroesophageal reflux disease (GERD) experiences worsening symptoms at
night. What is the FIRST recommended lifestyle modification?
A. Avoid caffeine
B. Elevate the head of the bed ✓
C. Eat smaller meals
D. Avoid chocolate
7. Which finding is most specific for bacterial sinusitis versus viral rhinosinusitis?
A. Nasal congestion
B. Purulent nasal discharge
C. Maxillary tooth pain
D. "Double sickening" or symptoms worsening after initial improvement ✓
8. Wells' Criteria are used to assess the probability of which condition?
A. Deep Vein Thrombosis (DVT) ✓
B. Community-Acquired Pneumonia (CAP)
C. Heart Failure
D. Pancreatitis
9. A 35-year-old female presents with symmetric joint pain and stiffness in her hands, worse
in the morning and lasting over an hour. You suspect rheumatoid arthritis. What is the most
appropriate initial lab test?
A. Uric acid
B. Anti-nuclear antibody (ANA)
,C. Rheumatoid factor (RF) and Anti-CCP ✓
D. Erythrocyte Sedimentation Rate (ESR) only
10. Otitis media with effusion (OME) is characterized by:
A. A bulging, red tympanic membrane with purulent fluid
B. A retracted TM with amber fluid and air bubbles ✓
C. Severe otalgia and fever
D. Tenderness on traction of the pinna
11. McBurney's point tenderness suggests:
A. Cholecystitis
B. Diverticulitis
C. Appendicitis ✓
D. Pancreatitis
12. The clinical diagnosis of influenza is most reliable during:
A. Summer months
B. Local outbreak with high community prevalence ✓
C. Any time a patient has a cough and fever
D. Only with lab confirmation
13. Murphy's sign is positive in which condition?
A. Acute Cholecystitis ✓
B. Acute Pyelonephritis
C. Hepatitis
D. Peptic Ulcer Disease
14. For a patient with suspected bacterial conjunctivitis, the classic finding is:
A. Clear, watery discharge
B. Copious purulent discharge ✓
C. Severe eye pain and photophobia
D. A unilateral, dilated pupil
15. Which symptom is NOT typical of uncomplicated acute bronchitis?
A. Productive or non-productive cough
B. Fever >102°F (38.9°C) ✓
C. Possible wheezing on auscultation
D. Self-limiting course of 1-3 weeks
16. The Centor Criteria are used to evaluate the likelihood of:
A. Strep Pharyngitis ✓
, B. Influenza
C. Infectious Mononucleosis
D. Pertussis
17. A key historical feature distinguishing migraine from tension-type headache is:
A. Bilateral location
B. Presence of aura, photophobia, phonophobia, or nausea ✓
C. Band-like pressure quality
D. Association with muscle tenderness
18. Which characteristic suggests a headache may be secondary to a brain tumor?
A. Throbbing quality
B. New onset in a patient >50 years old ✓
C. Association with menstrual cycle
D. Relief with over-the-counter NSAIDs
19. For a patient with suspected allergic rhinitis, first-line pharmacotherapy is:
A. Oral decongestants
B. Intranasal corticosteroids ✓
C. Oral antihistamines
D. Leukotriene receptor antagonists
20. The "classic" presentation of pertussis in the paroxysmal stage includes:
A. Low-grade fever and coryza
B. A whooping sound after a paroxysm of coughing ✓
C. Continuous barking cough
D. Wheezing and chest tightness
Section 2: Pharmacology & Treatment (20 Questions)
21. First-line antibiotic therapy for uncomplicated acute bacterial sinusitis in a patient with no
penicillin allergy is:
A. Azithromycin
B. Amoxicillin-clavulanate ✓
C. Ciprofloxacin
D. Doxycycline
22. The recommended first-line therapy for mild, intermittent asthma (Step 1) is:
A. Inhaled corticosteroid (ICS)
B. Inhaled corticosteroid/long-acting beta-agonist (ICS/LABA)
Study Guide – Detailed, Correct Responses
This guide focuses on NR 511’s Week 3 Case Study, offering
detailed responses to ensure students understand and master
the material for the final exam.
Key Words: NR 511, Case Study, Week 3, Study Guide, Final
Exam
NR 511 Week 3 Study Guide: 100 Q&A
Section 1: Differential Diagnosis & Clinical Reasoning (20 Questions)
1. What is the single most critical step in the diagnostic process?
A. Ordering laboratory tests
B. Obtaining a detailed history ✓
C. Performing a physical exam
D. Reviewing prior records
2. A patient presents with acute-onset sharp chest pain that worsens with inspiration and is
relieved by leaning forward. The lung sounds are clear. What is the MOST likely diagnosis?
A. Myocardial Infarction (MI)
B. Pulmonary Embolism (PE)
C. Acute Pericarditis ✓
D. Pneumothorax
3. Which symptom is a "red flag" for a serious cause of headache?
A. Gradual onset over hours
B. Bilateral, pressure-like pain
,C. Headache awakening patient from sleep ✓
D. Association with stress
4. The classic triad for diagnosing meningitis includes all EXCEPT:
A. Fever
B. Headache
C. Nuchal rigidity
D. Photophobia ✓ (Note: Classic triad is fever, headache, nuchal rigidity. Photophobia is a
common associated symptom but not part of the classic triad.)
5. When formulating a differential diagnosis, you should list possibilities in order of:
A. Alphabetical order
B. Most common to least common
C. Most serious to least serious
D. Most likely to least likely, considering prevalence and patient-specific factors ✓
6. A patient with gastroesophageal reflux disease (GERD) experiences worsening symptoms at
night. What is the FIRST recommended lifestyle modification?
A. Avoid caffeine
B. Elevate the head of the bed ✓
C. Eat smaller meals
D. Avoid chocolate
7. Which finding is most specific for bacterial sinusitis versus viral rhinosinusitis?
A. Nasal congestion
B. Purulent nasal discharge
C. Maxillary tooth pain
D. "Double sickening" or symptoms worsening after initial improvement ✓
8. Wells' Criteria are used to assess the probability of which condition?
A. Deep Vein Thrombosis (DVT) ✓
B. Community-Acquired Pneumonia (CAP)
C. Heart Failure
D. Pancreatitis
9. A 35-year-old female presents with symmetric joint pain and stiffness in her hands, worse
in the morning and lasting over an hour. You suspect rheumatoid arthritis. What is the most
appropriate initial lab test?
A. Uric acid
B. Anti-nuclear antibody (ANA)
,C. Rheumatoid factor (RF) and Anti-CCP ✓
D. Erythrocyte Sedimentation Rate (ESR) only
10. Otitis media with effusion (OME) is characterized by:
A. A bulging, red tympanic membrane with purulent fluid
B. A retracted TM with amber fluid and air bubbles ✓
C. Severe otalgia and fever
D. Tenderness on traction of the pinna
11. McBurney's point tenderness suggests:
A. Cholecystitis
B. Diverticulitis
C. Appendicitis ✓
D. Pancreatitis
12. The clinical diagnosis of influenza is most reliable during:
A. Summer months
B. Local outbreak with high community prevalence ✓
C. Any time a patient has a cough and fever
D. Only with lab confirmation
13. Murphy's sign is positive in which condition?
A. Acute Cholecystitis ✓
B. Acute Pyelonephritis
C. Hepatitis
D. Peptic Ulcer Disease
14. For a patient with suspected bacterial conjunctivitis, the classic finding is:
A. Clear, watery discharge
B. Copious purulent discharge ✓
C. Severe eye pain and photophobia
D. A unilateral, dilated pupil
15. Which symptom is NOT typical of uncomplicated acute bronchitis?
A. Productive or non-productive cough
B. Fever >102°F (38.9°C) ✓
C. Possible wheezing on auscultation
D. Self-limiting course of 1-3 weeks
16. The Centor Criteria are used to evaluate the likelihood of:
A. Strep Pharyngitis ✓
, B. Influenza
C. Infectious Mononucleosis
D. Pertussis
17. A key historical feature distinguishing migraine from tension-type headache is:
A. Bilateral location
B. Presence of aura, photophobia, phonophobia, or nausea ✓
C. Band-like pressure quality
D. Association with muscle tenderness
18. Which characteristic suggests a headache may be secondary to a brain tumor?
A. Throbbing quality
B. New onset in a patient >50 years old ✓
C. Association with menstrual cycle
D. Relief with over-the-counter NSAIDs
19. For a patient with suspected allergic rhinitis, first-line pharmacotherapy is:
A. Oral decongestants
B. Intranasal corticosteroids ✓
C. Oral antihistamines
D. Leukotriene receptor antagonists
20. The "classic" presentation of pertussis in the paroxysmal stage includes:
A. Low-grade fever and coryza
B. A whooping sound after a paroxysm of coughing ✓
C. Continuous barking cough
D. Wheezing and chest tightness
Section 2: Pharmacology & Treatment (20 Questions)
21. First-line antibiotic therapy for uncomplicated acute bacterial sinusitis in a patient with no
penicillin allergy is:
A. Azithromycin
B. Amoxicillin-clavulanate ✓
C. Ciprofloxacin
D. Doxycycline
22. The recommended first-line therapy for mild, intermittent asthma (Step 1) is:
A. Inhaled corticosteroid (ICS)
B. Inhaled corticosteroid/long-acting beta-agonist (ICS/LABA)
