FNP NR511 : Differential
Diagnosis Midterm Exam at
Chamberlain College 2024
Expected Questions &
Revised Correct Answers.
(2025 / 2026) 100% Guarantee
Pass
Section 1: Diagnostic Reasoning & Evidence-Based Practice
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Medical Diagnostic Reasoning: Practice Questions and Answers, Exams of Nursing
A series of multiple-choice questions focused on diagnostic reasoning and evidence-based practice in medicine. It covers key steps in developing a differential diagnosis, understanding evidence-based practice, and applying diagnostic tools. The questions are organized by system, including cardiovascular, gastrointestinal, and neurological systems, providing a comprehensive review of common medical conditions and their diagnostic approaches. This resource is valuable for medical students and healthcare professionals seeking to enhance their diagnostic skills and knowledge. (410 characters)
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FNP NR511 : Differential
Diagnosis Midterm Exam at
Chamberlain College 2024
Expected Questions &
Revised Correct Answers.
(2025 / 2026) 100% Guarantee
Pass
Section 1: Diagnostic Reasoning & Evidence-Based Practice
- What is the most important step in developing a differential diagnosis? A. Ordering diagnostic tests B. Performing a physical examination C. Taking a comprehensive history D. Referring to a specialist Answer: C. Taking a comprehensive history Rationale: History-taking provides 80-90% of the clues needed for diagnosis.
- Which of the following best describes a "working diagnosis"? A. A confirmed diagnosis B. A diagnosis that is most likely and will guide initial treatment C. A rare condition being ruled out D. A diagnosis used for billing Answer: B. A diagnosis that is most likely and will guide initial treatment Rationale: A working diagnosis guides further evaluation and treatment while remaining open to refinement.
- In evidence-based practice, the “P” in PICO stands for: A. Plan B. Patient/Population/Problem C. Probability D. Prescription Answer: B. Patient/Population/Problem Section 2: Systems-Based Differential Diagnosis
- A 55-year-old male presents with chest pain relieved by sitting forward. What is the most likely diagnosis? A. GERD B. Acute pericarditis C. Myocardial infarction D. Pneumonia Answer: B. Acute pericarditis
- Which of the following is considered a "red flag" in a patient presenting with low back pain? A. Age 30 B. Pain relieved with rest C. History of cancer D. Mild scoliosis Answer: C. History of cancer Rationale: Red flags include cancer, infection, trauma, or neurological deficits.
- A 40-year-old female presents with fatigue, cold intolerance, and weight gain. What is the most likely diagnosis? A. Hyperthyroidism B. Depression C. Hypothyroidism D. Anemia Answer: C. Hypothyroidism Rationale: Classic symptoms of underactive thyroid.
- What physical exam finding is associated with appendicitis? A. Murphy’s sign B. McBurney’s point tenderness C. Cullen’s sign D. Rovsing’s sign Answer: B. McBurney’s point tenderness Rationale: Pain at McBurney’s point is a hallmark of appendicitis. Section 4: Diagnostic Tools and Lab Interpretation
- What lab finding is most specific for bacterial infection? A. Elevated ESR B. High WBC count C. Positive CRP D. Elevated neutrophils with left shift
Answer: D. Elevated neutrophils with left shift Rationale: Indicates acute bacterial infection.
- A patient presents with a sudden severe headache, “worst of their life.” What is the immediate next step? A. MRI of the brain B. CT scan without contrast C. Lumbar puncture D. CBC and electrolytes Answer: B. CT scan without contrast Rationale: Rule out subarachnoid hemorrhage immediately.
- In assessing for strep pharyngitis, which tool is used? A. Wells score B. Ottawa rules C. Centor criteria D. Alvarado score Answer: C. Centor criteria
- What is the gold standard for diagnosing pulmonary embolism? A. Chest X-ray B. D-dimer C. V/Q scan D. CT pulmonary angiography Answer: D. CT pulmonary angiography
- What diagnostic tool is best for evaluating right lower quadrant pain in a pregnant woman? A. CT scan B. Pelvic X-ray C. Ultrasound D. MRI
- A child presents with honey-colored crusts around the mouth and nose. What is the most likely diagnosis? A. Herpes simplex B. Eczema C. Impetigo D. Contact dermatitis Answer: C. Impetigo Rationale: Classic bacterial skin infection, often caused by Staph aureus.
- A 45-year-old woman presents with a butterfly-shaped rash on her face that worsens with sun exposure. What condition is this characteristic of? A. Psoriasis B. Rosacea C. Systemic lupus erythematosus D. Contact dermatitis Answer: C. Systemic lupus erythematosus Rationale: Malar rash is a hallmark symptom.
- Which skin lesion is most concerning for melanoma? A. Symmetric brown mole with defined border B. 1 mm pink papule C. Asymmetric dark lesion with irregular borders and multiple colors D. Uniform brown macule Answer: C. Asymmetric dark lesion with irregular borders and multiple colors Rationale: ABCDE criteria for melanoma. Section 7: HEENT (Head, Eyes, Ears, Nose, Throat)
- What is the most likely cause of unilateral ear pain with a tragus tenderness and recent swimming? A. Otitis media B. Otitis externa C. Eustachian tube dysfunction
D. Temporomandibular joint disorder Answer: B. Otitis externa Rationale: External ear canal infection often caused by water exposure.
- A 65-year-old presents with sudden, painless vision loss in one eye and a pale retina on fundoscopy. Most likely diagnosis? A. Glaucoma B. Central retinal artery occlusion C. Macular degeneration D. Retinal detachment Answer: B. Central retinal artery occlusion Rationale: Sudden loss and pale retina is classic.
- A 5-year-old child presents with sore throat, fever, drooling, and muffled voice. What condition must be ruled out immediately? A. Strep pharyngitis B. Peritonsillar abscess C. Epiglottitis D. Hand-foot-mouth disease Answer: C. Epiglottitis Rationale: Airway emergency; avoid throat exam and refer to ED. Section 8: Gastrointestinal System
- A 22-year-old woman presents with right lower quadrant pain, nausea, and rebound tenderness. Most likely diagnosis? A. Ovarian cyst B. Appendicitis C. Ectopic pregnancy D. Diverticulitis Answer: B. Appendicitis Rationale: Classic presentation, especially with McBurney’s point tenderness.
- What is the next step when a Pap smear returns as ASC-US in a 25-year-old? A. Immediate colposcopy B. Repeat Pap in 6 months C. HPV testing D. Start antibiotics Answer: C. HPV testing Rationale: HPV triage is the recommended next step for ASC-US in women over 25. Section 10: Cardiovascular System
- A 68-year-old man presents with crushing substernal chest pain radiating to the left arm. ECG shows ST elevation in leads II, III, and aVF. What is the diagnosis? A. Anterior wall MI B. Lateral wall MI C. Inferior wall MI D. Angina pectoris Answer: C. Inferior wall MI Rationale: Leads II, III, and aVF correspond to the inferior heart wall.
- What heart sound is heard in a patient with congestive heart failure and is associated with volume overload? A. S B. S C. S D. S Answer: C. S Rationale: S3 indicates increased fluid volume and poor ventricular compliance.
- A 58-year-old with uncontrolled hypertension has a displaced apical impulse and systolic murmur at the apex. Likely diagnosis? A. Aortic stenosis B. Mitral regurgitation
C. Tricuspid stenosis D. Pericarditis Answer: B. Mitral regurgitation
- Which condition is associated with a crescendo-decrescendo systolic murmur heard best at the right upper sternal border? A. Mitral valve prolapse B. Aortic stenosis C. Pulmonary stenosis D. Mitral regurgitation Answer: B. Aortic stenosis Section 11: Pulmonary System
- A 45-year-old smoker presents with chronic cough, sputum, and mild dyspnea. Spirometry shows FEV1/FVC ratio <70%. Diagnosis? A. Asthma B. Chronic bronchitis (COPD) C. Bronchiectasis D. CHF Answer: B. Chronic bronchitis (COPD)
- Which of the following is a hallmark sign of asthma in spirometry? A. Decreased total lung capacity B. Irreversible airflow limitation C. Normal FEV1/FVC ratio D. Reversible obstruction with bronchodilator Answer: D. Reversible obstruction with bronchodilator
- A 30-year-old with asthma presents with respiratory distress, no wheezing, and silent chest. What does this suggest? A. Recovery B. Upper airway obstruction
- A 4-year-old presents with high fever, drooling, and tripod positioning. What is the first intervention? A. Give oral antibiotics B. Examine throat for swelling C. Intubation or emergency airway D. Administer nebulized albuterol Answer: C. Intubation or emergency airway Rationale: Epiglottitis is an airway emergency.
- A child with recent URI now presents with ear pain and a red, immobile tympanic membrane. Diagnosis? A. Otitis externa B. Otitis media C. Sinusitis D. Mastoiditis Answer: B. Otitis media Section 13: Men’s Health
- A 65-year-old male presents with difficulty starting urination, weak stream, and nocturia. What is the most likely cause? A. Bladder cancer B. Prostatitis C. Benign prostatic hyperplasia (BPH) D. UTI Answer: C. BPH
- A male patient has sudden testicular pain, high-riding testis, and absent cremasteric reflex. Next step? A. Urinalysis B. Testicular ultrasound C. Manual detorsion D. Immediate surgical referral
Answer: D. Immediate surgical referral Rationale: Suspect testicular torsion—emergency. Section 14: Endocrine Disorders
- A 35-year-old woman presents with weight loss, palpitations, heat intolerance, and tremor. Likely diagnosis? A. Hypothyroidism B. Type 2 diabetes C. Hyperthyroidism D. Addison’s disease Answer: C. Hyperthyroidism
- A patient with DM presents with polyuria, fruity breath, and Kussmaul respirations. What is the diagnosis? A. Hyperosmolar state B. Hypoglycemia C. DKA (Diabetic Ketoacidosis) D. Lactic acidosis Answer: C. DKA
- What test confirms the diagnosis of hypothyroidism? A. TSH elevated, free T4 low B. TSH low, free T4 high C. TSH and T4 both high D. Normal TSH, low T Answer: A. TSH elevated, free T4 low Section 15: Genitourinary and Renal Disorders
- A 28-year-old woman presents with dysuria, urinary frequency, and suprapubic discomfort. No fever or flank pain. Likely diagnosis? A. Pyelonephritis B. Urethritis
- A 25-year-old reports low mood, anhedonia, fatigue, and difficulty concentrating for 6 weeks. Most likely diagnosis? A. Adjustment disorder B. Bipolar disorder C. Major depressive disorder D. Dysthymia Answer: C. Major depressive disorder
- Which of the following requires urgent psychiatric referral? A. Panic attack B. Mild depression C. Suicidal ideation with plan D. Insomnia Answer: C. Suicidal ideation with plan
- A patient with bipolar disorder presents with decreased need for sleep, increased goal-directed activity, and grandiosity. This suggests: A. Depression B. Hypomania C. Acute mania D. Delirium Answer: C. Acute mania Section 17: Hematology and Oncology
- A 70-year-old male presents with fatigue, pallor, and microcytic anemia. What condition must be ruled out? A. Hemophilia B. Iron deficiency from GI bleed C. B12 deficiency D. Sickle cell anemia Answer: B. Iron deficiency from GI bleed
- A patient with a history of chronic alcohol use presents with macrocytic anemia. Which lab is most useful next? A. Serum iron B. Ferritin C. Vitamin B12 and folate D. Reticulocyte count Answer: C. Vitamin B12 and folate
- Which of the following is a red flag symptom requiring urgent cancer evaluation? A. Back pain relieved with rest B. Weight loss and night sweats C. Fatigue with normal labs D. Headache with cold weather Answer: B. Weight loss and night sweats Section 18: Multisystem/Red Flag Presentations
- A 45-year-old female presents with fatigue, dry skin, constipation, and cold intolerance. What test should you order first? A. CBC B. Fasting glucose C. TSH D. BUN and creatinine Answer: C. TSH
- A patient with history of asthma presents with wheezing, urticaria, and hypotension after taking ibuprofen. Diagnosis? A. Asthma attack B. Vasovagal reaction C. Anaphylaxis D. COPD exacerbation Answer: C. Anaphylaxis
Rationale: Updated guidelines recommend starting at 45.
- A 25-year-old female presents for Pap screening. What is the current guideline? A. Start at age 21, every 3 years B. Start at age 25, every 2 years C. Start at first sexual activity D. Start at age 30 with HPV co-testing Answer: A. Start at age 21, every 3 yearsSection 20: Musculoskeletal Disorders
- A 45-year-old woman complains of bilateral joint stiffness in the morning lasting over an hour. She has swollen MCP and PIP joints. Likely diagnosis? A. Osteoarthritis B. Rheumatoid arthritis C. Gout D. Fibromyalgia Answer: B. Rheumatoid arthritis Rationale: Morning stiffness >1 hour and symmetrical joint involvement is characteristic of RA.
- A 60-year-old male presents with acute monoarticular joint pain in the big toe, red and swollen. Best diagnostic test? A. ESR B. Rheumatoid factor C. Synovial fluid aspiration D. X-ray Answer: C. Synovial fluid aspiration Rationale: To confirm crystals for gout diagnosis.
- What is the first-line treatment for mild to moderate osteoarthritis of the knee? A. Oral steroids B. NSAIDs and exercise C. Intra-articular corticosteroids D. Methotrexate
Answer: B. NSAIDs and exercise
- Which of the following is most consistent with fibromyalgia? A. Morning stiffness that improves during the day B. Widespread pain with tender points and fatigue C. Decreased ROM of joints D. Red, hot, swollen joints Answer: B. Widespread pain with tender points and fatigue Section 21: Neurology
- A 75-year-old presents with sudden-onset facial droop, arm weakness, and speech difficulty. First diagnostic step? A. EEG B. Non-contrast CT head C. MRI D. Carotid ultrasound Answer: B. Non-contrast CT head Rationale: Rule out hemorrhagic stroke.
- A patient presents with tremor that improves with movement and worsens at rest. This is characteristic of: A. Essential tremor B. Parkinson’s disease C. Multiple sclerosis D. Cerebellar stroke Answer: B. Parkinson’s disease
- Which of the following is a red flag in a patient with headache? A. Headache after exercise B. Headache with photophobia C. Headache with neck stiffness and fever D. Recurrent migraine with aura