FNP NR511: DIFFERENTIAL DIAGNOSIS
MIDTERM EXAM AT CHAMBERLAIN
COLLEGE 2024 EXPECTED QUESTIONS &
REVISED CORRECT ANSWERS. (2026)
100% GUARANTEE PASS
1. A 32-year-old male patient presents to the clinic with a 2-day history of hoarseness,
sore throat, and dry cough. The NP diagnoses him with laryngitis. Which is the best
treatment?
A. Bactrim
B. Supportive care
C. Amoxicillin
D. Levofloxacin
Answer: B. Supportive care
Rationale: Laryngitis is most commonly viral in etiology, and antibiotics are not
indicated. Management is supportive, including voice rest, hydration, and analgesics
as needed. Antibiotics should only be used if a bacterial infection is confirmed.
Overuse of antibiotics can contribute to resistance.
2. Medicare Part A covers which of the following services?
A. Outpatient provider visits
B. Eyeglasses and routine dental
C. Hospital services
D. Prescription medications
Answer: C. Hospital services
Rationale: Medicare Part A primarily covers inpatient hospital stays, skilled nursing
facility care, hospice, and some home health services. Outpatient services,
eyeglasses, dental, and routine medications are typically covered under Medicare Part
,B or supplemental plans. Correct knowledge of Medicare coverage ensures accurate
patient counseling.
3. A 35-year-old male uses high-potency corticosteroid cream for dermatosis and also
has tinea corporis. Which should the clinician advise regarding the cream?
A. "You must use this for an extended period of time for it to be effective."
B. "It will work better if you occlude the area."
C. "It may exacerbate your concurrent tinea corporis."
D. "Be sure to use it daily."
Answer: C. "It may exacerbate your concurrent tinea corporis."
Rationale: Topical corticosteroids can worsen fungal infections like tinea corporis
because they suppress local immune response. High-potency corticosteroids should be
used intermittently to minimize adverse effects. Occlusion and prolonged use can
increase systemic absorption and local side effects. Clinicians should always rule out
fungal infections before prescribing high-potency steroids.
4. A 21-year-old male presents with pruritic and emaciated skin in the groin area.
Which is the most likely diagnosis?
A. Eczema
B. Tinea cruris
C. Psoriasis
D. Intertrigo
Answer: B. Tinea cruris
Rationale: Tinea cruris, or "jock itch," presents with pruritic, well-demarcated
erythematous patches in the groin. It is caused by dermatophyte fungi and worsens
with moisture and friction. Topical antifungal therapy is the first-line treatment.
Eczema and intertrigo may mimic the appearance but are differentiated by lack of
fungal hyphae on KOH prep.
,5. Marcia, age 4, presents with sore throat, difficulty swallowing, copious oral
secretions, respiratory difficulty, stridor, and a temperature of 102°F but no
pharyngeal erythema or cough. What do you suspect?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal pharyngitis
C. Tonsillitis
D. Diphtheria
Answer: A. Epiglottitis
Rationale: Epiglottitis presents with sudden onset of sore throat, drooling, stridor,
high fever, and difficulty swallowing. Absence of pharyngeal erythema and cough
differentiates it from strep throat or tonsillitis. Epiglottitis is a medical emergency
requiring immediate airway management. Vaccination against Haemophilus influenzae
type B has decreased incidence.
6. A patient presents with epigastric discomfort described as burning or gnawing.
Which condition does this suggest?
A. Gastroesophageal reflux disease
B. Peptic ulcer disease
C. Cholecystitis
D. Pancreatitis
Answer: B. Peptic ulcer disease
Rationale: Peptic ulcer disease typically presents as burning or gnawing epigastric
pain, often related to meals. Pain may improve or worsen with eating depending on
ulcer location. Risk factors include H. pylori infection, NSAID use, and stress. Prompt
diagnosis prevents complications such as bleeding or perforation.
, 7. You are assessing a first grader and find that the tonsils are touching the uvula.
What grade is this?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
Answer: C. Grade 3
Rationale: Tonsil grading is as follows: 1+ visible, 2+ halfway between pillars and
uvula, 3+ touching the uvula, 4+ touching each other (kissing tonsils). Grade 3 tonsils
indicate significant enlargement, which may contribute to obstructive symptoms or
recurrent infections. Assessment of airway compromise is essential.
8. A 45-year-old female presents with fatigue, weight gain, cold intolerance, and dry
skin. Lab shows elevated TSH and low T4. What is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
C. Hashimoto’s thyroiditis
D. Graves’ disease
Answer: B. Hypothyroidism
Rationale: Hypothyroidism presents with fatigue, cold intolerance, weight gain, and
dry skin. Elevated TSH with low T4 confirms primary hypothyroidism. Hashimoto’s
thyroiditis is a common autoimmune cause of hypothyroidism. Early diagnosis and
levothyroxine therapy prevent cardiovascular and cognitive complications.
9. A 28-year-old female presents with sudden onset right lower quadrant pain, nausea,
and anorexia. What is the most likely diagnosis?
A. Cholecystitis
B. Appendicitis
MIDTERM EXAM AT CHAMBERLAIN
COLLEGE 2024 EXPECTED QUESTIONS &
REVISED CORRECT ANSWERS. (2026)
100% GUARANTEE PASS
1. A 32-year-old male patient presents to the clinic with a 2-day history of hoarseness,
sore throat, and dry cough. The NP diagnoses him with laryngitis. Which is the best
treatment?
A. Bactrim
B. Supportive care
C. Amoxicillin
D. Levofloxacin
Answer: B. Supportive care
Rationale: Laryngitis is most commonly viral in etiology, and antibiotics are not
indicated. Management is supportive, including voice rest, hydration, and analgesics
as needed. Antibiotics should only be used if a bacterial infection is confirmed.
Overuse of antibiotics can contribute to resistance.
2. Medicare Part A covers which of the following services?
A. Outpatient provider visits
B. Eyeglasses and routine dental
C. Hospital services
D. Prescription medications
Answer: C. Hospital services
Rationale: Medicare Part A primarily covers inpatient hospital stays, skilled nursing
facility care, hospice, and some home health services. Outpatient services,
eyeglasses, dental, and routine medications are typically covered under Medicare Part
,B or supplemental plans. Correct knowledge of Medicare coverage ensures accurate
patient counseling.
3. A 35-year-old male uses high-potency corticosteroid cream for dermatosis and also
has tinea corporis. Which should the clinician advise regarding the cream?
A. "You must use this for an extended period of time for it to be effective."
B. "It will work better if you occlude the area."
C. "It may exacerbate your concurrent tinea corporis."
D. "Be sure to use it daily."
Answer: C. "It may exacerbate your concurrent tinea corporis."
Rationale: Topical corticosteroids can worsen fungal infections like tinea corporis
because they suppress local immune response. High-potency corticosteroids should be
used intermittently to minimize adverse effects. Occlusion and prolonged use can
increase systemic absorption and local side effects. Clinicians should always rule out
fungal infections before prescribing high-potency steroids.
4. A 21-year-old male presents with pruritic and emaciated skin in the groin area.
Which is the most likely diagnosis?
A. Eczema
B. Tinea cruris
C. Psoriasis
D. Intertrigo
Answer: B. Tinea cruris
Rationale: Tinea cruris, or "jock itch," presents with pruritic, well-demarcated
erythematous patches in the groin. It is caused by dermatophyte fungi and worsens
with moisture and friction. Topical antifungal therapy is the first-line treatment.
Eczema and intertrigo may mimic the appearance but are differentiated by lack of
fungal hyphae on KOH prep.
,5. Marcia, age 4, presents with sore throat, difficulty swallowing, copious oral
secretions, respiratory difficulty, stridor, and a temperature of 102°F but no
pharyngeal erythema or cough. What do you suspect?
A. Epiglottitis
B. Group A beta-hemolytic streptococcal pharyngitis
C. Tonsillitis
D. Diphtheria
Answer: A. Epiglottitis
Rationale: Epiglottitis presents with sudden onset of sore throat, drooling, stridor,
high fever, and difficulty swallowing. Absence of pharyngeal erythema and cough
differentiates it from strep throat or tonsillitis. Epiglottitis is a medical emergency
requiring immediate airway management. Vaccination against Haemophilus influenzae
type B has decreased incidence.
6. A patient presents with epigastric discomfort described as burning or gnawing.
Which condition does this suggest?
A. Gastroesophageal reflux disease
B. Peptic ulcer disease
C. Cholecystitis
D. Pancreatitis
Answer: B. Peptic ulcer disease
Rationale: Peptic ulcer disease typically presents as burning or gnawing epigastric
pain, often related to meals. Pain may improve or worsen with eating depending on
ulcer location. Risk factors include H. pylori infection, NSAID use, and stress. Prompt
diagnosis prevents complications such as bleeding or perforation.
, 7. You are assessing a first grader and find that the tonsils are touching the uvula.
What grade is this?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
Answer: C. Grade 3
Rationale: Tonsil grading is as follows: 1+ visible, 2+ halfway between pillars and
uvula, 3+ touching the uvula, 4+ touching each other (kissing tonsils). Grade 3 tonsils
indicate significant enlargement, which may contribute to obstructive symptoms or
recurrent infections. Assessment of airway compromise is essential.
8. A 45-year-old female presents with fatigue, weight gain, cold intolerance, and dry
skin. Lab shows elevated TSH and low T4. What is the most likely diagnosis?
A. Hyperthyroidism
B. Hypothyroidism
C. Hashimoto’s thyroiditis
D. Graves’ disease
Answer: B. Hypothyroidism
Rationale: Hypothyroidism presents with fatigue, cold intolerance, weight gain, and
dry skin. Elevated TSH with low T4 confirms primary hypothyroidism. Hashimoto’s
thyroiditis is a common autoimmune cause of hypothyroidism. Early diagnosis and
levothyroxine therapy prevent cardiovascular and cognitive complications.
9. A 28-year-old female presents with sudden onset right lower quadrant pain, nausea,
and anorexia. What is the most likely diagnosis?
A. Cholecystitis
B. Appendicitis
