NR 569 Exam 1: Differential Diagnosis in Acute Care Practicum -
Questions and Answers and Explanations | Latest - Chamberlain
1. Which statistical term refers to the ability of a test to correctly identify those
with a disease (true positive rate)?
A. Specificity
B. Positive Predictive Value
C. Sensitivity
D. Prevalence
Answer: C
Explanation: Sensitivity is the probability that a test will indicate ‘disease’ among those
with the disease. High sensitivity is useful for screening.
2. A patient presents with sharp, pleuritic chest pain that is relieved by sitting
forward. What is the most likely differential diagnosis?
A. Myocardial Infarction
B. Aortic Dissection
C. Pulmonary Embolism
D. Acute Pericarditis
Answer: D
,Explanation: Pleuritic chest pain improved by leaning forward is a classic presentation of
acute pericarditis, often accompanied by a friction rub.
3. Which of the following is considered the ‘gold standard’ for diagnosing a
pulmonary embolism?
A. D-dimer assay
B. Chest X-ray
C. CT Angiography (CTPA)
D. V/Q Scan
Answer: C
Explanation: CT Pulmonary Angiography is the preferred diagnostic imaging for PE due to
high sensitivity and specificity.
4. In the differential diagnosis of abdominal pain, Murphy’s sign is most
associated with which condition?
A. Appendicitis
B. Acute Cholecystitis
C. Pancreatitis
D. Diverticulitis
Answer: B
Explanation: Murphy’s sign (arrest of inspiration on palpation of the RUQ) is highly
suggestive of acute cholecystitis.
,5. Which diagnostic finding is most characteristic of Diabetic Ketoacidosis (DKA)
compared to Hyperosmolar Hyperglycemic State (HHS)?
A. Blood glucose > 600 mg/dL
B. Absence of ketones
C. Severe dehydration
D. Significant metabolic acidosis with an anion gap
Answer: D
Explanation: DKA is defined by the presence of ketosis and a significant metabolic
acidosis, whereas HHS presents with higher glucose and minimal acidosis.
6. A 65-year-old male presents with ‘tearing’ chest pain radiating to the back.
His BP is 180/100 in the right arm and 140/90 in the left arm. What is the
priority diagnosis?
A. Acute Myocardial Infarction
B. Esophageal Rupture
C. Tension Pneumothorax
D. Aortic Dissection
Answer: D
Explanation: Tearing pain radiating to the back and a BP differential between arms are
classic signs of a thoracic aortic dissection.
, 7. Specificity represents the ability of a test to:
A. Correctly identify those without the disease
B. Rule out a disease
C. Predict the severity of a disease
D. Identify the prevalence in a population
Answer: A
Explanation: Specificity is the true negative rate; it measures the proportion of people who
do not have the disease and test negative.
8. A patient with a history of alcohol abuse presents with epigastric pain
radiating to the back, nausea, and elevated lipase. What is the diagnosis?
A. Acute Pancreatitis
B. Peptic Ulcer Disease
C. Gastroenteritis
D. Biliary Colic
Answer: A
Explanation: Epigastric pain radiating to the back and elevated lipase (3x normal) are the
hallmarks of acute pancreatitis.
Questions and Answers and Explanations | Latest - Chamberlain
1. Which statistical term refers to the ability of a test to correctly identify those
with a disease (true positive rate)?
A. Specificity
B. Positive Predictive Value
C. Sensitivity
D. Prevalence
Answer: C
Explanation: Sensitivity is the probability that a test will indicate ‘disease’ among those
with the disease. High sensitivity is useful for screening.
2. A patient presents with sharp, pleuritic chest pain that is relieved by sitting
forward. What is the most likely differential diagnosis?
A. Myocardial Infarction
B. Aortic Dissection
C. Pulmonary Embolism
D. Acute Pericarditis
Answer: D
,Explanation: Pleuritic chest pain improved by leaning forward is a classic presentation of
acute pericarditis, often accompanied by a friction rub.
3. Which of the following is considered the ‘gold standard’ for diagnosing a
pulmonary embolism?
A. D-dimer assay
B. Chest X-ray
C. CT Angiography (CTPA)
D. V/Q Scan
Answer: C
Explanation: CT Pulmonary Angiography is the preferred diagnostic imaging for PE due to
high sensitivity and specificity.
4. In the differential diagnosis of abdominal pain, Murphy’s sign is most
associated with which condition?
A. Appendicitis
B. Acute Cholecystitis
C. Pancreatitis
D. Diverticulitis
Answer: B
Explanation: Murphy’s sign (arrest of inspiration on palpation of the RUQ) is highly
suggestive of acute cholecystitis.
,5. Which diagnostic finding is most characteristic of Diabetic Ketoacidosis (DKA)
compared to Hyperosmolar Hyperglycemic State (HHS)?
A. Blood glucose > 600 mg/dL
B. Absence of ketones
C. Severe dehydration
D. Significant metabolic acidosis with an anion gap
Answer: D
Explanation: DKA is defined by the presence of ketosis and a significant metabolic
acidosis, whereas HHS presents with higher glucose and minimal acidosis.
6. A 65-year-old male presents with ‘tearing’ chest pain radiating to the back.
His BP is 180/100 in the right arm and 140/90 in the left arm. What is the
priority diagnosis?
A. Acute Myocardial Infarction
B. Esophageal Rupture
C. Tension Pneumothorax
D. Aortic Dissection
Answer: D
Explanation: Tearing pain radiating to the back and a BP differential between arms are
classic signs of a thoracic aortic dissection.
, 7. Specificity represents the ability of a test to:
A. Correctly identify those without the disease
B. Rule out a disease
C. Predict the severity of a disease
D. Identify the prevalence in a population
Answer: A
Explanation: Specificity is the true negative rate; it measures the proportion of people who
do not have the disease and test negative.
8. A patient with a history of alcohol abuse presents with epigastric pain
radiating to the back, nausea, and elevated lipase. What is the diagnosis?
A. Acute Pancreatitis
B. Peptic Ulcer Disease
C. Gastroenteritis
D. Biliary Colic
Answer: A
Explanation: Epigastric pain radiating to the back and elevated lipase (3x normal) are the
hallmarks of acute pancreatitis.
