NR 511 Final Exam Study Guide:
150+ Practice Questions with
Answers and Explanations for
Differential Diagnosis and Primary
Care Practicum
1. After 6 months of synthroid therapy, the clinician should expect which of the
following in the repeat thyroid studies?
a. elevated TSH
b. normal TSH
c. low TSH
d. undetectable TSH
Correct Answer: b. normal TSH
Explanation: The goal of Synthroid (levothyroxine) therapy for hypothyroidism is to
restore thyroid hormone levels to normal. A normal TSH indicates that the dose is
appropriate and the patient is euthyroid .
2. Which of the following is an example of an articular structure?
a. Fascia
b. Bone
c. Synovium
d. Tendons
Correct Answer: c. Synovium
,Explanation: Articular structures are those directly involved in the joint. The synovium is
the lining of the joint capsule. Fascia, tendons, and bone are considered nonarticular
structures, although bone is part of the skeletal system .
3. Cat bites are commonly associated with which of the following pathogens?
a. pasteurella multocida
b. vibrio vulnificus
c. group B streptococcus
d. Group A beta hemolytic streptococcus
Correct Answer: a. pasteurella multocida
Explanation: Pasteurella multocida is a bacterium commonly found in the mouths of
cats and is a frequent cause of infection following cat bites and scratches .
4. You are performing muscle strength testing on a patient and find that the
patient has complete range of motion with gravity eliminated. Which numeric
grade of muscle strength would you give this patient?
a. 1
b. 2
c. 3
d. 4
Correct Answer: b. 2
Explanation: Muscle strength is graded on a 0-5 scale. Grade 2 (Poor) indicates full
range of motion with gravity eliminated. Grade 3 (Fair) is full range of motion against
gravity only. Grade 1 is a flicker of contraction, and grade 4 is movement against some
resistance .
5. A patient is diagnosed with Giardia after a backpacking trip in the mountains.
Which of the following would be the appropriate treatment?
a. Vancomycin
b. Penicillin
c. Metronidazole
d. Bactrim
Correct Answer: c. Metronidazole
Explanation: Metronidazole (Flagyl) is a first-line antibiotic for treating Giardia
infections. It is effective against this protozoan parasite commonly contracted from
contaminated water .
,6. The most cost-effective screening test to determine HIV status is which of the
following?
a. western blot
b. enzyme-linked immunosorbent assay (ELISA)
c. venereal disease research laboratory test (VDRL)
d. Viral load
Correct Answer: b. enzyme-linked immunosorbent assay (ELISA)
Explanation: The ELISA test is the initial and most cost-effective screening test for HIV.
It has high sensitivity. Positive results are then confirmed with a more specific test like
the Western blot .
7. Which of the following dietary information should be given to a patient with
gastroesophageal reflux disease (GERD)?
a. eliminate coffee
b. drink peppermint tea to relieve stomach distress
c. recline and rest after meals
d. limit the amount of antacids
Correct Answer: a. eliminate coffee
Explanation: Caffeinated beverages like coffee can relax the lower esophageal sphincter
(LES) and increase gastric acid secretion, worsening GERD. Patients are advised to
eliminate or reduce these triggers .
8. What is the meaning of the "A" in the SNAPPS model for clinical education?
a. Assessment
b. Analyze
c. Ask
d. Action
Correct Answer: b. Analyze
Explanation: SNAPPS is a learner-centered model for case presentations. It stands
for: Summarize, Narrow the differential, Analyze the differential, Probe the
preceptor, Plan management, and Select an issue for self-directed learning .
9. A 56-year-old man with chronic prostatitis should be treated with
trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim) for how long?
a. 3-7 days
b. 14-21 days
, c. 3-6 weeks
d. 6-12 weeks
Correct Answer: d. 6-12 weeks
Explanation: Chronic bacterial prostatitis requires a prolonged course of antibiotics,
typically 4 to 12 weeks, to penetrate prostatic tissue and fully eradicate the infection.
Fluoroquinolones or TMP-SMX are commonly used .
10. A 28-year-old patient is seen in the office with colicky abdominal pain,
particularly with meals. She has frequent constipation, flatulence, and abdominal
distention. Which of the data makes a diagnosis of diverticulitis unlikely?
a. her age
b. frequent constipation
c. flatulence
d. colicky abdominal pain
Correct Answer: d. colicky abdominal pain
Explanation: Diverticulitis pain is typically constant and localized (often in the LLQ), not
"colicky." Colicky pain that comes and goes is more characteristic of conditions like
irritable bowel syndrome (IBS) or a bowel obstruction .
11. Which of the following signs or symptoms indicate an inflammatory etiology
to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Correct Answer: c. Morning stiffness
Explanation: Morning stiffness lasting more than 30 minutes to an hour is a classic sign
of inflammatory arthritis (e.g., rheumatoid arthritis). In contrast, mechanical joint pain
often worsens with activity and improves with rest .
12. The clinician sees a patient who is 5 feet tall and weighs 150 pounds (BMI
29.3). How would the clinician classify this patient?
a. overweight
b. Mild Obesity
c. Moderate Obesity
d. morbid obesity
150+ Practice Questions with
Answers and Explanations for
Differential Diagnosis and Primary
Care Practicum
1. After 6 months of synthroid therapy, the clinician should expect which of the
following in the repeat thyroid studies?
a. elevated TSH
b. normal TSH
c. low TSH
d. undetectable TSH
Correct Answer: b. normal TSH
Explanation: The goal of Synthroid (levothyroxine) therapy for hypothyroidism is to
restore thyroid hormone levels to normal. A normal TSH indicates that the dose is
appropriate and the patient is euthyroid .
2. Which of the following is an example of an articular structure?
a. Fascia
b. Bone
c. Synovium
d. Tendons
Correct Answer: c. Synovium
,Explanation: Articular structures are those directly involved in the joint. The synovium is
the lining of the joint capsule. Fascia, tendons, and bone are considered nonarticular
structures, although bone is part of the skeletal system .
3. Cat bites are commonly associated with which of the following pathogens?
a. pasteurella multocida
b. vibrio vulnificus
c. group B streptococcus
d. Group A beta hemolytic streptococcus
Correct Answer: a. pasteurella multocida
Explanation: Pasteurella multocida is a bacterium commonly found in the mouths of
cats and is a frequent cause of infection following cat bites and scratches .
4. You are performing muscle strength testing on a patient and find that the
patient has complete range of motion with gravity eliminated. Which numeric
grade of muscle strength would you give this patient?
a. 1
b. 2
c. 3
d. 4
Correct Answer: b. 2
Explanation: Muscle strength is graded on a 0-5 scale. Grade 2 (Poor) indicates full
range of motion with gravity eliminated. Grade 3 (Fair) is full range of motion against
gravity only. Grade 1 is a flicker of contraction, and grade 4 is movement against some
resistance .
5. A patient is diagnosed with Giardia after a backpacking trip in the mountains.
Which of the following would be the appropriate treatment?
a. Vancomycin
b. Penicillin
c. Metronidazole
d. Bactrim
Correct Answer: c. Metronidazole
Explanation: Metronidazole (Flagyl) is a first-line antibiotic for treating Giardia
infections. It is effective against this protozoan parasite commonly contracted from
contaminated water .
,6. The most cost-effective screening test to determine HIV status is which of the
following?
a. western blot
b. enzyme-linked immunosorbent assay (ELISA)
c. venereal disease research laboratory test (VDRL)
d. Viral load
Correct Answer: b. enzyme-linked immunosorbent assay (ELISA)
Explanation: The ELISA test is the initial and most cost-effective screening test for HIV.
It has high sensitivity. Positive results are then confirmed with a more specific test like
the Western blot .
7. Which of the following dietary information should be given to a patient with
gastroesophageal reflux disease (GERD)?
a. eliminate coffee
b. drink peppermint tea to relieve stomach distress
c. recline and rest after meals
d. limit the amount of antacids
Correct Answer: a. eliminate coffee
Explanation: Caffeinated beverages like coffee can relax the lower esophageal sphincter
(LES) and increase gastric acid secretion, worsening GERD. Patients are advised to
eliminate or reduce these triggers .
8. What is the meaning of the "A" in the SNAPPS model for clinical education?
a. Assessment
b. Analyze
c. Ask
d. Action
Correct Answer: b. Analyze
Explanation: SNAPPS is a learner-centered model for case presentations. It stands
for: Summarize, Narrow the differential, Analyze the differential, Probe the
preceptor, Plan management, and Select an issue for self-directed learning .
9. A 56-year-old man with chronic prostatitis should be treated with
trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim) for how long?
a. 3-7 days
b. 14-21 days
, c. 3-6 weeks
d. 6-12 weeks
Correct Answer: d. 6-12 weeks
Explanation: Chronic bacterial prostatitis requires a prolonged course of antibiotics,
typically 4 to 12 weeks, to penetrate prostatic tissue and fully eradicate the infection.
Fluoroquinolones or TMP-SMX are commonly used .
10. A 28-year-old patient is seen in the office with colicky abdominal pain,
particularly with meals. She has frequent constipation, flatulence, and abdominal
distention. Which of the data makes a diagnosis of diverticulitis unlikely?
a. her age
b. frequent constipation
c. flatulence
d. colicky abdominal pain
Correct Answer: d. colicky abdominal pain
Explanation: Diverticulitis pain is typically constant and localized (often in the LLQ), not
"colicky." Colicky pain that comes and goes is more characteristic of conditions like
irritable bowel syndrome (IBS) or a bowel obstruction .
11. Which of the following signs or symptoms indicate an inflammatory etiology
to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Correct Answer: c. Morning stiffness
Explanation: Morning stiffness lasting more than 30 minutes to an hour is a classic sign
of inflammatory arthritis (e.g., rheumatoid arthritis). In contrast, mechanical joint pain
often worsens with activity and improves with rest .
12. The clinician sees a patient who is 5 feet tall and weighs 150 pounds (BMI
29.3). How would the clinician classify this patient?
a. overweight
b. Mild Obesity
c. Moderate Obesity
d. morbid obesity
