NR 511 Midterm Exam 2026| Chamberlain
University| Actual Exam Questions and
Correct Answers
Question 1
Which of the following is associated with severe tinnitus?
A. Depressive disorder
B. Hypertension
C. Stroke
D. Diabetic retinopathy
Correct Answer: B. Hypertension
Explanation: Hypertension is a vascular condition that can contribute to tinnitus through
changes in blood flow or pulsatile effects near the ear. While depressive disorder is commonly
associated with (or exacerbated by) tinnitus distress, and stroke or retinopathy have links in
broader contexts, standard exam references for this question identify hypertension as the
associated factor among the options.
Question 2
How do most clients on traditional Medicare cover their out-of-pocket expenses?
A. Acquiring Medicare Part being
B. Acquiring a secondary insurance plan
C. Setting up a monthly payment plan
D. Paying after the service has been rendered
Correct Answer: B. Acquiring a secondary insurance plan
Explanation: Traditional Medicare (Parts A and B) leaves beneficiaries responsible for
deductibles, coinsurance, and copayments. Most cover these gaps with a secondary plan such as
a Medigap (Medicare Supplement) policy, which pays after Medicare as the primary payer.
Question 3
,Which of the following is true regarding atopic dermatitis?
A. The client complaints of itching after the rash appears
B. The Cardinal sign is severe puritas
C. Puritas occurs during the acute phase of the rash
Correct Answer: B. The Cardinal sign is severe pruritus (Note: "puritas" appears to be a typo
for pruritus/itching)
Explanation: The hallmark (cardinal sign) of atopic dermatitis is intense pruritus (itching),
often severe enough to disrupt sleep. It is frequently described as the "itch that rashes," where
itching may precede or trigger the visible rash through scratching. Itching is prominent in both
acute and chronic phases.
Question 4
A 16-year-old client presents to the clinic with right ear pain for two days following participating
in high school swim meet. The eardrum demonstrates tenderness with traction of the pinna and
tragus pain, when pressure is applied. The ear canal is red and swollen to the point that the
tympanic membrane cannot be visualized. Which of the following is the most likely diagnosis?
A. Foreign body in the ear
B. Otitis media
C. Otitis externa
D. Ruptured tympanic membrane
Correct Answer: C. Otitis externa
Explanation: This presentation is classic for otitis externa ("swimmer's ear"): pain worsened
by traction on the pinna or pressure on the tragus, red/swollen canal (often preventing TM
visualization), and history of water exposure (swim meet). Otitis media typically involves
middle-ear findings without external canal swelling or tragus/pinna tenderness.
Question 5
A 10-year-old client was prescribed amoxicillin for otitis media. The FNP receives a call from
the parents that the client has developed a rash on the trunk. What is the most appropriate next
activity by the FNP?
A. Stop the medication
B. Prescribe systemic Antihistamines
C. Prescribe a short course of systemic steroids
, D. Continue the drug since it is expected early reaction
Correct Answer: D. Continue the drug since it is expected early reaction (with caveats—see
explanation)
Explanation: Many children develop a non-allergic, morbilliform (measles-like) rash on
amoxicillin, especially if they have a concurrent viral illness (common with otitis media). This is
not a true IgE-mediated allergy and does not usually require stopping the antibiotic if the child is
otherwise well. However, the provider should evaluate (ideally in person or via
description/photos) to rule out hives or more serious reactions. Antihistamines may help itching
if needed.
Question 6
Which of the following statements regarding the client history is true?
A. History of present illness (HPI) Is a detailed breakdown of the client's chief complaint
B. Objective findings are reported in the review of systems (ROS)
C. The OLDCART Acronym Represents the client's previous medical history
D. Objective findings are reported in the history of present illness (HPI)
Correct Answer: A. History of present illness (HPI) Is a detailed breakdown of the client's
chief complaint
Explanation: The HPI is the narrative expansion of the chief complaint using elements such
as OLDCARTS (Onset, Location, Duration, Characteristics, Aggravating/Alleviating factors,
Radiation/Relieving, Timing, Severity). ROS captures subjective symptoms by system; objective
findings belong in the physical exam. Past medical history is separate from OLDCARTS.
Question 7
Which of the following individuals is at most risk for developing epiphora (Excessive tearing)?
A. A 15-year-old soccer player
B. A 76-year-old with Type 2 diabetes
C. 40-year-old with hypertension
D. A 30-year-old computer programmer
Correct Answer: B. A 76-year-old with Type 2 diabetes
University| Actual Exam Questions and
Correct Answers
Question 1
Which of the following is associated with severe tinnitus?
A. Depressive disorder
B. Hypertension
C. Stroke
D. Diabetic retinopathy
Correct Answer: B. Hypertension
Explanation: Hypertension is a vascular condition that can contribute to tinnitus through
changes in blood flow or pulsatile effects near the ear. While depressive disorder is commonly
associated with (or exacerbated by) tinnitus distress, and stroke or retinopathy have links in
broader contexts, standard exam references for this question identify hypertension as the
associated factor among the options.
Question 2
How do most clients on traditional Medicare cover their out-of-pocket expenses?
A. Acquiring Medicare Part being
B. Acquiring a secondary insurance plan
C. Setting up a monthly payment plan
D. Paying after the service has been rendered
Correct Answer: B. Acquiring a secondary insurance plan
Explanation: Traditional Medicare (Parts A and B) leaves beneficiaries responsible for
deductibles, coinsurance, and copayments. Most cover these gaps with a secondary plan such as
a Medigap (Medicare Supplement) policy, which pays after Medicare as the primary payer.
Question 3
,Which of the following is true regarding atopic dermatitis?
A. The client complaints of itching after the rash appears
B. The Cardinal sign is severe puritas
C. Puritas occurs during the acute phase of the rash
Correct Answer: B. The Cardinal sign is severe pruritus (Note: "puritas" appears to be a typo
for pruritus/itching)
Explanation: The hallmark (cardinal sign) of atopic dermatitis is intense pruritus (itching),
often severe enough to disrupt sleep. It is frequently described as the "itch that rashes," where
itching may precede or trigger the visible rash through scratching. Itching is prominent in both
acute and chronic phases.
Question 4
A 16-year-old client presents to the clinic with right ear pain for two days following participating
in high school swim meet. The eardrum demonstrates tenderness with traction of the pinna and
tragus pain, when pressure is applied. The ear canal is red and swollen to the point that the
tympanic membrane cannot be visualized. Which of the following is the most likely diagnosis?
A. Foreign body in the ear
B. Otitis media
C. Otitis externa
D. Ruptured tympanic membrane
Correct Answer: C. Otitis externa
Explanation: This presentation is classic for otitis externa ("swimmer's ear"): pain worsened
by traction on the pinna or pressure on the tragus, red/swollen canal (often preventing TM
visualization), and history of water exposure (swim meet). Otitis media typically involves
middle-ear findings without external canal swelling or tragus/pinna tenderness.
Question 5
A 10-year-old client was prescribed amoxicillin for otitis media. The FNP receives a call from
the parents that the client has developed a rash on the trunk. What is the most appropriate next
activity by the FNP?
A. Stop the medication
B. Prescribe systemic Antihistamines
C. Prescribe a short course of systemic steroids
, D. Continue the drug since it is expected early reaction
Correct Answer: D. Continue the drug since it is expected early reaction (with caveats—see
explanation)
Explanation: Many children develop a non-allergic, morbilliform (measles-like) rash on
amoxicillin, especially if they have a concurrent viral illness (common with otitis media). This is
not a true IgE-mediated allergy and does not usually require stopping the antibiotic if the child is
otherwise well. However, the provider should evaluate (ideally in person or via
description/photos) to rule out hives or more serious reactions. Antihistamines may help itching
if needed.
Question 6
Which of the following statements regarding the client history is true?
A. History of present illness (HPI) Is a detailed breakdown of the client's chief complaint
B. Objective findings are reported in the review of systems (ROS)
C. The OLDCART Acronym Represents the client's previous medical history
D. Objective findings are reported in the history of present illness (HPI)
Correct Answer: A. History of present illness (HPI) Is a detailed breakdown of the client's
chief complaint
Explanation: The HPI is the narrative expansion of the chief complaint using elements such
as OLDCARTS (Onset, Location, Duration, Characteristics, Aggravating/Alleviating factors,
Radiation/Relieving, Timing, Severity). ROS captures subjective symptoms by system; objective
findings belong in the physical exam. Past medical history is separate from OLDCARTS.
Question 7
Which of the following individuals is at most risk for developing epiphora (Excessive tearing)?
A. A 15-year-old soccer player
B. A 76-year-old with Type 2 diabetes
C. 40-year-old with hypertension
D. A 30-year-old computer programmer
Correct Answer: B. A 76-year-old with Type 2 diabetes
