NR 511 Final Exam ACTUAL EXAM
2026/2027 | Chamberlain NR 511
Differential Diagnosis | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1 – HEENT, Dermatology, Pulmonology (Questions 1–20)
Q1. A 34-year-old teacher presents with sore throat, fever 101.5°F, and fatigue for 2 days. Exam shows
erythematous tonsils with white exudate, tender anterior cervical lymphadenopathy, and no cough.
What is the most likely diagnosis?
A. Allergic rhinitis
B. Viral pharyngitis
C. Group A streptococcal pharyngitis [CORRECT]
D. Infectious mononucleosis
Correct Answer: C
Rationale:
Correct because: Fever + exudate + tender nodes + no cough = Centor criteria suggest strep.
The option saying allergic rhinitis is wrong because: No itching, sneezing, or clear drainage.
The option saying viral pharyngitis is wrong because: Viral usually has cough and less exudate.
The option saying infectious mononucleosis is wrong because: More common with severe
fatigue, posterior nodes, and younger age.
Q2. A 62-year-old male presents with sudden onset left facial droop, inability to close his left eye, and
decreased taste on the anterior tongue. He denies limb weakness or slurred speech. What is the next
best step?
A. Immediate CT head to rule out stroke
, B. Start prednisone 60 mg daily for Bell palsy [CORRECT]
C. Refer to neurology for electromyography
D. Prescribe acyclovir alone without steroids
Correct Answer: B
Rationale:
Correct because: Isolated facial nerve palsy without other neuro deficits = Bell palsy; early
steroids improve recovery.
The option saying immediate CT head is wrong because: No stroke signs (limb weakness,
aphasia); facial droop alone is peripheral.
The option saying EMG referral is wrong because: EMG is not first-line; it confirms diagnosis
later if atypical.
The option saying acyclovir alone is wrong because: Antivirals add minimal benefit; steroids are
the main treatment.
Q3. A 45-year-old female presents with itchy, watery eyes, sneezing, and clear nasal discharge for 3
weeks in spring. She has no fever. What is the first-line treatment?
A. Amoxicillin for sinus infection
B. Intranasal corticosteroid + second-generation antihistamine [CORRECT]
C. Oral decongestant as monotherapy
D. Referral for allergy shots immediately
Correct Answer: B
Rationale:
Correct because: Seasonal pattern + itchy eyes + clear discharge = allergic rhinitis; intranasal
steroids are most effective, antihistamines help symptoms.
The option saying amoxicillin is wrong because: No fever, purulence, or facial pain; this is not
bacterial sinusitis.
The option saying oral decongestant monotherapy is wrong because: Decongestants treat
congestion only, not the underlying inflammation or itching.
The option saying allergy shots immediately is wrong because: Immunotherapy is for refractory
cases after medication failure, not first-line.
, Q4. A 28-year-old presents with a painful, vesicular rash in a band-like pattern on the right chest. The
lesions do not cross midline. What is the treatment?
A. Topical hydrocortisone cream
B. Oral acyclovir 800 mg 5 times daily started within 72 hours [CORRECT]
C. Oral cephalexin for bacterial coverage
D. Observation only since it is self-limited
Correct Answer: B
Rationale:
Correct because: Dermatomal vesicular rash = herpes zoster (shingles); antivirals within 72 hours
reduce pain and complications.
The option saying topical hydrocortisone is wrong because: Steroids on active viral lesions
worsen infection and delay healing.
The option saying oral cephalexin is wrong because: This is viral, not bacterial; antibiotics are
unnecessary unless secondary infection.
The option saying observation only is wrong because: Untreated shingles increases risk of
postherpetic neuralgia, especially in younger patients.
Q5. A 55-year-old smoker with COPD presents with increased dyspnea, purulent sputum, and fever
100.8°F. Lung exam shows diffuse wheezing and crackles. What is the next best step?
A. Start albuterol nebulizer only
B. Oral azithromycin + increased bronchodilators + oral prednisone [CORRECT]
C. Admit to hospital for IV vancomycin
D. Order chest CT to rule out lung cancer
Correct Answer: B
Rationale:
Correct because: COPD exacerbation with purulent sputum and fever = bacterial trigger;
antibiotics + steroids + bronchodilators are outpatient mainstays.
2026/2027 | Chamberlain NR 511
Differential Diagnosis | Verified Q&A |
Pass Guaranteed - A+ Graded
Section 1 – HEENT, Dermatology, Pulmonology (Questions 1–20)
Q1. A 34-year-old teacher presents with sore throat, fever 101.5°F, and fatigue for 2 days. Exam shows
erythematous tonsils with white exudate, tender anterior cervical lymphadenopathy, and no cough.
What is the most likely diagnosis?
A. Allergic rhinitis
B. Viral pharyngitis
C. Group A streptococcal pharyngitis [CORRECT]
D. Infectious mononucleosis
Correct Answer: C
Rationale:
Correct because: Fever + exudate + tender nodes + no cough = Centor criteria suggest strep.
The option saying allergic rhinitis is wrong because: No itching, sneezing, or clear drainage.
The option saying viral pharyngitis is wrong because: Viral usually has cough and less exudate.
The option saying infectious mononucleosis is wrong because: More common with severe
fatigue, posterior nodes, and younger age.
Q2. A 62-year-old male presents with sudden onset left facial droop, inability to close his left eye, and
decreased taste on the anterior tongue. He denies limb weakness or slurred speech. What is the next
best step?
A. Immediate CT head to rule out stroke
, B. Start prednisone 60 mg daily for Bell palsy [CORRECT]
C. Refer to neurology for electromyography
D. Prescribe acyclovir alone without steroids
Correct Answer: B
Rationale:
Correct because: Isolated facial nerve palsy without other neuro deficits = Bell palsy; early
steroids improve recovery.
The option saying immediate CT head is wrong because: No stroke signs (limb weakness,
aphasia); facial droop alone is peripheral.
The option saying EMG referral is wrong because: EMG is not first-line; it confirms diagnosis
later if atypical.
The option saying acyclovir alone is wrong because: Antivirals add minimal benefit; steroids are
the main treatment.
Q3. A 45-year-old female presents with itchy, watery eyes, sneezing, and clear nasal discharge for 3
weeks in spring. She has no fever. What is the first-line treatment?
A. Amoxicillin for sinus infection
B. Intranasal corticosteroid + second-generation antihistamine [CORRECT]
C. Oral decongestant as monotherapy
D. Referral for allergy shots immediately
Correct Answer: B
Rationale:
Correct because: Seasonal pattern + itchy eyes + clear discharge = allergic rhinitis; intranasal
steroids are most effective, antihistamines help symptoms.
The option saying amoxicillin is wrong because: No fever, purulence, or facial pain; this is not
bacterial sinusitis.
The option saying oral decongestant monotherapy is wrong because: Decongestants treat
congestion only, not the underlying inflammation or itching.
The option saying allergy shots immediately is wrong because: Immunotherapy is for refractory
cases after medication failure, not first-line.
, Q4. A 28-year-old presents with a painful, vesicular rash in a band-like pattern on the right chest. The
lesions do not cross midline. What is the treatment?
A. Topical hydrocortisone cream
B. Oral acyclovir 800 mg 5 times daily started within 72 hours [CORRECT]
C. Oral cephalexin for bacterial coverage
D. Observation only since it is self-limited
Correct Answer: B
Rationale:
Correct because: Dermatomal vesicular rash = herpes zoster (shingles); antivirals within 72 hours
reduce pain and complications.
The option saying topical hydrocortisone is wrong because: Steroids on active viral lesions
worsen infection and delay healing.
The option saying oral cephalexin is wrong because: This is viral, not bacterial; antibiotics are
unnecessary unless secondary infection.
The option saying observation only is wrong because: Untreated shingles increases risk of
postherpetic neuralgia, especially in younger patients.
Q5. A 55-year-old smoker with COPD presents with increased dyspnea, purulent sputum, and fever
100.8°F. Lung exam shows diffuse wheezing and crackles. What is the next best step?
A. Start albuterol nebulizer only
B. Oral azithromycin + increased bronchodilators + oral prednisone [CORRECT]
C. Admit to hospital for IV vancomycin
D. Order chest CT to rule out lung cancer
Correct Answer: B
Rationale:
Correct because: COPD exacerbation with purulent sputum and fever = bacterial trigger;
antibiotics + steroids + bronchodilators are outpatient mainstays.
