2025 /2026 Midterm Exam: NR 511/
NR511 Differential Diagnosis and
Primary Care Practicum Guide
Questions and Answers
A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the
following tests should be the first priority?
a. Pregnancy test
b. Pelvic ultrasound
c. Endometrial biopsy
d. Platelet count
Answer: a. Pregnancy test
A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to
antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
pg. 1
,c. Order a cytoscopy.
d. Order a different antibiotic.
Answer: a. Send a urine specimen for microscopy looking for fungal colonies.
A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of "my feet
feel like they are on fire." He has a loss of vibratory sense, +1 Achilles reflex, and a tack
embedded in his left heel. Which of the following would be an appropriate treatment?
a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin
Answer: a. Tricyclic antidepressants
A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral
vision loss, poor night vision, and frequent prescription changes that started 6 months
previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic
open-angle glaucoma. Which of the following statements is true concerning the diagnosis of
chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the
diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective
complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
pg. 2
,d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic
nerve.
Answer: c. Physical diagnosis relies on goniscopic evaluation of the angle by an
ophthalmologist.
A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Answer: a. Stage 2 hypertension
A bulla is:
a. A vesicle larger than 1 cm in diameter.
b. An elevated solid mass with a hard texture, and the shape and borders can be regular or
irregular.
c. A superficial elevated lesion filled with purulent fluid.
d. Thinning of the skin (epidermis and dermis) that appears white or translucent. - Answer: a. A
vesicle larger than 1 cm in diameter.
A chronic cough lasts longer than:
pg. 3
, a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Answer: a. 3 weeks
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The
clinician should inquire about the ingestion of which of these substances that might be the
cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Answer: a. NSAIDs
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and
diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of
differential diagnoses?
a. Pancreatitis
pg. 4
NR511 Differential Diagnosis and
Primary Care Practicum Guide
Questions and Answers
A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the
following tests should be the first priority?
a. Pregnancy test
b. Pelvic ultrasound
c. Endometrial biopsy
d. Platelet count
Answer: a. Pregnancy test
A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to
antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
pg. 1
,c. Order a cytoscopy.
d. Order a different antibiotic.
Answer: a. Send a urine specimen for microscopy looking for fungal colonies.
A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of "my feet
feel like they are on fire." He has a loss of vibratory sense, +1 Achilles reflex, and a tack
embedded in his left heel. Which of the following would be an appropriate treatment?
a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin
Answer: a. Tricyclic antidepressants
A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral
vision loss, poor night vision, and frequent prescription changes that started 6 months
previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic
open-angle glaucoma. Which of the following statements is true concerning the diagnosis of
chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the
diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective
complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
pg. 2
,d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic
nerve.
Answer: c. Physical diagnosis relies on goniscopic evaluation of the angle by an
ophthalmologist.
A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Answer: a. Stage 2 hypertension
A bulla is:
a. A vesicle larger than 1 cm in diameter.
b. An elevated solid mass with a hard texture, and the shape and borders can be regular or
irregular.
c. A superficial elevated lesion filled with purulent fluid.
d. Thinning of the skin (epidermis and dermis) that appears white or translucent. - Answer: a. A
vesicle larger than 1 cm in diameter.
A chronic cough lasts longer than:
pg. 3
, a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Answer: a. 3 weeks
A patient is seen in the clinic with hematuria confirmed on microscopic examination. The
clinician should inquire about the ingestion of which of these substances that might be the
cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Answer: a. NSAIDs
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and
diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of
differential diagnoses?
a. Pancreatitis
pg. 4
