NR 576 Final Exam (2025/2026 Newly Updated) –
Differential Diagnosis in Adult-Gerontology
Primary Care | Chamberlain University | Verified
Answers and Comprehensive Study Guide
This final exam for NR576 Differential Diagnosis in Adult-Gerontology Primary Care
(2025/2026) features 50 verified questions on adult and geriatric differential diagnosis, covering
common presentations, risk factors, and management. Questions are scenario-based, with the
correct answer in RED, and rationales with clinical implications and evidence-based references.
Question 1
A 52-year-old female presents with 4 weeks of fatigue, weight gain, and cold intolerance. Exam
shows dry skin and bradycardia. What is the most likely diagnosis?
Answer: Hypothyroidism
Rationale: Symptoms and signs suggest thyroid hormone deficiency. Clinical Implication:
Order TSH; start levothyroxine if confirmed.
Question 2
A 68-year-old male with 3 months of progressive memory loss and difficulty managing finances.
No focal neurological deficits. Diagnosis?
Answer: Mild cognitive impairment
Rationale: Gradual decline without functional loss beyond expected aging. Clinical
Implication: Cognitive testing; monitor for progression (AA guidelines).
Question 3
A 45-year-old male has chest pain radiating to jaw, diaphoresis, and nausea. ECG shows ST
elevation. Diagnosis?
Answer: Acute myocardial infarction
Rationale: Classic symptoms and ECG findings. Clinical Implication: PCI within 90 minutes
(AHA/ACC).
, Question 4
A 60-year-old female has fatigue, dyspnea, and edema. BNP 450 pg/mL, echo shows EF 35%.
Diagnosis?
Answer: Heart failure with reduced ejection fraction
Rationale: Symptoms, elevated BNP, and low EF. Clinical Implication: ACEI, beta-blocker,
SGLT2i (ACC/AHA).
Question 5
A 55-year-old male has 2 months of cough, weight loss, and hemoptysis. Chest X-ray shows a
mass. Diagnosis?
Answer: Lung cancer
Rationale: Risk factors and symptoms. Clinical Implication: CT biopsy, staging (NCCN).
Question 6
A 70-year-old female has acute confusion, urinary incontinence, and recent UTI. Diagnosis?
Answer: Delirium
Rationale: Acute onset, fluctuating course (CAM criteria). Clinical Implication: Treat UTI;
reorient (AGS).
Question 7
A 48-year-old male has fatigue, polyuria, and polydipsia. Glucose 300 mg/dL. Diagnosis?
Answer: Type 2 diabetes mellitus
Rationale: Classic symptoms, hyperglycemia. Clinical Implication: HbA1c, metformin (ADA).
Question 8
A 65-year-old male has flank pain, hematuria, and fever. CT shows hydronephrosis. Diagnosis?
Answer: Pyelonephritis
Rationale: Upper UTI with obstruction. Clinical Implication: Antibiotics, urology consult
(IDSA).
Question 9
A 50-year-old female has irregular menses, hirsutism, and obesity. Ultrasound shows polycystic
ovaries. Diagnosis?
Answer: Polycystic ovary syndrome
Rationale: Rotterdam criteria: oligo-anovulation + hyperandrogenism. Clinical Implication:
OCP, metformin (ASRM).
Differential Diagnosis in Adult-Gerontology
Primary Care | Chamberlain University | Verified
Answers and Comprehensive Study Guide
This final exam for NR576 Differential Diagnosis in Adult-Gerontology Primary Care
(2025/2026) features 50 verified questions on adult and geriatric differential diagnosis, covering
common presentations, risk factors, and management. Questions are scenario-based, with the
correct answer in RED, and rationales with clinical implications and evidence-based references.
Question 1
A 52-year-old female presents with 4 weeks of fatigue, weight gain, and cold intolerance. Exam
shows dry skin and bradycardia. What is the most likely diagnosis?
Answer: Hypothyroidism
Rationale: Symptoms and signs suggest thyroid hormone deficiency. Clinical Implication:
Order TSH; start levothyroxine if confirmed.
Question 2
A 68-year-old male with 3 months of progressive memory loss and difficulty managing finances.
No focal neurological deficits. Diagnosis?
Answer: Mild cognitive impairment
Rationale: Gradual decline without functional loss beyond expected aging. Clinical
Implication: Cognitive testing; monitor for progression (AA guidelines).
Question 3
A 45-year-old male has chest pain radiating to jaw, diaphoresis, and nausea. ECG shows ST
elevation. Diagnosis?
Answer: Acute myocardial infarction
Rationale: Classic symptoms and ECG findings. Clinical Implication: PCI within 90 minutes
(AHA/ACC).
, Question 4
A 60-year-old female has fatigue, dyspnea, and edema. BNP 450 pg/mL, echo shows EF 35%.
Diagnosis?
Answer: Heart failure with reduced ejection fraction
Rationale: Symptoms, elevated BNP, and low EF. Clinical Implication: ACEI, beta-blocker,
SGLT2i (ACC/AHA).
Question 5
A 55-year-old male has 2 months of cough, weight loss, and hemoptysis. Chest X-ray shows a
mass. Diagnosis?
Answer: Lung cancer
Rationale: Risk factors and symptoms. Clinical Implication: CT biopsy, staging (NCCN).
Question 6
A 70-year-old female has acute confusion, urinary incontinence, and recent UTI. Diagnosis?
Answer: Delirium
Rationale: Acute onset, fluctuating course (CAM criteria). Clinical Implication: Treat UTI;
reorient (AGS).
Question 7
A 48-year-old male has fatigue, polyuria, and polydipsia. Glucose 300 mg/dL. Diagnosis?
Answer: Type 2 diabetes mellitus
Rationale: Classic symptoms, hyperglycemia. Clinical Implication: HbA1c, metformin (ADA).
Question 8
A 65-year-old male has flank pain, hematuria, and fever. CT shows hydronephrosis. Diagnosis?
Answer: Pyelonephritis
Rationale: Upper UTI with obstruction. Clinical Implication: Antibiotics, urology consult
(IDSA).
Question 9
A 50-year-old female has irregular menses, hirsutism, and obesity. Ultrasound shows polycystic
ovaries. Diagnosis?
Answer: Polycystic ovary syndrome
Rationale: Rotterdam criteria: oligo-anovulation + hyperandrogenism. Clinical Implication:
OCP, metformin (ASRM).
