NR511 | NR511 Differential Diagnosis & Primary
Care Exam 1 v3 | Questions with Correct Answers
and Expert Explanation for Each Question |
Chamberlain
1. A 24-year-old female presents with a sore throat, fever of 101.5 F, and cervical
lymphadenopathy. She denies having a cough. According to the Centor criteria, what is the
most appropriate next step?
A. Prescribe Amoxicillin immediately.
B. Perform a Rapid Antigen Detection Test (RADT).
C. Advise rest and fluids as the cause is likely viral.
D. Refer to an Ear, Nose, and Throat specialist.
Correct Answer: B
Expert Explanation: The Centor criteria are used to estimate the probability that a sore
throat is caused by Group A Streptococcus. This patient has three criteria: fever, absence of
cough, and lymphadenopathy, giving her a high probability. A Rapid Antigen Detection Test
or throat culture is indicated for scores of 2 or higher to confirm the diagnosis before
starting antibiotics.
2. Which of the following describes the ‘S’ in the VINDICATE acronym used for differential
diagnosis?
A. Supratentorial
B. Systemic
C. Social status
D. Surgical
Correct Answer: A
Expert Explanation: VINDICATE is a mnemonic used to categorize differential diagnoses
to ensure all potential causes are considered. The letter ‘S’ stands for Supratentorial, which
refers to psychological or psychiatric etiologies. This systematic approach helps clinicians
avoid premature closure and broadens the diagnostic scope.
3. A test’s ability to correctly identify those without the disease is known as:
A. Sensitivity
B. Specificity
C. Positive Predictive Value
,D. Negative Predictive Value
Correct Answer: B
Expert Explanation: Specificity refers to the proportion of people who do not have the
disease and test negative. A highly specific test has a low false-positive rate, meaning if the
result is positive, the person likely has the disease. This is often summarized by the
mnemonic SpPIn: high Specificity, Positive result, rules In the condition.
4. In the SOAP note format, where should the clinician document the patient’s reported
symptoms and history?
A. Subjective
B. Objective
C. Assessment
D. Plan
Correct Answer: A
Expert Explanation: The Subjective section of the SOAP note includes information
provided by the patient, such as the Chief Complaint, HPI, and Review of Systems. It
captures the patient’s perspective and personal history regarding their current health
status. Objective data, by contrast, includes physical exam findings and laboratory results.
5. Which ICD-10 code type is used to describe the reason for a patient’s visit or the diagnosis
made during the encounter?
A. CPT codes
B. HCPCS codes
C. E&M codes
D. Diagnosis codes
Correct Answer: D
Expert Explanation: ICD-10 codes are international classification systems used
specifically for coding diagnoses and conditions. They are necessary for tracking health
statistics and for billing purposes to justify medical necessity. CPT codes, on the other hand,
are used to describe the procedures and services performed during the visit.
6. A 45-year-old male smoker presents with a cough productive of yellowish sputum for the
last 10 days. He has no fever, and his lungs are clear to auscultation. What is the most likely
diagnosis?
A. Pneumonia
B. Chronic Obstructive Pulmonary Disease
, C. Acute Bronchitis
D. Pulmonary Embolism
Correct Answer: C
Expert Explanation: Acute bronchitis is characterized by a cough that lasts between one
and three weeks, often following a viral upper respiratory infection. In the absence of fever,
tachycardia, or crackles on exam, pneumonia is less likely, and antibiotics are generally not
indicated. Management typically focuses on symptom relief and patient education
regarding the viral nature of the illness.
7. What is the first-line antibiotic treatment for a patient diagnosed with Acute Bacterial
Rhinosinusitis who has no drug allergies?
A. Azithromycin
B. Amoxicillin-Clavulanate
C. Ciprofloxacin
D. Doxycycline
Correct Answer: B
Expert Explanation: Amoxicillin-Clavulanate (Augmentin) is recommended as the first-
line treatment for acute bacterial rhinosinusitis to provide coverage for Streptococcus
pneumoniae and Haemophilus influenzae. While plain Amoxicillin was previously used,
increasing resistance rates have made the combination drug the preferred choice.
Treatment duration typically ranges from 5 to 7 days for uncomplicated cases in adults.
8. Which of the following physical exam findings is most suggestive of Otitis Media with
Effusion (OME)?
A. Bulging, erythematous tympanic membrane
B. Purulent drainage in the ear canal
C. Cloudy tympanic membrane with impaired mobility
D. Pain with manipulation of the tragus
Correct Answer: C
Expert Explanation: Otitis Media with Effusion is characterized by fluid in the middle ear
without signs of acute infection like fever or severe pain. The tympanic membrane may
appear retracted or cloudy, and pneumatic otoscopy will show decreased mobility. This
condition often follows an episode of acute otitis media or can be related to eustachian tube
dysfunction.
Care Exam 1 v3 | Questions with Correct Answers
and Expert Explanation for Each Question |
Chamberlain
1. A 24-year-old female presents with a sore throat, fever of 101.5 F, and cervical
lymphadenopathy. She denies having a cough. According to the Centor criteria, what is the
most appropriate next step?
A. Prescribe Amoxicillin immediately.
B. Perform a Rapid Antigen Detection Test (RADT).
C. Advise rest and fluids as the cause is likely viral.
D. Refer to an Ear, Nose, and Throat specialist.
Correct Answer: B
Expert Explanation: The Centor criteria are used to estimate the probability that a sore
throat is caused by Group A Streptococcus. This patient has three criteria: fever, absence of
cough, and lymphadenopathy, giving her a high probability. A Rapid Antigen Detection Test
or throat culture is indicated for scores of 2 or higher to confirm the diagnosis before
starting antibiotics.
2. Which of the following describes the ‘S’ in the VINDICATE acronym used for differential
diagnosis?
A. Supratentorial
B. Systemic
C. Social status
D. Surgical
Correct Answer: A
Expert Explanation: VINDICATE is a mnemonic used to categorize differential diagnoses
to ensure all potential causes are considered. The letter ‘S’ stands for Supratentorial, which
refers to psychological or psychiatric etiologies. This systematic approach helps clinicians
avoid premature closure and broadens the diagnostic scope.
3. A test’s ability to correctly identify those without the disease is known as:
A. Sensitivity
B. Specificity
C. Positive Predictive Value
,D. Negative Predictive Value
Correct Answer: B
Expert Explanation: Specificity refers to the proportion of people who do not have the
disease and test negative. A highly specific test has a low false-positive rate, meaning if the
result is positive, the person likely has the disease. This is often summarized by the
mnemonic SpPIn: high Specificity, Positive result, rules In the condition.
4. In the SOAP note format, where should the clinician document the patient’s reported
symptoms and history?
A. Subjective
B. Objective
C. Assessment
D. Plan
Correct Answer: A
Expert Explanation: The Subjective section of the SOAP note includes information
provided by the patient, such as the Chief Complaint, HPI, and Review of Systems. It
captures the patient’s perspective and personal history regarding their current health
status. Objective data, by contrast, includes physical exam findings and laboratory results.
5. Which ICD-10 code type is used to describe the reason for a patient’s visit or the diagnosis
made during the encounter?
A. CPT codes
B. HCPCS codes
C. E&M codes
D. Diagnosis codes
Correct Answer: D
Expert Explanation: ICD-10 codes are international classification systems used
specifically for coding diagnoses and conditions. They are necessary for tracking health
statistics and for billing purposes to justify medical necessity. CPT codes, on the other hand,
are used to describe the procedures and services performed during the visit.
6. A 45-year-old male smoker presents with a cough productive of yellowish sputum for the
last 10 days. He has no fever, and his lungs are clear to auscultation. What is the most likely
diagnosis?
A. Pneumonia
B. Chronic Obstructive Pulmonary Disease
, C. Acute Bronchitis
D. Pulmonary Embolism
Correct Answer: C
Expert Explanation: Acute bronchitis is characterized by a cough that lasts between one
and three weeks, often following a viral upper respiratory infection. In the absence of fever,
tachycardia, or crackles on exam, pneumonia is less likely, and antibiotics are generally not
indicated. Management typically focuses on symptom relief and patient education
regarding the viral nature of the illness.
7. What is the first-line antibiotic treatment for a patient diagnosed with Acute Bacterial
Rhinosinusitis who has no drug allergies?
A. Azithromycin
B. Amoxicillin-Clavulanate
C. Ciprofloxacin
D. Doxycycline
Correct Answer: B
Expert Explanation: Amoxicillin-Clavulanate (Augmentin) is recommended as the first-
line treatment for acute bacterial rhinosinusitis to provide coverage for Streptococcus
pneumoniae and Haemophilus influenzae. While plain Amoxicillin was previously used,
increasing resistance rates have made the combination drug the preferred choice.
Treatment duration typically ranges from 5 to 7 days for uncomplicated cases in adults.
8. Which of the following physical exam findings is most suggestive of Otitis Media with
Effusion (OME)?
A. Bulging, erythematous tympanic membrane
B. Purulent drainage in the ear canal
C. Cloudy tympanic membrane with impaired mobility
D. Pain with manipulation of the tragus
Correct Answer: C
Expert Explanation: Otitis Media with Effusion is characterized by fluid in the middle ear
without signs of acute infection like fever or severe pain. The tympanic membrane may
appear retracted or cloudy, and pneumatic otoscopy will show decreased mobility. This
condition often follows an episode of acute otitis media or can be related to eustachian tube
dysfunction.
