1
NR607 Pre-Diagnostic Exam Chamberlain with
Complete Real Questions Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
[SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING —
Questions 1-20]
Q1: A 54-year-old patient presents with chest pain. Using the OLDCARTS mnemonic for the
History of Present Illness (HPI), what does the "C" represent?
A. Color of the skin
B. Complications of the illness
C. Character [CORRECT]
D. Contraction of the pain
Correct Answer: C
Rationale: OLDCARTS stands for Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Timing, and Severity. "Character" describes the
quality of the pain (e.g., sharp, dull, crushing, burning). Options A, B, and D are not components
of this specific mnemonic for pain description.
Q2: During auscultation of the heart, the Nurse Practitioner (NP) hears a low-pitched, rumbling,
diastolic murmur best heard at the apex. This is most consistent with:
A. Aortic regurgitation
B. Mitral stenosis [CORRECT]
C. Mitral regurgitation
D. Aortic stenosis
Correct Answer: B
Rationale: Mitral stenosis is characterized by a diastolic murmur, often described as a rumbling
sound, best heard at the apex with the bell of the stethoscope. Aortic regurgitation (A) is a
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diastolic murmur heard at the left sternal border. Mitral regurgitation (C) and Aortic stenosis (D)
are systolic murmurs.
Q3: A patient with suspected bacterial meningitis undergoes a neurological assessment. Which
physical finding is a classic sign of meningeal irritation?
A. Positive Babinski reflex
B. Positive Kernig’s sign [CORRECT]
C. Hyperreflexia
D. Dysmetria
Correct Answer: B
Rationale: Kernig’s sign is positive when resistance and pain are elicited when the NP flexes the
patient's hip and extends the knee while the patient is supine. This is a classic sign of meningeal
irritation. Babinski (A) indicates upper motor neuron lesion. Hyperreflexia (C) is spasticity.
Dysmetria (D) is a cerebellar sign.
Q4: When interpreting a Chest X-ray (CXR), the NP observes a " silhouette sign " where the
right heart border is obscured. This indicates pathology in which anatomical structure?
A. Right upper lobe
B. Right middle lobe
C. Right middle lobe or lingula [CORRECT]
D. Left lower lobe
Correct Answer: C
Rationale: The silhouette sign occurs when a mass or fluid-filled area (e.g., pneumonia or
atelectasis) touches a heart border, causing the border to disappear. The right heart border is
adjacent to the right middle lobe, and the left heart border is adjacent to the lingula. Options A
and D would obliterate other borders or the diaphragm.
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Q5: A patient presents with a "red, hot, swollen" calf. The NP orders a D-dimer. What is the
limitation of this test in the outpatient setting?
A. It is invasive.
B. It cannot differentiate between Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).
C. It has a high negative predictive value but low positive predictive value in low-risk patients.
[CORRECT]
D. It takes 48 hours to process.
Correct Answer: C
Rationale: D-dimer is highly sensitive (negative result rules out DVT in low-risk patients) but
has low specificity. A positive result can be caused by infection, trauma, surgery, or cancer,
leading to false positives. Therefore, it is not diagnostic on its own for positive results.
Q6: Which component of the Comprehensive Metabolic Panel (CMP) is the primary indicator of
renal function?
A. Serum Creatinine [CORRECT]
B. ALT
C. Sodium
D. Albumin
Correct Answer: A
Rationale: Serum creatinine is a breakdown product of muscle metabolism and is excreted by the
kidneys; elevated levels indicate impaired renal filtration (GFR). ALT (B) is liver specific.
Sodium (C) is an electrolyte. Albumin (D) is a protein synthesized by the liver.
Q7: In a Mental Status Examination (MSE), the term "flat affect" refers to:
A. Inability to recognize familiar faces.
B. Absence or near absence of emotional expression. [CORRECT]
C. Apathy regarding personal hygiene.
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D. Constant crying.
Correct Answer: B
Rationale: Flat affect is a severe reduction in the expression of emotion characterized by an
immobile face and monotonous voice. It is commonly seen in schizophrenia or severe
depression. Option A refers to prosopagnosia. Option C is neglect. Option D is lability.
Q8: When palpating the abdomen, the NP feels a pulsatile mass in the epigastric region. This is
most suspicious for:
A. Enlarged spleen
C. Abdominal Aortic Aneurysm (AAA) [CORRECT]
C. Ascites
D. Gastric ulcer
Correct Answer: B
Rationale: A pulsatile mass in the abdomen, especially in the epigastric or upper midline area, is
a hallmark sign of an Abdominal Aortic Aneurysm (AAA). An enlarged spleen (A) is not
typically pulsatile. Ascites (C) is fluid fluctuance. Gastric ulcers (D) do not present as a palpable
mass.
Q9: A 65-year-old patient presents with sudden onset of right-sided facial droop, inability to raise
the eyebrow, and inability to smile on the right side. The rest of the neurological exam is normal.
The most likely diagnosis is:
A. Stroke (CVA)
B. Bell’s Palsy [CORRECT]
C. Trigeminal Neuralgia
D. Myasthenia Gravis
Correct Answer: B
NR607 Pre-Diagnostic Exam Chamberlain with
Complete Real Questions Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
[SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING —
Questions 1-20]
Q1: A 54-year-old patient presents with chest pain. Using the OLDCARTS mnemonic for the
History of Present Illness (HPI), what does the "C" represent?
A. Color of the skin
B. Complications of the illness
C. Character [CORRECT]
D. Contraction of the pain
Correct Answer: C
Rationale: OLDCARTS stands for Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Timing, and Severity. "Character" describes the
quality of the pain (e.g., sharp, dull, crushing, burning). Options A, B, and D are not components
of this specific mnemonic for pain description.
Q2: During auscultation of the heart, the Nurse Practitioner (NP) hears a low-pitched, rumbling,
diastolic murmur best heard at the apex. This is most consistent with:
A. Aortic regurgitation
B. Mitral stenosis [CORRECT]
C. Mitral regurgitation
D. Aortic stenosis
Correct Answer: B
Rationale: Mitral stenosis is characterized by a diastolic murmur, often described as a rumbling
sound, best heard at the apex with the bell of the stethoscope. Aortic regurgitation (A) is a
,2
diastolic murmur heard at the left sternal border. Mitral regurgitation (C) and Aortic stenosis (D)
are systolic murmurs.
Q3: A patient with suspected bacterial meningitis undergoes a neurological assessment. Which
physical finding is a classic sign of meningeal irritation?
A. Positive Babinski reflex
B. Positive Kernig’s sign [CORRECT]
C. Hyperreflexia
D. Dysmetria
Correct Answer: B
Rationale: Kernig’s sign is positive when resistance and pain are elicited when the NP flexes the
patient's hip and extends the knee while the patient is supine. This is a classic sign of meningeal
irritation. Babinski (A) indicates upper motor neuron lesion. Hyperreflexia (C) is spasticity.
Dysmetria (D) is a cerebellar sign.
Q4: When interpreting a Chest X-ray (CXR), the NP observes a " silhouette sign " where the
right heart border is obscured. This indicates pathology in which anatomical structure?
A. Right upper lobe
B. Right middle lobe
C. Right middle lobe or lingula [CORRECT]
D. Left lower lobe
Correct Answer: C
Rationale: The silhouette sign occurs when a mass or fluid-filled area (e.g., pneumonia or
atelectasis) touches a heart border, causing the border to disappear. The right heart border is
adjacent to the right middle lobe, and the left heart border is adjacent to the lingula. Options A
and D would obliterate other borders or the diaphragm.
,3
Q5: A patient presents with a "red, hot, swollen" calf. The NP orders a D-dimer. What is the
limitation of this test in the outpatient setting?
A. It is invasive.
B. It cannot differentiate between Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).
C. It has a high negative predictive value but low positive predictive value in low-risk patients.
[CORRECT]
D. It takes 48 hours to process.
Correct Answer: C
Rationale: D-dimer is highly sensitive (negative result rules out DVT in low-risk patients) but
has low specificity. A positive result can be caused by infection, trauma, surgery, or cancer,
leading to false positives. Therefore, it is not diagnostic on its own for positive results.
Q6: Which component of the Comprehensive Metabolic Panel (CMP) is the primary indicator of
renal function?
A. Serum Creatinine [CORRECT]
B. ALT
C. Sodium
D. Albumin
Correct Answer: A
Rationale: Serum creatinine is a breakdown product of muscle metabolism and is excreted by the
kidneys; elevated levels indicate impaired renal filtration (GFR). ALT (B) is liver specific.
Sodium (C) is an electrolyte. Albumin (D) is a protein synthesized by the liver.
Q7: In a Mental Status Examination (MSE), the term "flat affect" refers to:
A. Inability to recognize familiar faces.
B. Absence or near absence of emotional expression. [CORRECT]
C. Apathy regarding personal hygiene.
, 4
D. Constant crying.
Correct Answer: B
Rationale: Flat affect is a severe reduction in the expression of emotion characterized by an
immobile face and monotonous voice. It is commonly seen in schizophrenia or severe
depression. Option A refers to prosopagnosia. Option C is neglect. Option D is lability.
Q8: When palpating the abdomen, the NP feels a pulsatile mass in the epigastric region. This is
most suspicious for:
A. Enlarged spleen
C. Abdominal Aortic Aneurysm (AAA) [CORRECT]
C. Ascites
D. Gastric ulcer
Correct Answer: B
Rationale: A pulsatile mass in the abdomen, especially in the epigastric or upper midline area, is
a hallmark sign of an Abdominal Aortic Aneurysm (AAA). An enlarged spleen (A) is not
typically pulsatile. Ascites (C) is fluid fluctuance. Gastric ulcers (D) do not present as a palpable
mass.
Q9: A 65-year-old patient presents with sudden onset of right-sided facial droop, inability to raise
the eyebrow, and inability to smile on the right side. The rest of the neurological exam is normal.
The most likely diagnosis is:
A. Stroke (CVA)
B. Bell’s Palsy [CORRECT]
C. Trigeminal Neuralgia
D. Myasthenia Gravis
Correct Answer: B
