NR511 Differential Diagnosis & Primary Care MidTerm September 2026 Verified Questions

Question 1

A 55-year-old patient presents to the primary care clinic with sudden, painless loss of vision in the right eye that started an hour ago. The patient denies trauma but has a history of hypertension and diabetes. The nurse practitioner identifies no abnormalities of the external eye on inspection, including no redness or discharge. What is the nurse practitioner’s next step? Answers: A – D A Advise the patient to monitor symptoms and return if they worsen B Start the patient on artificial tears and schedule a follow-up in one week C Refer the patient to an ophthalmologist immediately D Prescribe antibiotic eye drops and reassess in 48 hours Correct Answer: C Refer the patient to an ophthalmologist immediately

 Question 2

A patient reports to the office with “feeling of sand” in both eyes, blurry vision, burning and itching and complaint of foreign body sensation in both eyes. The physical exam reveals sensitivity to light and glossy appearance the cornea. Based on the patient’s presentation and physical exam, what is the likely diagnosis? Answers: A – D A Hordeolum internum B Chalazion C Dry eye syndrome D Conjunctivitis Correct Answer: C Dry eye syndrome

 Question 3

A 32-year-old male presents to the clinic with intense itching that has been worsening over the past two weeks. He reports that the itching is particularly severe at night and has spread from his wrists to his elbows and between his fingers. On examination, the nurse practitioner notes the presence of small red bumps and burrows on the skin, and the patient mentions that several family members have also experienced similar symptoms. Which of the following should be considered in the differential? Answers: A – D A Pediculosis corporis B Tinea corporis C Atopic dermatitis D Contact dermatitis Correct Answer: A Pediculosis corporis

Question 4 Which of the following is the most effective systemic treatment for scabies that has not responded to topical therapy? A. Oral metronidazole B. Oral fluconazole C. Oral Ivermectin D. Oral corticosteroids Correct Answer: C Oral Ivermectin

Question 5  A 35-year-old patient presents to the office with right ear pain following a recent airplane flight. The nurse practitioner diagnoses barotrauma to the right ear. What is the MOST appropriate management plan? A. Oral decongestants and nasal corticosteroids B. Immediate referral for surgical tympanostomy C. High-dose corticosteroids and bed rest D. Systemic antibiotics and ear irrigation Correct Answer: A Oral decongestants and nasal corticosteroids

Question 6  A 16-year-old patient presents to the clinic with right ear pain for 2 days following a high school swim meet. The ear exam demonstrates tenderness with traction of the pinna and tragus pain when pressure is applied. The ear canal is red and swollen to the point that the tympanic membrane cannot be visualized. Which of the following is the most likely diagnosis? A. Otitis media B. Otitis externa C. Mastoiditis D. Eustachian tube dysfunction Correct Answer: B Otitis externa

Question 7  A 30-year-old woman presents to the clinic with complaints of sharp pain in her left ear that started suddenly two days ago. She reports feeling feverish and has had a runny nose for the past week. On examination, her left tympanic membrane appears red and bulging. Which of the following is a differential diagnosis for ear pain in this patient? A. Acoustic neuroma B. Presbycusis C. Eustachian tube dysfunction D. Otitis media Correct Answer: D Otitis media

Question 8  When prescribing systemic therapy for the suppression of recurrent genital herpes in immunocompromised clients, which of the following is the most appropriate medication? A. Famciclovir B. Ganciclovir C. Valacyclovir D. Acyclovir Correct Answer: D Acyclovir

Question 9  What is the first-line antibiotic therapy for an adult with no known allergies and suspected group A beta-hemolytic streptococcal pharyngitis? A. Ceftriaxone B. Clindamycin C. Azithromycin D. Amoxicillin Correct Answer: D Amoxicillin

Question 10  A 10-year-old patient was prescribed amoxicillin for otitis media. The nurse practitioner receives a call from the parent stating that the client has developed a rash on the trunk. What is the most appropriate next action by the nurse practitioner? A. Reassure the parent that rashes are common with viral infections and advise to continue the medication B. Advise the parent to stop the amoxicillin immediately and go to the emergency room C. Recommend an over-the-counter antihistamine and continue the medication if the rash is not bothersome D. Instruct the parent to stop the medication and schedule an evaluation for a possible allergic reaction Correct Answer: D Instruct the parent to stop the medication and schedule an evaluation for a possible allergic reaction