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NURS 6531 Final Exam / NURS6531 Final Exam (New, 2025) : (100 Q & A)(ANSWERS VERIFIED 100, Exams of Nursing

Chapman UniversityNursing

NURS 6531 Final Exam / NURS6531 Final Exam (New, 2025) : (100 Q & A)(ANSWERS VERIFIED 100% CORRECT)

Typology: Exams

2024/2025

Available from 07/02/2025

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NURS 6531 Final Exam / NURS6531 Final Exam (New,
2025) : (100 Q & A)(ANSWERS VERIFIED 100%
CORRECT)
1. **A 60-year-old male presents with chest pain for 1 hour, described as pressure with
radiation to the jaw. He is diaphoretic. What is the first diagnostic test to order?**
- A) Chest X-ray
- B) 12-lead ECG
- C) Echocardiogram
- D) Stress test
- **Answer:** B) 12-lead ECG
- **Rationale:** Chest pain with radiation and diaphoresis suggests acute coronary syndrome
(ACS). A 12-lead ECG is the first test to evaluate for ST-elevation myocardial infarction (STEMI) or
ischemia.
2. **A 55-year-old female has hypertension (BP 150/90 mmHg). She is asymptomatic. What is
the first-line medication?**
- A) Lisinopril
- B) Metoprolol
- C) Amlodipine
- D) Hydrochlorothiazide
- **Answer:** D) Hydrochlorothiazide
- **Rationale:** For stage 1 hypertension (BP 130-139/80-89 or slightly above), thiazide
diuretics are first-line per JNC 8 guidelines, especially in patients without compelling indications.
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Download NURS 6531 Final Exam / NURS6531 Final Exam (New, 2025) : (100 Q & A)(ANSWERS VERIFIED 100 and more Exams Nursing in PDF only on Docsity!

NURS 6531 Final Exam / NURS6531 Final Exam (New,

2025 ) : (100 Q & A)(ANSWERS VERIFIED 100%

CORRECT)

  1. A 60-year-old male presents with chest pain for 1 hour, described as pressure with radiation to the jaw. He is diaphoretic. What is the first diagnostic test to order?
    • A) Chest X-ray
    • B) 12-lead ECG
    • C) Echocardiogram
    • D) Stress test
    • Answer: B) 12-lead ECG
    • Rationale: Chest pain with radiation and diaphoresis suggests acute coronary syndrome (ACS). A 12-lead ECG is the first test to evaluate for ST-elevation myocardial infarction (STEMI) or ischemia.
  2. A 55-year-old female has hypertension (BP 150/90 mmHg). She is asymptomatic. What is the first-line medication?
    • A) Lisinopril
    • B) Metoprolol
    • C) Amlodipine
    • D) Hydrochlorothiazide
    • Answer: D) Hydrochlorothiazide
    • Rationale: For stage 1 hypertension (BP 130-139/80-89 or slightly above), thiazide diuretics are first-line per JNC 8 guidelines, especially in patients without compelling indications.
  1. A patient with atrial fibrillation is prescribed warfarin. What is the target INR range?
    • A) 1.0-1.
    • B) 2.0-3.
    • C) 3.5-4.
    • D) 4.0-5.
    • Answer: B) 2.0-3.
    • Rationale: For atrial fibrillation, the therapeutic INR range is 2.0-3.0 to balance anticoagulation and bleeding risk.
  2. A 65-year-old male with heart failure has dyspnea and edema. Which medication reduces preload and afterload?
    • A) Furosemide
    • B) Lisinopril
    • C) Digoxin
    • D) Spironolactone
    • Answer: B) Lisinopril
    • Rationale: ACE inhibitors like lisinopril reduce both preload (via vasodilation) and afterload, improving cardiac output in heart failure.
  3. A patient with chest pain is diagnosed with unstable angina. What is the most appropriate initial treatment?
    • A) Nitroglycerin sublingual
    • B) Ibuprofen
    • C) Prednisone
    • D) Metformin
    • Answer: A) Nitroglycerin sublingual
  • D) Omega-3 fatty acids
  • Answer: B) Atorvastatin
  • Rationale: Statins (e.g., atorvastatin) are first-line for hyperlipidemia with elevated LDL, per ACC/AHA guidelines.
  1. A patient with a history of MI is prescribed clopidogrel. What is its mechanism of action?
  • A) Inhibits thrombin
  • B) Inhibits platelet aggregation
  • C) Activates fibrinolysis
  • D) Blocks calcium channels
  • Answer: B) Inhibits platelet aggregation
  • Rationale: Clopidogrel is an antiplatelet agent that inhibits ADP-mediated platelet activation.
  1. A 45-year-old female presents with palpitations. ECG shows supraventricular tachycardia. What is the first-line treatment?
  • A) Adenosine
  • B) Amiodarone
  • C) Metoprolol
  • D) Digoxin
  • Answer: A) Adenosine
  • Rationale: Adenosine is the first-line treatment for acute supraventricular tachycardia to restore sinus rhythm.

Endocrine (10 Questions)

  1. A 50-year-old female has fatigue, weight gain, and cold intolerance. TSH is 7.8 mIU/L, free T4 is low. What is the diagnosis?
    • A) Hyperthyroidism
    • B) Hypothyroidism
    • C) Cushing’s syndrome
    • D) Addison’s disease
    • Answer: B) Hypothyroidism
    • Rationale: Elevated TSH and low free T4 with classic symptoms indicate primary hypothyroidism.
  2. What is the first-line treatment for hypothyroidism?
    • A) Propylthiouracil
    • B) Levothyroxine
    • C) Methimazole
    • D) Liothyronine
    • Answer: B) Levothyroxine
    • Rationale: Levothyroxine (T4) is the standard treatment for hypothyroidism, restoring thyroid hormone levels.
  3. A 60-year-old male with type 2 diabetes has an A1C of 9% on metformin. What should be added?
    • A) Insulin glargine
    • B) Glipizide
    • C) Sitagliptin
    • D) Pioglitazone
    • Answer: B) Glipizide
  • Answer: B) <7.0%
  • Rationale: ADA recommends an A1C <7.0% for most non-pregnant adults to reduce complications.
  1. A 45-year-old female has a goiter and TSH of 0.1 mIU/L. What is the most likely diagnosis?
  • A) Hypothyroidism
  • B) Hyperthyroidism
  • C) Thyroid cancer
  • D) Pituitary adenoma
  • Answer: B) Hyperthyroidism
  • Rationale: Low TSH and goiter suggest hyperthyroidism, likely due to Graves’ disease or toxic nodule.
  1. What is the first-line treatment for hyperthyroidism?
  • A) Levothyroxine
  • B) Methimazole
  • C) Propranolol
  • D) Radioactive iodine
  • Answer: B) Methimazole
  • Rationale: Methimazole inhibits thyroid hormone synthesis and is first-line for hyperthyroidism.
  1. A patient with diabetes has microalbuminuria. What is the first-line treatment?
  • A) Metformin
  • B) Lisinopril
  • C) Atorvastatin
  • D) Aspirin
  • Answer: B) Lisinopril
  • Rationale: ACE inhibitors like lisinopril are renoprotective in diabetic nephropathy with microalbuminuria.
  1. A 55-year-old male has erectile dysfunction and low testosterone. What should be evaluated first?
  • A) Prolactin level
  • B) PSA level
  • C) Lipid profile
  • D) Blood glucose
  • Answer: A) Prolactin level
  • Rationale: Hyperprolactinemia can cause low testosterone and ED; it should be ruled out first.

Respiratory (10 Questions)

  1. A 65-year-old male with COPD presents with dyspnea and wheezing. What is the first-line maintenance therapy?
  • A) Albuterol
  • B) Ipratropium
  • C) Fluticasone/salmeterol
  • D) Prednisone
  • Answer: C) Fluticasone/salmeterol
  • D) Theophylline
  • Answer: B) Inhaled fluticasone
  • Rationale: Inhaled corticosteroids are the preferred add-on therapy for persistent asthma per GINA guidelines.
  1. A 50-year-old male smoker has a chronic cough and sputum production. What is the most likely diagnosis?
  • A) Asthma
  • B) Chronic bronchitis
  • C) Lung cancer
  • D) Tuberculosis
  • Answer: B) Chronic bronchitis
  • Rationale: Chronic cough with sputum in a smoker suggests chronic bronchitis, a form of COPD.
  1. What is the gold standard for diagnosing pulmonary embolism?
  • A) D-dimer
  • B) Chest X-ray
  • C) CT pulmonary angiography
  • D) V/Q scan
  • Answer: C) CT pulmonary angiography
  • Rationale: CTPA is the most accurate imaging test for diagnosing pulmonary embolism.
  1. A patient with COPD exacerbation is hypoxic. What is the initial oxygen target saturation?
  • A) 88-92%
  • B) 92-96%

- C) 96-100%

- D) >100%

  • Answer: A) 88-92%
  • Rationale: In COPD, oxygen is titrated to 88-92% to avoid hypercapnia while correcting hypoxemia.
  1. A 25-year-old female has allergic rhinitis. What is the first-line treatment?
  • A) Oral antihistamines
  • B) Intranasal corticosteroids
  • C) Decongestants
  • D) Immunotherapy
  • Answer: B) Intranasal corticosteroids
  • Rationale: Intranasal corticosteroids are most effective for controlling allergic rhinitis symptoms.
  1. A patient with pneumonia develops pleural effusion. What is the next step?
  • A) Start broad-spectrum antibiotics
  • B) Perform thoracentesis
  • C) Order a bronchoscopy
  • D) Increase oxygen therapy
  • Answer: B) Perform thoracentesis
  • Rationale: Thoracentesis is indicated to evaluate and manage pleural effusion in pneumonia (e.g., for parapneumonic effusion).
  1. A 40-year-old male has a positive TB skin test. What is the next step?
  • A) Start rifampin
  • B) Order a chest X-ray
  1. A 50-year-old male has acute pain in the big toe. Uric acid is elevated. What is the diagnosis?
    • A) Osteoarthritis
    • B) Gout
    • C) Rheumatoid arthritis
    • D) Pseudogout
    • Answer: B) Gout
    • Rationale: Acute monoarticular pain with hyperuricemia is characteristic of gout.
  2. What is the acute treatment for gout?
    • A) Allopurinol
    • B) Colchicine
    • C) Prednisone
    • D) Methotrexate
    • Answer: B) Colchicine
    • Rationale: Colchicine is used for acute gout flares to reduce inflammation.
  3. A 35-year-old female has symmetric joint pain and morning stiffness >1 hour. What is the most likely diagnosis?
    • A) Osteoarthritis
    • B) Rheumatoid arthritis
    • C) Fibromyalgia
    • D) Lupus
    • Answer: B) Rheumatoid arthritis
    • Rationale: Symmetric polyarthritis with prolonged morning stiffness suggests rheumatoid arthritis.
  1. What lab test is most specific for rheumatoid arthritis?
    • A) ANA
    • B) RF
    • C) Anti-CCP
    • D) ESR
    • Answer: C) Anti-CCP
    • Rationale: Anti-cyclic citrullinated peptide antibodies are highly specific for rheumatoid arthritis.
  2. A patient with low back pain has a positive straight leg raise test. What is the most likely diagnosis?
    • A) Spinal stenosis
    • B) Herniated disc
    • C) Muscle strain
    • D) Ankylosing spondylitis
    • Answer: B) Herniated disc
    • Rationale: A positive straight leg raise suggests nerve root compression, commonly from a herniated disc.
  3. A 70-year-old female has a T-score of - 2.7 on DEXA scan. What is the diagnosis?
    • A) Normal bone density
    • B) Osteopenia
    • C) Osteoporosis
    • D) Osteomalacia
    • Answer: C) Osteoporosis
    • Rationale: A T-score ≤-2.5 indicates osteoporosis per WHO criteria.
  • B) Peptic ulcer disease
  • C) Pancreatitis
  • D) Cholecystitis
  • Answer: B) Peptic ulcer disease
  • Rationale: Epigastric pain relieved by food is classic for duodenal ulcers.
  1. What is the first-line treatment for H. pylori-associated peptic ulcer disease?
  • A) Omeprazole alone
  • B) Amoxicillin, clarithromycin, and omeprazole
  • C) Metronidazole alone
  • D) Ranitidine
  • Answer: B) Amoxicillin, clarithromycin, and omeprazole
  • Rationale: Triple therapy (PPI + two antibiotics) is standard for H. pylori eradication.
  1. A 45-year-old female has right upper quadrant pain after meals. What is the most likely diagnosis?
  • A) Appendicitis
  • B) Cholecystitis
  • C) Pancreatitis
  • D) Diverticulitis
  • Answer: B) Cholecystitis
  • Rationale: Postprandial RUQ pain suggests gallstones or cholecystitis.
  1. What is the diagnostic test of choice for cholecystitis?
  • A) Abdominal X-ray
  • B) Ultrasound
  • C) CT scan
  • D) HIDA scan
  • Answer: B) Ultrasound
  • Rationale: Ultrasound is the initial test to detect gallstones and gallbladder inflammation.
  1. A patient with GERD is prescribed omeprazole. What is its mechanism of action?
  • A) H2 receptor blocker
  • B) Proton pump inhibitor
  • C) Antacid
  • D) Prokinetic agent
  • Answer: B) Proton pump inhibitor
  • Rationale: Omeprazole inhibits the H+/K+ ATPase pump, reducing acid secretion.
  1. A 60-year-old male has chronic diarrhea and weight loss. What is a likely diagnosis?
  • A) Irritable bowel syndrome
  • B) Celiac disease
  • C) Ulcerative colitis
  • D) Diverticulitis
  • Answer: B) Celiac disease
  • Rationale: Chronic diarrhea and weight loss suggest malabsorption, such as celiac disease.
  1. What is the screening test for celiac disease?
  • A) Anti-tissue transglutaminase IgA
  • B) Stool culture
  • C) Colonoscopy
  • D) CT colonography every 2 years
  • Answer: A) Colonoscopy every 10 years
  • Rationale: USPSTF recommends colonoscopy every 10 years starting at age 45 for average-risk individuals.

Neurology/Psychiatry (10 Questions)

  1. A 70-year-old male has unilateral resting tremor. What is the most likely diagnosis?
  • A) Essential tremor
  • B) Parkinson’s disease
  • C) Multiple sclerosis
  • D) Stroke
  • Answer: B) Parkinson’s disease
  • Rationale: Unilateral resting tremor is a hallmark of Parkinson’s disease.
  1. What is the first-line treatment for Parkinson’s disease?
  • A) Levodopa/carbidopa
  • B) Propranolol
  • C) Gabapentin
  • D) Donepezil
  • Answer: A) Levodopa/carbidopa
  • Rationale: Levodopa/carbidopa is the most effective treatment for Parkinson’s motor symptoms.
  1. A 35-year-old female has a severe headache with photophobia. What is the most likely diagnosis?
    • A) Tension headache
    • B) Migraine
    • C) Cluster headache
    • D) Subarachnoid hemorrhage
    • Answer: B) Migraine
    • Rationale: Headache with photophobia is characteristic of migraine.
  2. What is the acute treatment for migraine?
    • A) Sumatriptan
    • B) Propranolol
    • C) Amitriptyline
    • D) Gabapentin
    • Answer: A) Sumatriptan
    • Rationale: Triptans like sumatriptan are first-line for acute migraine treatment.
  3. A patient with depression is prescribed sertraline. What is its drug class?
    • A) SSRI
    • B) SNRI
    • C) TCA
    • D) MAOI
    • Answer: A) SSRI
    • Rationale: Sertraline is a selective serotonin reuptake inhibitor, first-line for depression.
  4. A 40-year-old male has insomnia and anxiety. What is a non-pharmacologic treatment?