NRNP 6531 Primary Care Of Adults Across The
Lifespan Midterm Exam.
EXAMINATION OVERVIEW
Section Questions Topics Covered
Section A 1-15 Cardiovascular Disorders
Section B 16-30 Respiratory Conditions
Section C 31-45 Dermatological Disorders
Section D 46-60 Gastrointestinal Conditions
Section E 61-75 Endocrine & Genitourinary Disorders
Section F 76-90 Infectious Diseases & Special Populations
Section G 91-100 Professional Practice & Diagnostic Reasoning
Total Questions: 100
Format: Multiple Choice with Detailed Rationales
Difficulty Level: Exam-Ready (Based on NRNP 6531 curriculum)
SECTION A: CARDIOVASCULAR DISORDERS (Questions 1-15)
,Question 1
An African-American patient who is being treated with a thiazide diuretic for
chronic hypertension reports blurred vision and shortness of breath. The provider
notes a blood pressure of 185/115. What is the recommended action for this
patient?
A) Increase the dose of the thiazide medication
B) Add a beta blocker to the patient's regimen
C) Admit to the hospital for evaluation and treatment
D) Prescribe a calcium channel blocker
Answer: C) Admit to the hospital for evaluation and treatment
Rationale: This patient presents with hypertensive urgency/emergency (BP
185/115 with symptoms of blurred vision and shortness of breath). Admission for
evaluation and treatment is indicated to prevent target organ damage. Outpatient
medication adjustments are not appropriate for symptomatic severe
hypertension .
Question 2
A patient reports sustained, irregular heart palpitations. What is the most likely
cause of these symptoms?
A) Atrial fibrillation
B) Anemia
C) Extrasystole
D) Paroxysmal attacks
Answer: A) Atrial fibrillation
Rationale: Sustained, irregular heart palpitations are classic for atrial fibrillation,
which presents with an irregularly irregular rhythm. Anemia may cause
tachycardia but not irregularity. Extrasystoles cause intermittent "skipped beats"
rather than sustained irregularity .
,Question 3
A patient has a cardiac murmur that peaks in midsystole and is best heard along
the left sternal border. The provider determines that the murmur decreases in
intensity when the patient changes from standing to squatting and increases in
intensity with the Valsalva maneuver. Which cause will the provider suspect for
this murmur?
A) Aortic stenosis
B) Tricuspid regurgitation
C) Hypertrophic cardiomyopathy
D) Mitral valve prolapse
Answer: C) Hypertrophic cardiomyopathy
Rationale: Hypertrophic cardiomyopathy murmurs decrease with increased
preload (squatting) and increase with decreased preload (Valsalva/standing). This
dynamic response distinguishes it from other murmurs. The location (left sternal
border) and midsystolic timing are also consistent with HCM .
Question 4
A patient is brought to an emergency department with symptoms of acute ST-
segment elevation MI (STEMI). The nearest hospital that can perform
percutaneous coronary intervention (PCI) is 3 hours away. What is the initial
treatment for this patient?
A) Give the patient an oral beta blocker
B) Transfer to the PCI-capable institution
C) Administer heparin
D) Initiate fibrinolytic treatment
Answer: D) Initiate fibrinolytic treatment
Rationale: When PCI is not available within 120 minutes (2 hours) of first medical
contact, fibrinolytic therapy should be administered within 30 minutes of arrival.
With a 3-hour transport time, fibrinolytics are indicated rather than delaying
treatment for transfer .
, Question 5
Patients who meet the criteria for statin therapy to help prevent atherosclerotic
cardiovascular disease are those with a history of: (Select all that apply.)
A) Previous myocardial infarction
B) A low-density lipoprotein (LDL) level >190 mg/dL
C) Diabetes and an LDL between 40 and 70 mg/dL
D) A 10-year risk score of 8% with an LDL of 80 mg/dL
E) A 10-year risk score of 5% and an LDL of 165 mg/dL
Answer: A, B, D
Rationale: Statin therapy is indicated for: (1) clinical ASCVD (prior MI), (2) primary
elevations of LDL ≥190 mg/dL, (3) diabetes with LDL 70-189 mg/dL, and (4)
estimated 10-year ASCVD risk ≥7.5% with LDL 70-189 mg/dL. A 10-year risk of 8%
meets this threshold .
Question 6
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only
relieves after sitting for 30 minutes or more. What does the provider suspect as
the cause for these symptoms?
A) Buerger's disease
B) Cauda equina syndrome
C) Diabetic neuropathy
D) Peripheral arterial disease
Answer: B) Cauda equina syndrome
Rationale: Cauda equina syndrome presents with bilateral leg pain and weakness
that worsens with standing/walking and is relieved only by sitting. The prolonged
relief time (30+ minutes) and bilateral symptoms differentiate it from vascular
claudication, which typically resolves within 2-5 minutes of rest .
Lifespan Midterm Exam.
EXAMINATION OVERVIEW
Section Questions Topics Covered
Section A 1-15 Cardiovascular Disorders
Section B 16-30 Respiratory Conditions
Section C 31-45 Dermatological Disorders
Section D 46-60 Gastrointestinal Conditions
Section E 61-75 Endocrine & Genitourinary Disorders
Section F 76-90 Infectious Diseases & Special Populations
Section G 91-100 Professional Practice & Diagnostic Reasoning
Total Questions: 100
Format: Multiple Choice with Detailed Rationales
Difficulty Level: Exam-Ready (Based on NRNP 6531 curriculum)
SECTION A: CARDIOVASCULAR DISORDERS (Questions 1-15)
,Question 1
An African-American patient who is being treated with a thiazide diuretic for
chronic hypertension reports blurred vision and shortness of breath. The provider
notes a blood pressure of 185/115. What is the recommended action for this
patient?
A) Increase the dose of the thiazide medication
B) Add a beta blocker to the patient's regimen
C) Admit to the hospital for evaluation and treatment
D) Prescribe a calcium channel blocker
Answer: C) Admit to the hospital for evaluation and treatment
Rationale: This patient presents with hypertensive urgency/emergency (BP
185/115 with symptoms of blurred vision and shortness of breath). Admission for
evaluation and treatment is indicated to prevent target organ damage. Outpatient
medication adjustments are not appropriate for symptomatic severe
hypertension .
Question 2
A patient reports sustained, irregular heart palpitations. What is the most likely
cause of these symptoms?
A) Atrial fibrillation
B) Anemia
C) Extrasystole
D) Paroxysmal attacks
Answer: A) Atrial fibrillation
Rationale: Sustained, irregular heart palpitations are classic for atrial fibrillation,
which presents with an irregularly irregular rhythm. Anemia may cause
tachycardia but not irregularity. Extrasystoles cause intermittent "skipped beats"
rather than sustained irregularity .
,Question 3
A patient has a cardiac murmur that peaks in midsystole and is best heard along
the left sternal border. The provider determines that the murmur decreases in
intensity when the patient changes from standing to squatting and increases in
intensity with the Valsalva maneuver. Which cause will the provider suspect for
this murmur?
A) Aortic stenosis
B) Tricuspid regurgitation
C) Hypertrophic cardiomyopathy
D) Mitral valve prolapse
Answer: C) Hypertrophic cardiomyopathy
Rationale: Hypertrophic cardiomyopathy murmurs decrease with increased
preload (squatting) and increase with decreased preload (Valsalva/standing). This
dynamic response distinguishes it from other murmurs. The location (left sternal
border) and midsystolic timing are also consistent with HCM .
Question 4
A patient is brought to an emergency department with symptoms of acute ST-
segment elevation MI (STEMI). The nearest hospital that can perform
percutaneous coronary intervention (PCI) is 3 hours away. What is the initial
treatment for this patient?
A) Give the patient an oral beta blocker
B) Transfer to the PCI-capable institution
C) Administer heparin
D) Initiate fibrinolytic treatment
Answer: D) Initiate fibrinolytic treatment
Rationale: When PCI is not available within 120 minutes (2 hours) of first medical
contact, fibrinolytic therapy should be administered within 30 minutes of arrival.
With a 3-hour transport time, fibrinolytics are indicated rather than delaying
treatment for transfer .
, Question 5
Patients who meet the criteria for statin therapy to help prevent atherosclerotic
cardiovascular disease are those with a history of: (Select all that apply.)
A) Previous myocardial infarction
B) A low-density lipoprotein (LDL) level >190 mg/dL
C) Diabetes and an LDL between 40 and 70 mg/dL
D) A 10-year risk score of 8% with an LDL of 80 mg/dL
E) A 10-year risk score of 5% and an LDL of 165 mg/dL
Answer: A, B, D
Rationale: Statin therapy is indicated for: (1) clinical ASCVD (prior MI), (2) primary
elevations of LDL ≥190 mg/dL, (3) diabetes with LDL 70-189 mg/dL, and (4)
estimated 10-year ASCVD risk ≥7.5% with LDL 70-189 mg/dL. A 10-year risk of 8%
meets this threshold .
Question 6
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only
relieves after sitting for 30 minutes or more. What does the provider suspect as
the cause for these symptoms?
A) Buerger's disease
B) Cauda equina syndrome
C) Diabetic neuropathy
D) Peripheral arterial disease
Answer: B) Cauda equina syndrome
Rationale: Cauda equina syndrome presents with bilateral leg pain and weakness
that worsens with standing/walking and is relieved only by sitting. The prolonged
relief time (30+ minutes) and bilateral symptoms differentiate it from vascular
claudication, which typically resolves within 2-5 minutes of rest .
