NUR 6121 – EXAM 2 / ACTUAL EXAM
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
WILLIAM PATERSON UNIVERSITY
Question 1
A 65-year-old patient with chronic heart failure presents with increasing shortness
of breath, peripheral edema, and weight gain over the past 3 days. Which
laboratory test is most useful in assessing fluid overload in this patient?
A. Serum creatinine
B. Brain natriuretic peptide (BNP)
C. Serum sodium
D. Hemoglobin
Answer: B. Brain natriuretic peptide (BNP)
Rationale: BNP is released by the ventricles in response to increased wall stress
and volume overload. Elevated BNP levels correlate with severity of heart failure
and fluid retention.
Question 2
A nurse practitioner is evaluating a patient for hypertension. Which lifestyle
modification has the most evidence for reducing systolic blood pressure?
A. Increasing saturated fat intake
B. Daily aerobic exercise
C. Reducing potassium intake
D. Limiting water intake
Answer: B. Daily aerobic exercise
Rationale: Regular aerobic exercise has been shown to significantly reduce
systolic and diastolic blood pressure and improve cardiovascular health.
,Question 3
A patient presents with sudden onset chest pain radiating to the left arm and jaw,
nausea, and diaphoresis. Which immediate action should the nurse practitioner take
first?
A. Administer nitroglycerin sublingually
B. Obtain a 12-lead ECG
C. Give aspirin 81 mg orally
D. Order a chest X-ray
Answer: B. Obtain a 12-lead ECG
Rationale: A 12-lead ECG is essential to rapidly identify acute myocardial
infarction and guide immediate management. Time-sensitive interventions depend
on early ECG results.
Question 4
A patient on warfarin therapy for atrial fibrillation presents with an INR of 5.5 but
is asymptomatic. What is the most appropriate intervention?
A. Hold the next warfarin dose and monitor
B. Administer vitamin K immediately
C. Continue the current dose
D. Increase the dose to compensate
Answer: A. Hold the next warfarin dose and monitor
Rationale: An INR >5 increases bleeding risk. If the patient is asymptomatic and
not actively bleeding, holding the next dose and closely monitoring INR is the
safest approach.
Question 5
Which of the following is a hallmark feature of nephrotic syndrome in adults?
A. Hematuria
B. Hypoalbuminemia
,C. Polyuria
D. Hyperkalemia
Answer: B. Hypoalbuminemia
Rationale: Nephrotic syndrome is characterized by heavy proteinuria (>3.5 g/day),
hypoalbuminemia, edema, and hyperlipidemia.
Question 6
A 50-year-old patient presents with jaundice, dark urine, and pruritus. Laboratory
results reveal elevated AST and ALT with a higher ALT than AST. What is the
most likely cause?
A. Alcoholic liver disease
B. Viral hepatitis
C. Hemochromatosis
D. Wilson disease
Answer: B. Viral hepatitis
Rationale: In viral hepatitis, ALT is typically higher than AST, whereas in
alcoholic liver disease AST > ALT (usually 2:1).
Question 7
A patient with COPD presents with increasing dyspnea and a PaCO₂ of 60 mmHg.
Which intervention should the nurse practitioner prioritize?
A. Administer high-flow oxygen at 15 L/min
B. Initiate noninvasive positive pressure ventilation
C. Encourage pursed-lip breathing only
D. Prescribe sedatives to reduce anxiety
Answer: B. Initiate noninvasive positive pressure ventilation
Rationale: Elevated PaCO₂ indicates hypercapnic respiratory failure. Noninvasive
ventilation can improve gas exchange, reduce work of breathing, and avoid
intubation.
, Question 8
Which vaccine is recommended annually for all adults, particularly those with
chronic health conditions?
A. Tdap
B. Pneumococcal
C. Influenza
D. Hepatitis B
Answer: C. Influenza
Rationale: Annual influenza vaccination reduces morbidity and mortality,
especially in adults with chronic illnesses such as diabetes, COPD, or heart disease.
Question 9
A patient with type 2 diabetes presents with fatigue, polyuria, and blurred vision.
Laboratory results: glucose 360 mg/dL, serum ketones negative, bicarbonate
normal. What is the most likely diagnosis?
A. Diabetic ketoacidosis
B. Hyperosmolar hyperglycemic state
C. Hypoglycemia
D. Metabolic acidosis
Answer: B. Hyperosmolar hyperglycemic state
Rationale: HHS typically presents with extreme hyperglycemia without
significant ketosis, dehydration, and altered mental status in type 2 diabetes.
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
WILLIAM PATERSON UNIVERSITY
Question 1
A 65-year-old patient with chronic heart failure presents with increasing shortness
of breath, peripheral edema, and weight gain over the past 3 days. Which
laboratory test is most useful in assessing fluid overload in this patient?
A. Serum creatinine
B. Brain natriuretic peptide (BNP)
C. Serum sodium
D. Hemoglobin
Answer: B. Brain natriuretic peptide (BNP)
Rationale: BNP is released by the ventricles in response to increased wall stress
and volume overload. Elevated BNP levels correlate with severity of heart failure
and fluid retention.
Question 2
A nurse practitioner is evaluating a patient for hypertension. Which lifestyle
modification has the most evidence for reducing systolic blood pressure?
A. Increasing saturated fat intake
B. Daily aerobic exercise
C. Reducing potassium intake
D. Limiting water intake
Answer: B. Daily aerobic exercise
Rationale: Regular aerobic exercise has been shown to significantly reduce
systolic and diastolic blood pressure and improve cardiovascular health.
,Question 3
A patient presents with sudden onset chest pain radiating to the left arm and jaw,
nausea, and diaphoresis. Which immediate action should the nurse practitioner take
first?
A. Administer nitroglycerin sublingually
B. Obtain a 12-lead ECG
C. Give aspirin 81 mg orally
D. Order a chest X-ray
Answer: B. Obtain a 12-lead ECG
Rationale: A 12-lead ECG is essential to rapidly identify acute myocardial
infarction and guide immediate management. Time-sensitive interventions depend
on early ECG results.
Question 4
A patient on warfarin therapy for atrial fibrillation presents with an INR of 5.5 but
is asymptomatic. What is the most appropriate intervention?
A. Hold the next warfarin dose and monitor
B. Administer vitamin K immediately
C. Continue the current dose
D. Increase the dose to compensate
Answer: A. Hold the next warfarin dose and monitor
Rationale: An INR >5 increases bleeding risk. If the patient is asymptomatic and
not actively bleeding, holding the next dose and closely monitoring INR is the
safest approach.
Question 5
Which of the following is a hallmark feature of nephrotic syndrome in adults?
A. Hematuria
B. Hypoalbuminemia
,C. Polyuria
D. Hyperkalemia
Answer: B. Hypoalbuminemia
Rationale: Nephrotic syndrome is characterized by heavy proteinuria (>3.5 g/day),
hypoalbuminemia, edema, and hyperlipidemia.
Question 6
A 50-year-old patient presents with jaundice, dark urine, and pruritus. Laboratory
results reveal elevated AST and ALT with a higher ALT than AST. What is the
most likely cause?
A. Alcoholic liver disease
B. Viral hepatitis
C. Hemochromatosis
D. Wilson disease
Answer: B. Viral hepatitis
Rationale: In viral hepatitis, ALT is typically higher than AST, whereas in
alcoholic liver disease AST > ALT (usually 2:1).
Question 7
A patient with COPD presents with increasing dyspnea and a PaCO₂ of 60 mmHg.
Which intervention should the nurse practitioner prioritize?
A. Administer high-flow oxygen at 15 L/min
B. Initiate noninvasive positive pressure ventilation
C. Encourage pursed-lip breathing only
D. Prescribe sedatives to reduce anxiety
Answer: B. Initiate noninvasive positive pressure ventilation
Rationale: Elevated PaCO₂ indicates hypercapnic respiratory failure. Noninvasive
ventilation can improve gas exchange, reduce work of breathing, and avoid
intubation.
, Question 8
Which vaccine is recommended annually for all adults, particularly those with
chronic health conditions?
A. Tdap
B. Pneumococcal
C. Influenza
D. Hepatitis B
Answer: C. Influenza
Rationale: Annual influenza vaccination reduces morbidity and mortality,
especially in adults with chronic illnesses such as diabetes, COPD, or heart disease.
Question 9
A patient with type 2 diabetes presents with fatigue, polyuria, and blurred vision.
Laboratory results: glucose 360 mg/dL, serum ketones negative, bicarbonate
normal. What is the most likely diagnosis?
A. Diabetic ketoacidosis
B. Hyperosmolar hyperglycemic state
C. Hypoglycemia
D. Metabolic acidosis
Answer: B. Hyperosmolar hyperglycemic state
Rationale: HHS typically presents with extreme hyperglycemia without
significant ketosis, dehydration, and altered mental status in type 2 diabetes.
