NRNP 6540 FINAL EXAM NEWEST 2026 UPDATE FAST
REVIWED FROM ACTUAL TEST 300 QUESTIONS AND 100%
VERIFIED ANSWERS| A+ GRADE Q&A | INSTANT
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1. A 58-year-old male presents with exertional chest pain relieved by rest. Which is the
most likely diagnosis?
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
Stable angina is characterized by predictable chest pain with exertion that is relieved by
rest or nitroglycerin.
2. Which medication is first-line for the treatment of hypertension in a patient with
diabetes?
A. Beta-blocker
B. Calcium channel blocker
C. ACE inhibitor
D. Loop diuretic
ACE inhibitors provide renal protection and are preferred in diabetic patients with
hypertension.
3. A patient presents with sudden onset unilateral facial droop. Which cranial nerve is most
likely affected?
A. CN V
B. CN VIII
C. CN IX
D. CN VII
The facial nerve (CN VII) controls muscles of facial expression and is affected in facial
droop.
4. Which lab value is most indicative of acute pancreatitis?
A. Elevated AST
B. Elevated ALT
C. Elevated lipase
D. Elevated bilirubin
Lipase is more specific and remains elevated longer than amylase in pancreatitis.
5. A 25-year-old female presents with dysuria and frequency. Urinalysis shows leukocytes
and nitrites. What is the most likely diagnosis?
A. Pyelonephritis
B. Interstitial cystitis
C. Acute cystitis
D. Urethritis
Positive leukocytes and nitrites indicate bacterial infection of the bladder.
,6. Which condition is associated with “moon face” and central obesity?
A. Addison’s disease
B. Cushing’s syndrome
C. Hyperthyroidism
D. Hypothyroidism
Cushing’s syndrome results from excess cortisol leading to characteristic physical
changes.
7. A patient with COPD has worsening dyspnea and productive cough. What is the first-line
treatment?
A. Oral steroids only
B. Antibiotics only
C. Short-acting bronchodilators
D. Long-acting beta agonists
Short-acting bronchodilators provide rapid symptom relief during exacerbations.
8. Which ECG finding is characteristic of hyperkalemia?
A. ST depression
B. U waves
C. Peaked T waves
D. Prolonged QT interval
Hyperkalemia causes tall, peaked T waves due to altered cardiac conduction.
9. A fasting blood glucose of 130 mg/dL on two occasions indicates:
A. Prediabetes
B. Normal glucose
C. Diabetes mellitus
D. Hypoglycemia
A fasting glucose ≥126 mg/dL on two separate tests confirms diabetes.
10. Which vaccine is recommended annually for all adults?
A. Hepatitis B
B. Tdap
C. HPV
D. Influenza
Annual influenza vaccination is recommended for all adults.
11. A patient reports weight loss, heat intolerance, and palpitations. Which condition is most
likely?
A. Hypothyroidism
B. Hyperthyroidism
C. Cushing’s syndrome
D. Addison’s disease
These are classic symptoms of excess thyroid hormone.
12. Which test is most appropriate to diagnose deep vein thrombosis (DVT)?
A. CT scan
B. MRI
C. Doppler ultrasound
D. X-ray
Doppler ultrasound is the first-line imaging for DVT.
,13. A patient presents with severe headache, neck stiffness, and fever. What is the priority
intervention?
A. CT scan
B. Lumbar puncture
C. MRI
D. EEG
Lumbar puncture is essential to diagnose meningitis by analyzing cerebrospinal fluid.
14. Which medication class is used for first-line treatment of GERD?
A. Antacids
B. H2 blockers
C. Proton pump inhibitors
D. Antibiotics
PPIs are most effective at reducing gastric acid secretion.
15. A patient has a hemoglobin A1c of 8.5%. What does this indicate?
A. Normal glucose control
B. Prediabetes
C. Poor diabetes control
D. Hypoglycemia
An A1c above 7% generally indicates inadequate glycemic control.
16. Which electrolyte imbalance causes muscle weakness and cardiac arrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Low potassium affects neuromuscular and cardiac function.
17. A patient presents with right lower quadrant abdominal pain and rebound tenderness.
What is the most likely diagnosis?
A. Cholecystitis
B. Pancreatitis
C. Appendicitis
D. Diverticulitis
RLQ pain with rebound tenderness is classic for appendicitis.
18. Which condition is characterized by decreased bone density and increased fracture risk?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Osteoporosis
D. Gout
Osteoporosis leads to fragile bones and increased fracture risk.
19. A patient with asthma experiences acute bronchospasm. Which medication provides
rapid relief?
A. Inhaled corticosteroids
B. Leukotriene modifiers
C. Short-acting beta agonists
D. Long-acting beta agonists
SABAs provide quick bronchodilation during acute attacks.
, 20. Which screening test is recommended for colorectal cancer starting at age 45?
A. PSA test
B. Mammogram
C. Colonoscopy
D. Pap smear
Colonoscopy allows direct visualization and removal of precancerous polyps.
21. Which pathogen is most commonly associated with community-acquired pneumonia?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Legionella pneumophila
Streptococcus pneumoniae is the most common cause of CAP.
22. A patient presents with elevated LDL cholesterol. What is the first-line pharmacologic
treatment?
A. Fibrates
B. Niacin
C. Statins
D. Bile acid sequestrants
Statins are first-line due to their effectiveness in lowering LDL.
23. Which sign is characteristic of Parkinson’s disease?
A. Hyperreflexia
B. Resting tremor
C. Spasticity
D. Clonus
Resting tremor is a hallmark feature of Parkinson’s disease.
24. A patient with anemia has low ferritin levels. What type of anemia is most likely?
A. Vitamin B12 deficiency
B. Folate deficiency
C. Iron deficiency anemia
D. Hemolytic anemia
Low ferritin indicates depleted iron stores.
25. Which condition presents with polyuria, polydipsia, and polyphagia?
A. Hyperthyroidism
B. Diabetes mellitus
C. Addison’s disease
D. Cushing’s syndrome
These are the classic “three Ps” of diabetes.
26. A patient presents with sudden severe headache described as “worst of life.” What is the
priority diagnosis?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinusitis
This description is classic for subarachnoid hemorrhage.
27. Which medication is used for acute treatment of gout?
A. Allopurinol
REVIWED FROM ACTUAL TEST 300 QUESTIONS AND 100%
VERIFIED ANSWERS| A+ GRADE Q&A | INSTANT
DOWNLOAD PDF
1. A 58-year-old male presents with exertional chest pain relieved by rest. Which is the
most likely diagnosis?
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
Stable angina is characterized by predictable chest pain with exertion that is relieved by
rest or nitroglycerin.
2. Which medication is first-line for the treatment of hypertension in a patient with
diabetes?
A. Beta-blocker
B. Calcium channel blocker
C. ACE inhibitor
D. Loop diuretic
ACE inhibitors provide renal protection and are preferred in diabetic patients with
hypertension.
3. A patient presents with sudden onset unilateral facial droop. Which cranial nerve is most
likely affected?
A. CN V
B. CN VIII
C. CN IX
D. CN VII
The facial nerve (CN VII) controls muscles of facial expression and is affected in facial
droop.
4. Which lab value is most indicative of acute pancreatitis?
A. Elevated AST
B. Elevated ALT
C. Elevated lipase
D. Elevated bilirubin
Lipase is more specific and remains elevated longer than amylase in pancreatitis.
5. A 25-year-old female presents with dysuria and frequency. Urinalysis shows leukocytes
and nitrites. What is the most likely diagnosis?
A. Pyelonephritis
B. Interstitial cystitis
C. Acute cystitis
D. Urethritis
Positive leukocytes and nitrites indicate bacterial infection of the bladder.
,6. Which condition is associated with “moon face” and central obesity?
A. Addison’s disease
B. Cushing’s syndrome
C. Hyperthyroidism
D. Hypothyroidism
Cushing’s syndrome results from excess cortisol leading to characteristic physical
changes.
7. A patient with COPD has worsening dyspnea and productive cough. What is the first-line
treatment?
A. Oral steroids only
B. Antibiotics only
C. Short-acting bronchodilators
D. Long-acting beta agonists
Short-acting bronchodilators provide rapid symptom relief during exacerbations.
8. Which ECG finding is characteristic of hyperkalemia?
A. ST depression
B. U waves
C. Peaked T waves
D. Prolonged QT interval
Hyperkalemia causes tall, peaked T waves due to altered cardiac conduction.
9. A fasting blood glucose of 130 mg/dL on two occasions indicates:
A. Prediabetes
B. Normal glucose
C. Diabetes mellitus
D. Hypoglycemia
A fasting glucose ≥126 mg/dL on two separate tests confirms diabetes.
10. Which vaccine is recommended annually for all adults?
A. Hepatitis B
B. Tdap
C. HPV
D. Influenza
Annual influenza vaccination is recommended for all adults.
11. A patient reports weight loss, heat intolerance, and palpitations. Which condition is most
likely?
A. Hypothyroidism
B. Hyperthyroidism
C. Cushing’s syndrome
D. Addison’s disease
These are classic symptoms of excess thyroid hormone.
12. Which test is most appropriate to diagnose deep vein thrombosis (DVT)?
A. CT scan
B. MRI
C. Doppler ultrasound
D. X-ray
Doppler ultrasound is the first-line imaging for DVT.
,13. A patient presents with severe headache, neck stiffness, and fever. What is the priority
intervention?
A. CT scan
B. Lumbar puncture
C. MRI
D. EEG
Lumbar puncture is essential to diagnose meningitis by analyzing cerebrospinal fluid.
14. Which medication class is used for first-line treatment of GERD?
A. Antacids
B. H2 blockers
C. Proton pump inhibitors
D. Antibiotics
PPIs are most effective at reducing gastric acid secretion.
15. A patient has a hemoglobin A1c of 8.5%. What does this indicate?
A. Normal glucose control
B. Prediabetes
C. Poor diabetes control
D. Hypoglycemia
An A1c above 7% generally indicates inadequate glycemic control.
16. Which electrolyte imbalance causes muscle weakness and cardiac arrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Low potassium affects neuromuscular and cardiac function.
17. A patient presents with right lower quadrant abdominal pain and rebound tenderness.
What is the most likely diagnosis?
A. Cholecystitis
B. Pancreatitis
C. Appendicitis
D. Diverticulitis
RLQ pain with rebound tenderness is classic for appendicitis.
18. Which condition is characterized by decreased bone density and increased fracture risk?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Osteoporosis
D. Gout
Osteoporosis leads to fragile bones and increased fracture risk.
19. A patient with asthma experiences acute bronchospasm. Which medication provides
rapid relief?
A. Inhaled corticosteroids
B. Leukotriene modifiers
C. Short-acting beta agonists
D. Long-acting beta agonists
SABAs provide quick bronchodilation during acute attacks.
, 20. Which screening test is recommended for colorectal cancer starting at age 45?
A. PSA test
B. Mammogram
C. Colonoscopy
D. Pap smear
Colonoscopy allows direct visualization and removal of precancerous polyps.
21. Which pathogen is most commonly associated with community-acquired pneumonia?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Legionella pneumophila
Streptococcus pneumoniae is the most common cause of CAP.
22. A patient presents with elevated LDL cholesterol. What is the first-line pharmacologic
treatment?
A. Fibrates
B. Niacin
C. Statins
D. Bile acid sequestrants
Statins are first-line due to their effectiveness in lowering LDL.
23. Which sign is characteristic of Parkinson’s disease?
A. Hyperreflexia
B. Resting tremor
C. Spasticity
D. Clonus
Resting tremor is a hallmark feature of Parkinson’s disease.
24. A patient with anemia has low ferritin levels. What type of anemia is most likely?
A. Vitamin B12 deficiency
B. Folate deficiency
C. Iron deficiency anemia
D. Hemolytic anemia
Low ferritin indicates depleted iron stores.
25. Which condition presents with polyuria, polydipsia, and polyphagia?
A. Hyperthyroidism
B. Diabetes mellitus
C. Addison’s disease
D. Cushing’s syndrome
These are the classic “three Ps” of diabetes.
26. A patient presents with sudden severe headache described as “worst of life.” What is the
priority diagnosis?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinusitis
This description is classic for subarachnoid hemorrhage.
27. Which medication is used for acute treatment of gout?
A. Allopurinol
