NRNP 6540 FINAL EXAM LATEST
UPDATE 2026/2027 REAL EXAM
QUESTIONS WITH CORRECT ANSWERS
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Sample Question 1:
Mrs. Williams is 76 years old. She fell a month ago and the wound on her
leg has not healed. The nurse practitioner examines the wound and sees
that it has been cleaned properly and has no signs of infection. The edges
are approximated, but the skin around the wound is red and tender to
touch. What is the best response regarding Mrs. Williams' concern?
A. "Wound healing for older people may take up to four times longer
than it does for younger people."
B. "Let's talk about what you are eating."
C. "Had you come in earlier, I would have ordered medicine that
would have healed that right up."
D. "I will order an antibiotic to prevent infection."
Correct Answer: A
Rationale: Skin renewal turnover time increases to approximately 87 days
in older adults, compared with 20 days during youth. The perceived
extended healing time is not related to diet, there is no medication that will
heal the wound quickly, and prophylactic antibiotics are not appropriate
when there are no signs or symptoms of infection.
Sample Question 2:
Sheila is pregnant and fearful of getting cervical cancer as her sister
recently did. She asks about receiving the HPV vaccine. How do you
respond?
, A. "As long as you're in your first trimester, the HPV vaccine is safe
and effective."
B. "Research has not shown this vaccine to be effective against
preventing cervical cancer."
C. "After the age of 20, the HPV vaccine is not recommended."
D. "You should not receive the vaccination when you are pregnant."
Correct Answer: D
Rationale: The HPV vaccine is not recommended during pregnancy. While
it is not known to cause harm, it is contraindicated, and vaccination should
be postponed until after the pregnancy.
Sample Question 3:
A patient with renal disease has blood work drawn, and the results show an
increase in serum creatinine. The nurse practitioner needs to know which of
the following laboratory values before ordering medications?
A. CBC
B. Culture and sensitivity of the urine
C. Creatinine clearance
D. Uric acid levels
Correct Answer: C
Rationale: The calculation of creatinine clearance provides an estimation of
renal function, which is essential for dosing medications that are renally
excreted. A CBC does not evaluate kidney function, culture and sensitivity
test reflects the presence of an infection, and uric acid level is typically
elevated in the presence of gout.
Sample Question 4:
A patient in a long-term care facility has arms and elbows that are
excoriated and the skin is shearing. The nurse practitioner explains to the
staff that the patient needs frequent assessment of her skin and protection
provided to prevent skin breakdown because:
A. Her lack of activity causes the skin to tear.
, B. Fat has redistributed to the abdomen and thighs, leaving bony
surfaces in areas such as the face, hands, and sacrum, which can result
in injury.
C. She has lost weight and is in jeopardy of falling.
D. She picks at herself and causes skin breakdown.
Correct Answer: B
Rationale: With aging, fat is redistributed to the abdomen and thighs,
leaving bony surfaces, such as the face, hands, and sacrum, exposed to
potential injury, especially skin tears from shearing, friction forces, and
pressure ulcer development. Lack of activity alone does not cause skin
breakdown, and there is no evidence she is picking at herself.
Sample Question 5
An 82-year-old man reports progressive difficulty with balance and
frequent falls. He has a masked facies, cogwheel rigidity, and a resting
tremor in his right hand. Which medication is most appropriate as initial
therapy?
A. Levodopa-carbidopa
B. Benztropine
C. Selegiline
D. Amantadine
Correct Answer: A
Rationale: Levodopa-carbidopa is the most effective symptomatic
treatment for Parkinson’s disease in older adults. Anticholinergics
(benztropine) often cause confusion and are avoided. Selegiline and
amantadine have milder effects.
Sample Question 6
A 78-year-old female has a TSH of 0.1 mIU/L (low), free T4 elevated, and
, complains of palpitations, weight loss, and heat intolerance. What is the
most appropriate next step?
A. Methimazole
B. Radioactive iodine uptake scan
C. Propranolol
D. Levothyroxine
Correct Answer: C
Rationale: In an older adult with symptomatic hyperthyroidism, beta-
blockers (propranolol) provide rapid symptom control while awaiting
definitive treatment. Radioactive iodine uptake can help differentiate causes
but is not immediate management.
Sample Question 7
Which of the following vaccines is recommended annually for all adults
aged ≥65 years?
A. Pneumococcal polysaccharide vaccine (PPSV23)
B. Herpes zoster (RZV)
C. Influenza (inactivated or recombinant)
D. Tdap
Correct Answer: C
Rationale: Annual influenza vaccine is recommended for all adults ≥65.
PPSV23 is given once or twice, RZV is given two doses, and Tdap is given
once then Td every 10 years.
Sample Question 8
An 85-year-old man with CKD stage 3b is prescribed a new medication.
UPDATE 2026/2027 REAL EXAM
QUESTIONS WITH CORRECT ANSWERS
TOP RATED DOCUMENT, 100%
SUCCESS GUARANTEED, GRADED A+
Sample Question 1:
Mrs. Williams is 76 years old. She fell a month ago and the wound on her
leg has not healed. The nurse practitioner examines the wound and sees
that it has been cleaned properly and has no signs of infection. The edges
are approximated, but the skin around the wound is red and tender to
touch. What is the best response regarding Mrs. Williams' concern?
A. "Wound healing for older people may take up to four times longer
than it does for younger people."
B. "Let's talk about what you are eating."
C. "Had you come in earlier, I would have ordered medicine that
would have healed that right up."
D. "I will order an antibiotic to prevent infection."
Correct Answer: A
Rationale: Skin renewal turnover time increases to approximately 87 days
in older adults, compared with 20 days during youth. The perceived
extended healing time is not related to diet, there is no medication that will
heal the wound quickly, and prophylactic antibiotics are not appropriate
when there are no signs or symptoms of infection.
Sample Question 2:
Sheila is pregnant and fearful of getting cervical cancer as her sister
recently did. She asks about receiving the HPV vaccine. How do you
respond?
, A. "As long as you're in your first trimester, the HPV vaccine is safe
and effective."
B. "Research has not shown this vaccine to be effective against
preventing cervical cancer."
C. "After the age of 20, the HPV vaccine is not recommended."
D. "You should not receive the vaccination when you are pregnant."
Correct Answer: D
Rationale: The HPV vaccine is not recommended during pregnancy. While
it is not known to cause harm, it is contraindicated, and vaccination should
be postponed until after the pregnancy.
Sample Question 3:
A patient with renal disease has blood work drawn, and the results show an
increase in serum creatinine. The nurse practitioner needs to know which of
the following laboratory values before ordering medications?
A. CBC
B. Culture and sensitivity of the urine
C. Creatinine clearance
D. Uric acid levels
Correct Answer: C
Rationale: The calculation of creatinine clearance provides an estimation of
renal function, which is essential for dosing medications that are renally
excreted. A CBC does not evaluate kidney function, culture and sensitivity
test reflects the presence of an infection, and uric acid level is typically
elevated in the presence of gout.
Sample Question 4:
A patient in a long-term care facility has arms and elbows that are
excoriated and the skin is shearing. The nurse practitioner explains to the
staff that the patient needs frequent assessment of her skin and protection
provided to prevent skin breakdown because:
A. Her lack of activity causes the skin to tear.
, B. Fat has redistributed to the abdomen and thighs, leaving bony
surfaces in areas such as the face, hands, and sacrum, which can result
in injury.
C. She has lost weight and is in jeopardy of falling.
D. She picks at herself and causes skin breakdown.
Correct Answer: B
Rationale: With aging, fat is redistributed to the abdomen and thighs,
leaving bony surfaces, such as the face, hands, and sacrum, exposed to
potential injury, especially skin tears from shearing, friction forces, and
pressure ulcer development. Lack of activity alone does not cause skin
breakdown, and there is no evidence she is picking at herself.
Sample Question 5
An 82-year-old man reports progressive difficulty with balance and
frequent falls. He has a masked facies, cogwheel rigidity, and a resting
tremor in his right hand. Which medication is most appropriate as initial
therapy?
A. Levodopa-carbidopa
B. Benztropine
C. Selegiline
D. Amantadine
Correct Answer: A
Rationale: Levodopa-carbidopa is the most effective symptomatic
treatment for Parkinson’s disease in older adults. Anticholinergics
(benztropine) often cause confusion and are avoided. Selegiline and
amantadine have milder effects.
Sample Question 6
A 78-year-old female has a TSH of 0.1 mIU/L (low), free T4 elevated, and
, complains of palpitations, weight loss, and heat intolerance. What is the
most appropriate next step?
A. Methimazole
B. Radioactive iodine uptake scan
C. Propranolol
D. Levothyroxine
Correct Answer: C
Rationale: In an older adult with symptomatic hyperthyroidism, beta-
blockers (propranolol) provide rapid symptom control while awaiting
definitive treatment. Radioactive iodine uptake can help differentiate causes
but is not immediate management.
Sample Question 7
Which of the following vaccines is recommended annually for all adults
aged ≥65 years?
A. Pneumococcal polysaccharide vaccine (PPSV23)
B. Herpes zoster (RZV)
C. Influenza (inactivated or recombinant)
D. Tdap
Correct Answer: C
Rationale: Annual influenza vaccine is recommended for all adults ≥65.
PPSV23 is given once or twice, RZV is given two doses, and Tdap is given
once then Td every 10 years.
Sample Question 8
An 85-year-old man with CKD stage 3b is prescribed a new medication.
