NURS 6531 / NRNP 6531 FINAL EXAM 2026-2027
250 Questions with Verified Answers & Detailed Rationales
Advanced Practice Care of Adults | Walden University |
Graded A+
EXAM OVERVIEW
The NURS 6531/NRNP 6531 Final Exam covers advanced primary care of adults across the lifespan,
including assessment, diagnosis, and evidence-based management of acute and chronic conditions. This
guide contains 250 high-yield questions with verified answers and detailed rationales.
SECTION 1: CLINICAL REASONING & DIAGNOSTIC TESTS
Question 1
A 72-year-old reports sudden onset of "flashes of light" and new floaters in the right eye. He says his
vision now looks like a "curtain coming down." There is no eye pain. What is the next best step?
• A) Start oral antibiotics and recheck in 48 hours
• B) Same-day urgent ophthalmology/emergency referral
• C) Reassure; this is typical age-related vision change
• D) Start topical antihistamine drops
Correct Answer: B
Rationale: Flashes, floaters, and a curtain/veil over vision are classic red flags for retinal
detachment and require emergent evaluation to preserve vision. Reassurance is unsafe because time-
sensitive repair may be needed.
Question 2
A 64-year-old with diabetes presents with severe ear pain, purulent otorrhea, and granulation tissue in
the ear canal. The auricle is swollen and erythematous. Which organism is most likely?
• A) Streptococcus pyogenes
• B) Staphylococcus aureus
• C) Pseudomonas aeruginosa
• D) Moraxella catarrhalis
Correct Answer: C
,Rationale: Malignant otitis externa in older adults with diabetes is most commonly caused
by Pseudomonas aeruginosa.
Question 3
A 72-year-old female reports a 6-month history of gradually progressive swollen and painful distal
interphalangeal (DIP) joints of one hand. She has no systemic symptoms but ESR, ANA, and RF are all
minimally elevated. What is the most likely diagnosis?
• A) Rheumatoid arthritis
• B) Osteoarthritis (OA)
• C) Systemic lupus erythematosus
• D) Pseudogout
Correct Answer: B
Rationale: Osteoarthritis typically presents with joint pain and swelling at the DIP joints (Heberden's
nodes). Elevated ESR, ANA, and RF are not characteristic of OA.
Question 4
Phalen's test, 90° wrist flexion for 60 seconds, reproduces symptoms of:
• A) Ulnar tunnel syndrome
• B) Carpal tunnel syndrome
• C) Tarsal tunnel syndrome
• D) Myofascial pain syndrome
Correct Answer: B
Rationale: Phalen's test is a provocative maneuver for carpal tunnel syndrome. By placing the wrist in
maximal flexion, pressure on the median nerve increases. Reproduction of paresthesia in the thumb,
index, and middle fingers is a positive test.
Question 5
Which patient would benefit most from screening for type 2 diabetes?
• A) 30-year-old female with unintended weight loss
• B) 25-year-old male with family history of type 1 diabetes
• C) An obese female with recurrent vaginitis
, • D) 50-year-old hyperlipidemic male
Correct Answer: C
Rationale: Recurrent vaginitis can be a sign of undiagnosed diabetes. Obesity is a major risk factor for
type 2 diabetes.
Question 6
A 32-year-old male complains of urinary frequency and burning on urination for 3 days. Urinalysis
reveals bacteriuria. He denies any past history of UTI. The initial treatment should be:
• A) Trimethoprim-sulfamethoxazole for 3 days
• B) Ciprofloxacin for 7-10 days
• C) TMP-SMX for 14 days
• D) Ciprofloxacin for 3 days
Correct Answer: A
Rationale: Uncomplicated cystitis in a young male is treated with a short course (3 days) of TMP-SMX.
Question 7
A thymectomy is usually recommended in the early treatment of which disease?
• A) Parkinson's disease
• B) Multiple sclerosis
• C) Myasthenia Gravis
• D) Huntington's chorea
Correct Answer: C
Rationale: Thymectomy is a standard treatment for myasthenia gravis (MG) in patients under 60 with
generalized disease and anti-acetylcholine receptor antibodies.
Question 8
The most effective intervention(s) to prevent stroke is (are):
• A) Smoking cessation and treatment of hypertension
• B) Aspirin alone
• C) Statin therapy alone
, • D) Exercise alone
Correct Answer: A
Rationale: Smoking cessation and hypertension treatment are the most effective interventions for
stroke prevention.
Question 9
What is the most common cause of Cushing's syndrome?
• A) Pituitary adenoma
• B) Administration of a glucocorticoid or ACTH
• C) Adrenal adenoma
• D) Ectopic ACTH production
Correct Answer: B
Rationale: Exogenous glucocorticoid administration is the most common cause of Cushing's syndrome.
Question 10
Which of the following medications may predispose the patient to hypoglycemia?
• A) ACE inhibitors
• B) Beta-adrenergic blockers
• C) Thiazide diuretics
• D) Calcium channel blockers
Correct Answer: B
Rationale: Beta-blockers can potentiate and mask the symptoms of hypoglycemia. They also blunt the
normal physiologic response to low blood sugar.
Question 11
After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been
cured?
• A) Stool antigen test
• B) Serology
• C) A urea breath test
250 Questions with Verified Answers & Detailed Rationales
Advanced Practice Care of Adults | Walden University |
Graded A+
EXAM OVERVIEW
The NURS 6531/NRNP 6531 Final Exam covers advanced primary care of adults across the lifespan,
including assessment, diagnosis, and evidence-based management of acute and chronic conditions. This
guide contains 250 high-yield questions with verified answers and detailed rationales.
SECTION 1: CLINICAL REASONING & DIAGNOSTIC TESTS
Question 1
A 72-year-old reports sudden onset of "flashes of light" and new floaters in the right eye. He says his
vision now looks like a "curtain coming down." There is no eye pain. What is the next best step?
• A) Start oral antibiotics and recheck in 48 hours
• B) Same-day urgent ophthalmology/emergency referral
• C) Reassure; this is typical age-related vision change
• D) Start topical antihistamine drops
Correct Answer: B
Rationale: Flashes, floaters, and a curtain/veil over vision are classic red flags for retinal
detachment and require emergent evaluation to preserve vision. Reassurance is unsafe because time-
sensitive repair may be needed.
Question 2
A 64-year-old with diabetes presents with severe ear pain, purulent otorrhea, and granulation tissue in
the ear canal. The auricle is swollen and erythematous. Which organism is most likely?
• A) Streptococcus pyogenes
• B) Staphylococcus aureus
• C) Pseudomonas aeruginosa
• D) Moraxella catarrhalis
Correct Answer: C
,Rationale: Malignant otitis externa in older adults with diabetes is most commonly caused
by Pseudomonas aeruginosa.
Question 3
A 72-year-old female reports a 6-month history of gradually progressive swollen and painful distal
interphalangeal (DIP) joints of one hand. She has no systemic symptoms but ESR, ANA, and RF are all
minimally elevated. What is the most likely diagnosis?
• A) Rheumatoid arthritis
• B) Osteoarthritis (OA)
• C) Systemic lupus erythematosus
• D) Pseudogout
Correct Answer: B
Rationale: Osteoarthritis typically presents with joint pain and swelling at the DIP joints (Heberden's
nodes). Elevated ESR, ANA, and RF are not characteristic of OA.
Question 4
Phalen's test, 90° wrist flexion for 60 seconds, reproduces symptoms of:
• A) Ulnar tunnel syndrome
• B) Carpal tunnel syndrome
• C) Tarsal tunnel syndrome
• D) Myofascial pain syndrome
Correct Answer: B
Rationale: Phalen's test is a provocative maneuver for carpal tunnel syndrome. By placing the wrist in
maximal flexion, pressure on the median nerve increases. Reproduction of paresthesia in the thumb,
index, and middle fingers is a positive test.
Question 5
Which patient would benefit most from screening for type 2 diabetes?
• A) 30-year-old female with unintended weight loss
• B) 25-year-old male with family history of type 1 diabetes
• C) An obese female with recurrent vaginitis
, • D) 50-year-old hyperlipidemic male
Correct Answer: C
Rationale: Recurrent vaginitis can be a sign of undiagnosed diabetes. Obesity is a major risk factor for
type 2 diabetes.
Question 6
A 32-year-old male complains of urinary frequency and burning on urination for 3 days. Urinalysis
reveals bacteriuria. He denies any past history of UTI. The initial treatment should be:
• A) Trimethoprim-sulfamethoxazole for 3 days
• B) Ciprofloxacin for 7-10 days
• C) TMP-SMX for 14 days
• D) Ciprofloxacin for 3 days
Correct Answer: A
Rationale: Uncomplicated cystitis in a young male is treated with a short course (3 days) of TMP-SMX.
Question 7
A thymectomy is usually recommended in the early treatment of which disease?
• A) Parkinson's disease
• B) Multiple sclerosis
• C) Myasthenia Gravis
• D) Huntington's chorea
Correct Answer: C
Rationale: Thymectomy is a standard treatment for myasthenia gravis (MG) in patients under 60 with
generalized disease and anti-acetylcholine receptor antibodies.
Question 8
The most effective intervention(s) to prevent stroke is (are):
• A) Smoking cessation and treatment of hypertension
• B) Aspirin alone
• C) Statin therapy alone
, • D) Exercise alone
Correct Answer: A
Rationale: Smoking cessation and hypertension treatment are the most effective interventions for
stroke prevention.
Question 9
What is the most common cause of Cushing's syndrome?
• A) Pituitary adenoma
• B) Administration of a glucocorticoid or ACTH
• C) Adrenal adenoma
• D) Ectopic ACTH production
Correct Answer: B
Rationale: Exogenous glucocorticoid administration is the most common cause of Cushing's syndrome.
Question 10
Which of the following medications may predispose the patient to hypoglycemia?
• A) ACE inhibitors
• B) Beta-adrenergic blockers
• C) Thiazide diuretics
• D) Calcium channel blockers
Correct Answer: B
Rationale: Beta-blockers can potentiate and mask the symptoms of hypoglycemia. They also blunt the
normal physiologic response to low blood sugar.
Question 11
After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been
cured?
• A) Stool antigen test
• B) Serology
• C) A urea breath test
