NUR611/NUR 611 Exam 3 V2 | Adv
Practice Nursing I Q&A with Rationale |
William Paterson University
1. What is the primary diagnostic marker used to confirm a diagnosis of Hypothyroidism in a
primary care setting?
A. The Serum Thyroid Stimulating Hormone level is the most sensitive indicator.
B. The Free T3 level is the most reliable marker for early diagnosis.
C. The Radioactive iodine uptake test is standard for initial screening.
D. The Total Thyroxine level provides the most comprehensive diagnostic data.
Correct Answer: A
Expert Explanation: Serum TSH is the most sensitive and specific test for diagnosing
primary hypothyroidism. An elevated TSH indicates that the pituitary gland is attempting
to stimulate a failing thyroid gland. This test is the initial screening tool recommended by
major clinical guidelines for thyroid dysfunction.
2. According to the JNC-8 guidelines, what is the goal blood pressure for an adult aged 60 or
older without diabetes or chronic kidney disease?
A. The blood pressure should be maintained below 130 over 80 mmHg.
B. The goal blood pressure should be less than 150 over 90 mmHg.
C. The target blood pressure is strictly less than 120 over 70 mmHg.
,D. The systolic pressure must be under 140 regardless of the diastolic value.
Correct Answer: B
Expert Explanation: For patients aged 60 and older, JNC-8 recommends a target of less
than 150/90 mmHg. This higher threshold is intended to reduce the risk of adverse events
like falls or hypotension in the elderly. Clinical judgment is still required to tailor targets for
individual patient health statuses.
3. Which physical examination finding is most characteristic of a patient presenting with
bacterial pneumonia?
A. The patient will exhibit decreased breath sounds and tracheal deviation.
B. There will be hyper-resonance noted upon percussion of the lung fields.
C. The patient will demonstrate increased tactile fremitus over the affected area.
D. The examiner will note vesicular breath sounds throughout all lung lobes.
Correct Answer: C
Expert Explanation: Tactile fremitus is increased in conditions where the lung tissue is
consolidated, such as bacterial pneumonia. Consolidation allows vibrations to travel more
efficiently from the bronchi to the chest wall. In contrast, conditions like pneumothorax or
COPD would result in decreased fremitus or hyper-resonance.
4. Which of the following is considered the first-line pharmacologic treatment for a patient
newly diagnosed with Type 2 Diabetes Mellitus?
A. Insulin Glargine is initiated to achieve rapid glycemic control.
, B. Glipizide is the preferred initial sulfonylurea for most patients.
C. Pioglitazone is used first to improve peripheral insulin sensitivity.
D. Metformin is the gold standard initial therapy for Type 2 Diabetes.
Correct Answer: D
Expert Explanation: Metformin is the first-line medication because of its efficacy, safety
profile, and low cost. It works by decreasing hepatic glucose production and improving
insulin sensitivity. Most clinical guidelines recommend starting Metformin alongside
lifestyle modifications unless a contraindication exists.
5. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
lesions. What is the most likely diagnosis?
A. The patient is most likely suffering from Tinea Corporis.
B. The clinical presentation is consistent with Pityriasis Rosea.
C. The lesions indicate a primary outbreak of Guttate Psoriasis.
D. The rash is a classic manifestation of Secondary Syphilis.
Correct Answer: B
Expert Explanation: Pityriasis Rosea typically begins with a single herald patch followed
by smaller scaly lesions in a Christmas tree pattern on the trunk. It is an acute, self-limiting
inflammatory skin disease. Management is usually supportive as the condition resolves
spontaneously over several weeks.
Practice Nursing I Q&A with Rationale |
William Paterson University
1. What is the primary diagnostic marker used to confirm a diagnosis of Hypothyroidism in a
primary care setting?
A. The Serum Thyroid Stimulating Hormone level is the most sensitive indicator.
B. The Free T3 level is the most reliable marker for early diagnosis.
C. The Radioactive iodine uptake test is standard for initial screening.
D. The Total Thyroxine level provides the most comprehensive diagnostic data.
Correct Answer: A
Expert Explanation: Serum TSH is the most sensitive and specific test for diagnosing
primary hypothyroidism. An elevated TSH indicates that the pituitary gland is attempting
to stimulate a failing thyroid gland. This test is the initial screening tool recommended by
major clinical guidelines for thyroid dysfunction.
2. According to the JNC-8 guidelines, what is the goal blood pressure for an adult aged 60 or
older without diabetes or chronic kidney disease?
A. The blood pressure should be maintained below 130 over 80 mmHg.
B. The goal blood pressure should be less than 150 over 90 mmHg.
C. The target blood pressure is strictly less than 120 over 70 mmHg.
,D. The systolic pressure must be under 140 regardless of the diastolic value.
Correct Answer: B
Expert Explanation: For patients aged 60 and older, JNC-8 recommends a target of less
than 150/90 mmHg. This higher threshold is intended to reduce the risk of adverse events
like falls or hypotension in the elderly. Clinical judgment is still required to tailor targets for
individual patient health statuses.
3. Which physical examination finding is most characteristic of a patient presenting with
bacterial pneumonia?
A. The patient will exhibit decreased breath sounds and tracheal deviation.
B. There will be hyper-resonance noted upon percussion of the lung fields.
C. The patient will demonstrate increased tactile fremitus over the affected area.
D. The examiner will note vesicular breath sounds throughout all lung lobes.
Correct Answer: C
Expert Explanation: Tactile fremitus is increased in conditions where the lung tissue is
consolidated, such as bacterial pneumonia. Consolidation allows vibrations to travel more
efficiently from the bronchi to the chest wall. In contrast, conditions like pneumothorax or
COPD would result in decreased fremitus or hyper-resonance.
4. Which of the following is considered the first-line pharmacologic treatment for a patient
newly diagnosed with Type 2 Diabetes Mellitus?
A. Insulin Glargine is initiated to achieve rapid glycemic control.
, B. Glipizide is the preferred initial sulfonylurea for most patients.
C. Pioglitazone is used first to improve peripheral insulin sensitivity.
D. Metformin is the gold standard initial therapy for Type 2 Diabetes.
Correct Answer: D
Expert Explanation: Metformin is the first-line medication because of its efficacy, safety
profile, and low cost. It works by decreasing hepatic glucose production and improving
insulin sensitivity. Most clinical guidelines recommend starting Metformin alongside
lifestyle modifications unless a contraindication exists.
5. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
lesions. What is the most likely diagnosis?
A. The patient is most likely suffering from Tinea Corporis.
B. The clinical presentation is consistent with Pityriasis Rosea.
C. The lesions indicate a primary outbreak of Guttate Psoriasis.
D. The rash is a classic manifestation of Secondary Syphilis.
Correct Answer: B
Expert Explanation: Pityriasis Rosea typically begins with a single herald patch followed
by smaller scaly lesions in a Christmas tree pattern on the trunk. It is an acute, self-limiting
inflammatory skin disease. Management is usually supportive as the condition resolves
spontaneously over several weeks.
