NUR611/NUR 611 Exam 4 V2 | Adv
Practice Nursing I Q&A with Rationale |
William Paterson University
1. Which of the following is the first-line medication class recommended for a non-black
patient with newly diagnosed Stage 1 hypertension and no other comorbidities?
A. The patient should be started on a Beta-blocker medication.
B. The patient should be started on an alpha-agonist.
C. The patient should be started on a loop diuretic.
D. The patient should be started on an ACE inhibitor.
Correct Answer: D
Expert Explanation: ACE inhibitors are considered first-line therapy for non-black
patients according to current hypertension guidelines. They effectively reduce blood
pressure and offer protection against target organ damage. Monitoring serum creatinine
and potassium levels is essential when initiating this therapy.
2. When diagnosing Chronic Obstructive Pulmonary Disease (COPD), which objective finding
is required to confirm the diagnosis?
A. The diagnosis is confirmed with a post-bronchodilator FEV1/FVC ratio less than 0.70.
B. The diagnosis is confirmed with a peak flow meter reading.
C. The diagnosis is confirmed with a chest X-ray showing hyperinflation.
,D. The diagnosis is confirmed with an arterial blood gas showing hypoxia.
Correct Answer: A
Expert Explanation: Spirometry is the gold standard for diagnosing and assessing the
severity of COPD. A post-bronchodilator FEV1/FVC ratio of less than 0.70 confirms the
presence of persistent airflow limitation. This measurement helps differentiate COPD from
other obstructive lung diseases like asthma.
3. A patient presents with symptoms of GERD that have not responded to lifestyle
modifications. What is the next step in pharmacological management?
A. The patient should begin long-term antibiotic therapy for H. pylori.
B. The patient should take an antacid as needed for symptom relief.
C. The patient should start a daily Proton Pump Inhibitor (PPI) for eight weeks.
D. The patient should undergo immediate surgical fundoplication.
Correct Answer: C
Expert Explanation: Proton Pump Inhibitors are the most effective therapy for healing
esophagitis and providing symptom relief in GERD. Guidelines suggest an initial eight-week
course to assess response and achieve healing. If symptoms persist after this period,
further diagnostic evaluation such as endoscopy may be warranted.
4. In the management of Type 2 Diabetes, what is the recommended initial pharmacological
agent for most patients?
A. The patient should begin therapy with Metformin.
, B. The patient should begin therapy with basal insulin.
C. The patient should begin therapy with a Sulfonylurea.
D. The patient should begin therapy with a SGLT2 inhibitor.
Correct Answer: A
Expert Explanation: Metformin is the preferred initial pharmacological agent for the
treatment of type 2 diabetes unless contraindicated. It is effective, safe, and inexpensive,
and it may reduce the risk of cardiovascular events and death. Patients should be
monitored for gastrointestinal side effects and vitamin B12 deficiency over time.
5. Which of the following physical exam findings is most characteristic of Osteoarthritis of the
knee?
A. The knee will show systemic warmth and redness.
B. The knee will exhibit joint crepitus and bony enlargement.
C. The patient will have symmetrical joint swelling in the wrists.
D. The patient will experience prolonged morning stiffness lasting over two hours.
Correct Answer: B
Expert Explanation: Osteoarthritis is characterized by the breakdown of joint cartilage
and underlying bone, often resulting in crepitus. Bony enlargements such as Heberden’s
and Bouchard’s nodes are common in this condition. Unlike rheumatoid arthritis, morning
stiffness in osteoarthritis typically lasts less than 30 minutes.
Practice Nursing I Q&A with Rationale |
William Paterson University
1. Which of the following is the first-line medication class recommended for a non-black
patient with newly diagnosed Stage 1 hypertension and no other comorbidities?
A. The patient should be started on a Beta-blocker medication.
B. The patient should be started on an alpha-agonist.
C. The patient should be started on a loop diuretic.
D. The patient should be started on an ACE inhibitor.
Correct Answer: D
Expert Explanation: ACE inhibitors are considered first-line therapy for non-black
patients according to current hypertension guidelines. They effectively reduce blood
pressure and offer protection against target organ damage. Monitoring serum creatinine
and potassium levels is essential when initiating this therapy.
2. When diagnosing Chronic Obstructive Pulmonary Disease (COPD), which objective finding
is required to confirm the diagnosis?
A. The diagnosis is confirmed with a post-bronchodilator FEV1/FVC ratio less than 0.70.
B. The diagnosis is confirmed with a peak flow meter reading.
C. The diagnosis is confirmed with a chest X-ray showing hyperinflation.
,D. The diagnosis is confirmed with an arterial blood gas showing hypoxia.
Correct Answer: A
Expert Explanation: Spirometry is the gold standard for diagnosing and assessing the
severity of COPD. A post-bronchodilator FEV1/FVC ratio of less than 0.70 confirms the
presence of persistent airflow limitation. This measurement helps differentiate COPD from
other obstructive lung diseases like asthma.
3. A patient presents with symptoms of GERD that have not responded to lifestyle
modifications. What is the next step in pharmacological management?
A. The patient should begin long-term antibiotic therapy for H. pylori.
B. The patient should take an antacid as needed for symptom relief.
C. The patient should start a daily Proton Pump Inhibitor (PPI) for eight weeks.
D. The patient should undergo immediate surgical fundoplication.
Correct Answer: C
Expert Explanation: Proton Pump Inhibitors are the most effective therapy for healing
esophagitis and providing symptom relief in GERD. Guidelines suggest an initial eight-week
course to assess response and achieve healing. If symptoms persist after this period,
further diagnostic evaluation such as endoscopy may be warranted.
4. In the management of Type 2 Diabetes, what is the recommended initial pharmacological
agent for most patients?
A. The patient should begin therapy with Metformin.
, B. The patient should begin therapy with basal insulin.
C. The patient should begin therapy with a Sulfonylurea.
D. The patient should begin therapy with a SGLT2 inhibitor.
Correct Answer: A
Expert Explanation: Metformin is the preferred initial pharmacological agent for the
treatment of type 2 diabetes unless contraindicated. It is effective, safe, and inexpensive,
and it may reduce the risk of cardiovascular events and death. Patients should be
monitored for gastrointestinal side effects and vitamin B12 deficiency over time.
5. Which of the following physical exam findings is most characteristic of Osteoarthritis of the
knee?
A. The knee will show systemic warmth and redness.
B. The knee will exhibit joint crepitus and bony enlargement.
C. The patient will have symmetrical joint swelling in the wrists.
D. The patient will experience prolonged morning stiffness lasting over two hours.
Correct Answer: B
Expert Explanation: Osteoarthritis is characterized by the breakdown of joint cartilage
and underlying bone, often resulting in crepitus. Bony enlargements such as Heberden’s
and Bouchard’s nodes are common in this condition. Unlike rheumatoid arthritis, morning
stiffness in osteoarthritis typically lasts less than 30 minutes.
