NUR611/NUR 611 Exam 2 V2 | Adv
Practice Nursing I Q&A with Rationale |
William Paterson University
1. A 55-year-old male with a history of hypertension presents for a routine check-up.
According to the JNC 8 guidelines, what is the goal blood pressure for this patient if he does
not have diabetes or chronic kidney disease?
A. The goal blood pressure is less than 130/80 mmHg.
B. The goal blood pressure is less than 150/90 mmHg.
C. The goal blood pressure is less than 140/90 mmHg.
D. The goal blood pressure is less than 120/80 mmHg.
Correct Answer: C
Expert Explanation: For patients under the age of 60 without diabetes or chronic kidney
disease, the JNC 8 guideline recommends a blood pressure goal of less than 140/90 mmHg.
This threshold is designed to reduce the risk of cardiovascular events while balancing the
risks of over-medication. Clinicians should monitor patients regularly to ensure they
remain within this target range through lifestyle or pharmacological interventions.
2. Which of the following physical examination findings is most characteristic of a patient
presenting with an acute exacerbation of COPD?
A. The patient exhibits hyperresonance on percussion and a prolonged expiratory phase.
,B. The patient shows increased tactile fremitus and dullness on percussion.
C. The patient presents with inspiratory stridor and tracheal deviation.
D. The patient has vesicular breath sounds and a normal AP chest diameter.
Correct Answer: A
Expert Explanation: Hyperresonance on percussion occurs because of air trapping and
lung hyperinflation associated with chronic obstructive pulmonary disease. A prolonged
expiratory phase is a hallmark sign indicating significant airflow obstruction during
exhalation. These findings help distinguish obstructive lung diseases from restrictive
diseases or localized pneumonia during a physical assessment.
3. A patient with newly diagnosed Type 2 Diabetes Mellitus is being started on Metformin.
What is the primary mechanism of action for this medication?
A. It stimulates the beta cells of the pancreas to release more insulin.
B. It slows the absorption of carbohydrates in the small intestine.
C. It decreases hepatic glucose production and improves insulin sensitivity.
D. It increases the excretion of glucose through the renal system.
Correct Answer: C
Expert Explanation: Metformin works primarily by inhibiting gluconeogenesis in the liver
and increasing the uptake of glucose by peripheral tissues. Unlike sulfonylureas, it does not
, cause hypoglycemia because it does not directly stimulate insulin secretion. It is considered
first-line therapy for Type 2 Diabetes due to its efficacy and safety profile.
4. Which class of antihypertensive medications is most likely to cause a dry, non-productive
cough as a side effect?
A. Calcium Channel Blockers are the most likely cause.
B. Beta-blockers are the most likely cause.
C. Angiotensin-Converting Enzyme (ACE) Inhibitors are the most likely cause.
D. Angiotensin II Receptor Blockers are the most likely cause.
Correct Answer: C
Expert Explanation: The dry cough associated with ACE inhibitors is caused by the
accumulation of bradykinin in the upper respiratory tract. This side effect occurs in
approximately 10 to 20 percent of patients and often necessitates a switch to an alternative
medication. Angiotensin II Receptor Blockers (ARBs) are frequently substituted because
they do not affect bradykinin levels.
5. When assessing a patient for Community-Acquired Pneumonia (CAP), which criteria are
included in the CURB-65 score to determine the need for hospitalization?
A. The criteria include Cyanosis, Unresponsiveness, Rhonchi, Bronchospasm, and Age.
B. The criteria include Cough, Upper respiratory infection, Rash, Bradycardia, and Age.
C. The criteria include Chest pain, Urine output, RR, Bilateral rales, and Age.
Practice Nursing I Q&A with Rationale |
William Paterson University
1. A 55-year-old male with a history of hypertension presents for a routine check-up.
According to the JNC 8 guidelines, what is the goal blood pressure for this patient if he does
not have diabetes or chronic kidney disease?
A. The goal blood pressure is less than 130/80 mmHg.
B. The goal blood pressure is less than 150/90 mmHg.
C. The goal blood pressure is less than 140/90 mmHg.
D. The goal blood pressure is less than 120/80 mmHg.
Correct Answer: C
Expert Explanation: For patients under the age of 60 without diabetes or chronic kidney
disease, the JNC 8 guideline recommends a blood pressure goal of less than 140/90 mmHg.
This threshold is designed to reduce the risk of cardiovascular events while balancing the
risks of over-medication. Clinicians should monitor patients regularly to ensure they
remain within this target range through lifestyle or pharmacological interventions.
2. Which of the following physical examination findings is most characteristic of a patient
presenting with an acute exacerbation of COPD?
A. The patient exhibits hyperresonance on percussion and a prolonged expiratory phase.
,B. The patient shows increased tactile fremitus and dullness on percussion.
C. The patient presents with inspiratory stridor and tracheal deviation.
D. The patient has vesicular breath sounds and a normal AP chest diameter.
Correct Answer: A
Expert Explanation: Hyperresonance on percussion occurs because of air trapping and
lung hyperinflation associated with chronic obstructive pulmonary disease. A prolonged
expiratory phase is a hallmark sign indicating significant airflow obstruction during
exhalation. These findings help distinguish obstructive lung diseases from restrictive
diseases or localized pneumonia during a physical assessment.
3. A patient with newly diagnosed Type 2 Diabetes Mellitus is being started on Metformin.
What is the primary mechanism of action for this medication?
A. It stimulates the beta cells of the pancreas to release more insulin.
B. It slows the absorption of carbohydrates in the small intestine.
C. It decreases hepatic glucose production and improves insulin sensitivity.
D. It increases the excretion of glucose through the renal system.
Correct Answer: C
Expert Explanation: Metformin works primarily by inhibiting gluconeogenesis in the liver
and increasing the uptake of glucose by peripheral tissues. Unlike sulfonylureas, it does not
, cause hypoglycemia because it does not directly stimulate insulin secretion. It is considered
first-line therapy for Type 2 Diabetes due to its efficacy and safety profile.
4. Which class of antihypertensive medications is most likely to cause a dry, non-productive
cough as a side effect?
A. Calcium Channel Blockers are the most likely cause.
B. Beta-blockers are the most likely cause.
C. Angiotensin-Converting Enzyme (ACE) Inhibitors are the most likely cause.
D. Angiotensin II Receptor Blockers are the most likely cause.
Correct Answer: C
Expert Explanation: The dry cough associated with ACE inhibitors is caused by the
accumulation of bradykinin in the upper respiratory tract. This side effect occurs in
approximately 10 to 20 percent of patients and often necessitates a switch to an alternative
medication. Angiotensin II Receptor Blockers (ARBs) are frequently substituted because
they do not affect bradykinin levels.
5. When assessing a patient for Community-Acquired Pneumonia (CAP), which criteria are
included in the CURB-65 score to determine the need for hospitalization?
A. The criteria include Cyanosis, Unresponsiveness, Rhonchi, Bronchospasm, and Age.
B. The criteria include Cough, Upper respiratory infection, Rash, Bradycardia, and Age.
C. The criteria include Chest pain, Urine output, RR, Bilateral rales, and Age.
