NUR612/NUR 612 Final Exam V3 |
Advanced Nursing II Q&A with Rationale |
William Paterson University
1. A 65-year-old patient presents with shortness of breath and an audible S3 heart sound.
Which of the following conditions is most likely suggested by this finding?
A. Aortic Stenosis
B. Heart Failure
C. Mitral Valve Prolapse
D. Pulmonary Hypertension
Correct Answer: B
Expert Explanation: The presence of an S3 heart sound, also known as a ventricular
gallop, is a classic sign of volume overload in the ventricles. In older adults, this is often
indicative of congestive heart failure where the heart cannot pump effectively. This sound
occurs early in diastole during the rapid ventricular filling phase.
2. Which pharmacological agent is considered first-line for a patient newly diagnosed with
Type 2 Diabetes Mellitus and no contraindications?
A. Glyburide
B. Liraglutide
C. Metformin
,D. Sitagliptin
Correct Answer: C
Expert Explanation: Metformin is the gold standard for initial therapy in Type 2 Diabetes
due to its efficacy and safety profile. It works primarily by decreasing hepatic glucose
production and improving insulin sensitivity. Most clinical guidelines recommend it as the
first-line medication unless the patient has severe renal impairment.
3. When assessing a patient for a potential Stroke, which of the following is the most critical
initial diagnostic test to perform?
A. Carotid Ultrasound
B. MRI of the Brain
C. Electroencephalogram (EEG)
D. Non-contrast CT scan of the Head
Correct Answer: D
Expert Explanation: A non-contrast CT scan is the standard initial imaging modality to
rule out intracranial hemorrhage before initiating thrombolytic therapy. It is fast, widely
available, and highly effective at detecting acute bleeding in the brain. Rapid diagnosis is
essential because the window for administering tPA is very narrow.
4. A patient with a history of COPD presents with increased sputum production and cyanosis.
This clinical picture is most consistent with which condition?
A. Emphysema
, B. Chronic Bronchitis
C. Acute Asthma Attack
D. Pneumothorax
Correct Answer: B
Expert Explanation: Chronic bronchitis is characterized by a productive cough and mucus
production for at least three months in two consecutive years. These patients are often
referred to as ‘blue bloaters’ due to hypoxemia and resulting cyanosis. In contrast,
emphysema typically involves air trapping and a ‘pink puffer’ appearance without
significant sputum.
5. Which of the following electrolyte imbalances is most likely to cause a flattened T-wave
and the presence of U-waves on an ECG?
A. Hyperkalemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: C
Expert Explanation: Hypokalemia, or low serum potassium, significantly affects cardiac
repolarization and leads to specific ECG changes. Common findings include flattened or
Advanced Nursing II Q&A with Rationale |
William Paterson University
1. A 65-year-old patient presents with shortness of breath and an audible S3 heart sound.
Which of the following conditions is most likely suggested by this finding?
A. Aortic Stenosis
B. Heart Failure
C. Mitral Valve Prolapse
D. Pulmonary Hypertension
Correct Answer: B
Expert Explanation: The presence of an S3 heart sound, also known as a ventricular
gallop, is a classic sign of volume overload in the ventricles. In older adults, this is often
indicative of congestive heart failure where the heart cannot pump effectively. This sound
occurs early in diastole during the rapid ventricular filling phase.
2. Which pharmacological agent is considered first-line for a patient newly diagnosed with
Type 2 Diabetes Mellitus and no contraindications?
A. Glyburide
B. Liraglutide
C. Metformin
,D. Sitagliptin
Correct Answer: C
Expert Explanation: Metformin is the gold standard for initial therapy in Type 2 Diabetes
due to its efficacy and safety profile. It works primarily by decreasing hepatic glucose
production and improving insulin sensitivity. Most clinical guidelines recommend it as the
first-line medication unless the patient has severe renal impairment.
3. When assessing a patient for a potential Stroke, which of the following is the most critical
initial diagnostic test to perform?
A. Carotid Ultrasound
B. MRI of the Brain
C. Electroencephalogram (EEG)
D. Non-contrast CT scan of the Head
Correct Answer: D
Expert Explanation: A non-contrast CT scan is the standard initial imaging modality to
rule out intracranial hemorrhage before initiating thrombolytic therapy. It is fast, widely
available, and highly effective at detecting acute bleeding in the brain. Rapid diagnosis is
essential because the window for administering tPA is very narrow.
4. A patient with a history of COPD presents with increased sputum production and cyanosis.
This clinical picture is most consistent with which condition?
A. Emphysema
, B. Chronic Bronchitis
C. Acute Asthma Attack
D. Pneumothorax
Correct Answer: B
Expert Explanation: Chronic bronchitis is characterized by a productive cough and mucus
production for at least three months in two consecutive years. These patients are often
referred to as ‘blue bloaters’ due to hypoxemia and resulting cyanosis. In contrast,
emphysema typically involves air trapping and a ‘pink puffer’ appearance without
significant sputum.
5. Which of the following electrolyte imbalances is most likely to cause a flattened T-wave
and the presence of U-waves on an ECG?
A. Hyperkalemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: C
Expert Explanation: Hypokalemia, or low serum potassium, significantly affects cardiac
repolarization and leads to specific ECG changes. Common findings include flattened or
