NUR612/NUR 612 Final Exam V2 |
Advanced Nursing II Q&A with Rationale |
William Paterson University
1. A 68-year-old patient presents with symptoms of heart failure. Which laboratory test is the
most specific biomarker for diagnosing acute heart failure?
A. Creatine Kinase-MB (CK-MB)
B. B-type Natriuretic Peptide (BNP)
C. C-Reactive Protein (CRP)
D. Serum Lactate
Correct Answer: B
Expert Explanation: BNP is a hormone released by the ventricles in response to increased
wall tension and volume overload. It is highly specific for heart failure and helps
distinguish cardiac causes of dyspnea from pulmonary causes. A level greater than 100
pg/mL strongly suggests the presence of heart failure.
2. Which of the following is a common side effect of ACE inhibitors that often necessitates a
change in medication class?
A. Dry, non-productive cough
B. Peripheral edema
C. Hypokalemia
,D. Gingival hyperplasia
Correct Answer: A
Expert Explanation: ACE inhibitors can cause a persistent dry cough due to the
accumulation of bradykinin in the lungs. This side effect occurs in approximately 10 to 20
percent of patients taking the medication. If the cough becomes intolerable, patients are
typically switched to an Angiotensin II Receptor Blocker (ARB).
3. A patient with COPD is being evaluated for long-term oxygen therapy. What is the standard
criteria for initiating home oxygen?
A. PaO2 of 65 mmHg or SaO2 of 92% at rest
B. PaO2 of 70 mmHg or SaO2 of 94% during exercise
C. PaO2 of 55 mmHg or SaO2 of 88% at rest
D. FEV1 less than 50% of predicted value
Correct Answer: C
Expert Explanation: Long-term oxygen therapy is indicated for patients with stable COPD
who have a resting PaO2 of 55 mmHg or less. It is also indicated if the SaO2 is 88% or less
on room air. Meeting these criteria has been shown to improve survival rates in patients
with chronic respiratory failure.
4. In the management of Type 2 Diabetes, which medication works primarily by decreasing
hepatic glucose production?
A. Metformin
, B. Pioglitazone
C. Glipizide
D. Sitagliptin
Correct Answer: A
Expert Explanation: Metformin is the first-line treatment for Type 2 Diabetes and belongs
to the biguanide class. It acts by inhibiting gluconeogenesis in the liver and increasing
peripheral insulin sensitivity. Because it does not stimulate insulin secretion, it has a lower
risk of causing hypoglycemia.
5. According to JNC 8 guidelines, what is the target blood pressure for an adult aged 60 years
or older without diabetes or chronic kidney disease?
A. <150/90 mmHg
B. <130/80 mmHg
C. <140/90 mmHg
D. <120/80 mmHg
Correct Answer: A
Expert Explanation: JNC 8 guidelines relaxed the blood pressure goals for older adults to
reduce the risk of hypotension and falls. For those 60 years and older, the recommendation
is to initiate therapy if systolic pressure is 150 or higher. The goal is to maintain a blood
pressure below 150/90 mmHg in this specific demographic.
Advanced Nursing II Q&A with Rationale |
William Paterson University
1. A 68-year-old patient presents with symptoms of heart failure. Which laboratory test is the
most specific biomarker for diagnosing acute heart failure?
A. Creatine Kinase-MB (CK-MB)
B. B-type Natriuretic Peptide (BNP)
C. C-Reactive Protein (CRP)
D. Serum Lactate
Correct Answer: B
Expert Explanation: BNP is a hormone released by the ventricles in response to increased
wall tension and volume overload. It is highly specific for heart failure and helps
distinguish cardiac causes of dyspnea from pulmonary causes. A level greater than 100
pg/mL strongly suggests the presence of heart failure.
2. Which of the following is a common side effect of ACE inhibitors that often necessitates a
change in medication class?
A. Dry, non-productive cough
B. Peripheral edema
C. Hypokalemia
,D. Gingival hyperplasia
Correct Answer: A
Expert Explanation: ACE inhibitors can cause a persistent dry cough due to the
accumulation of bradykinin in the lungs. This side effect occurs in approximately 10 to 20
percent of patients taking the medication. If the cough becomes intolerable, patients are
typically switched to an Angiotensin II Receptor Blocker (ARB).
3. A patient with COPD is being evaluated for long-term oxygen therapy. What is the standard
criteria for initiating home oxygen?
A. PaO2 of 65 mmHg or SaO2 of 92% at rest
B. PaO2 of 70 mmHg or SaO2 of 94% during exercise
C. PaO2 of 55 mmHg or SaO2 of 88% at rest
D. FEV1 less than 50% of predicted value
Correct Answer: C
Expert Explanation: Long-term oxygen therapy is indicated for patients with stable COPD
who have a resting PaO2 of 55 mmHg or less. It is also indicated if the SaO2 is 88% or less
on room air. Meeting these criteria has been shown to improve survival rates in patients
with chronic respiratory failure.
4. In the management of Type 2 Diabetes, which medication works primarily by decreasing
hepatic glucose production?
A. Metformin
, B. Pioglitazone
C. Glipizide
D. Sitagliptin
Correct Answer: A
Expert Explanation: Metformin is the first-line treatment for Type 2 Diabetes and belongs
to the biguanide class. It acts by inhibiting gluconeogenesis in the liver and increasing
peripheral insulin sensitivity. Because it does not stimulate insulin secretion, it has a lower
risk of causing hypoglycemia.
5. According to JNC 8 guidelines, what is the target blood pressure for an adult aged 60 years
or older without diabetes or chronic kidney disease?
A. <150/90 mmHg
B. <130/80 mmHg
C. <140/90 mmHg
D. <120/80 mmHg
Correct Answer: A
Expert Explanation: JNC 8 guidelines relaxed the blood pressure goals for older adults to
reduce the risk of hypotension and falls. For those 60 years and older, the recommendation
is to initiate therapy if systolic pressure is 150 or higher. The goal is to maintain a blood
pressure below 150/90 mmHg in this specific demographic.
