CMN 574 FINAL EXAM AND STUDY GUIDE NEWEST
2026 TEST BANK| COMPLETE 450 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+| CMN 574 FINAL
EXAM REVIEW 2025 (BRAND NEW!!)
1. A 68-year-old male with CKD stage 3a presents with new-
onset atrial fibrillation. Which anticoagulant is most
appropriate?
A) Warfarin
B) Apixaban
C) Dabigatran
D) Rivaroxaban
Answer: B) Apixaban
Rationale: Apixaban is partially renally cleared but safe in CKD
3a. Rivaroxaban and dabigatran have higher renal
1
,accumulation; warfarin is effective but requires frequent
monitoring and has more interactions.
2. A 45-year-old female reports fatigue, cold intolerance, and
weight gain. TSH is 12.4 mIU/L (ref 0.4–4.0), free T4 is 0.6
ng/dL. What is the next best step?
A) Check TPO antibodies
B) Start levothyroxine 1.6 mcg/kg/day
C) Repeat TSH in 6 weeks
D) Order thyroid ultrasound
Answer: B) Start levothyroxine 1.6 mcg/kg/day
Rationale: Overt hypothyroidism (high TSH, low free T4) requires
treatment. Antibodies confirm autoimmune cause but don’t
change initial management. Delaying treatment is inappropriate.
2
,3. Which finding is most specific for alcoholic liver disease?
A) AST > ALT with AST/ALT ratio > 1.5
B) ALT > AST with ratio < 1
C) Isolated elevation of GGT
D) Normal AST with elevated alkaline phosphatase
Answer: A) AST > ALT with AST/ALT ratio > 1.5
Rationale: In alcoholic liver disease, AST is typically elevated
more than ALT (ratio often >1.5–2). ALT > AST suggests viral
hepatitis. GGT is sensitive but not specific.
4. A 72-year-old male on hydrochlorothiazide presents with
muscle weakness, fatigue, and serum K+ 2.9 mEq/L. EKG
shows U waves. What is the most appropriate acute
management?
A) IV potassium chloride 40 mEq over 2 hours
B) Oral potassium 20 mEq once daily
3
, C) Hold thiazide and give IV potassium 10 mEq/hour cardiac
monitored
D) Magnesium sulfate 2g IV
Answer: C) Hold thiazide and give IV potassium 10 mEq/hour
cardiac monitored
Rationale: Severe hypokalemia with EKG changes requires
cardiac monitoring and cautious IV repletion (max 10 mEq/hour
peripherally). Oral is too slow. Magnesium should be checked but
isn’t first-line without known deficiency.
5. A 62-year-old with HFrEF (EF 30%) on lisinopril, carvedilol,
furosemide, and spironolactone has K+ 5.8 mEq/L. Creatinine
1.4 mg/dL (baseline 1.0). What is the best next step?
A) Continue all meds, repeat BMP in 1 week
B) Hold spironolactone and lisinopril, monitor potassium
4
2026 TEST BANK| COMPLETE 450 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+| CMN 574 FINAL
EXAM REVIEW 2025 (BRAND NEW!!)
1. A 68-year-old male with CKD stage 3a presents with new-
onset atrial fibrillation. Which anticoagulant is most
appropriate?
A) Warfarin
B) Apixaban
C) Dabigatran
D) Rivaroxaban
Answer: B) Apixaban
Rationale: Apixaban is partially renally cleared but safe in CKD
3a. Rivaroxaban and dabigatran have higher renal
1
,accumulation; warfarin is effective but requires frequent
monitoring and has more interactions.
2. A 45-year-old female reports fatigue, cold intolerance, and
weight gain. TSH is 12.4 mIU/L (ref 0.4–4.0), free T4 is 0.6
ng/dL. What is the next best step?
A) Check TPO antibodies
B) Start levothyroxine 1.6 mcg/kg/day
C) Repeat TSH in 6 weeks
D) Order thyroid ultrasound
Answer: B) Start levothyroxine 1.6 mcg/kg/day
Rationale: Overt hypothyroidism (high TSH, low free T4) requires
treatment. Antibodies confirm autoimmune cause but don’t
change initial management. Delaying treatment is inappropriate.
2
,3. Which finding is most specific for alcoholic liver disease?
A) AST > ALT with AST/ALT ratio > 1.5
B) ALT > AST with ratio < 1
C) Isolated elevation of GGT
D) Normal AST with elevated alkaline phosphatase
Answer: A) AST > ALT with AST/ALT ratio > 1.5
Rationale: In alcoholic liver disease, AST is typically elevated
more than ALT (ratio often >1.5–2). ALT > AST suggests viral
hepatitis. GGT is sensitive but not specific.
4. A 72-year-old male on hydrochlorothiazide presents with
muscle weakness, fatigue, and serum K+ 2.9 mEq/L. EKG
shows U waves. What is the most appropriate acute
management?
A) IV potassium chloride 40 mEq over 2 hours
B) Oral potassium 20 mEq once daily
3
, C) Hold thiazide and give IV potassium 10 mEq/hour cardiac
monitored
D) Magnesium sulfate 2g IV
Answer: C) Hold thiazide and give IV potassium 10 mEq/hour
cardiac monitored
Rationale: Severe hypokalemia with EKG changes requires
cardiac monitoring and cautious IV repletion (max 10 mEq/hour
peripherally). Oral is too slow. Magnesium should be checked but
isn’t first-line without known deficiency.
5. A 62-year-old with HFrEF (EF 30%) on lisinopril, carvedilol,
furosemide, and spironolactone has K+ 5.8 mEq/L. Creatinine
1.4 mg/dL (baseline 1.0). What is the best next step?
A) Continue all meds, repeat BMP in 1 week
B) Hold spironolactone and lisinopril, monitor potassium
4
