EXAM 3 | QUESTIONS AND ANSWERS | 2026
UPDATE
100% CORRECT — WPU
Advanced Neurological, Endocrine, Reproductive & Chronic Disease Management
Comprehensive Exam 3 Practice Review — 50 Questions
2026|2027 Aligned
June 2026
Course NUR 6011 — Advanced Pathophysiology & Pharmacology
Questions 50 Multiple-Choice (Scenario-Based & Knowledge)
Sections 5 Comprehensive Content Sections
Focus Neurological Endocrine Reproductive Chronic Disease Clinical Judgment
Source Evidence-Based Practice Current Guidelines 2026 Updates
,NUR 6011 Exam 3 — Practice Review 2026 | WPU
Table of Contents
Section 1: Advanced Neurological Pathophysiology & Pharmacology
Stroke Pathophysiology Seizure Disorders & AEDs Neurodegenerative Diseases Neuropathic
Pain Psychotropic Medication Effects 2026 AI-Assisted Neurological Assessment [Q1–Q10]
Section 2: Advanced Endocrine & Metabolic Disorders & Management
DKA & HHS GLP-1 Agonists & SGLT2 Inhibitors Thyroid Disorders Adrenal Disorders SIADH
& DI Closed-Loop Insulin Systems Precision Endocrinology 2026 [Q11–Q20]
Section 3: Advanced Reproductive & Genitourinary Health
PCOS & Endometriosis Menopause & HRT BPH & Prostate Cancer AKI & CKD Management
Nephrolithiasis Testosterone Deficiency LGBTQ+ Inclusive Care 2026 [Q21–Q30]
Section 4: Complex Chronic Disease Management & Polypharmacy
Beers & STOPP/START Criteria PK/PD Changes in Aging CYP450 Interactions Pharmacogenomics
Deprescribing Protocols ADR Assessment AI Drug Interaction Platforms 2026 [Q31–Q40]
Section 5: Integrated Clinical Judgment: Diagnostic Reasoning,
Prioritization & EBP
NCJMM & Tanner's Model Advanced Diagnostic Reasoning Multi-Morbidity Prioritization
SMART Goals Palliative Care Integration AI-Assisted Clinical Decision Support Ethical AI in
Nursing 2026 [Q41–Q50]
Document Contents: 50 evidence-based multiple-choice questions across 5 sections, each with detailed
rationales incorporating current clinical guidelines, pharmacological mechanisms, and 2026 practice
updates. Correct answers distributed approximately equally across A, B, C, D.
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, NUR 6011 Exam 3 — Practice Review 2026 | WPU
Section 1: Advanced Neurological Pathophysiology &
Pharmacology
Stroke Pathophysiology Seizure Disorders & AEDs Neurodegenerative Diseases Neuropathic Pain
Psychotropic Medication Effects 2026 AI-Assisted Neurological Assessment
Q1: A 62-year-old woman presents to the ED with sudden-onset left-sided hemiparesis and
slurred speech. Symptoms began 2 hours ago. CT scan shows no hemorrhage. Her NIH Stroke
Scale score is 14. She takes apixaban for atrial fibrillation. What is the most
appropriate next step in management?
A. Administer IV alteplase (tPA) immediately, as the 3-hour window has not elapsed.
B. Obtain CT perfusion imaging to assess the ischemic penumbra before deciding on
thrombolysis. [CORRECT]
C. Start aspirin 325 mg and hold all anticoagulation for 24 hours.
D. Administer IV heparin and consult neurosurgery for mechanical thrombectomy.
Correct Answer: B
Rationale: This patient presents with an acute ischemic stroke within the therapeutic window, but
her use of apixaban (a direct oral anticoagulant) is a relative contraindication to IV alteplase.
Current AHA/ACC guidelines (updated 2024-2026) recommend CT perfusion imaging to evaluate the
ischemic penumbra and guide decision-making regarding thrombolysis versus endovascular therapy in
anticoagulated patients. Administering tPA without confirming the penumbra in a patient on DOACs
increases hemorrhagic transformation risk.
Q2: A 58-year-old man with a history of poorly controlled hypertension presents with
sudden severe headache, vomiting, and decreasing level of consciousness. CT reveals a
right putaminal hemorrhage. His current blood pressure is 198/112 mmHg. According to
current AHA/ACC guidelines for intracerebral hemorrhage management, what is the target
blood pressure range for the first 24 hours?
A. 120-130/70-80 mmHg to minimize hematoma expansion.
B. Reduce systolic BP by 20% from baseline and maintain MAP >80 mmHg.
C. Systolic BP target of 140-180 mmHg, depending on the hematoma volume and baseline
blood pressure. [CORRECT]
D. Maintain systolic BP <160 mmHg with labetalol only if ICP monitoring is in place.
Correct Answer: C
Rationale: AHA/ACC 2022 guidelines (still current through 2026) recommend a systolic BP target of
140-180 mmHg for ICH patients, with the specific target individualized based on hematoma volume,
baseline BP, and surgical considerations. More aggressive lowering to 120-130 mmHg (ATACH-2
trial) was associated with higher renal adverse events without significant hematoma reduction
benefit. A fixed 20% reduction is not guideline-endorsed as a blanket approach.
Q3: A 55-year-old woman with type 2 diabetes and hypertension presents with a 20-minute
episode of left arm weakness and dysarthria that has completely resolved. Her ABCD2 score
is 5 (Age 3, BP 0, Clinical symptoms 1, Duration 1). What is the most appropriate
management strategy?
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