NR 607/ NR607 Chamberlain College Of Nursing -NR607 Final Exam Questions With Complete
Solutions.
Course
NR 607/ NR607
1. Question:
A 55-year-old male presents with fatigue, weight loss, and night sweats for three months. On
physical examination, you note splenomegaly. Blood work shows leukocytosis, anemia, and
thrombocytosis. What is the most likely diagnosis?
Answer: Chronic Myelogenous Leukemia (CML).
Rationale:
The symptoms (fatigue, weight loss, night sweats) and splenomegaly suggest a chronic
disease process.
Leukocytosis, anemia, and thrombocytosis are hallmark findings in CML.
Confirmation involves a blood smear and cytogenetic studies showing the Philadelphia
chromosome (t(9;22) translocation).
2. Question:
Which medication is considered first-line therapy for a patient diagnosed with Stage 1
hypertension without comorbidities?
Answer: Thiazide diuretics (e.g., hydrochlorothiazide).
Rationale:
Thiazide diuretics are recommended as first-line agents due to their efficacy in reducing
blood pressure and cardiovascular events in patients without comorbidities.
Lifestyle modifications should also be emphasized in Stage 1 hypertension management.
3. Question:
A 24-year-old female presents with a burning sensation during urination and frequent urination.
A urine dipstick is positive for nitrites and leukocyte esterase. What is the best next step?
Answer: Start empiric antibiotic therapy (e.g., nitrofurantoin) and obtain a urine culture.
,Rationale:
Symptoms and positive dipstick findings are suggestive of a urinary tract infection (UTI).
Empiric antibiotic treatment should be started promptly while awaiting culture results
for definitive therapy.
4. Question:
In a patient with Type 2 Diabetes Mellitus and a history of heart failure, which glucose-lowering
medication class is preferred?
Answer: SGLT2 inhibitors (e.g., empagliflozin).
Rationale:
SGLT2 inhibitors have shown benefits in reducing heart failure hospitalizations and
cardiovascular mortality in patients with Type 2 Diabetes.
They also have a mild diuretic effect, which can help with volume management in heart
failure.
5. Question:
A patient presents with sudden onset of unilateral facial drooping and difficulty closing one eye.
The remainder of the neurological exam is normal. What is the most likely diagnosis?
Answer: Bell’s Palsy.
Rationale:
Sudden-onset unilateral facial paralysis without other focal neurological deficits is typical
of Bell’s Palsy.
Treatment includes corticosteroids within 72 hours of symptom onset to improve
outcomes.
6. Question:
What is the primary purpose of administering low-dose aspirin in patients with diabetes?
Answer: To reduce the risk of cardiovascular events.
, Rationale:
Diabetes is a major risk factor for cardiovascular disease.
Low-dose aspirin is indicated for secondary prevention or primary prevention in high-risk
individuals, balancing bleeding risk.
7. Question:
A patient with chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea
and a productive cough. What is the most appropriate initial step?
Answer: Assess oxygenation and consider initiating a short course of systemic corticosteroids
and antibiotics.
Rationale:
Exacerbations of COPD often involve infection and inflammation.
Systemic corticosteroids and antibiotics improve recovery and reduce the risk of
treatment failure in moderate to severe exacerbations.
8. Question:
A 30-year-old woman presents with a palpable thyroid nodule. What is the next best diagnostic
test?
Answer: Fine-needle aspiration (FNA) biopsy.
Rationale:
FNA biopsy is the gold standard for evaluating thyroid nodules.
It helps differentiate benign from malignant nodules based on cytology.
9. Question:
In patients with atrial fibrillation, which anticoagulant is preferred for stroke prevention in the
absence of valvular disease?
Answer: Direct oral anticoagulants (DOACs) such as apixaban or rivaroxaban.
Rationale:
Solutions.
Course
NR 607/ NR607
1. Question:
A 55-year-old male presents with fatigue, weight loss, and night sweats for three months. On
physical examination, you note splenomegaly. Blood work shows leukocytosis, anemia, and
thrombocytosis. What is the most likely diagnosis?
Answer: Chronic Myelogenous Leukemia (CML).
Rationale:
The symptoms (fatigue, weight loss, night sweats) and splenomegaly suggest a chronic
disease process.
Leukocytosis, anemia, and thrombocytosis are hallmark findings in CML.
Confirmation involves a blood smear and cytogenetic studies showing the Philadelphia
chromosome (t(9;22) translocation).
2. Question:
Which medication is considered first-line therapy for a patient diagnosed with Stage 1
hypertension without comorbidities?
Answer: Thiazide diuretics (e.g., hydrochlorothiazide).
Rationale:
Thiazide diuretics are recommended as first-line agents due to their efficacy in reducing
blood pressure and cardiovascular events in patients without comorbidities.
Lifestyle modifications should also be emphasized in Stage 1 hypertension management.
3. Question:
A 24-year-old female presents with a burning sensation during urination and frequent urination.
A urine dipstick is positive for nitrites and leukocyte esterase. What is the best next step?
Answer: Start empiric antibiotic therapy (e.g., nitrofurantoin) and obtain a urine culture.
,Rationale:
Symptoms and positive dipstick findings are suggestive of a urinary tract infection (UTI).
Empiric antibiotic treatment should be started promptly while awaiting culture results
for definitive therapy.
4. Question:
In a patient with Type 2 Diabetes Mellitus and a history of heart failure, which glucose-lowering
medication class is preferred?
Answer: SGLT2 inhibitors (e.g., empagliflozin).
Rationale:
SGLT2 inhibitors have shown benefits in reducing heart failure hospitalizations and
cardiovascular mortality in patients with Type 2 Diabetes.
They also have a mild diuretic effect, which can help with volume management in heart
failure.
5. Question:
A patient presents with sudden onset of unilateral facial drooping and difficulty closing one eye.
The remainder of the neurological exam is normal. What is the most likely diagnosis?
Answer: Bell’s Palsy.
Rationale:
Sudden-onset unilateral facial paralysis without other focal neurological deficits is typical
of Bell’s Palsy.
Treatment includes corticosteroids within 72 hours of symptom onset to improve
outcomes.
6. Question:
What is the primary purpose of administering low-dose aspirin in patients with diabetes?
Answer: To reduce the risk of cardiovascular events.
, Rationale:
Diabetes is a major risk factor for cardiovascular disease.
Low-dose aspirin is indicated for secondary prevention or primary prevention in high-risk
individuals, balancing bleeding risk.
7. Question:
A patient with chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea
and a productive cough. What is the most appropriate initial step?
Answer: Assess oxygenation and consider initiating a short course of systemic corticosteroids
and antibiotics.
Rationale:
Exacerbations of COPD often involve infection and inflammation.
Systemic corticosteroids and antibiotics improve recovery and reduce the risk of
treatment failure in moderate to severe exacerbations.
8. Question:
A 30-year-old woman presents with a palpable thyroid nodule. What is the next best diagnostic
test?
Answer: Fine-needle aspiration (FNA) biopsy.
Rationale:
FNA biopsy is the gold standard for evaluating thyroid nodules.
It helps differentiate benign from malignant nodules based on cytology.
9. Question:
In patients with atrial fibrillation, which anticoagulant is preferred for stroke prevention in the
absence of valvular disease?
Answer: Direct oral anticoagulants (DOACs) such as apixaban or rivaroxaban.
Rationale:
