Wilkes NSG500 Exam 3 /NSG 500 Advanced Health Assessment Exam
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1. What is the primary mechanism of action of ACE inhibitors in the management of
hypertension?
Answer: They block the conversion of angiotensin I to angiotensin II, reducing vasoconstriction
and aldosterone secretion.
2. A 54-year-old patient presents with new-onset atrial fibrillation. What is the most
important first step in management?
Answer: Assess hemodynamic stability (blood pressure, perfusion, mental status) before
deciding on rate vs rhythm control.
3. Which diagnostic finding confirms a diagnosis of acute bacterial meningitis?
Answer: Cerebrospinal fluid analysis showing low glucose, high protein, and elevated
neutrophils.
4. What is the mechanism of action of beta-blockers in the treatment of chronic heart failure?
Answer: They reduce sympathetic activation, decrease heart rate, and improve ventricular filling
time.
5. In type 2 diabetes, what is the primary effect of GLP-1 receptor agonists?
Answer: Enhance glucose-dependent insulin secretion and delay gastric emptying.
6. What is the gold standard diagnostic test for pulmonary embolism?
Answer: CT pulmonary angiography.
7. Which electrolyte abnormality is most commonly associated with digoxin toxicity?
Answer: Hypokalemia.
8. What is the earliest ECG change in myocardial ischemia?
Answer: Peaked T waves or ST-segment depression.
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9. Which antibiotic is most appropriate for community-acquired pneumonia in an otherwise
healthy adult?
Answer: A macrolide such as azithromycin.
10. A patient with chronic kidney disease has anemia. What is the primary treatment?
Answer: Erythropoiesis-stimulating agents (e.g., epoetin alfa).
11. What is the first-line treatment for generalized anxiety disorder?
Answer: SSRIs such as escitalopram or sertraline.
12. Which lab value best indicates long-term glycemic control in diabetes?
Answer: Hemoglobin A1C.
13. A 70-year-old patient on warfarin presents with hematuria. INR is 7.0. What is the best
management?
Answer: Administer vitamin K and consider prothrombin complex concentrate if bleeding is
severe.
14. What is the primary pathophysiological difference between restrictive and obstructive
lung diseases?
Answer: Restrictive diseases limit lung expansion; obstructive diseases limit airflow.
15. Which class of diuretics is preferred in managing acute decompensated heart failure with
pulmonary edema?
Answer: Loop diuretics such as furosemide.
16. What is the mechanism of action of metformin?
Answer: Decreases hepatic glucose production and increases insulin sensitivity.
17. Which lab test is most specific for myocardial infarction?
Answer: Cardiac troponins.
18. What is the most important initial step in the management of sepsis?
Answer: Early administration of broad-spectrum antibiotics and fluid resuscitation.
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19. A patient presents with severe chest pain relieved by leaning forward. What is the likely
diagnosis?
Answer: Acute pericarditis.
20. Which antihypertensive medication is contraindicated in pregnancy?
Answer: ACE inhibitors and ARBs.
21. What is the drug of choice for status epilepticus?
Answer: IV benzodiazepines (lorazepam or diazepam).
22. Which vaccine is contraindicated in immunocompromised patients?
Answer: Live attenuated vaccines (e.g., MMR, varicella).
23. Which blood gas abnormality is expected in early stages of pulmonary embolism?
Answer: Respiratory alkalosis due to hyperventilation.
24. Which imaging study is first-line for suspected stroke?
Answer: Non-contrast CT of the head.
25. What is the first-line pharmacologic therapy for osteoporosis?
Answer: Bisphosphonates such as alendronate.
26. What is the hallmark finding of nephrotic syndrome?
Answer: Proteinuria >3.5 g/day.
27. Which cranial nerve is tested by asking the patient to stick out their tongue?
Answer: Cranial nerve XII (hypoglossal).
28. What is the primary treatment for acute gout attack?
Answer: NSAIDs such as indomethacin.
29. Which condition is characterized by “butterfly rash” and positive ANA?
Answer: Systemic lupus erythematosus.
30. What is the mechanism of action of statins?
Answer: Inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver.
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31. What is the most important nursing intervention when administering IV potassium?
Answer: Administer via infusion pump and never as IV push.
32. Which cardiac murmur is described as a mid-systolic click with late systolic murmur?
Answer: Mitral valve prolapse.
33. Which vitamin deficiency causes megaloblastic anemia and neurological symptoms?
Answer: Vitamin B12 deficiency.
34. A patient develops severe angioedema after starting a new antihypertensive. Which drug
is most likely responsible?
Answer: ACE inhibitors.
35. What is the antidote for opioid overdose?
Answer: Naloxone.
36. Which lab marker is used to monitor heparin therapy?
Answer: aPTT.
37. Which lab marker is used to monitor warfarin therapy?
Answer: INR.
38. What is the mechanism of action of proton pump inhibitors?
Answer: Irreversibly inhibit H+/K+ ATPase pumps in gastric parietal cells.
39. Which electrolyte imbalance is most common with thiazide diuretics?
Answer: Hyponatremia and hypokalemia.
40. A 40-year-old presents with exophthalmos, weight loss, and tachycardia. What is the
diagnosis?
Answer: Graves’ disease (hyperthyroidism).
41. Which heart rhythm is most associated with sudden cardiac death?
Answer: Ventricular fibrillation.