1|Page
NR 566 FINAL EXAM 2025-2026 | ALL QUESTIONS AND
CORRECT ANSWERS | ALREADY GRADED A+ | VERIFIED
ANSWERS | ALREADY GRADED A+
1.
Topic: Heart Failure – Pathophysiology
Question: Which cellular change most directly contributes to systolic
dysfunction in long-standing hypertension with LV hypertrophy?
A. Decreased preload
B. Myocyte apoptosis and fibrosis
C. Loss of β-adrenergic receptors
D. Increased coronary perfusion
Correct Answer: B
Rationale: Chronic pressure overload causes hypertrophy, ischemia,
apoptosis, and fibrosis, leading to contractile failure (systolic dysfunction).
2.
Topic: ARDS – Clinical features
Question: Which is the hallmark feature of ARDS in the exudative phase?
A. Refractory hypoxemia with bilateral infiltrates
B. Hypercapnia with unilateral opacity
C. Clear lungs with metabolic alkalosis
D. Decreased DLCO with normal oxygenation
Correct Answer: A
Rationale: ARDS is characterized by severe hypoxemia not corrected by O₂
and bilateral diffuse infiltrates.
3.
,2|Page
Topic: Diabetes Ketoacidosis
Question: In DKA, why is serum K⁺ often elevated despite total body
potassium depletion?
A. Increased renal reabsorption of K⁺
B. Extracellular shift due to acidosis and insulin deficiency
C. Increased dietary potassium intake
D. Excess aldosterone secretion
Correct Answer: B
Rationale: Acidosis and lack of insulin push K⁺ out of cells, masking total
body depletion.
4.
Topic: Acute Kidney Injury – Differentiation
Question: Which urine finding most suggests acute tubular necrosis?
A. Hyaline casts, high osmolality
B. Muddy brown granular casts
C. Low urine sodium (<20 mEq/L)
D. BUN:Cr ratio >20
Correct Answer: B
Rationale: ATN produces muddy brown granular casts and FeNa >2%.
5.
Topic: Disseminated Intravascular Coagulation
Question: Which lab results indicate acute DIC?
A. Elevated fibrin degradation products and low fibrinogen
B. Increased platelet count
C. Normal PT/PTT with high platelets
D. Isolated prolonged bleeding time
Correct Answer: A
Rationale: DIC = consumption coagulopathy → ↑D-dimer, ↓fibrinogen,
thrombocytopenia.
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6.
Topic: Sepsis Management
Question: Which intervention most reduces mortality if done promptly?
A. Corticosteroids
B. Early empiric antibiotics
C. Routine heparin drip
D. Blood transfusion to Hb >12
Correct Answer: B
Rationale: Early empiric antibiotics are critical; delay increases mortality.
7.
Topic: Acid–Base Disorders
Question: ABG: pH 7.25, PaCO₂ 60, HCO₃⁻ 24. What’s the disorder?
A. Metabolic acidosis
B. Acute respiratory acidosis
C. Mixed acidosis
D. Metabolic alkalosis with resp acidosis
Correct Answer: B
Rationale: Low pH + high PaCO₂ + near-normal HCO₃⁻ = acute
respiratory acidosis.
8.
Topic: Hypertension – Pharmacology
Question: Which antihypertensive is first-line for diabetes with proteinuria?
A. Thiazide diuretic
B. ACE inhibitor
C. Beta blocker
D. Calcium channel blocker
Correct Answer: B
, 4|Page
Rationale: ACE inhibitors slow nephropathy progression in diabetic
patients.
9.
Topic: COPD Exacerbation
Question: First-line therapy for acute COPD exacerbation includes:
A. IV beta blockers
B. Short-acting bronchodilators and systemic corticosteroids
C. High-dose opioids
D. Long-acting muscarinic antagonists only
Correct Answer: B
Rationale: SABA + systemic steroids improve airflow and reduce
inflammation.
10.
Topic: Thyroid Disorders
Question: What lab profile suggests primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. High TSH, high free T4
D. Low TSH, low free T4
Correct Answer: B
Rationale: Primary hypothyroidism = failure of thyroid → ↓T4,
compensatory ↑TSH.
11.
Topic: Pharmacokinetics – Elderly
Question: Which pharmacokinetic change occurs most with aging?
A. Increased renal clearance
B. Decreased hepatic metabolism and renal elimination
NR 566 FINAL EXAM 2025-2026 | ALL QUESTIONS AND
CORRECT ANSWERS | ALREADY GRADED A+ | VERIFIED
ANSWERS | ALREADY GRADED A+
1.
Topic: Heart Failure – Pathophysiology
Question: Which cellular change most directly contributes to systolic
dysfunction in long-standing hypertension with LV hypertrophy?
A. Decreased preload
B. Myocyte apoptosis and fibrosis
C. Loss of β-adrenergic receptors
D. Increased coronary perfusion
Correct Answer: B
Rationale: Chronic pressure overload causes hypertrophy, ischemia,
apoptosis, and fibrosis, leading to contractile failure (systolic dysfunction).
2.
Topic: ARDS – Clinical features
Question: Which is the hallmark feature of ARDS in the exudative phase?
A. Refractory hypoxemia with bilateral infiltrates
B. Hypercapnia with unilateral opacity
C. Clear lungs with metabolic alkalosis
D. Decreased DLCO with normal oxygenation
Correct Answer: A
Rationale: ARDS is characterized by severe hypoxemia not corrected by O₂
and bilateral diffuse infiltrates.
3.
,2|Page
Topic: Diabetes Ketoacidosis
Question: In DKA, why is serum K⁺ often elevated despite total body
potassium depletion?
A. Increased renal reabsorption of K⁺
B. Extracellular shift due to acidosis and insulin deficiency
C. Increased dietary potassium intake
D. Excess aldosterone secretion
Correct Answer: B
Rationale: Acidosis and lack of insulin push K⁺ out of cells, masking total
body depletion.
4.
Topic: Acute Kidney Injury – Differentiation
Question: Which urine finding most suggests acute tubular necrosis?
A. Hyaline casts, high osmolality
B. Muddy brown granular casts
C. Low urine sodium (<20 mEq/L)
D. BUN:Cr ratio >20
Correct Answer: B
Rationale: ATN produces muddy brown granular casts and FeNa >2%.
5.
Topic: Disseminated Intravascular Coagulation
Question: Which lab results indicate acute DIC?
A. Elevated fibrin degradation products and low fibrinogen
B. Increased platelet count
C. Normal PT/PTT with high platelets
D. Isolated prolonged bleeding time
Correct Answer: A
Rationale: DIC = consumption coagulopathy → ↑D-dimer, ↓fibrinogen,
thrombocytopenia.
,3|Page
6.
Topic: Sepsis Management
Question: Which intervention most reduces mortality if done promptly?
A. Corticosteroids
B. Early empiric antibiotics
C. Routine heparin drip
D. Blood transfusion to Hb >12
Correct Answer: B
Rationale: Early empiric antibiotics are critical; delay increases mortality.
7.
Topic: Acid–Base Disorders
Question: ABG: pH 7.25, PaCO₂ 60, HCO₃⁻ 24. What’s the disorder?
A. Metabolic acidosis
B. Acute respiratory acidosis
C. Mixed acidosis
D. Metabolic alkalosis with resp acidosis
Correct Answer: B
Rationale: Low pH + high PaCO₂ + near-normal HCO₃⁻ = acute
respiratory acidosis.
8.
Topic: Hypertension – Pharmacology
Question: Which antihypertensive is first-line for diabetes with proteinuria?
A. Thiazide diuretic
B. ACE inhibitor
C. Beta blocker
D. Calcium channel blocker
Correct Answer: B
, 4|Page
Rationale: ACE inhibitors slow nephropathy progression in diabetic
patients.
9.
Topic: COPD Exacerbation
Question: First-line therapy for acute COPD exacerbation includes:
A. IV beta blockers
B. Short-acting bronchodilators and systemic corticosteroids
C. High-dose opioids
D. Long-acting muscarinic antagonists only
Correct Answer: B
Rationale: SABA + systemic steroids improve airflow and reduce
inflammation.
10.
Topic: Thyroid Disorders
Question: What lab profile suggests primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. High TSH, high free T4
D. Low TSH, low free T4
Correct Answer: B
Rationale: Primary hypothyroidism = failure of thyroid → ↓T4,
compensatory ↑TSH.
11.
Topic: Pharmacokinetics – Elderly
Question: Which pharmacokinetic change occurs most with aging?
A. Increased renal clearance
B. Decreased hepatic metabolism and renal elimination
