NR 508 Week 4 Mid-term Exam Version 2|
Chamberlain University| Actual Exam
Questions and Correct Answers
A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When
teaching this patient about the medication, the NP should:
A) Instruct the patient to take it with food to avoid gastrointestinal upset
B) Tell the patient to report weight gain and insomnia
C) Advise the patient to take it at the same time each day, preferably in the morning
D) Warn the patient to avoid calcium supplements entirely
Correct Answer: C) Advise the patient to take it at the same time each day, preferably in the
morning
Explanation: Levothyroxine should be taken consistently at the same time daily, ideally in the
morning on an empty stomach, to ensure optimal absorption and steady hormone levels. Weight
gain and insomnia may indicate over- or under-dosing, but these are not the primary teaching
points.
An African-American patient is taking captopril 25 mg twice daily. The primary care NP notes
continued blood pressure readings of 135/90 mm Hg. The NP should:
A) Increase the captopril dose to 50 mg twice daily
B) Add a thiazide diuretic to the regimen
C) Switch to losartan immediately
D) Continue captopril and monitor for 3 months
Correct Answer: B) Add a thiazide diuretic to the regimen
Explanation: For stage 1 hypertension (BP 130–139/80–89 mm Hg) not controlled on captopril
alone, adding a thiazide diuretic is recommended, especially in African-American patients, who
may respond better to combination therapy per JNC 8 guidelines.
A primary care NP sees a patient who is about to take a cruise and reports motion sickness with
nausea on a previous cruise. The NP prescribes a scopolamine transdermal patch and should
instruct the patient to apply the patch:
A) 4 hours before boarding the ship
B) Immediately before boarding
,C) 12 hours after boarding
D) Every 24 hours during the cruise
Correct Answer: A) 4 hours before boarding the ship
Explanation: The scopolamine patch should be applied at least 4 hours before travel to allow
sufficient time for absorption and onset of action to prevent motion sickness.
A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care NP
should order:
A) Insulin glargine once daily
B) Metformin as first-line therapy
C) A sulfonylurea such as glyburide
D) An SGLT2 inhibitor like empagliflozin
Correct Answer: B) Metformin as first-line therapy
Explanation: Metformin is the first-line treatment for type 2 diabetes in children and
adolescents, as it improves insulin sensitivity and is safe and effective, especially in obese
patients.
A patient with four to five liquid stools per day for 4 days asks about medications to stop
diarrhea. The NP tells the patient that antidiarrheal medications are:
A) Contraindicated due to risk of toxicity
B) Safe if no fever or bloody stools are present
C) Only effective for bacterial diarrhea
D) Not recommended for adults
Correct Answer: B) Safe if no fever or bloody stools are present
Explanation: Antidiarrheals like loperamide are safe for acute, non-infectious diarrhea in adults
without fever or bloody stools, but caution is needed to rule out infectious causes.
In every state, prescriptive authority for NPs includes the ability to write prescriptions:
A) For all controlled substances without restrictions
B) Only for non-controlled substances
C) For controlled substances, with state-specific regulations
D) Only with physician supervision
Correct Answer: C) For controlled substances, with state-specific regulations
Explanation: NPs have prescriptive authority in all states, including for controlled substances,
but regulations vary by state, often requiring specific certifications or protocols.
, A 55-year-old woman with a history of myocardial infarction has an LDL of 130 mg/dL, HDL of
35 mg/dL, and triglycerides of 150 mg/dL. She is sedentary with a BMI of 26. The NP should:
A) Recommend continuing lifestyle changes without medication
B) Initiate a statin due to her cardiovascular risk
C) Prescribe niacin to increase HDL
D) Start ezetimibe as first-line therapy
Correct Answer: B) Initiate a statin due to her cardiovascular risk
Explanation: Given her history of MI, the patient is at high cardiovascular risk. A statin is
indicated to lower LDL and reduce further risk, per ACC/AHA guidelines.
A patient develops hypertension. The NP notes clear breath sounds, no organomegaly, no
peripheral edema, and normal electrolytes. The NP should prescribe:
A) Furosemide
B) Hydrochlorothiazide
C) Spironolactone
D) Mannitol
Correct Answer: B) Hydrochlorothiazide
Explanation: Hydrochlorothiazide is a first-line diuretic for uncomplicated hypertension in
patients with normal renal function and no contraindications, per JNC 8 guidelines.
The primary care NP is using critical thinking skills when:
A) Following a standardized protocol for all patients
B) Analyzing patient data to individualize treatment plans
C) Prescribing medications based solely on patient preference
D) Avoiding consultation with specialists
Correct Answer: B) Analyzing patient data to individualize treatment plans
Explanation: Critical thinking involves evaluating patient-specific data (e.g., history, labs, and
comorbidities) to tailor treatment plans for optimal outcomes.
A patient asks about a newly developed formulation of a drug taken for a year. When deciding
whether to prescribe it, the NP should:
A) Prescribe it without reviewing evidence
B) Evaluate clinical trial data and safety profile
C) Wait for at least 1 year post-release
D) Rely on patient testimonials
Chamberlain University| Actual Exam
Questions and Correct Answers
A primary care NP prescribes levothyroxine for a patient to treat thyroid deficiency. When
teaching this patient about the medication, the NP should:
A) Instruct the patient to take it with food to avoid gastrointestinal upset
B) Tell the patient to report weight gain and insomnia
C) Advise the patient to take it at the same time each day, preferably in the morning
D) Warn the patient to avoid calcium supplements entirely
Correct Answer: C) Advise the patient to take it at the same time each day, preferably in the
morning
Explanation: Levothyroxine should be taken consistently at the same time daily, ideally in the
morning on an empty stomach, to ensure optimal absorption and steady hormone levels. Weight
gain and insomnia may indicate over- or under-dosing, but these are not the primary teaching
points.
An African-American patient is taking captopril 25 mg twice daily. The primary care NP notes
continued blood pressure readings of 135/90 mm Hg. The NP should:
A) Increase the captopril dose to 50 mg twice daily
B) Add a thiazide diuretic to the regimen
C) Switch to losartan immediately
D) Continue captopril and monitor for 3 months
Correct Answer: B) Add a thiazide diuretic to the regimen
Explanation: For stage 1 hypertension (BP 130–139/80–89 mm Hg) not controlled on captopril
alone, adding a thiazide diuretic is recommended, especially in African-American patients, who
may respond better to combination therapy per JNC 8 guidelines.
A primary care NP sees a patient who is about to take a cruise and reports motion sickness with
nausea on a previous cruise. The NP prescribes a scopolamine transdermal patch and should
instruct the patient to apply the patch:
A) 4 hours before boarding the ship
B) Immediately before boarding
,C) 12 hours after boarding
D) Every 24 hours during the cruise
Correct Answer: A) 4 hours before boarding the ship
Explanation: The scopolamine patch should be applied at least 4 hours before travel to allow
sufficient time for absorption and onset of action to prevent motion sickness.
A 12-year-old patient who is obese develops type 2 diabetes mellitus. The primary care NP
should order:
A) Insulin glargine once daily
B) Metformin as first-line therapy
C) A sulfonylurea such as glyburide
D) An SGLT2 inhibitor like empagliflozin
Correct Answer: B) Metformin as first-line therapy
Explanation: Metformin is the first-line treatment for type 2 diabetes in children and
adolescents, as it improves insulin sensitivity and is safe and effective, especially in obese
patients.
A patient with four to five liquid stools per day for 4 days asks about medications to stop
diarrhea. The NP tells the patient that antidiarrheal medications are:
A) Contraindicated due to risk of toxicity
B) Safe if no fever or bloody stools are present
C) Only effective for bacterial diarrhea
D) Not recommended for adults
Correct Answer: B) Safe if no fever or bloody stools are present
Explanation: Antidiarrheals like loperamide are safe for acute, non-infectious diarrhea in adults
without fever or bloody stools, but caution is needed to rule out infectious causes.
In every state, prescriptive authority for NPs includes the ability to write prescriptions:
A) For all controlled substances without restrictions
B) Only for non-controlled substances
C) For controlled substances, with state-specific regulations
D) Only with physician supervision
Correct Answer: C) For controlled substances, with state-specific regulations
Explanation: NPs have prescriptive authority in all states, including for controlled substances,
but regulations vary by state, often requiring specific certifications or protocols.
, A 55-year-old woman with a history of myocardial infarction has an LDL of 130 mg/dL, HDL of
35 mg/dL, and triglycerides of 150 mg/dL. She is sedentary with a BMI of 26. The NP should:
A) Recommend continuing lifestyle changes without medication
B) Initiate a statin due to her cardiovascular risk
C) Prescribe niacin to increase HDL
D) Start ezetimibe as first-line therapy
Correct Answer: B) Initiate a statin due to her cardiovascular risk
Explanation: Given her history of MI, the patient is at high cardiovascular risk. A statin is
indicated to lower LDL and reduce further risk, per ACC/AHA guidelines.
A patient develops hypertension. The NP notes clear breath sounds, no organomegaly, no
peripheral edema, and normal electrolytes. The NP should prescribe:
A) Furosemide
B) Hydrochlorothiazide
C) Spironolactone
D) Mannitol
Correct Answer: B) Hydrochlorothiazide
Explanation: Hydrochlorothiazide is a first-line diuretic for uncomplicated hypertension in
patients with normal renal function and no contraindications, per JNC 8 guidelines.
The primary care NP is using critical thinking skills when:
A) Following a standardized protocol for all patients
B) Analyzing patient data to individualize treatment plans
C) Prescribing medications based solely on patient preference
D) Avoiding consultation with specialists
Correct Answer: B) Analyzing patient data to individualize treatment plans
Explanation: Critical thinking involves evaluating patient-specific data (e.g., history, labs, and
comorbidities) to tailor treatment plans for optimal outcomes.
A patient asks about a newly developed formulation of a drug taken for a year. When deciding
whether to prescribe it, the NP should:
A) Prescribe it without reviewing evidence
B) Evaluate clinical trial data and safety profile
C) Wait for at least 1 year post-release
D) Rely on patient testimonials
