1|Page
NRNP 6552 MIDTERM EXAM WEEK 6 2026-2027 |
150+ PRACTICE QUESTIONS & RATIONALES |
ADVANCED PRACTICE NURSING | HIGH-YIELD |
PASS FIRST ATTEMPT
## Table of Contents
1. **Advanced Health Assessment & Diagnostic Reasoning** (Q1–
Q20)
2. **Primary Care of Adults & Geriatrics** (Q21–Q40)
3. **Chronic Disease Management** (Q41–Q60)
4. **Pharmacology for Advanced Practice** (Q61–Q80)
5. **Preventive Care & Health Promotion** (Q81–Q95)
6. **Mental Health in Primary Care** (Q96–Q110)
7. **Women's & Men's Health** (Q111–Q125)
8. **Geriatric Syndromes & Polypharmacy** (Q126–Q135)
9. **Evidence-Based Practice & Clinical Guidelines** (Q136–Q145)
10. **High-Yield NGN/Scenario-Based Questions** (Q146–Q155)
---
,2|Page
# Section 1: Advanced Health Assessment & Diagnostic Reasoning (Q1–
Q20)
**Q1.** A 65-year-old male presents with a complaint of "feeling like
my heart is skipping beats" for the past week. He denies chest pain,
shortness of breath, or dizziness. On exam, his pulse is irregularly
irregular at 110 bpm. What is the most likely diagnosis?
A. Atrial fibrillation
B. Sinus tachycardia
C. Premature ventricular contractions (PVCs)
D. Supraventricular tachycardia (SVT)
**Correct Answer: A – Atrial fibrillation**
*Rationale: An irregularly irregular pulse is characteristic of atrial
fibrillation, especially in older adults.*
**Q2.** A 58-year-old female presents with a 3-month history of
progressive weakness in her legs, difficulty rising from a chair, and
climbing stairs. She has no sensory loss. Which condition is most likely?
A. Proximal myopathy (e.g., polymyositis)
B. Peripheral neuropathy
C. Lumbar radiculopathy
D. Multiple sclerosis
,3|Page
**Correct Answer: A – Proximal myopathy (e.g., polymyositis)**
*Rationale: Proximal muscle weakness without sensory loss suggests a
myopathy.*
**Q3.** A patient presents with a painful, red, swollen left great toe that
started suddenly overnight. He denies trauma. Which diagnosis is most
likely?
A. Gout
B. Pseudogout
C. Septic arthritis
D. Osteoarthritis
**Correct Answer: A – Gout**
*Rationale: Sudden onset of monoarticular arthritis of the first
metatarsophalangeal joint is classic for gout.*
**Q4.** A 72-year-old male reports waking up at night with shortness
of breath that improves when he sits up. He has a history of
hypertension. What is the most likely diagnosis?
A. Paroxysmal nocturnal dyspnea (PND) from heart failure
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Gastroesophageal reflux disease (GERD)
, 4|Page
**Correct Answer: A – Paroxysmal nocturnal dyspnea (PND) from heart
failure**
*Rationale: PND is a classic symptom of left-sided heart failure.*
**Q5.** On fundoscopic exam, you see sharp optic disc margins,
arteriovenous nicking, and copper-wire arteries. This is consistent with:
A. Hypertensive retinopathy
B. Diabetic retinopathy
C. Papilledema
D. Glaucoma
**Correct Answer: A – Hypertensive retinopathy**
*Rationale: AV nicking and copper/silver wiring are signs of chronic
hypertension.*
**Q6.** A patient has a positive Murphy’s sign (inspiratory arrest on
palpation of the right upper quadrant). This is most consistent with:
A. Acute cholecystitis
B. Appendicitis
C. Pancreatitis
D. Peptic ulcer disease
**Correct Answer: A – Acute cholecystitis**
NRNP 6552 MIDTERM EXAM WEEK 6 2026-2027 |
150+ PRACTICE QUESTIONS & RATIONALES |
ADVANCED PRACTICE NURSING | HIGH-YIELD |
PASS FIRST ATTEMPT
## Table of Contents
1. **Advanced Health Assessment & Diagnostic Reasoning** (Q1–
Q20)
2. **Primary Care of Adults & Geriatrics** (Q21–Q40)
3. **Chronic Disease Management** (Q41–Q60)
4. **Pharmacology for Advanced Practice** (Q61–Q80)
5. **Preventive Care & Health Promotion** (Q81–Q95)
6. **Mental Health in Primary Care** (Q96–Q110)
7. **Women's & Men's Health** (Q111–Q125)
8. **Geriatric Syndromes & Polypharmacy** (Q126–Q135)
9. **Evidence-Based Practice & Clinical Guidelines** (Q136–Q145)
10. **High-Yield NGN/Scenario-Based Questions** (Q146–Q155)
---
,2|Page
# Section 1: Advanced Health Assessment & Diagnostic Reasoning (Q1–
Q20)
**Q1.** A 65-year-old male presents with a complaint of "feeling like
my heart is skipping beats" for the past week. He denies chest pain,
shortness of breath, or dizziness. On exam, his pulse is irregularly
irregular at 110 bpm. What is the most likely diagnosis?
A. Atrial fibrillation
B. Sinus tachycardia
C. Premature ventricular contractions (PVCs)
D. Supraventricular tachycardia (SVT)
**Correct Answer: A – Atrial fibrillation**
*Rationale: An irregularly irregular pulse is characteristic of atrial
fibrillation, especially in older adults.*
**Q2.** A 58-year-old female presents with a 3-month history of
progressive weakness in her legs, difficulty rising from a chair, and
climbing stairs. She has no sensory loss. Which condition is most likely?
A. Proximal myopathy (e.g., polymyositis)
B. Peripheral neuropathy
C. Lumbar radiculopathy
D. Multiple sclerosis
,3|Page
**Correct Answer: A – Proximal myopathy (e.g., polymyositis)**
*Rationale: Proximal muscle weakness without sensory loss suggests a
myopathy.*
**Q3.** A patient presents with a painful, red, swollen left great toe that
started suddenly overnight. He denies trauma. Which diagnosis is most
likely?
A. Gout
B. Pseudogout
C. Septic arthritis
D. Osteoarthritis
**Correct Answer: A – Gout**
*Rationale: Sudden onset of monoarticular arthritis of the first
metatarsophalangeal joint is classic for gout.*
**Q4.** A 72-year-old male reports waking up at night with shortness
of breath that improves when he sits up. He has a history of
hypertension. What is the most likely diagnosis?
A. Paroxysmal nocturnal dyspnea (PND) from heart failure
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Gastroesophageal reflux disease (GERD)
, 4|Page
**Correct Answer: A – Paroxysmal nocturnal dyspnea (PND) from heart
failure**
*Rationale: PND is a classic symptom of left-sided heart failure.*
**Q5.** On fundoscopic exam, you see sharp optic disc margins,
arteriovenous nicking, and copper-wire arteries. This is consistent with:
A. Hypertensive retinopathy
B. Diabetic retinopathy
C. Papilledema
D. Glaucoma
**Correct Answer: A – Hypertensive retinopathy**
*Rationale: AV nicking and copper/silver wiring are signs of chronic
hypertension.*
**Q6.** A patient has a positive Murphy’s sign (inspiratory arrest on
palpation of the right upper quadrant). This is most consistent with:
A. Acute cholecystitis
B. Appendicitis
C. Pancreatitis
D. Peptic ulcer disease
**Correct Answer: A – Acute cholecystitis**
