NURS 6560 MIDTERM EXAM – LATEST
UPDATE 2025/2026 | QUESTIONS WITH
CORRECT ANSWERS
1. S. is a 59-year-old female who has been followed for aortic regurgitation.
Serial echocardiography has demonstrated normal left ventricular function,
but the patient was lost to follow-up for the last 16 months and now
complains of activity intolerance and weight gain. Physical examination
reveals a grade IV/VI diastolic decrescendo murmur and 2+ lower extremity
edema. The most appropriate diagnostic workup includes:
A. Serial echocardiography every 6 months
B. Transthoracic echocardiogram with assessment of valve morphology and
ventricular function
C. Begin an angiotensin-converting enzyme (ACE) inhibitor and referral for
surgical consultation
D. Imaging studies including CT, MRI, and angiography
• CORRECT ANSWER✔ B. Transthoracic echocardiogram with
assessment of valve morphology and ventricular function
2. An upper GI series shows dilation of 8-15 cm in the proximal duodenum and
mid-jejunum. A barium swallow study also shows a small gastric ulcer.
Management of this condition should include:
A. Proton pump inhibitors
B. Histamine H2 receptor antagonists
C. Antibiotics
D. Surgery
• CORRECT ANSWER✔ A. Proton pump inhibitors
3. Jasmine is a 31-year-old female who presents with neck pain, injection drug
use (admits to injecting opiates into her neck), diffuse tracking and scarring,
a disfiguring neck without pain, throat pain, temperature of 102.1°F, and
foul breath. In order to evaluate for a deep neck space infection, she should
have:
, A. Anteroposterior neck radiography
B. CT scan of the neck
C. Ultrasound
D. Aspiration and culture of fluid
• CORRECT ANSWER✔ B. CT scan of the neck
4. Mr. Draper is a 39-year-old male recovering from an extended alcohol
binge. As a result of a serious motor vehicle accident, he has had repair of a
fractured femur, bowel perforation, splenectomy, and repair of a hepatic
laceration. His vital signs are normal except for a temperature of 101.5°F.
His Glasgow Coma Scale (GCS) is 13. The patient's GCS score indicates
that he is:
A. Moderately brain injured
B. Severely brain injured
C. Minimally impaired
D. In a vegetative state
• CORRECT ANSWER✔ A. Moderately brain injured
5. Total peritonitis in a patient receiving nutritional support via a central line is
most likely caused by:
A. Contamination of the infusion
B. Bowel disease or gastrointestinal tract obstruction
C. The central venous line used for infusion
D. Resultant diarrhea and volume overload
• CORRECT ANSWER✔ C. The central venous line used for infusion
6. A 72-year-old male with a history of hypertension and heart failure presents
with acute dyspnea. His blood pressure is 190/100 mmHg, heart rate 110
bpm, and oxygen saturation 88% on room air. Lung auscultation reveals
crackles bilaterally. Which medication should be administered first?
A. Furosemide 40 mg IV
B. Nitroglycerin 0.4 mg sublingual
C. Oxygen via non-rebreather mask
D. Morphine 2 mg IV
• CORRECT ANSWER✔ C. Oxygen via non-rebreather mask
,7. A 45-year-old male with a history of alcohol use disorder presents with
severe epigastric pain radiating to the back, nausea, and vomiting. Serum
amylase is 1200 U/L. Which additional laboratory finding is most specific
for acute pancreatitis?
A. Elevated serum lipase
B. Elevated bilirubin
C. Hypocalcemia
D. Hyperglycemia
• CORRECT ANSWER✔ A. Elevated serum lipase
8. A 68-year-old female with a history of COPD presents with increased
shortness of breath, purulent sputum, and fever. Arterial blood gas on room
air shows pH 7.32, PaCO₂ 65 mmHg, PaO₂ 55 mmHg, HCO₃ 30 mEq/L. The
most appropriate initial intervention is:
A. Intubation and mechanical ventilation
B. BiPAP
C. Nebulized albuterol and ipratropium
D. Oxygen via nasal cannula at 2 L/min
• CORRECT ANSWER✔ B. BiPAP
9. A patient with septic shock has a mean arterial pressure of 55 mmHg despite
30 mL/kg of IV crystalloid. Which vasopressor is recommended as first-line
therapy?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
• CORRECT ANSWER✔ B. Norepinephrine
10.A 62-year-old male with a history of atrial fibrillation on warfarin presents
with sudden onset of left leg pain, pallor, and pulselessness. The most likely
diagnosis is:
A. Deep vein thrombosis
B. Arterial embolism
C. Compartment syndrome
D. Acute limb ischemia from in-situ thrombosis
, • CORRECT ANSWER✔ B. Arterial embolism
11.A patient with a history of myasthenia gravis develops acute respiratory
failure. Which medication should be avoided in this patient?
A. Pyridostigmine
B. Prednisone
C. Succinylcholine
D. Rocuronium
• CORRECT ANSWER✔ C. Succinylcholine
12.A 55-year-old female with a history of diabetes and hypertension presents
with acute onset of right arm weakness and aphasia. Last known normal was
2 hours ago. Non-contrast CT head shows no hemorrhage. Which
intervention is most appropriate?
A. Aspirin 325 mg
B. IV alteplase (tPA)
C. Mechanical thrombectomy
D. Blood pressure reduction to < 140/90
• CORRECT ANSWER✔ B. IV alteplase (tPA)
13.A patient with cirrhosis and ascites develops fever and abdominal
tenderness. Paracentesis reveals a neutrophil count of 500 cells/mm³. Which
antibiotic regimen is most appropriate?
A. Oral norfloxacin
B. IV ceftriaxone
C. IV vancomycin and piperacillin-tazobactam
D. Oral ciprofloxacin
• CORRECT ANSWER✔ B. IV ceftriaxone
14.A 78-year-old male with a history of dementia is admitted for pneumonia.
He becomes agitated and pulls at his IV lines. Which medication should be
avoided due to risk of worsening delirium?
A. Haloperidol
B. Quetiapine
C. Diphenhydramine
D. Olanzapine
UPDATE 2025/2026 | QUESTIONS WITH
CORRECT ANSWERS
1. S. is a 59-year-old female who has been followed for aortic regurgitation.
Serial echocardiography has demonstrated normal left ventricular function,
but the patient was lost to follow-up for the last 16 months and now
complains of activity intolerance and weight gain. Physical examination
reveals a grade IV/VI diastolic decrescendo murmur and 2+ lower extremity
edema. The most appropriate diagnostic workup includes:
A. Serial echocardiography every 6 months
B. Transthoracic echocardiogram with assessment of valve morphology and
ventricular function
C. Begin an angiotensin-converting enzyme (ACE) inhibitor and referral for
surgical consultation
D. Imaging studies including CT, MRI, and angiography
• CORRECT ANSWER✔ B. Transthoracic echocardiogram with
assessment of valve morphology and ventricular function
2. An upper GI series shows dilation of 8-15 cm in the proximal duodenum and
mid-jejunum. A barium swallow study also shows a small gastric ulcer.
Management of this condition should include:
A. Proton pump inhibitors
B. Histamine H2 receptor antagonists
C. Antibiotics
D. Surgery
• CORRECT ANSWER✔ A. Proton pump inhibitors
3. Jasmine is a 31-year-old female who presents with neck pain, injection drug
use (admits to injecting opiates into her neck), diffuse tracking and scarring,
a disfiguring neck without pain, throat pain, temperature of 102.1°F, and
foul breath. In order to evaluate for a deep neck space infection, she should
have:
, A. Anteroposterior neck radiography
B. CT scan of the neck
C. Ultrasound
D. Aspiration and culture of fluid
• CORRECT ANSWER✔ B. CT scan of the neck
4. Mr. Draper is a 39-year-old male recovering from an extended alcohol
binge. As a result of a serious motor vehicle accident, he has had repair of a
fractured femur, bowel perforation, splenectomy, and repair of a hepatic
laceration. His vital signs are normal except for a temperature of 101.5°F.
His Glasgow Coma Scale (GCS) is 13. The patient's GCS score indicates
that he is:
A. Moderately brain injured
B. Severely brain injured
C. Minimally impaired
D. In a vegetative state
• CORRECT ANSWER✔ A. Moderately brain injured
5. Total peritonitis in a patient receiving nutritional support via a central line is
most likely caused by:
A. Contamination of the infusion
B. Bowel disease or gastrointestinal tract obstruction
C. The central venous line used for infusion
D. Resultant diarrhea and volume overload
• CORRECT ANSWER✔ C. The central venous line used for infusion
6. A 72-year-old male with a history of hypertension and heart failure presents
with acute dyspnea. His blood pressure is 190/100 mmHg, heart rate 110
bpm, and oxygen saturation 88% on room air. Lung auscultation reveals
crackles bilaterally. Which medication should be administered first?
A. Furosemide 40 mg IV
B. Nitroglycerin 0.4 mg sublingual
C. Oxygen via non-rebreather mask
D. Morphine 2 mg IV
• CORRECT ANSWER✔ C. Oxygen via non-rebreather mask
,7. A 45-year-old male with a history of alcohol use disorder presents with
severe epigastric pain radiating to the back, nausea, and vomiting. Serum
amylase is 1200 U/L. Which additional laboratory finding is most specific
for acute pancreatitis?
A. Elevated serum lipase
B. Elevated bilirubin
C. Hypocalcemia
D. Hyperglycemia
• CORRECT ANSWER✔ A. Elevated serum lipase
8. A 68-year-old female with a history of COPD presents with increased
shortness of breath, purulent sputum, and fever. Arterial blood gas on room
air shows pH 7.32, PaCO₂ 65 mmHg, PaO₂ 55 mmHg, HCO₃ 30 mEq/L. The
most appropriate initial intervention is:
A. Intubation and mechanical ventilation
B. BiPAP
C. Nebulized albuterol and ipratropium
D. Oxygen via nasal cannula at 2 L/min
• CORRECT ANSWER✔ B. BiPAP
9. A patient with septic shock has a mean arterial pressure of 55 mmHg despite
30 mL/kg of IV crystalloid. Which vasopressor is recommended as first-line
therapy?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
• CORRECT ANSWER✔ B. Norepinephrine
10.A 62-year-old male with a history of atrial fibrillation on warfarin presents
with sudden onset of left leg pain, pallor, and pulselessness. The most likely
diagnosis is:
A. Deep vein thrombosis
B. Arterial embolism
C. Compartment syndrome
D. Acute limb ischemia from in-situ thrombosis
, • CORRECT ANSWER✔ B. Arterial embolism
11.A patient with a history of myasthenia gravis develops acute respiratory
failure. Which medication should be avoided in this patient?
A. Pyridostigmine
B. Prednisone
C. Succinylcholine
D. Rocuronium
• CORRECT ANSWER✔ C. Succinylcholine
12.A 55-year-old female with a history of diabetes and hypertension presents
with acute onset of right arm weakness and aphasia. Last known normal was
2 hours ago. Non-contrast CT head shows no hemorrhage. Which
intervention is most appropriate?
A. Aspirin 325 mg
B. IV alteplase (tPA)
C. Mechanical thrombectomy
D. Blood pressure reduction to < 140/90
• CORRECT ANSWER✔ B. IV alteplase (tPA)
13.A patient with cirrhosis and ascites develops fever and abdominal
tenderness. Paracentesis reveals a neutrophil count of 500 cells/mm³. Which
antibiotic regimen is most appropriate?
A. Oral norfloxacin
B. IV ceftriaxone
C. IV vancomycin and piperacillin-tazobactam
D. Oral ciprofloxacin
• CORRECT ANSWER✔ B. IV ceftriaxone
14.A 78-year-old male with a history of dementia is admitted for pneumonia.
He becomes agitated and pulls at his IV lines. Which medication should be
avoided due to risk of worsening delirium?
A. Haloperidol
B. Quetiapine
C. Diphenhydramine
D. Olanzapine
