NR-707 Advanced Practice Nursing 2025-2026:
Practice Questions with Detailed Rationales
for Exam Success
1. Which of the following is the most common cause of left-sided
heart failure?
A. Pulmonary embolism
B. Hypertension
C. Chronic bronchitis
D. Pulmonary stenosis
Rationale: Hypertension increases afterload, which over time causes left
ventricular hypertrophy and ultimately left-sided heart failure.
2. Which cell type is primarily responsible for humoral immunity?
A. T cells
B. B cells
C. Macrophages
D. Natural killer cells
Rationale: B cells produce antibodies and mediate humoral immunity,
while T cells mediate cell-mediated immunity.
3. The pathophysiology of type 2 diabetes mellitus primarily involves:
A. Absolute insulin deficiency
B. Insulin resistance with relative insulin deficiency
,C. Autoimmune destruction of beta cells
D. Excess glucagon secretion
Rationale: Type 2 diabetes is characterized by peripheral insulin
resistance and impaired insulin secretion, unlike type 1 which is
autoimmune-mediated.
4. Which electrolyte abnormality is most likely to cause peaked T
waves on ECG?
A. Hypocalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hypernatremia
Rationale: Hyperkalemia increases cardiac membrane excitability,
causing peaked T waves on ECG.
5. Which cytokine is considered the primary mediator of systemic
inflammation?
A. IL-2
B. IL-4
C. TNF-alpha
D. IFN-gamma
Rationale: TNF-alpha is a pro-inflammatory cytokine that mediates
fever, apoptosis, and systemic inflammatory response.
6. Which of the following best describes the mechanism of asthma?
,A. Alveolar destruction
B. Bronchial hyperresponsiveness and inflammation
C. Pulmonary fibrosis
D. Pleural effusion
Rationale: Asthma involves airway inflammation and hyperreactivity,
leading to reversible bronchoconstriction.
7. In chronic kidney disease, the most common cause of secondary
hyperparathyroidism is:
A. Hypercalcemia
B. Vitamin D toxicity
C. Hypocalcemia and phosphate retention
D. Excess PTH secretion
Rationale: CKD leads to phosphate retention and decreased vitamin D
activation, causing hypocalcemia and secondary hyperparathyroidism.
8. Which of the following is a hallmark of nephrotic syndrome?
A. Hematuria
B. Proteinuria >3.5 g/day
C. Hyperkalemia
D. Polyuria
Rationale: Nephrotic syndrome is defined by heavy proteinuria,
hypoalbuminemia, and edema.
9. Which pathogen is most commonly associated with peptic ulcer
disease?
, A. Escherichia coli
B. Helicobacter pylori
C. Staphylococcus aureus
D. Clostridium difficile
Rationale: H. pylori infection leads to gastric mucosal damage and ulcer
formation.
10. Which acid-base disorder is indicated by pH 7.25, PaCO2 60
mmHg, HCO3- 26 mEq/L?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Rationale: Low pH with elevated PaCO2 indicates primary respiratory
acidosis.
11. Which of the following is the most common cause of
hyperthyroidism?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Iodine deficiency
Rationale: Graves disease is an autoimmune disorder causing thyroid
hormone overproduction.
12. The most likely electrolyte disturbance in Addison’s disease is:
Practice Questions with Detailed Rationales
for Exam Success
1. Which of the following is the most common cause of left-sided
heart failure?
A. Pulmonary embolism
B. Hypertension
C. Chronic bronchitis
D. Pulmonary stenosis
Rationale: Hypertension increases afterload, which over time causes left
ventricular hypertrophy and ultimately left-sided heart failure.
2. Which cell type is primarily responsible for humoral immunity?
A. T cells
B. B cells
C. Macrophages
D. Natural killer cells
Rationale: B cells produce antibodies and mediate humoral immunity,
while T cells mediate cell-mediated immunity.
3. The pathophysiology of type 2 diabetes mellitus primarily involves:
A. Absolute insulin deficiency
B. Insulin resistance with relative insulin deficiency
,C. Autoimmune destruction of beta cells
D. Excess glucagon secretion
Rationale: Type 2 diabetes is characterized by peripheral insulin
resistance and impaired insulin secretion, unlike type 1 which is
autoimmune-mediated.
4. Which electrolyte abnormality is most likely to cause peaked T
waves on ECG?
A. Hypocalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hypernatremia
Rationale: Hyperkalemia increases cardiac membrane excitability,
causing peaked T waves on ECG.
5. Which cytokine is considered the primary mediator of systemic
inflammation?
A. IL-2
B. IL-4
C. TNF-alpha
D. IFN-gamma
Rationale: TNF-alpha is a pro-inflammatory cytokine that mediates
fever, apoptosis, and systemic inflammatory response.
6. Which of the following best describes the mechanism of asthma?
,A. Alveolar destruction
B. Bronchial hyperresponsiveness and inflammation
C. Pulmonary fibrosis
D. Pleural effusion
Rationale: Asthma involves airway inflammation and hyperreactivity,
leading to reversible bronchoconstriction.
7. In chronic kidney disease, the most common cause of secondary
hyperparathyroidism is:
A. Hypercalcemia
B. Vitamin D toxicity
C. Hypocalcemia and phosphate retention
D. Excess PTH secretion
Rationale: CKD leads to phosphate retention and decreased vitamin D
activation, causing hypocalcemia and secondary hyperparathyroidism.
8. Which of the following is a hallmark of nephrotic syndrome?
A. Hematuria
B. Proteinuria >3.5 g/day
C. Hyperkalemia
D. Polyuria
Rationale: Nephrotic syndrome is defined by heavy proteinuria,
hypoalbuminemia, and edema.
9. Which pathogen is most commonly associated with peptic ulcer
disease?
, A. Escherichia coli
B. Helicobacter pylori
C. Staphylococcus aureus
D. Clostridium difficile
Rationale: H. pylori infection leads to gastric mucosal damage and ulcer
formation.
10. Which acid-base disorder is indicated by pH 7.25, PaCO2 60
mmHg, HCO3- 26 mEq/L?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Rationale: Low pH with elevated PaCO2 indicates primary respiratory
acidosis.
11. Which of the following is the most common cause of
hyperthyroidism?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Iodine deficiency
Rationale: Graves disease is an autoimmune disorder causing thyroid
hormone overproduction.
12. The most likely electrolyte disturbance in Addison’s disease is:
