1
NURS 6531 Final Exam 2026/2027 Actual Exam | 2
Versions Week 11 Spring Qtr with All 200 Questions &
Correct Answers with Detailed Rationales | Walden
University | Pass Guaranteed - A+ Graded
Version 1: Adult Primary Care
Q1: A 58-year-old patient with hypertension and type 2 diabetes has a blood pressure of 148/92
mmHg on two separate readings. According to ACC/AHA guidelines, what is the blood pressure
target for this patient?
A. <140/90 mmHg
B. <130/80 mmHg [CORRECT]
C. <135/85 mmHg
D. <120/80 mmHg
Correct Answer: B
Rationale: The 2017 ACC/AHA guidelines recommend a blood pressure target of <130/80
mmHg for patients with comorbidities such as diabetes mellitus and chronic kidney disease to
reduce cardiovascular risk.
Q2: A 45-year-old male presents with acute onset of severe right great toe pain, redness, and
swelling. He has a history of alcohol use. Joint aspiration shows negatively birefringent needle-
shaped crystals. What is the first-line treatment for this acute condition?
A. Allopurinol
B. Colchicine [CORRECT]
C. Febuxostat
D. Methotrexate
Correct Answer: B
,2
Rationale: The diagnosis is acute gouty arthritis. Colchicine or NSAIDs (like indomethacin) are
first-line for acute attacks. Allopurinol and Febuxostat are urate-lowering therapies used for
prophylaxis, not acute treatment, and can initially worsen the attack.
Q3: A 35-year-old female presents with a "butterfly rash" on her face, fatigue, and joint pain.
Laboratory results reveal a positive ANA and anti-dsDNA. Which of the following organ
systems requires the most urgent assessment?
A. Cardiac (Pericarditis)
B. Renal (Nephritis) [CORRECT]
C. Gastrointestinal (Pancreatitis)
D. Pulmonary (Pleurisy)
Correct Answer: B
Rationale: The patient has signs and labs consistent with Systemic Lupus Erythematosus (SLE).
Lupus nephritis is a major cause of morbidity and mortality. While pericarditis and pleurisy are
common, renal involvement requires aggressive management to prevent renal failure.
Q4: A 30-year-old male presents with low back pain that radiates down his right leg to the foot.
He reports numbness in the lateral foot. Which finding would indicate a surgical emergency
(Cauda Equina Syndrome)?
A. Positive straight leg raise test
B. Urinary retention and saddle anesthesia [CORRECT]
C. Diminished patellar reflex
D. Pain worsened by Valsalva maneuver
Correct Answer: B
Rationale: Cauda Equina Syndrome involves compression of the nerve roots of the cauda equina.
Red flags include bowel or bladder dysfunction (urinary retention/incontinence), saddle
anesthesia (sensory loss in perineal area), and lower extremity weakness. This requires
immediate surgical decompression.
,3
Q5: A 50-year-old patient is diagnosed with Clostridium difficile infection (CDI) for the first
time. Which antibiotic is the preferred treatment?
A. Metronidazole
B. Vancomycin (PO) [CORRECT]
C. Ciprofloxacin
D. Clindamycin
Correct Answer: B
Rationale: Current IDSA guidelines recommend oral Vancomycin or Fidaxomicin as first-line
therapy for initial CDI episodes, regardless of severity. Metronidazole is no longer preferred for
initial therapy due to lower cure rates in severe cases, though still used in resource-limited
settings.
Q6: A 60-year-old male with a history of COPD presents with increased dyspnea, purulent
sputum, and fever. An AECOPD is diagnosed. In addition to bronchodilators, what is the
appropriate antibiotic therapy duration?
A. 3 days
B. 5-7 days [CORRECT]
C. 10-14 days
D. 21 days
Correct Answer: B
Rationale: Current guidelines recommend shorter antibiotic courses (5-7 days) for acute
exacerbations of COPD to minimize resistance, provided the patient is clinically stable.
Q7: A 42-year-old female presents with palpitations, weight loss, and heat intolerance. TSH is
<0.01 and Free T4 is elevated. What is the most common cause of hyperthyroidism?
A. Thyroid storm
B. Toxic multinodular goiter
C. Graves' disease [CORRECT]
, 4
D. Subacute thyroiditis
Correct Answer: C
Rationale: Graves' disease is the most common cause of hyperthyroidism in the US. It is an
autoimmune process where antibodies stimulate the TSH receptor.
Q8: A 55-year-old male presents with crushing chest pain. ECG shows ST elevation in leads II,
III, and aVF. Which area of the heart is affected?
A. Anterior wall
B. Lateral wall
C. Inferior wall [CORRECT]
D. Septal wall
Correct Answer: C
Rationale: Leads II, III, and aVF view the inferior wall of the heart. Right Coronary Artery
(RCA) occlusion is usually responsible.
Q9: Which of the following patients meets the criteria for initiating statin therapy for primary
prevention based on ACC/AHA guidelines?
A. 40-year-old male with LDL 120 mg/dL and no risk factors.
B. 55-year-old female with Diabetes and LDL 100 mg/dL. [CORRECT]
C. 30-year-old male with hypertension.
D. 50-year-old female with a 10-year ASCVD risk of 3%.
Correct Answer: B
Rationale: Patients with Diabetes mellitus (Type 1 or 2) aged 40-75 should be started on statin
therapy. Additionally, a 10-year ASCVD risk >7.5% generally warrants statin therapy.
NURS 6531 Final Exam 2026/2027 Actual Exam | 2
Versions Week 11 Spring Qtr with All 200 Questions &
Correct Answers with Detailed Rationales | Walden
University | Pass Guaranteed - A+ Graded
Version 1: Adult Primary Care
Q1: A 58-year-old patient with hypertension and type 2 diabetes has a blood pressure of 148/92
mmHg on two separate readings. According to ACC/AHA guidelines, what is the blood pressure
target for this patient?
A. <140/90 mmHg
B. <130/80 mmHg [CORRECT]
C. <135/85 mmHg
D. <120/80 mmHg
Correct Answer: B
Rationale: The 2017 ACC/AHA guidelines recommend a blood pressure target of <130/80
mmHg for patients with comorbidities such as diabetes mellitus and chronic kidney disease to
reduce cardiovascular risk.
Q2: A 45-year-old male presents with acute onset of severe right great toe pain, redness, and
swelling. He has a history of alcohol use. Joint aspiration shows negatively birefringent needle-
shaped crystals. What is the first-line treatment for this acute condition?
A. Allopurinol
B. Colchicine [CORRECT]
C. Febuxostat
D. Methotrexate
Correct Answer: B
,2
Rationale: The diagnosis is acute gouty arthritis. Colchicine or NSAIDs (like indomethacin) are
first-line for acute attacks. Allopurinol and Febuxostat are urate-lowering therapies used for
prophylaxis, not acute treatment, and can initially worsen the attack.
Q3: A 35-year-old female presents with a "butterfly rash" on her face, fatigue, and joint pain.
Laboratory results reveal a positive ANA and anti-dsDNA. Which of the following organ
systems requires the most urgent assessment?
A. Cardiac (Pericarditis)
B. Renal (Nephritis) [CORRECT]
C. Gastrointestinal (Pancreatitis)
D. Pulmonary (Pleurisy)
Correct Answer: B
Rationale: The patient has signs and labs consistent with Systemic Lupus Erythematosus (SLE).
Lupus nephritis is a major cause of morbidity and mortality. While pericarditis and pleurisy are
common, renal involvement requires aggressive management to prevent renal failure.
Q4: A 30-year-old male presents with low back pain that radiates down his right leg to the foot.
He reports numbness in the lateral foot. Which finding would indicate a surgical emergency
(Cauda Equina Syndrome)?
A. Positive straight leg raise test
B. Urinary retention and saddle anesthesia [CORRECT]
C. Diminished patellar reflex
D. Pain worsened by Valsalva maneuver
Correct Answer: B
Rationale: Cauda Equina Syndrome involves compression of the nerve roots of the cauda equina.
Red flags include bowel or bladder dysfunction (urinary retention/incontinence), saddle
anesthesia (sensory loss in perineal area), and lower extremity weakness. This requires
immediate surgical decompression.
,3
Q5: A 50-year-old patient is diagnosed with Clostridium difficile infection (CDI) for the first
time. Which antibiotic is the preferred treatment?
A. Metronidazole
B. Vancomycin (PO) [CORRECT]
C. Ciprofloxacin
D. Clindamycin
Correct Answer: B
Rationale: Current IDSA guidelines recommend oral Vancomycin or Fidaxomicin as first-line
therapy for initial CDI episodes, regardless of severity. Metronidazole is no longer preferred for
initial therapy due to lower cure rates in severe cases, though still used in resource-limited
settings.
Q6: A 60-year-old male with a history of COPD presents with increased dyspnea, purulent
sputum, and fever. An AECOPD is diagnosed. In addition to bronchodilators, what is the
appropriate antibiotic therapy duration?
A. 3 days
B. 5-7 days [CORRECT]
C. 10-14 days
D. 21 days
Correct Answer: B
Rationale: Current guidelines recommend shorter antibiotic courses (5-7 days) for acute
exacerbations of COPD to minimize resistance, provided the patient is clinically stable.
Q7: A 42-year-old female presents with palpitations, weight loss, and heat intolerance. TSH is
<0.01 and Free T4 is elevated. What is the most common cause of hyperthyroidism?
A. Thyroid storm
B. Toxic multinodular goiter
C. Graves' disease [CORRECT]
, 4
D. Subacute thyroiditis
Correct Answer: C
Rationale: Graves' disease is the most common cause of hyperthyroidism in the US. It is an
autoimmune process where antibodies stimulate the TSH receptor.
Q8: A 55-year-old male presents with crushing chest pain. ECG shows ST elevation in leads II,
III, and aVF. Which area of the heart is affected?
A. Anterior wall
B. Lateral wall
C. Inferior wall [CORRECT]
D. Septal wall
Correct Answer: C
Rationale: Leads II, III, and aVF view the inferior wall of the heart. Right Coronary Artery
(RCA) occlusion is usually responsible.
Q9: Which of the following patients meets the criteria for initiating statin therapy for primary
prevention based on ACC/AHA guidelines?
A. 40-year-old male with LDL 120 mg/dL and no risk factors.
B. 55-year-old female with Diabetes and LDL 100 mg/dL. [CORRECT]
C. 30-year-old male with hypertension.
D. 50-year-old female with a 10-year ASCVD risk of 3%.
Correct Answer: B
Rationale: Patients with Diabetes mellitus (Type 1 or 2) aged 40-75 should be started on statin
therapy. Additionally, a 10-year ASCVD risk >7.5% generally warrants statin therapy.
