NUR612/NUR 612 Exam 2 V3 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. Which of the following is the first-line pharmacologic treatment for a patient newly
diagnosed with Stage 1 hypertension according to JNC-8 guidelines?
A. Potassium-sparing diuretic
B. Beta-blocker
C. Thiazide-type diuretic
D. Loop diuretic
Answer: C
Rationale: Thiazide-type diuretics are recommended as one of the four first-line options
for non-black patients with hypertension. They work by inhibiting sodium reabsorption in
the distal convoluted tubules. Beta-blockers are no longer considered first-line therapy for
uncomplicated hypertension because they are less effective in preventing stroke.
2. A 55-year-old male presents with a fasting plasma glucose of 130 mg/dL on two separate
occasions. What is the most appropriate next step in management?
A. Initiate insulin therapy immediately
B. Diagnose Type 2 Diabetes Mellitus and start Metformin
C. Order a 24-hour urine glucose test
,D. Advise the patient he has prediabetes and suggest diet only
Answer: B
Rationale: A fasting plasma glucose level of 126 mg/dL or higher on two separate
occasions meets the diagnostic criteria for Diabetes Mellitus. Metformin is considered the
first-line oral medication for most patients due to its efficacy and safety profile. Lifestyle
modifications should also be initiated alongside pharmacologic therapy.
3. A patient with COPD presents with increased dyspnea and cough. Which diagnostic tool is
most essential for determining the severity of airflow limitation?
A. Chest X-ray
B. Arterial Blood Gas
C. Spirometry
D. Pulse Oximetry
Answer: C
Rationale: Spirometry is the gold standard for diagnosing COPD and assessing the degree
of airflow obstruction. It measures the forced expiratory volume in one second (FEV1) and
the forced vital capacity (FVC). A post-bronchodilator FEV1/FVC ratio of less than 0.70
confirms persistent airflow limitation.
4. Which of the following physical exam findings is most suggestive of an acute asthma
exacerbation?
A. Fine crackles at the bases
, B. Pleural friction rub
C. Clubbing of the fingers
D. Expiratory wheezing
Answer: D
Rationale: Expiratory wheezing is a hallmark physical finding during an asthma attack
caused by narrowing of the lower airways. The nurse practitioner should also assess for the
use of accessory muscles and decreased breath sounds. These findings help determine the
severity of the obstruction and the need for urgent intervention.
5. A patient reports persistent heartburn and regurgitation three times per week. Which
medication class is most effective for healing esophageal erosions in GERD?
A. H2-Receptor Antagonists
B. Proton Pump Inhibitors (PPIs)
C. Antacids
D. Sucralfate
Answer: B
Rationale: Proton Pump Inhibitors are the most effective therapy for managing symptoms
and promoting healing of erosive esophagitis. They should typically be taken 30 to 60
minutes before the first meal of the day for maximum efficacy. While H2 blockers provide
relief, they are less potent than PPIs for severe cases.
Nursing II Q&A with Rationale | William
Paterson University
1. Which of the following is the first-line pharmacologic treatment for a patient newly
diagnosed with Stage 1 hypertension according to JNC-8 guidelines?
A. Potassium-sparing diuretic
B. Beta-blocker
C. Thiazide-type diuretic
D. Loop diuretic
Answer: C
Rationale: Thiazide-type diuretics are recommended as one of the four first-line options
for non-black patients with hypertension. They work by inhibiting sodium reabsorption in
the distal convoluted tubules. Beta-blockers are no longer considered first-line therapy for
uncomplicated hypertension because they are less effective in preventing stroke.
2. A 55-year-old male presents with a fasting plasma glucose of 130 mg/dL on two separate
occasions. What is the most appropriate next step in management?
A. Initiate insulin therapy immediately
B. Diagnose Type 2 Diabetes Mellitus and start Metformin
C. Order a 24-hour urine glucose test
,D. Advise the patient he has prediabetes and suggest diet only
Answer: B
Rationale: A fasting plasma glucose level of 126 mg/dL or higher on two separate
occasions meets the diagnostic criteria for Diabetes Mellitus. Metformin is considered the
first-line oral medication for most patients due to its efficacy and safety profile. Lifestyle
modifications should also be initiated alongside pharmacologic therapy.
3. A patient with COPD presents with increased dyspnea and cough. Which diagnostic tool is
most essential for determining the severity of airflow limitation?
A. Chest X-ray
B. Arterial Blood Gas
C. Spirometry
D. Pulse Oximetry
Answer: C
Rationale: Spirometry is the gold standard for diagnosing COPD and assessing the degree
of airflow obstruction. It measures the forced expiratory volume in one second (FEV1) and
the forced vital capacity (FVC). A post-bronchodilator FEV1/FVC ratio of less than 0.70
confirms persistent airflow limitation.
4. Which of the following physical exam findings is most suggestive of an acute asthma
exacerbation?
A. Fine crackles at the bases
, B. Pleural friction rub
C. Clubbing of the fingers
D. Expiratory wheezing
Answer: D
Rationale: Expiratory wheezing is a hallmark physical finding during an asthma attack
caused by narrowing of the lower airways. The nurse practitioner should also assess for the
use of accessory muscles and decreased breath sounds. These findings help determine the
severity of the obstruction and the need for urgent intervention.
5. A patient reports persistent heartburn and regurgitation three times per week. Which
medication class is most effective for healing esophageal erosions in GERD?
A. H2-Receptor Antagonists
B. Proton Pump Inhibitors (PPIs)
C. Antacids
D. Sucralfate
Answer: B
Rationale: Proton Pump Inhibitors are the most effective therapy for managing symptoms
and promoting healing of erosive esophagitis. They should typically be taken 30 to 60
minutes before the first meal of the day for maximum efficacy. While H2 blockers provide
relief, they are less potent than PPIs for severe cases.
