NUR 6111 Final Exam V2 | NUR 6111
Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Final Exam) | William
Paterson University
1. A 55-year-old male with a history of hypertension presents for a routine check-up. His
current blood pressure is 155/92 mmHg despite taking Lisinopril 20mg daily. According to JNC
8 guidelines, what is the next appropriate step in management?
A. Add Amlodipine 5mg daily
B. Switch Lisinopril to Losartan 50mg daily
C. Increase Lisinopril to 40mg daily
D. Instruct the patient to reduce sodium intake and return in 3 months
Answer: A
Rationale: According to JNC 8 guidelines, if the blood pressure goal is not achieved within
one month of treatment, the clinician should increase the dose of the initial drug or add a
second drug from one of the recommended classes (thiazide, CCB, ACEI, or ARB).
Amlodipine is a calcium channel blocker that works synergistically with ACE inhibitors like
Lisinopril. This approach addresses the persistent hypertension while monitoring for side
effects and efficacy.
,2. An 18-year-old female presents with symptoms of polyuria, polydipsia, and a 10lb weight
loss over the last month. Her random blood glucose is 280 mg/dL. What is the most likely
diagnosis?
A. Type 2 Diabetes Mellitus
B. Diabetes Insipidus
C. Type 1 Diabetes Mellitus
D. Metabolic Syndrome
Answer: C
Rationale: The clinical presentation of rapid weight loss, polyuria, and polydipsia in a
young patient is highly suggestive of Type 1 Diabetes Mellitus. A random plasma glucose
greater than or equal to 200 mg/dL in a symptomatic patient is diagnostic for diabetes
according to ADA criteria. Type 1 diabetes results from autoimmune destruction of
pancreatic beta cells, leading to absolute insulin deficiency.
3. Which of the following physical exam findings is most characteristic of Osteoarthritis (OA)
rather than Rheumatoid Arthritis (RA)?
A. Heberden’s nodes
B. Symmetrical joint involvement
C. Prolonged morning stiffness lasting over an hour
D. Ulnar deviation of the fingers
, Answer: A
Rationale: Heberden’s nodes are bony enlargements of the distal interphalangeal (DIP)
joints and are a classic sign of Osteoarthritis. In contrast, Rheumatoid Arthritis typically
involves the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints
symmetrically. Morning stiffness in OA is usually brief, typically lasting less than 30
minutes, whereas RA involves prolonged stiffness.
4. A 62-year-old female smoker presents with a chronic cough and progressive shortness of
breath. Pulmonary function testing shows an FEV1/FVC ratio of 0.62. This finding supports a
diagnosis of:
A. Restrictive Lung Disease
B. Congestive Heart Failure
C. Acute Bronchitis
D. Chronic Obstructive Pulmonary Disease (COPD)
Answer: D
Rationale: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the physiological
hallmark of airflow limitation and confirms the diagnosis of COPD. The patient’s history of
smoking and symptoms of chronic cough are consistent with GOLD guideline criteria. This
obstructive pattern differentiates COPD from restrictive diseases where the ratio is usually
preserved or increased.
Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Final Exam) | William
Paterson University
1. A 55-year-old male with a history of hypertension presents for a routine check-up. His
current blood pressure is 155/92 mmHg despite taking Lisinopril 20mg daily. According to JNC
8 guidelines, what is the next appropriate step in management?
A. Add Amlodipine 5mg daily
B. Switch Lisinopril to Losartan 50mg daily
C. Increase Lisinopril to 40mg daily
D. Instruct the patient to reduce sodium intake and return in 3 months
Answer: A
Rationale: According to JNC 8 guidelines, if the blood pressure goal is not achieved within
one month of treatment, the clinician should increase the dose of the initial drug or add a
second drug from one of the recommended classes (thiazide, CCB, ACEI, or ARB).
Amlodipine is a calcium channel blocker that works synergistically with ACE inhibitors like
Lisinopril. This approach addresses the persistent hypertension while monitoring for side
effects and efficacy.
,2. An 18-year-old female presents with symptoms of polyuria, polydipsia, and a 10lb weight
loss over the last month. Her random blood glucose is 280 mg/dL. What is the most likely
diagnosis?
A. Type 2 Diabetes Mellitus
B. Diabetes Insipidus
C. Type 1 Diabetes Mellitus
D. Metabolic Syndrome
Answer: C
Rationale: The clinical presentation of rapid weight loss, polyuria, and polydipsia in a
young patient is highly suggestive of Type 1 Diabetes Mellitus. A random plasma glucose
greater than or equal to 200 mg/dL in a symptomatic patient is diagnostic for diabetes
according to ADA criteria. Type 1 diabetes results from autoimmune destruction of
pancreatic beta cells, leading to absolute insulin deficiency.
3. Which of the following physical exam findings is most characteristic of Osteoarthritis (OA)
rather than Rheumatoid Arthritis (RA)?
A. Heberden’s nodes
B. Symmetrical joint involvement
C. Prolonged morning stiffness lasting over an hour
D. Ulnar deviation of the fingers
, Answer: A
Rationale: Heberden’s nodes are bony enlargements of the distal interphalangeal (DIP)
joints and are a classic sign of Osteoarthritis. In contrast, Rheumatoid Arthritis typically
involves the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints
symmetrically. Morning stiffness in OA is usually brief, typically lasting less than 30
minutes, whereas RA involves prolonged stiffness.
4. A 62-year-old female smoker presents with a chronic cough and progressive shortness of
breath. Pulmonary function testing shows an FEV1/FVC ratio of 0.62. This finding supports a
diagnosis of:
A. Restrictive Lung Disease
B. Congestive Heart Failure
C. Acute Bronchitis
D. Chronic Obstructive Pulmonary Disease (COPD)
Answer: D
Rationale: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the physiological
hallmark of airflow limitation and confirms the diagnosis of COPD. The patient’s history of
smoking and symptoms of chronic cough are consistent with GOLD guideline criteria. This
obstructive pattern differentiates COPD from restrictive diseases where the ratio is usually
preserved or increased.
