NUR 6121 Exam 1 V3 | NUR 6121
Advanced Nursing II | Q&A with Rationale
(NUR6121 Exam 1) | William Paterson
University
1. A 68-year-old patient presents with symptoms of heart failure. Which diagnostic finding is
most indicative of heart failure with preserved ejection fraction (HFpEF)?
A. Ejection fraction of 35%
B. Ejection fraction of 55%
C. Reduced Brain Natriuretic Peptide (BNP)
D. Right ventricular collapse
Answer: B
Rationale: HFpEF is characterized by clinical heart failure symptoms despite an ejection
fraction of 50 percent or greater. This condition often results from diastolic dysfunction
and stiffening of the left ventricle. Management focuses on treating underlying causes like
hypertension and managing fluid volume with diuretics.
2. When managing a patient with Type 2 Diabetes, which medication is recommended as
first-line therapy unless contraindicated?
A. Glipizide
B. Pioglitazone
,C. Metformin
D. Sitagliptin
Answer: C
Rationale: Metformin remains the gold standard for initial pharmacological management
of Type 2 Diabetes due to its efficacy and safety profile. It works by decreasing hepatic
glucose production and improving insulin sensitivity in peripheral tissues. Patients should
be monitored for gastrointestinal side effects and vitamin B12 deficiency during long-term
use.
3. Which of the following is a classic clinical finding in a patient presenting with Chronic
Obstructive Pulmonary Disease (COPD)?
A. Increased Forced Expiratory Volume in 1 second (FEV1)
B. Hyperresonance on percussion
C. Decreased total lung capacity
D. Increased diaphragmatic excursion
Answer: B
Rationale: Hyperresonance on percussion occurs in COPD due to air trapping and lung
hyperinflation. The obstructive nature of the disease leads to a decreased FEV1/FVC ratio
rather than an increase. Advanced practice nurses must recognize these physical exam
findings to properly stage the severity of the disease.
, 4. A patient with a history of hypertension and asthma requires a new antihypertensive
medication. Which class should be avoided?
A. Calcium Channel Blockers
B. ACE Inhibitors
C. Thiazide Diuretics
D. Non-selective Beta-blockers
Answer: D
Rationale: Non-selective beta-blockers can trigger bronchoconstriction by blocking beta-2
receptors in the lungs, making them dangerous for asthmatic patients. Selective beta-1
blockers are preferred if a beta-blocker is absolutely necessary, though still used with
caution. Alternative classes like ARBs or CCBs are generally safer choices for this
population.
5. What is the primary diagnostic laboratory finding for a patient suspected of having primary
hypothyroidism?
A. Low TSH and high Free T4
B. High TSH and low Free T4
C. High TSH and high Free T4
D. Low TSH and low Free T4
Answer: B
Advanced Nursing II | Q&A with Rationale
(NUR6121 Exam 1) | William Paterson
University
1. A 68-year-old patient presents with symptoms of heart failure. Which diagnostic finding is
most indicative of heart failure with preserved ejection fraction (HFpEF)?
A. Ejection fraction of 35%
B. Ejection fraction of 55%
C. Reduced Brain Natriuretic Peptide (BNP)
D. Right ventricular collapse
Answer: B
Rationale: HFpEF is characterized by clinical heart failure symptoms despite an ejection
fraction of 50 percent or greater. This condition often results from diastolic dysfunction
and stiffening of the left ventricle. Management focuses on treating underlying causes like
hypertension and managing fluid volume with diuretics.
2. When managing a patient with Type 2 Diabetes, which medication is recommended as
first-line therapy unless contraindicated?
A. Glipizide
B. Pioglitazone
,C. Metformin
D. Sitagliptin
Answer: C
Rationale: Metformin remains the gold standard for initial pharmacological management
of Type 2 Diabetes due to its efficacy and safety profile. It works by decreasing hepatic
glucose production and improving insulin sensitivity in peripheral tissues. Patients should
be monitored for gastrointestinal side effects and vitamin B12 deficiency during long-term
use.
3. Which of the following is a classic clinical finding in a patient presenting with Chronic
Obstructive Pulmonary Disease (COPD)?
A. Increased Forced Expiratory Volume in 1 second (FEV1)
B. Hyperresonance on percussion
C. Decreased total lung capacity
D. Increased diaphragmatic excursion
Answer: B
Rationale: Hyperresonance on percussion occurs in COPD due to air trapping and lung
hyperinflation. The obstructive nature of the disease leads to a decreased FEV1/FVC ratio
rather than an increase. Advanced practice nurses must recognize these physical exam
findings to properly stage the severity of the disease.
, 4. A patient with a history of hypertension and asthma requires a new antihypertensive
medication. Which class should be avoided?
A. Calcium Channel Blockers
B. ACE Inhibitors
C. Thiazide Diuretics
D. Non-selective Beta-blockers
Answer: D
Rationale: Non-selective beta-blockers can trigger bronchoconstriction by blocking beta-2
receptors in the lungs, making them dangerous for asthmatic patients. Selective beta-1
blockers are preferred if a beta-blocker is absolutely necessary, though still used with
caution. Alternative classes like ARBs or CCBs are generally safer choices for this
population.
5. What is the primary diagnostic laboratory finding for a patient suspected of having primary
hypothyroidism?
A. Low TSH and high Free T4
B. High TSH and low Free T4
C. High TSH and high Free T4
D. Low TSH and low Free T4
Answer: B
