NUR 6130 Exam 3 V1 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 3) | William
Paterson University
1. A 58-year-old male with a history of hypertension and Type 2 Diabetes presents for a
follow-up. His labs show a serum creatinine of 1.8 mg/dL and an eGFR of 42 mL/min/1.73m2.
According to the KDIGO guidelines, which stage of Chronic Kidney Disease (CKD) is this
patient in?
A. Stage 3b
B. Stage 3a
C. Stage 2
D. Stage 4
Answer: A
Rationale: Chronic Kidney Disease Stage 3b is defined by an eGFR ranging between 30 and
44 mL/min/1.73m2. This stage indicates a moderate to severe decrease in kidney function
and requires careful management of comorbidities like diabetes and hypertension.
Providers must monitor for complications such as anemia and mineral bone disease at this
level of renal impairment.
,2. Which of the following physical examination findings is most characteristic of a patient
with Cushing’s Syndrome?
A. Hyperpigmentation of skin creases
B. Exophthalmos
C. Supraclavicular fat pad accumulation
D. Pretibial myxedema
Answer: C
Rationale: Supraclavicular fat pad accumulation, often referred to as a buffalo hump, is a
classic sign of hypercortisolism or Cushing’s Syndrome. This condition results from
prolonged exposure to high levels of glucocorticoids, leading to central obesity and thin
extremities. Hyperpigmentation is more typical of Addison’s disease, while exophthalmos is
seen in Graves’ disease.
3. A 32-year-old female presents with tremors, heat intolerance, and a racing heart. Her TSH
is 0.01 mIU/L and her Free T4 is elevated. Which medication is the preferred first-line
treatment for symptomatic relief of her palpitations?
A. Methimazole
B. Propylthiouracil (PTU)
C. Levothyroxine
D. Propranolol
,Answer: D
Rationale: Beta-blockers like Propranolol are utilized to manage the adrenergic symptoms
of hyperthyroidism such as tachycardia and tremors. While Methimazole and PTU address
the underlying overproduction of thyroid hormone, they do not provide immediate
symptomatic relief. This approach stabilizes the patient while long-term antithyroid
therapy or radioactive iodine is initiated.
4. A patient with a history of epilepsy is being started on Phenytoin (Dilantin). Which adverse
effect requires the nurse practitioner to educate the patient on meticulous oral hygiene?
A. Glossitis
B. Gingival hyperplasia
C. Stomatitis
D. Xerostomia
Answer: B
Rationale: Gingival hyperplasia is a well-known side effect of long-term Phenytoin
therapy, characterized by the overgrowth of gum tissue. Regular dental check-ups and
excellent oral hygiene can help minimize the severity of this condition. It is essential for
advanced practice nurses to monitor the oral cavity of patients on this anticonvulsant
regularly.
, 5. What is the primary diagnostic test used to confirm the diagnosis of Myasthenia Gravis in
an outpatient setting?
A. Acetylcholine receptor antibody (AChR-Ab) test
B. Lumbar puncture for oligoclonal bands
C. Muscle biopsy
D. Creatine kinase levels
Answer: A
Rationale: The detection of Acetylcholine receptor antibodies is highly specific for
diagnosing Myasthenia Gravis, an autoimmune neuromuscular disorder. These antibodies
interfere with the transmission of nerve impulses to muscles, causing characteristic
weakness. In cases where this test is negative, MuSK antibody testing may be considered
for further evaluation.
6. A 65-year-old male with a history of chronic gout presents with an acute flare in his right
great toe. He has a history of Stage 3 CKD. Which medication is the safest choice for managing
his acute pain?
A. Indomethacin
B. Prednisone
C. Naproxen
D. Allopurinol
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 3) | William
Paterson University
1. A 58-year-old male with a history of hypertension and Type 2 Diabetes presents for a
follow-up. His labs show a serum creatinine of 1.8 mg/dL and an eGFR of 42 mL/min/1.73m2.
According to the KDIGO guidelines, which stage of Chronic Kidney Disease (CKD) is this
patient in?
A. Stage 3b
B. Stage 3a
C. Stage 2
D. Stage 4
Answer: A
Rationale: Chronic Kidney Disease Stage 3b is defined by an eGFR ranging between 30 and
44 mL/min/1.73m2. This stage indicates a moderate to severe decrease in kidney function
and requires careful management of comorbidities like diabetes and hypertension.
Providers must monitor for complications such as anemia and mineral bone disease at this
level of renal impairment.
,2. Which of the following physical examination findings is most characteristic of a patient
with Cushing’s Syndrome?
A. Hyperpigmentation of skin creases
B. Exophthalmos
C. Supraclavicular fat pad accumulation
D. Pretibial myxedema
Answer: C
Rationale: Supraclavicular fat pad accumulation, often referred to as a buffalo hump, is a
classic sign of hypercortisolism or Cushing’s Syndrome. This condition results from
prolonged exposure to high levels of glucocorticoids, leading to central obesity and thin
extremities. Hyperpigmentation is more typical of Addison’s disease, while exophthalmos is
seen in Graves’ disease.
3. A 32-year-old female presents with tremors, heat intolerance, and a racing heart. Her TSH
is 0.01 mIU/L and her Free T4 is elevated. Which medication is the preferred first-line
treatment for symptomatic relief of her palpitations?
A. Methimazole
B. Propylthiouracil (PTU)
C. Levothyroxine
D. Propranolol
,Answer: D
Rationale: Beta-blockers like Propranolol are utilized to manage the adrenergic symptoms
of hyperthyroidism such as tachycardia and tremors. While Methimazole and PTU address
the underlying overproduction of thyroid hormone, they do not provide immediate
symptomatic relief. This approach stabilizes the patient while long-term antithyroid
therapy or radioactive iodine is initiated.
4. A patient with a history of epilepsy is being started on Phenytoin (Dilantin). Which adverse
effect requires the nurse practitioner to educate the patient on meticulous oral hygiene?
A. Glossitis
B. Gingival hyperplasia
C. Stomatitis
D. Xerostomia
Answer: B
Rationale: Gingival hyperplasia is a well-known side effect of long-term Phenytoin
therapy, characterized by the overgrowth of gum tissue. Regular dental check-ups and
excellent oral hygiene can help minimize the severity of this condition. It is essential for
advanced practice nurses to monitor the oral cavity of patients on this anticonvulsant
regularly.
, 5. What is the primary diagnostic test used to confirm the diagnosis of Myasthenia Gravis in
an outpatient setting?
A. Acetylcholine receptor antibody (AChR-Ab) test
B. Lumbar puncture for oligoclonal bands
C. Muscle biopsy
D. Creatine kinase levels
Answer: A
Rationale: The detection of Acetylcholine receptor antibodies is highly specific for
diagnosing Myasthenia Gravis, an autoimmune neuromuscular disorder. These antibodies
interfere with the transmission of nerve impulses to muscles, causing characteristic
weakness. In cases where this test is negative, MuSK antibody testing may be considered
for further evaluation.
6. A 65-year-old male with a history of chronic gout presents with an acute flare in his right
great toe. He has a history of Stage 3 CKD. Which medication is the safest choice for managing
his acute pain?
A. Indomethacin
B. Prednisone
C. Naproxen
D. Allopurinol
