NUR 6130 Exam 3 V1 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 3) | William
Paterson University
1. When evaluating an 82-year-old patient with sudden onset confusion and fluctuating levels
of consciousness, which diagnosis is most likely according to the DSM-5 criteria?
A. Delirium
B. Vascular Dementia
C. Alzheimer’s Disease
D. Major Depressive Disorder
Answer: A
Rationale: Delirium is characterized by an acute onset of cognitive impairment and a
fluctuating course of consciousness. This condition is often reversible and usually
secondary to an underlying medical condition, such as infection or metabolic imbalance.
Advanced practice nurses must prioritize identifying the root cause to prevent further
decline in geriatric patients.
2. An NP is managing a patient with heart failure with reduced ejection fraction (HFrEF).
Which medication class is indicated to prevent cardiac remodeling and decrease mortality?
A. Loop Diuretics
,B. Calcium Channel Blockers
C. ACE Inhibitors
D. Short-acting Nitrates
Answer: C
Rationale: ACE Inhibitors are gold-standard treatments in HFrEF because they inhibit the
renin-angiotensin-aldosterone system, thereby reducing cardiac remodeling. Clinical
evidence demonstrates a significant reduction in both mortality and hospitalization rates
for these patients. NPs must monitor renal function and potassium levels closely when
initiating this therapy.
3. According to the Beers Criteria, which of the following medications should be avoided in
the elderly due to the high risk of orthostatic hypotension and falls?
A. Metformin
B. Amitriptyline
C. Lisinopril
D. Atorvastatin
Answer: B
Rationale: Amitriptyline is a tricyclic antidepressant with strong anticholinergic
properties that significantly increase the risk of orthostatic hypotension in older adults.
The Beers Criteria specifically lists this drug as potentially inappropriate for the geriatric
, population due to the high risk of falls and fractures. Alternative treatments with better
safety profiles, such as SSRIs, should be considered for depression management.
4. A patient with Stage IV lung cancer expresses a desire for symptom management without
curative intent. Which level of care is most appropriate to discuss?
A. Acute Rehabilitation
B. Palliative Care
C. Skilled Nursing Facility
D. Hospice Care
Answer: D
Rationale: Hospice care is specifically designed for patients with a terminal prognosis of
six months or less who have chosen to forgo curative treatments. The focus is entirely on
comfort, quality of life, and support for the family during the end-of-life process. Palliative
care could be used earlier in the disease trajectory, but hospice is the definitive choice for
terminal management.
5. Which screening tool is most appropriate for identifying cognitive impairment during a
Medicare Wellness Visit?
A. PHQ-9
B. CAGE Questionnaire
C. GDS
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 3) | William
Paterson University
1. When evaluating an 82-year-old patient with sudden onset confusion and fluctuating levels
of consciousness, which diagnosis is most likely according to the DSM-5 criteria?
A. Delirium
B. Vascular Dementia
C. Alzheimer’s Disease
D. Major Depressive Disorder
Answer: A
Rationale: Delirium is characterized by an acute onset of cognitive impairment and a
fluctuating course of consciousness. This condition is often reversible and usually
secondary to an underlying medical condition, such as infection or metabolic imbalance.
Advanced practice nurses must prioritize identifying the root cause to prevent further
decline in geriatric patients.
2. An NP is managing a patient with heart failure with reduced ejection fraction (HFrEF).
Which medication class is indicated to prevent cardiac remodeling and decrease mortality?
A. Loop Diuretics
,B. Calcium Channel Blockers
C. ACE Inhibitors
D. Short-acting Nitrates
Answer: C
Rationale: ACE Inhibitors are gold-standard treatments in HFrEF because they inhibit the
renin-angiotensin-aldosterone system, thereby reducing cardiac remodeling. Clinical
evidence demonstrates a significant reduction in both mortality and hospitalization rates
for these patients. NPs must monitor renal function and potassium levels closely when
initiating this therapy.
3. According to the Beers Criteria, which of the following medications should be avoided in
the elderly due to the high risk of orthostatic hypotension and falls?
A. Metformin
B. Amitriptyline
C. Lisinopril
D. Atorvastatin
Answer: B
Rationale: Amitriptyline is a tricyclic antidepressant with strong anticholinergic
properties that significantly increase the risk of orthostatic hypotension in older adults.
The Beers Criteria specifically lists this drug as potentially inappropriate for the geriatric
, population due to the high risk of falls and fractures. Alternative treatments with better
safety profiles, such as SSRIs, should be considered for depression management.
4. A patient with Stage IV lung cancer expresses a desire for symptom management without
curative intent. Which level of care is most appropriate to discuss?
A. Acute Rehabilitation
B. Palliative Care
C. Skilled Nursing Facility
D. Hospice Care
Answer: D
Rationale: Hospice care is specifically designed for patients with a terminal prognosis of
six months or less who have chosen to forgo curative treatments. The focus is entirely on
comfort, quality of life, and support for the family during the end-of-life process. Palliative
care could be used earlier in the disease trajectory, but hospice is the definitive choice for
terminal management.
5. Which screening tool is most appropriate for identifying cognitive impairment during a
Medicare Wellness Visit?
A. PHQ-9
B. CAGE Questionnaire
C. GDS
