NRNP 6531 Final Exam compilation Questions and Answers 100%Correct/Verified |2026-2027
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign should be used to identify the need to initiate
cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing ✔️Assessment of gasping breaths or not breathing
An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of
breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker ✔️Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks ✔️Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border. The provider determines that the
murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver.
Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse ✔️Hypertrophic cardiomyopathy
A patient is brought to an emergency department with symptoms of acute ST-segment elevation MI (STEMI). The nearest hospital that can
perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment ✔️Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those with a history of (Select all
that apply.)
previous myocardial infarction.
,a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. ✔️previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30 minutes or more. What the does
provider suspect as the cause for these symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease ✔️Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake ✔️Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider notes an apical systolic
murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests ✔️Consult with cardiology to determine appropriate diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea. During an exam, the provider notes a pulsatile abdominal mass. What is
the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
Ordering CT angiography ✔️US of the mass to determine size
A patient is brought to an emergency department with symptoms of acute ST-segment elevations MI (STEMI). The nearest hospital that can
perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
,Administer heparin
Transfer to the PCI-capable institution ✔️Initiate fibrinolytic treatment
A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness,
and nocturia and does not take any medications. What will the provider do next to evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study ✔️Order urinalysis, CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals partial obstruction in lower extremity arteries.
What will the provider recommend to help with relief of symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily ✔️Walking to the point of pain each day
An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70 beats per minute. What will
the provider do next?
Order an electrocardiogram and exercise stress test
Monitor the patient's heart rate while the patient is bearing down
Evaluate the patient's orthostatic vital signs
Reassure the patient that the symptoms are non-cardiac in origin ✔️Evaluate the patient's orthostatic vital signs
The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because most victims have which
arrhythmia?
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia ✔️Ventricular fibrillation
A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate of 225 beats per minute.
The provider notifies transport to take the child to the child emergency department. What initial intervention may be attempted in the clinic?
Administration of intravenous adenosine
Using a vagal maneuver or carotid massage
Providing a loading dose of digoxin
Giving a beta blocker ✔️Using a vagal maneuver or carotid massage
Current American Heart Association (AHA) recommendations include: (Select all that apply.)
Using a ratio of 2 rescue breaths to 30 compressions
A compression depth of 1.5 inches or more on an adult
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
, Rescue breaths given during 2 seconds to allow full chest rise ✔️Using a ratio of 2 rescue breaths to 30 compressions
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The provider administers a nitroglycerin
tablet which does not relieve the discomfort. What is the next action?
Prescribe a calcium channel blocker medication
Start aspirin therapy and refer the patient to a cardiologist
Give the patient a beta blocker medication
Administer a second nitroglycerin tablet ✔️Give the patient a beta blocker medication
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-controlled hypertension, and decompensated
heart failure. What is the recommendation for treatment for this patient?
No intervention is necessary for this patient
Immediate open surgical repair of the aneurysm
Endovascular stent grafting of the aneurysm
Serial ultrasonographic surveillance of the aneurysm ✔️Serial ultrasonographic surveillance of the aneurysm
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary
hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia ✔️Inappropriate secretion of PTH along with hypercalcemia
A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time. What initial diagnostic test will the
provider order in the clinic at this visit?
Hemoglobin A1C
Random serum glucose
C-peptide level
Thyroid studies ✔️Hemoglobin A1C
Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism? (normal TSH is 0.3-4)
0.2 uIU/L
4.2 uIU/L
0.4 uIU/L
2.4 uIU/L ✔️0.2 uIU/L
A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the following laboratory values: decreased TSH,
increased T3, and increased T4 and free T4. A pregnancy test is negative. What is the initial treatment for this patient?
Radioiodine therapy
Surgical resection of the thyroid gland
Beta blocker medications
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign should be used to identify the need to initiate
cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing ✔️Assessment of gasping breaths or not breathing
An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of
breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker ✔️Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks ✔️Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border. The provider determines that the
murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver.
Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse ✔️Hypertrophic cardiomyopathy
A patient is brought to an emergency department with symptoms of acute ST-segment elevation MI (STEMI). The nearest hospital that can
perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment ✔️Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those with a history of (Select all
that apply.)
previous myocardial infarction.
,a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. ✔️previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30 minutes or more. What the does
provider suspect as the cause for these symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease ✔️Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake ✔️Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider notes an apical systolic
murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests ✔️Consult with cardiology to determine appropriate diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea. During an exam, the provider notes a pulsatile abdominal mass. What is
the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
Ordering CT angiography ✔️US of the mass to determine size
A patient is brought to an emergency department with symptoms of acute ST-segment elevations MI (STEMI). The nearest hospital that can
perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Initiate fibrinolytic treatment
,Administer heparin
Transfer to the PCI-capable institution ✔️Initiate fibrinolytic treatment
A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness,
and nocturia and does not take any medications. What will the provider do next to evaluate this patient?
Continue to monitor blood pressure at each health maintenance visit
Assess serum cortisol levels
Order urinalysis, CBC, BUN and creatinine
Refer to specialist for sleep study ✔️Order urinalysis, CBC, BUN and creatinine
A patient is diagnosed with PAD and elects to not have angioplasty after an angiogram reveals partial obstruction in lower extremity arteries.
What will the provider recommend to help with relief of symptoms in this patient?
Statin therapy with clopidogrel
Walking to the point of pain each day
Daily aspirin therapy to prevent clotting
Walking slowly for 15 to 20 minutes twice daily ✔️Walking to the point of pain each day
An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70 beats per minute. What will
the provider do next?
Order an electrocardiogram and exercise stress test
Monitor the patient's heart rate while the patient is bearing down
Evaluate the patient's orthostatic vital signs
Reassure the patient that the symptoms are non-cardiac in origin ✔️Evaluate the patient's orthostatic vital signs
The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because most victims have which
arrhythmia?
Atrial flutter
Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia ✔️Ventricular fibrillation
A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate of 225 beats per minute.
The provider notifies transport to take the child to the child emergency department. What initial intervention may be attempted in the clinic?
Administration of intravenous adenosine
Using a vagal maneuver or carotid massage
Providing a loading dose of digoxin
Giving a beta blocker ✔️Using a vagal maneuver or carotid massage
Current American Heart Association (AHA) recommendations include: (Select all that apply.)
Using a ratio of 2 rescue breaths to 30 compressions
A compression depth of 1.5 inches or more on an adult
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
, Rescue breaths given during 2 seconds to allow full chest rise ✔️Using a ratio of 2 rescue breaths to 30 compressions
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The provider administers a nitroglycerin
tablet which does not relieve the discomfort. What is the next action?
Prescribe a calcium channel blocker medication
Start aspirin therapy and refer the patient to a cardiologist
Give the patient a beta blocker medication
Administer a second nitroglycerin tablet ✔️Give the patient a beta blocker medication
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-controlled hypertension, and decompensated
heart failure. What is the recommendation for treatment for this patient?
No intervention is necessary for this patient
Immediate open surgical repair of the aneurysm
Endovascular stent grafting of the aneurysm
Serial ultrasonographic surveillance of the aneurysm ✔️Serial ultrasonographic surveillance of the aneurysm
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary
hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia ✔️Inappropriate secretion of PTH along with hypercalcemia
A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time. What initial diagnostic test will the
provider order in the clinic at this visit?
Hemoglobin A1C
Random serum glucose
C-peptide level
Thyroid studies ✔️Hemoglobin A1C
Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism? (normal TSH is 0.3-4)
0.2 uIU/L
4.2 uIU/L
0.4 uIU/L
2.4 uIU/L ✔️0.2 uIU/L
A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the following laboratory values: decreased TSH,
increased T3, and increased T4 and free T4. A pregnancy test is negative. What is the initial treatment for this patient?
Radioiodine therapy
Surgical resection of the thyroid gland
Beta blocker medications
