NUR 600 Advanced Clinical Pharmacology and
Assessment Module 5 Exam St. Thomas
University Actual Exam 2026/2027 | Complete
Exam-Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
SECTION 1: Advanced Health Assessment & Diagnostic Reasoning
(Cardiovascular, Respiratory, Neurological, GI) — 40 Questions
Q1: A 45-year-old patient presents with substernal chest pain radiating to the left arm,
associated with diaphoresis and nausea. The pain began 30 minutes ago while at rest.
What is the most appropriate initial management?
A. Administer morphine and wait for troponin results
B. Administer aspirin 325 mg chewed and obtain a STAT ECG
C. Administer nitroglycerin sublingually and observe for 30 minutes
D. Order a chest x-ray and complete blood count
Correct Answer: B
Rationale: Correct because the initial management for acute coronary syndrome (ACS)
includes administering aspirin 325 mg chewed to reduce platelet aggregation and
obtaining a STAT ECG to evaluate for ST-segment elevation or other ischemic changes.
This matches NUR 600 Module 5 content on ACS management protocols.
Q2: A 68-year-old patient has progressive shortness of breath with exertion, orthopnea,
paroxysmal nocturnal dyspnea, jugular venous distention, crackles in both lung bases,
and 2+ pitting edema in the lower extremities. What is the most likely diagnosis?
A. Chronic obstructive pulmonary disease
B. Heart failure with reduced ejection fraction (HFrEF)
C. Pulmonary embolism
D. Acute respiratory distress syndrome
Correct Answer: B
,Rationale: Correct because the combination of orthopnea, paroxysmal nocturnal
dyspnea, jugular venous distention, crackles, and peripheral edema constitutes classic
findings for heart failure with reduced ejection fraction (HFrEF). The initial management
for ACS includes these diagnostic criteria per ACC/AHA guidelines.
Q3: A patient presents with a sudden, severe "thunderclap" headache described as "the
worst headache of my life." What is the initial diagnostic test of choice?
A. Magnetic resonance angiography (MRA)
B. Non-contrast CT head
C. Lumbar puncture
D. Carotid duplex ultrasound
Correct Answer: B
Rationale: Correct because a thunderclap headache requires immediate rule-out of
subarachnoid hemorrhage; non-contrast CT head is the initial test, followed by lumbar
puncture if negative. This matches NUR 600 Module 5 content on neurological
emergency assessment.
Q4: A 30-year-old patient presents with right lower quadrant pain, nausea, and low-grade
fever. What is the most likely diagnosis?
A. Diverticulitis
B. Appendicitis
C. Crohn's disease
D. Ectopic pregnancy
Correct Answer: B
Rationale: Correct because right lower quadrant pain with nausea and low-grade fever in
a young adult is the classic presentation for appendicitis. This matches NUR 600
Module 5 content on gastrointestinal assessment.
Q5: A 55-year-old patient with a history of hypertension presents with tearing chest pain
radiating to the back. Blood pressure is 180/110 mmHg in the right arm and 150/90
mmHg in the left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
,Correct Answer: B
Rationale: Correct because tearing chest pain radiating to the back with unequal blood
pressures in the arms is the classic presentation for aortic dissection. This matches
NUR 600 Module 5 content on cardiovascular emergency assessment.
Q6: A patient presents with unilateral facial droop, slurred speech, and right-sided
weakness. Symptoms began 45 minutes ago. What is the priority initial action?
A. Order a CT head without contrast to rule out hemorrhage
B. Administer tissue plasminogen activator (tPA) immediately
C. Obtain a complete metabolic panel and wait for results
D. Perform a lumbar puncture to rule out infection
Correct Answer: A
Rationale: Correct because the priority initial action for suspected stroke is a
non-contrast CT head to differentiate between ischemic and hemorrhagic stroke before
considering thrombolytic therapy. This matches NUR 600 Module 5 content on
neurological emergency protocols.
Q7: A 62-year-old patient presents with sharp, pleuritic chest pain that worsens with
inspiration and is associated with dyspnea and tachycardia. What is the most likely
diagnosis?
A. Acute coronary syndrome
B. Pulmonary embolism
C. Aortic dissection
D. Pneumothorax
Correct Answer: B
Rationale: Correct because sharp, pleuritic chest pain worsening with inspiration,
combined with dyspnea and tachycardia, is the classic triad for pulmonary embolism.
This matches NUR 600 Module 5 content on respiratory emergency assessment.
Q8: A patient with a history of atrial fibrillation presents with acute onset of left-sided
weakness and aphasia. What is the most likely etiology?
A. Hemorrhagic stroke
B. Cardioembolic stroke
C. Lacunar infarct
D. Subarachnoid hemorrhage
, Correct Answer: B
Rationale: Correct because atrial fibrillation predisposes to cardioembolic stroke due to
stasis and thrombus formation in the left atrial appendage. This matches NUR 600
Module 5 content on cardiovascular complications.
Q9: A 40-year-old patient presents with epigastric pain that radiates to the back,
worsens after meals, and is associated with nausea and vomiting. Serum lipase is
elevated. What is the most likely diagnosis?
A. Peptic ulcer disease
B. Acute pancreatitis
C. Cholecystitis
D. Gastroesophageal reflux disease
Correct Answer: B
Rationale: Correct because epigastric pain radiating to the back with elevated serum
lipase is diagnostic of acute pancreatitis. This matches NUR 600 Module 5 content on
gastrointestinal disorders.
Q10: A patient presents with progressive dyspnea, nonproductive cough, and bilateral
crackles on auscultation. Chest x-ray shows bilateral interstitial infiltrates. What is the
most likely diagnosis?
A. Community-acquired pneumonia
B. Acute respiratory distress syndrome (ARDS)
C. Congestive heart failure
D. Pulmonary fibrosis
Correct Answer: B
Rationale: Correct because progressive dyspnea with bilateral interstitial infiltrates and
nonproductive cough in the absence of cardiac failure is consistent with acute
respiratory distress syndrome (ARDS). This matches NUR 600 Module 5 content on
respiratory assessment.
Q11: A 50-year-old patient presents with severe abdominal pain out of proportion to
physical examination findings. The patient has a history of atrial fibrillation. What is the
most likely diagnosis?
A. Acute appendicitis
B. Acute mesenteric ischemia
Assessment Module 5 Exam St. Thomas
University Actual Exam 2026/2027 | Complete
Exam-Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
SECTION 1: Advanced Health Assessment & Diagnostic Reasoning
(Cardiovascular, Respiratory, Neurological, GI) — 40 Questions
Q1: A 45-year-old patient presents with substernal chest pain radiating to the left arm,
associated with diaphoresis and nausea. The pain began 30 minutes ago while at rest.
What is the most appropriate initial management?
A. Administer morphine and wait for troponin results
B. Administer aspirin 325 mg chewed and obtain a STAT ECG
C. Administer nitroglycerin sublingually and observe for 30 minutes
D. Order a chest x-ray and complete blood count
Correct Answer: B
Rationale: Correct because the initial management for acute coronary syndrome (ACS)
includes administering aspirin 325 mg chewed to reduce platelet aggregation and
obtaining a STAT ECG to evaluate for ST-segment elevation or other ischemic changes.
This matches NUR 600 Module 5 content on ACS management protocols.
Q2: A 68-year-old patient has progressive shortness of breath with exertion, orthopnea,
paroxysmal nocturnal dyspnea, jugular venous distention, crackles in both lung bases,
and 2+ pitting edema in the lower extremities. What is the most likely diagnosis?
A. Chronic obstructive pulmonary disease
B. Heart failure with reduced ejection fraction (HFrEF)
C. Pulmonary embolism
D. Acute respiratory distress syndrome
Correct Answer: B
,Rationale: Correct because the combination of orthopnea, paroxysmal nocturnal
dyspnea, jugular venous distention, crackles, and peripheral edema constitutes classic
findings for heart failure with reduced ejection fraction (HFrEF). The initial management
for ACS includes these diagnostic criteria per ACC/AHA guidelines.
Q3: A patient presents with a sudden, severe "thunderclap" headache described as "the
worst headache of my life." What is the initial diagnostic test of choice?
A. Magnetic resonance angiography (MRA)
B. Non-contrast CT head
C. Lumbar puncture
D. Carotid duplex ultrasound
Correct Answer: B
Rationale: Correct because a thunderclap headache requires immediate rule-out of
subarachnoid hemorrhage; non-contrast CT head is the initial test, followed by lumbar
puncture if negative. This matches NUR 600 Module 5 content on neurological
emergency assessment.
Q4: A 30-year-old patient presents with right lower quadrant pain, nausea, and low-grade
fever. What is the most likely diagnosis?
A. Diverticulitis
B. Appendicitis
C. Crohn's disease
D. Ectopic pregnancy
Correct Answer: B
Rationale: Correct because right lower quadrant pain with nausea and low-grade fever in
a young adult is the classic presentation for appendicitis. This matches NUR 600
Module 5 content on gastrointestinal assessment.
Q5: A 55-year-old patient with a history of hypertension presents with tearing chest pain
radiating to the back. Blood pressure is 180/110 mmHg in the right arm and 150/90
mmHg in the left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
,Correct Answer: B
Rationale: Correct because tearing chest pain radiating to the back with unequal blood
pressures in the arms is the classic presentation for aortic dissection. This matches
NUR 600 Module 5 content on cardiovascular emergency assessment.
Q6: A patient presents with unilateral facial droop, slurred speech, and right-sided
weakness. Symptoms began 45 minutes ago. What is the priority initial action?
A. Order a CT head without contrast to rule out hemorrhage
B. Administer tissue plasminogen activator (tPA) immediately
C. Obtain a complete metabolic panel and wait for results
D. Perform a lumbar puncture to rule out infection
Correct Answer: A
Rationale: Correct because the priority initial action for suspected stroke is a
non-contrast CT head to differentiate between ischemic and hemorrhagic stroke before
considering thrombolytic therapy. This matches NUR 600 Module 5 content on
neurological emergency protocols.
Q7: A 62-year-old patient presents with sharp, pleuritic chest pain that worsens with
inspiration and is associated with dyspnea and tachycardia. What is the most likely
diagnosis?
A. Acute coronary syndrome
B. Pulmonary embolism
C. Aortic dissection
D. Pneumothorax
Correct Answer: B
Rationale: Correct because sharp, pleuritic chest pain worsening with inspiration,
combined with dyspnea and tachycardia, is the classic triad for pulmonary embolism.
This matches NUR 600 Module 5 content on respiratory emergency assessment.
Q8: A patient with a history of atrial fibrillation presents with acute onset of left-sided
weakness and aphasia. What is the most likely etiology?
A. Hemorrhagic stroke
B. Cardioembolic stroke
C. Lacunar infarct
D. Subarachnoid hemorrhage
, Correct Answer: B
Rationale: Correct because atrial fibrillation predisposes to cardioembolic stroke due to
stasis and thrombus formation in the left atrial appendage. This matches NUR 600
Module 5 content on cardiovascular complications.
Q9: A 40-year-old patient presents with epigastric pain that radiates to the back,
worsens after meals, and is associated with nausea and vomiting. Serum lipase is
elevated. What is the most likely diagnosis?
A. Peptic ulcer disease
B. Acute pancreatitis
C. Cholecystitis
D. Gastroesophageal reflux disease
Correct Answer: B
Rationale: Correct because epigastric pain radiating to the back with elevated serum
lipase is diagnostic of acute pancreatitis. This matches NUR 600 Module 5 content on
gastrointestinal disorders.
Q10: A patient presents with progressive dyspnea, nonproductive cough, and bilateral
crackles on auscultation. Chest x-ray shows bilateral interstitial infiltrates. What is the
most likely diagnosis?
A. Community-acquired pneumonia
B. Acute respiratory distress syndrome (ARDS)
C. Congestive heart failure
D. Pulmonary fibrosis
Correct Answer: B
Rationale: Correct because progressive dyspnea with bilateral interstitial infiltrates and
nonproductive cough in the absence of cardiac failure is consistent with acute
respiratory distress syndrome (ARDS). This matches NUR 600 Module 5 content on
respiratory assessment.
Q11: A 50-year-old patient presents with severe abdominal pain out of proportion to
physical examination findings. The patient has a history of atrial fibrillation. What is the
most likely diagnosis?
A. Acute appendicitis
B. Acute mesenteric ischemia
