MARYVILLE NUR 615 CORE EXAM SET 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔To which client would the APN use caution in prescribing lithium to a client newly
diagnosed with bipolar disorder?
a. A 23-year old with an addition antidepressant medication.
b. A 42-year old taking a loop diuretic.
c. A 54-year old on a 4pm sodium diet.
d. A 30-year old with a urine output of 40mL/hr. - ✔✔b. A 42-year old taking a loop
diuretic.
✔✔An appropriate noncontrolled medication to prescribe for mild to moderate
generalized anxiety disorder is:
a. Sertraline (Zoloft).
b. Amitriptyline (Elavil).
c. Diazepam (Valium).
d. Alprazolam (Xanax). - ✔✔a. Sertraline (Zoloft).
✔✔Which of the following should be avoided when on a SSRI?
a. Aged blue-cheese.
b. Alcohol.
c. Green leafy vegetables.
d. Grapefruit. - ✔✔b. Alcohol.
✔✔A 64-year-old patient diagnosed with Alzheimer disease (AD) has been prescribed
donepezil 10mg/daily since displaying mild cognitive impairment 2 months ago.
Recently, the patient has begun to demonstrate problems with language and becomes
very disoriented and agitated with even slight deviations from the daily routine. Which
precription-related change should the healthcare provider discuss with the patient and
spouse?
a. Discontinuing donepezil while prescribing an alternative cholinesterase inhibitor.
b. Possibility of discontinuing donepezil entirely.
c. Changing the donepezil prescription to 5mg twice daily.
d. Increasing the dosage of donepezil to 15 mg daily. - ✔✔b. Possibility of discontinuing
donepezil entirely.
✔✔A practitioner is prescribing duloxetine (Cymbalta) for a patient with depression.
What class of drug is the agent?
a. Atypical.
b. Serotonin-norepinephrine reuptake inhibitors.
c. Selective serotonin reuptake inhibitors.
d. Tricyclic antidepressants. - ✔✔b. Serotonin-norepinephrine reuptake inhibitors.
,✔✔A 6-year-old child has been diagnosed with severe attention-deficient/hyperactivity
disorder (ADHD). Which intervention(s) will the healthcare provider consider for
includion in the child's plan of care?
a. Family counseling.
b. Bupropion.
c. Methylphenidate.
d. Atomexetine. - ✔✔c. Methylphenidate.
✔✔The healthcare provider is prescribing an antiarrhythmic drug (AAD) for a newly
diagnosed 72-year-old patient. Which intervention should the provider implement to best
maximize the patient's participation in a safe drug therapy regimen?
a. Encouraging the patient to keep all follow-up appointments with the health care
provider.
b. Discussing the importance of taking the medication as prescribed.
c. Encouraging the patient to stay well hydrated.
d. Assessing the patient's understanding of the physical signs of cardiac arrhythmic
activity. - ✔✔b. Discussing the importance of taking the medication as prescribed.
✔✔When discussing first-line therapy for paroxysmal supraventricular tachycardia
(PSVT), what patient-performed intervention would the health care provider describe?
Select all that apply.
a. Pinching off the nose, closing the mouth, and exhaling forcefully.
b. Massaging the carotid sinus.
c. Triggering the gag response.
d. Immersing the face in ice water.
e. Forcefully coughing. - ✔✔a. Pinching off the nose, closing the mouth, and exhaling
forcefully.
c. Triggering the gag response.
d. Immersing the face in ice water.
e. Forcefully coughing.
✔✔Blood pressure is controlled by the following mechanisms? (Select all that apply).
a. Difference between the systolic and diastolic readings.
b. Reflex control of blood volume.
c. The capacitance system.
d. Aldosterone-Antidiuretic hormone (ADH) system.
e. Stimulus from the sympathetic system. - ✔✔b. Reflex control of blood volume.
d. Aldosterone-Antidiuretic hormone (ADH) system.
e. Stimulus from the sympathetic system.
✔✔The APN, caring for a patient taking a beta-blocker and a nitrate to treat angina,
recognizes the need for careful monitoring as the result of what secondary diagnosis?
a. Rheumatoid arthritis (RA).
b. Irritable bowel syndrome (IBS).
c. Chronic urinary tract infection (UTI).
,d. Chronic obstructive pulmonary disease (COPD). - ✔✔d. Chronic obstructive
pulmonary disease (COPD).
✔✔Which patient(s) present(s) with a secondary risk factor for hyperlipidemia and, thus,
require(s) treatment? Select all that apply.
a. Patient prescribed metoprolol 5 years ago.
b. 27-year-old pregnant patient.
c. Patient diagnosed with type 2 diabetes.
d. 56-year-old patient with a family history of hyperlipidemia.
e. Patient who has been smoking for 10 years. - ✔✔a. Patient prescribed metoprolol 5
years ago.
b. 27-year-old pregnant patient.
c. Patient diagnosed with type 2 diabetes.
e. Patient who has been smoking for 10 years.
✔✔Which statin is the most likely to decrease low density lipoprotein (LDL) levels by
60%?
a. Fluvastatin.
b. Atorvastatin.
c. Pravastatin.
d. Lovastatin. - ✔✔b. Atorvastatin.
✔✔Which of the following medications is a beta-adrenergic receptor agonist?
a. Hydrochlorothiazide.
b. Spironolactone (Aldactone).
c. Clonidine (Catapres).
d. Carvedilol (Coreg). - ✔✔d. Carvedilol (Coreg).
✔✔A patient has been prescribed amiodarone. The APN knows that the
pharmacokinetic effect is as follows:
a. Prolongs action potential decreasing conduction through the AV node.
b. Decrease in cyclic adenosine monophosphate (cAMP).
c. Decrease in cAMP.
d. Increase in cardiac preload. - ✔✔a. Prolongs action potential decreasing conduction
through the AV node.
✔✔The APN is referring patient to the ER with a diagnosis of acute renal failure. While
collecting the medical history the patient reveals he was taking Pravastatin to reduce
lipid levels and enjoyed a glass of grapefruit juice every morning. The patient complains
of muscle pain. What does the APN suspect is the cause of the patient's renal failure?
a. Diabetes.
b. Congestive heart failure.
c. Gastric ulceration.
d. Drug toxicity. - ✔✔d. Drug toxicity.
, ✔✔What would the advanced practice nurse teach the diabetic patient to monitor for
when beginning a class II antidysrhythmics drug regiment in addition to insulin?
a. Weight loss.
b. Exercise intolerance.
c. Hypoglycemia.
d. Reduced peripheral perfusion. - ✔✔c. Hypoglycemia.
✔✔What classification of anti-hypertensive drugs is the most effective for treating
hypertension in African American clients?
a. ACE inhibitors.
b. Diuretics.
c. Beta blockers.
d. Alpha-adrenergic blockers. - ✔✔b. Diuretics.
✔✔The health care provider has prescribed chlorthialidones for initial treatment of
hypertension. What factor would be considered when determining the appropriateness
of this prescription?
a. Creatinine clearance of 100 mL/min/1.73 m2.
b. History of gout.
c. Family history of type 2 diabetes.
d. Reports experiencing tinnitus. - ✔✔a. Creatinine clearance of 100 mL/min/1.73 m2.
✔✔Beta blockers treat hypertension because they:
a. Reduce peripheral resistance.
b. Vasoconstrict coronary arteries.
c. Reduce angiotensin II production.
d. Reduce norepinephrine. - ✔✔a. Reduce peripheral resistance.
✔✔The APN reviews the patient's medical history and determines class II
antiarrhythmics are contraindicated due to the patient's history of what condition?
a. Migraine headaches.
b. Colitis.
c. Asthma.
d. Antidiarrheals. - ✔✔c. Asthma.
✔✔What are the JNC-8 recommendations for treating elevated triglycerides?
a. Treatment should be with combination therapy with a statin and fenodibrate.
b. Use a bile acid sequestrant.
c. Focus on lifestyle changes as initial therapy.
d. Aggressively treat with fenofibrated. - ✔✔c. Focus on lifestyle changes as initial
therapy.
✔✔Which patient population is more likely to experience myalgia (muscle pain) or
myopathy with use of HMG-CoA reducatase inhibitors?
QUESTIONS AND SOLUTIONS RATED A+
✔✔To which client would the APN use caution in prescribing lithium to a client newly
diagnosed with bipolar disorder?
a. A 23-year old with an addition antidepressant medication.
b. A 42-year old taking a loop diuretic.
c. A 54-year old on a 4pm sodium diet.
d. A 30-year old with a urine output of 40mL/hr. - ✔✔b. A 42-year old taking a loop
diuretic.
✔✔An appropriate noncontrolled medication to prescribe for mild to moderate
generalized anxiety disorder is:
a. Sertraline (Zoloft).
b. Amitriptyline (Elavil).
c. Diazepam (Valium).
d. Alprazolam (Xanax). - ✔✔a. Sertraline (Zoloft).
✔✔Which of the following should be avoided when on a SSRI?
a. Aged blue-cheese.
b. Alcohol.
c. Green leafy vegetables.
d. Grapefruit. - ✔✔b. Alcohol.
✔✔A 64-year-old patient diagnosed with Alzheimer disease (AD) has been prescribed
donepezil 10mg/daily since displaying mild cognitive impairment 2 months ago.
Recently, the patient has begun to demonstrate problems with language and becomes
very disoriented and agitated with even slight deviations from the daily routine. Which
precription-related change should the healthcare provider discuss with the patient and
spouse?
a. Discontinuing donepezil while prescribing an alternative cholinesterase inhibitor.
b. Possibility of discontinuing donepezil entirely.
c. Changing the donepezil prescription to 5mg twice daily.
d. Increasing the dosage of donepezil to 15 mg daily. - ✔✔b. Possibility of discontinuing
donepezil entirely.
✔✔A practitioner is prescribing duloxetine (Cymbalta) for a patient with depression.
What class of drug is the agent?
a. Atypical.
b. Serotonin-norepinephrine reuptake inhibitors.
c. Selective serotonin reuptake inhibitors.
d. Tricyclic antidepressants. - ✔✔b. Serotonin-norepinephrine reuptake inhibitors.
,✔✔A 6-year-old child has been diagnosed with severe attention-deficient/hyperactivity
disorder (ADHD). Which intervention(s) will the healthcare provider consider for
includion in the child's plan of care?
a. Family counseling.
b. Bupropion.
c. Methylphenidate.
d. Atomexetine. - ✔✔c. Methylphenidate.
✔✔The healthcare provider is prescribing an antiarrhythmic drug (AAD) for a newly
diagnosed 72-year-old patient. Which intervention should the provider implement to best
maximize the patient's participation in a safe drug therapy regimen?
a. Encouraging the patient to keep all follow-up appointments with the health care
provider.
b. Discussing the importance of taking the medication as prescribed.
c. Encouraging the patient to stay well hydrated.
d. Assessing the patient's understanding of the physical signs of cardiac arrhythmic
activity. - ✔✔b. Discussing the importance of taking the medication as prescribed.
✔✔When discussing first-line therapy for paroxysmal supraventricular tachycardia
(PSVT), what patient-performed intervention would the health care provider describe?
Select all that apply.
a. Pinching off the nose, closing the mouth, and exhaling forcefully.
b. Massaging the carotid sinus.
c. Triggering the gag response.
d. Immersing the face in ice water.
e. Forcefully coughing. - ✔✔a. Pinching off the nose, closing the mouth, and exhaling
forcefully.
c. Triggering the gag response.
d. Immersing the face in ice water.
e. Forcefully coughing.
✔✔Blood pressure is controlled by the following mechanisms? (Select all that apply).
a. Difference between the systolic and diastolic readings.
b. Reflex control of blood volume.
c. The capacitance system.
d. Aldosterone-Antidiuretic hormone (ADH) system.
e. Stimulus from the sympathetic system. - ✔✔b. Reflex control of blood volume.
d. Aldosterone-Antidiuretic hormone (ADH) system.
e. Stimulus from the sympathetic system.
✔✔The APN, caring for a patient taking a beta-blocker and a nitrate to treat angina,
recognizes the need for careful monitoring as the result of what secondary diagnosis?
a. Rheumatoid arthritis (RA).
b. Irritable bowel syndrome (IBS).
c. Chronic urinary tract infection (UTI).
,d. Chronic obstructive pulmonary disease (COPD). - ✔✔d. Chronic obstructive
pulmonary disease (COPD).
✔✔Which patient(s) present(s) with a secondary risk factor for hyperlipidemia and, thus,
require(s) treatment? Select all that apply.
a. Patient prescribed metoprolol 5 years ago.
b. 27-year-old pregnant patient.
c. Patient diagnosed with type 2 diabetes.
d. 56-year-old patient with a family history of hyperlipidemia.
e. Patient who has been smoking for 10 years. - ✔✔a. Patient prescribed metoprolol 5
years ago.
b. 27-year-old pregnant patient.
c. Patient diagnosed with type 2 diabetes.
e. Patient who has been smoking for 10 years.
✔✔Which statin is the most likely to decrease low density lipoprotein (LDL) levels by
60%?
a. Fluvastatin.
b. Atorvastatin.
c. Pravastatin.
d. Lovastatin. - ✔✔b. Atorvastatin.
✔✔Which of the following medications is a beta-adrenergic receptor agonist?
a. Hydrochlorothiazide.
b. Spironolactone (Aldactone).
c. Clonidine (Catapres).
d. Carvedilol (Coreg). - ✔✔d. Carvedilol (Coreg).
✔✔A patient has been prescribed amiodarone. The APN knows that the
pharmacokinetic effect is as follows:
a. Prolongs action potential decreasing conduction through the AV node.
b. Decrease in cyclic adenosine monophosphate (cAMP).
c. Decrease in cAMP.
d. Increase in cardiac preload. - ✔✔a. Prolongs action potential decreasing conduction
through the AV node.
✔✔The APN is referring patient to the ER with a diagnosis of acute renal failure. While
collecting the medical history the patient reveals he was taking Pravastatin to reduce
lipid levels and enjoyed a glass of grapefruit juice every morning. The patient complains
of muscle pain. What does the APN suspect is the cause of the patient's renal failure?
a. Diabetes.
b. Congestive heart failure.
c. Gastric ulceration.
d. Drug toxicity. - ✔✔d. Drug toxicity.
, ✔✔What would the advanced practice nurse teach the diabetic patient to monitor for
when beginning a class II antidysrhythmics drug regiment in addition to insulin?
a. Weight loss.
b. Exercise intolerance.
c. Hypoglycemia.
d. Reduced peripheral perfusion. - ✔✔c. Hypoglycemia.
✔✔What classification of anti-hypertensive drugs is the most effective for treating
hypertension in African American clients?
a. ACE inhibitors.
b. Diuretics.
c. Beta blockers.
d. Alpha-adrenergic blockers. - ✔✔b. Diuretics.
✔✔The health care provider has prescribed chlorthialidones for initial treatment of
hypertension. What factor would be considered when determining the appropriateness
of this prescription?
a. Creatinine clearance of 100 mL/min/1.73 m2.
b. History of gout.
c. Family history of type 2 diabetes.
d. Reports experiencing tinnitus. - ✔✔a. Creatinine clearance of 100 mL/min/1.73 m2.
✔✔Beta blockers treat hypertension because they:
a. Reduce peripheral resistance.
b. Vasoconstrict coronary arteries.
c. Reduce angiotensin II production.
d. Reduce norepinephrine. - ✔✔a. Reduce peripheral resistance.
✔✔The APN reviews the patient's medical history and determines class II
antiarrhythmics are contraindicated due to the patient's history of what condition?
a. Migraine headaches.
b. Colitis.
c. Asthma.
d. Antidiarrheals. - ✔✔c. Asthma.
✔✔What are the JNC-8 recommendations for treating elevated triglycerides?
a. Treatment should be with combination therapy with a statin and fenodibrate.
b. Use a bile acid sequestrant.
c. Focus on lifestyle changes as initial therapy.
d. Aggressively treat with fenofibrated. - ✔✔c. Focus on lifestyle changes as initial
therapy.
✔✔Which patient population is more likely to experience myalgia (muscle pain) or
myopathy with use of HMG-CoA reducatase inhibitors?
