NR 601 Primary Care of Adults Final Exam
Study Pack (2026/2027) | Updated |
Verified Test Bank with 300+ Q&A
with Correct Answers |Latest update
Mr. A, experienced a brief onset of right sided weakness, slurred speech and
confusion yesterday. The symptoms have resolved and the CT is normal. What is
the next step of the plan for Mr. A?
a. assure the patient that he will not experience the symptoms again
b. identify modifiable cardiovascular risk factors
c. order ASA 81mg stat
d. order a stat EEG and administer O2 by mask
Answer: b. identify modifiable cardiovascular risk factors
Expert Rationale
Mr. A's presentation of transient right-sided weakness, slurred speech, and
confusion with spontaneous resolution and a normal CT is consistent with a
,transient ischemic attack (TIA). A TIA is a critical warning sign of an impending
stroke, with a 10–20% risk of stroke within 90 days. The immediate next step is to
identify and aggressively manage modifiable cardiovascular risk factors, including
hypertension, hyperlipidemia, diabetes, smoking, and obesity, to prevent a future
stroke. Option A (assure the patient that he will not experience the symptoms
again) is incorrect and unsafe; TIA is a warning sign, and the risk of recurrence is
significant. Option C (order ASA 81mg stat) may be appropriate after risk
stratification but is not the first step; identifying risk factors and initiating
appropriate antiplatelet therapy is part of a comprehensive secondary prevention
plan. Option D (order a stat EEG and administer O2 by mask) is not indicated; the
CT is already normal, and oxygen is not routinely indicated for TIA. The NP should
perform a thorough cardiovascular risk assessment, initiate appropriate therapy
(antiplatelet, statin, blood pressure control), and consider urgent carotid imaging
and cardiology evaluation.
DIF: Cognitive Level: Apply (Application) TOP: Transient Ischemic Attack/Stroke
Prevention MSC: NCLEX: Physiological Integrity
A 56-year old male patient screened for diabetes has a fasting plasma glucose
level of 96mg/dl. The nurse practitioner management plan includes:
a. repeat fasting plasma glucose in three years
b. prescribe Metformin 500mg po BID
c. repeat fasting plasma glucose in one year
d. refer to ophthalmology for eye exam
Answer: a. repeat fasting plasma glucose in three years
Expert Rationale
A fasting plasma glucose (FPG) level of 96 mg/dL is within the normal range (<100
mg/dL). According to the American Diabetes Association (ADA) guidelines, patients
with normal fasting glucose should be screened every three years. Option A is the
correct answer. Option B (prescribe Metformin) is not indicated because the
patient does not have diabetes or prediabetes (FPG 100–125 mg/dL is
prediabetes). Option C (repeat fasting glucose in one year) is recommended for
patients with prediabetes, not normal glucose. Option D (refer to ophthalmology
for eye exam) is not indicated for a patient with normal glucose. The NP should
,provide lifestyle counseling to maintain healthy glucose levels and reassess in three
years.
DIF: Cognitive Level: Apply (Application) TOP: Diabetes Screening MSC: NCLEX:
Health Promotion and Maintenance
RW, a 57 year old native American female, presents to the office. RW states she
feels irritable and has difficulty concentrating as well as falling asleep and staying
asleep. She states she is worried about her finances, her husband has just lost his
job. The NP diagnoses anxiety. The NP prescribes a first line treatment which is
a. Diazepam
b. Clonazepam
c. Aripiprazole
d. Paroxetine
Answer: d. Paroxetine
Expert Rationale
Paroxetine is a selective serotonin reuptake inhibitor (SSRI) that is a first-line
pharmacologic treatment for generalized anxiety disorder (GAD) and other anxiety
disorders. SSRIs are preferred over benzodiazepines due to their lower risk of
dependence, tolerance, and sedation. Option A (Diazepam) and Option B
(Clonazepam) are benzodiazepines, which are generally not first-line for anxiety
due to the risk of dependence, tolerance, and falls in older adults. Option C
(Aripiprazole) is an atypical antipsychotic and is not first-line for anxiety. The NP
should start paroxetine at a low dose, titrate slowly, monitor for side effects, and
combine pharmacotherapy with psychotherapy for optimal outcomes.
DIF: Cognitive Level: Apply (Application) TOP: Anxiety Management MSC: NCLEX:
Pharmacological and Parenteral Therapies
The most common sustained rhythmic disorder, which consists of fibrillatory p
waves is:
a. AV block
b. atrial tachycardia
c. atrial fibrillation
, d. atrial flutter
Answer: c. atrial fibrillation
Expert Rationale
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is
characterized by fibrillatory (irregular) P waves, loss of organized atrial activity, and
an irregularly irregular ventricular response. On electrocardiogram, AF shows no
discernible P waves, with a chaotic, irregular baseline (fibrillatory waves). Option A
(AV block) is characterized by delayed or absent conduction between the atria and
ventricles, not fibrillatory P waves. Option B (Atrial tachycardia) is a regular rhythm
with organized P waves, not fibrillatory. Option D (Atrial flutter) is characterized by
regular, sawtooth flutter waves, not fibrillatory P waves. The NP should recognize
AF as a significant stroke risk factor and manage with rate or rhythm control and
anticoagulation based on the patient's CHA₂DS₂-VASc score.
DIF: Cognitive Level: Remember (Knowledge) TOP: Cardiac Arrhythmias MSC:
NCLEX: Physiological Integrity
According to the Sexually presentation, atrophic vaginitis
a. the symptoms are the same for each woman
b. creates a more acidic vaginal environment
c. is a contributing factor for frequent urinary tract infections
d. is not treated with vaginal lubricants
Answer: c. is a contributing factor for frequent urinary tract infections
Expert Rationale
Atrophic vaginitis, caused by decreased estrogen levels in postmenopausal women,
leads to thinning, drying, and inflammation of the vaginal mucosa. This creates a
less acidic vaginal environment (higher pH), which predisposes women to recurrent
urinary tract infections (UTIs). Option A (the symptoms are the same for each
woman) is incorrect; symptoms vary widely and may include vaginal dryness,
dyspareunia, itching, and burning. Option B (creates a more acidic vaginal
environment) is incorrect; atrophic vaginitis creates a less acidic (more alkaline)
environment due to decreased glycogen and Lactobacillus. Option D (is not treated
with vaginal lubricants) is incorrect; vaginal lubricants and moisturizers are first-line
treatments. The NP should recognize atrophic vaginitis as a risk factor for UTIs and
Study Pack (2026/2027) | Updated |
Verified Test Bank with 300+ Q&A
with Correct Answers |Latest update
Mr. A, experienced a brief onset of right sided weakness, slurred speech and
confusion yesterday. The symptoms have resolved and the CT is normal. What is
the next step of the plan for Mr. A?
a. assure the patient that he will not experience the symptoms again
b. identify modifiable cardiovascular risk factors
c. order ASA 81mg stat
d. order a stat EEG and administer O2 by mask
Answer: b. identify modifiable cardiovascular risk factors
Expert Rationale
Mr. A's presentation of transient right-sided weakness, slurred speech, and
confusion with spontaneous resolution and a normal CT is consistent with a
,transient ischemic attack (TIA). A TIA is a critical warning sign of an impending
stroke, with a 10–20% risk of stroke within 90 days. The immediate next step is to
identify and aggressively manage modifiable cardiovascular risk factors, including
hypertension, hyperlipidemia, diabetes, smoking, and obesity, to prevent a future
stroke. Option A (assure the patient that he will not experience the symptoms
again) is incorrect and unsafe; TIA is a warning sign, and the risk of recurrence is
significant. Option C (order ASA 81mg stat) may be appropriate after risk
stratification but is not the first step; identifying risk factors and initiating
appropriate antiplatelet therapy is part of a comprehensive secondary prevention
plan. Option D (order a stat EEG and administer O2 by mask) is not indicated; the
CT is already normal, and oxygen is not routinely indicated for TIA. The NP should
perform a thorough cardiovascular risk assessment, initiate appropriate therapy
(antiplatelet, statin, blood pressure control), and consider urgent carotid imaging
and cardiology evaluation.
DIF: Cognitive Level: Apply (Application) TOP: Transient Ischemic Attack/Stroke
Prevention MSC: NCLEX: Physiological Integrity
A 56-year old male patient screened for diabetes has a fasting plasma glucose
level of 96mg/dl. The nurse practitioner management plan includes:
a. repeat fasting plasma glucose in three years
b. prescribe Metformin 500mg po BID
c. repeat fasting plasma glucose in one year
d. refer to ophthalmology for eye exam
Answer: a. repeat fasting plasma glucose in three years
Expert Rationale
A fasting plasma glucose (FPG) level of 96 mg/dL is within the normal range (<100
mg/dL). According to the American Diabetes Association (ADA) guidelines, patients
with normal fasting glucose should be screened every three years. Option A is the
correct answer. Option B (prescribe Metformin) is not indicated because the
patient does not have diabetes or prediabetes (FPG 100–125 mg/dL is
prediabetes). Option C (repeat fasting glucose in one year) is recommended for
patients with prediabetes, not normal glucose. Option D (refer to ophthalmology
for eye exam) is not indicated for a patient with normal glucose. The NP should
,provide lifestyle counseling to maintain healthy glucose levels and reassess in three
years.
DIF: Cognitive Level: Apply (Application) TOP: Diabetes Screening MSC: NCLEX:
Health Promotion and Maintenance
RW, a 57 year old native American female, presents to the office. RW states she
feels irritable and has difficulty concentrating as well as falling asleep and staying
asleep. She states she is worried about her finances, her husband has just lost his
job. The NP diagnoses anxiety. The NP prescribes a first line treatment which is
a. Diazepam
b. Clonazepam
c. Aripiprazole
d. Paroxetine
Answer: d. Paroxetine
Expert Rationale
Paroxetine is a selective serotonin reuptake inhibitor (SSRI) that is a first-line
pharmacologic treatment for generalized anxiety disorder (GAD) and other anxiety
disorders. SSRIs are preferred over benzodiazepines due to their lower risk of
dependence, tolerance, and sedation. Option A (Diazepam) and Option B
(Clonazepam) are benzodiazepines, which are generally not first-line for anxiety
due to the risk of dependence, tolerance, and falls in older adults. Option C
(Aripiprazole) is an atypical antipsychotic and is not first-line for anxiety. The NP
should start paroxetine at a low dose, titrate slowly, monitor for side effects, and
combine pharmacotherapy with psychotherapy for optimal outcomes.
DIF: Cognitive Level: Apply (Application) TOP: Anxiety Management MSC: NCLEX:
Pharmacological and Parenteral Therapies
The most common sustained rhythmic disorder, which consists of fibrillatory p
waves is:
a. AV block
b. atrial tachycardia
c. atrial fibrillation
, d. atrial flutter
Answer: c. atrial fibrillation
Expert Rationale
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is
characterized by fibrillatory (irregular) P waves, loss of organized atrial activity, and
an irregularly irregular ventricular response. On electrocardiogram, AF shows no
discernible P waves, with a chaotic, irregular baseline (fibrillatory waves). Option A
(AV block) is characterized by delayed or absent conduction between the atria and
ventricles, not fibrillatory P waves. Option B (Atrial tachycardia) is a regular rhythm
with organized P waves, not fibrillatory. Option D (Atrial flutter) is characterized by
regular, sawtooth flutter waves, not fibrillatory P waves. The NP should recognize
AF as a significant stroke risk factor and manage with rate or rhythm control and
anticoagulation based on the patient's CHA₂DS₂-VASc score.
DIF: Cognitive Level: Remember (Knowledge) TOP: Cardiac Arrhythmias MSC:
NCLEX: Physiological Integrity
According to the Sexually presentation, atrophic vaginitis
a. the symptoms are the same for each woman
b. creates a more acidic vaginal environment
c. is a contributing factor for frequent urinary tract infections
d. is not treated with vaginal lubricants
Answer: c. is a contributing factor for frequent urinary tract infections
Expert Rationale
Atrophic vaginitis, caused by decreased estrogen levels in postmenopausal women,
leads to thinning, drying, and inflammation of the vaginal mucosa. This creates a
less acidic vaginal environment (higher pH), which predisposes women to recurrent
urinary tract infections (UTIs). Option A (the symptoms are the same for each
woman) is incorrect; symptoms vary widely and may include vaginal dryness,
dyspareunia, itching, and burning. Option B (creates a more acidic vaginal
environment) is incorrect; atrophic vaginitis creates a less acidic (more alkaline)
environment due to decreased glycogen and Lactobacillus. Option D (is not treated
with vaginal lubricants) is incorrect; vaginal lubricants and moisturizers are first-line
treatments. The NP should recognize atrophic vaginitis as a risk factor for UTIs and
