NUR 6111 Advanced Practice Nursing – Exam 2 | Questions
and Answers + Expert Rationales | 2026 Updates | 100%
correct
Section 1: Tuberculosis & Pulmonary Infections
1. When reading a TST (PPD), all of the following indicate a positive test except:
A) HIV-positive patient with induration ≥ 5 mm
B) Recent close contact with TB patient with induration ≥ 5 mm
C) Healthy individual with induration ≥ 10 mm
D) Immunocompromised patient with induration ≥ 5 mm
Correct Answer: C
Expert Rationale:
For a healthy individual with no risk factors, a PPD induration of ≥15 mm is considered positive,
not 10 mm. The 10 mm threshold applies to high-risk groups (recent immigrants, IV drug users,
etc.). Options A, B, and D are correctly positive at ≥5 mm.
2. In the employee health office, you have diagnosed latent TB in an employee who has a
positive tuberculin skin test (TST), a positive QuantiFERON (QFT) test, and a chest x-ray that
shows no active disease. What other diagnostic test would you order before starting this
employee on INH therapy?
A) Renal function tests
B) Liver function tests (LFTs)
C) Complete blood count
D) Serum glucose
Correct Answer: B
Expert Rationale:
Isoniazid (INH) is hepatotoxic. Baseline liver function tests (LFTs) are required before starting
therapy, especially in patients with risk factors for liver disease or those over 35 years old.
,3. The estimated attributed cause of lung cancer from active cigarette smoking is:
A) 50%
B) 70%
C) 90%
D) 30%
Correct Answer: C
Expert Rationale:
Active cigarette smoking is responsible for approximately 90% of lung cancer cases in men and
70-80% in women, making it the single most significant risk factor.
4. Assessment finding of greatest concern in an individual who smokes with a chronic cough
that warrants CT scan is:
A) Cough duration of 2 weeks
B) Persistent cough or change in cough pattern
C) Productive cough with clear sputum
D) Cough worse in the morning
Correct Answer: B
Expert Rationale:
A persistent cough or change in a chronic cough in a smoker is an alarm symptom that warrants
imaging (CT scan) to rule out malignancy. New or changing symptoms are more concerning than
stable chronic cough.
5. As a primary care clinician, recommendations you would give a patient for smoking
cessation would be all of the following except:
A) Recommend nicotine replacement therapy
B) Refer to a smoking cessation program
C) Recommend against e-cigarettes as a first-line cessation tool
D) Prescribe bupropion or varenicline
Correct Answer: C
Expert Rationale:
While e-cigarettes are not FDA-approved for cessation, the statement “recommend against e-
cigs” is too absolute. The current evidence supports pharmacotherapy (NRT, bupropion,
, varenicline) and behavioral counseling. E-cigarettes are not recommended as first-line, but the
wording “recommend against” is not a standard global recommendation. However, according to
CDC and USPSTF guidelines, e-cigarettes are not recommended for cessation, so this is the
exception.
6. Bacterial causes of acute bronchitis include all of the following except:
A) Mycoplasma pneumoniae
B) Chlamydophila pneumoniae
C) Streptococcus pneumoniae
D) Pneumocystis jirovecii
Correct Answer: D
Expert Rationale:
Pneumocystis jirovecii is not a cause of acute bronchitis; it causes pneumonia in
immunocompromised hosts. The others are atypical or typical bacterial causes of bronchitis.
7. All of the following are expected symptoms of pneumonia EXCEPT:
A) Cough with purulent sputum
B) Fever and chills
C) Altered mental status
D) Pleuritic chest pain
Correct Answer: C (Note: This question requires careful reading; altered mental status is NOT a
typical expected symptom in an otherwise healthy patient, though it can occur in the elderly)
Expert Rationale:
Typical pneumonia symptoms include cough, fever, chills, and pleuritic chest pain. Altered
mental status is more common in elderly patients or those with severe illness and is not an
“expected” symptom in all patients.
8. Which of the following is done to confirm a diagnosis of pneumonia?
A) Sputum culture
B) Chest X-ray / Chest radiograph
C) CT scan of the chest
D) Bronchoscopy
and Answers + Expert Rationales | 2026 Updates | 100%
correct
Section 1: Tuberculosis & Pulmonary Infections
1. When reading a TST (PPD), all of the following indicate a positive test except:
A) HIV-positive patient with induration ≥ 5 mm
B) Recent close contact with TB patient with induration ≥ 5 mm
C) Healthy individual with induration ≥ 10 mm
D) Immunocompromised patient with induration ≥ 5 mm
Correct Answer: C
Expert Rationale:
For a healthy individual with no risk factors, a PPD induration of ≥15 mm is considered positive,
not 10 mm. The 10 mm threshold applies to high-risk groups (recent immigrants, IV drug users,
etc.). Options A, B, and D are correctly positive at ≥5 mm.
2. In the employee health office, you have diagnosed latent TB in an employee who has a
positive tuberculin skin test (TST), a positive QuantiFERON (QFT) test, and a chest x-ray that
shows no active disease. What other diagnostic test would you order before starting this
employee on INH therapy?
A) Renal function tests
B) Liver function tests (LFTs)
C) Complete blood count
D) Serum glucose
Correct Answer: B
Expert Rationale:
Isoniazid (INH) is hepatotoxic. Baseline liver function tests (LFTs) are required before starting
therapy, especially in patients with risk factors for liver disease or those over 35 years old.
,3. The estimated attributed cause of lung cancer from active cigarette smoking is:
A) 50%
B) 70%
C) 90%
D) 30%
Correct Answer: C
Expert Rationale:
Active cigarette smoking is responsible for approximately 90% of lung cancer cases in men and
70-80% in women, making it the single most significant risk factor.
4. Assessment finding of greatest concern in an individual who smokes with a chronic cough
that warrants CT scan is:
A) Cough duration of 2 weeks
B) Persistent cough or change in cough pattern
C) Productive cough with clear sputum
D) Cough worse in the morning
Correct Answer: B
Expert Rationale:
A persistent cough or change in a chronic cough in a smoker is an alarm symptom that warrants
imaging (CT scan) to rule out malignancy. New or changing symptoms are more concerning than
stable chronic cough.
5. As a primary care clinician, recommendations you would give a patient for smoking
cessation would be all of the following except:
A) Recommend nicotine replacement therapy
B) Refer to a smoking cessation program
C) Recommend against e-cigarettes as a first-line cessation tool
D) Prescribe bupropion or varenicline
Correct Answer: C
Expert Rationale:
While e-cigarettes are not FDA-approved for cessation, the statement “recommend against e-
cigs” is too absolute. The current evidence supports pharmacotherapy (NRT, bupropion,
, varenicline) and behavioral counseling. E-cigarettes are not recommended as first-line, but the
wording “recommend against” is not a standard global recommendation. However, according to
CDC and USPSTF guidelines, e-cigarettes are not recommended for cessation, so this is the
exception.
6. Bacterial causes of acute bronchitis include all of the following except:
A) Mycoplasma pneumoniae
B) Chlamydophila pneumoniae
C) Streptococcus pneumoniae
D) Pneumocystis jirovecii
Correct Answer: D
Expert Rationale:
Pneumocystis jirovecii is not a cause of acute bronchitis; it causes pneumonia in
immunocompromised hosts. The others are atypical or typical bacterial causes of bronchitis.
7. All of the following are expected symptoms of pneumonia EXCEPT:
A) Cough with purulent sputum
B) Fever and chills
C) Altered mental status
D) Pleuritic chest pain
Correct Answer: C (Note: This question requires careful reading; altered mental status is NOT a
typical expected symptom in an otherwise healthy patient, though it can occur in the elderly)
Expert Rationale:
Typical pneumonia symptoms include cough, fever, chills, and pleuritic chest pain. Altered
mental status is more common in elderly patients or those with severe illness and is not an
“expected” symptom in all patients.
8. Which of the following is done to confirm a diagnosis of pneumonia?
A) Sputum culture
B) Chest X-ray / Chest radiograph
C) CT scan of the chest
D) Bronchoscopy
