NURS 572 EXAM 1 2026/2027 - Edition Real Exam|Questions
With 100% verified Answers
Overview:
NURS 572 typically covers advanced health assessment, pathophysiology,
pharmacology foundations, and clinical reasoning for nurse practitioners. This practice
set focuses on high-yield topics: HEENT, cardiovascular, respiratory, GI, neuro, and
pharmacology principles. Use it to test recall, application, and prioritization. All Correct
Answers are highlighted in bold and green.
1. A 58-year-old male presents with sudden onset “worst headache of my life,”
nuchal rigidity, and photophobia. BP 188/100. What is the most appropriate initial
diagnostic test?
A. CT scan of the head without contrast
B. Lumbar puncture
C. MRI brain with contrast
D. ESR and CRP
Answer: A. CT scan of the head without contrast
Rationale: The presentation suggests subarachnoid hemorrhage. Non-contrast CT is
the fastest, most sensitive initial test in the first 6-12 hours. LP is done only if CT is
negative but suspicion remains high. MRI takes longer and is less sensitive for acute
bleed. ESR/CRP assess for temporal arteritis, which is less likely with this acuity.
2. Which heart sound is best heard at the left lower sternal border with the patient
sitting up, leaning forward, and holding expiration?
A. Aortic regurgitation murmur
B. Mitral stenosis murmur
C. S3 gallop
D. Pericardial friction rub
Answer: A. Aortic regurgitation murmur
Rationale: AR produces a diastolic, decrescendo murmur best heard at LSB or right 2nd
ICS with the patient leaning forward in full expiration. This position brings the aorta
closer to the chest wall. Mitral stenosis is a diastolic rumble at the apex in left lateral
decubitus. S3 is low-pitched at apex. Friction rub is scratchy and heard best at LLSB,
but not specific to expiration.
3. A patient on lisinopril develops a persistent dry cough. What is the
mechanism?
A. Bradykinin accumulation
B. Histamine release
C. Direct bronchial irritation
D. Beta-2 receptor blockade
Answer: A. Bradykinin accumulation
Rationale: ACE inhibitors prevent bradykinin degradation. Increased bradykinin in lungs
, stimulates C-fibers, causing dry cough. Occurs in 5-20% of patients. Switching to ARB
is appropriate since ARBs don’t affect bradykinin.
4. When assessing a patient with suspected pneumonia, which finding is most
consistent with lung consolidation?
A. Hyperresonance on percussion
B. Decreased tactile fremitus
C. Bronchophony and egophony
D. Diminished breath sounds
Answer: C. Bronchophony and egophony
Rationale: Consolidation makes lung tissue solid, so it transmits sound better.
Bronchophony = clearer voice sounds, egophony = “E” to “A” change. Hyperresonance
and decreased fremitus occur with pneumothorax. Diminished sounds suggest pleural
effusion or obstruction.
5. A 45-year-old female has TSH 0.08 mIU/L, free T4 2.8 ng/dL. She reports
palpitations, weight loss, and heat intolerance. What is the next best step?
A. Start levothyroxine
B. Check TSH receptor antibodies and radioactive iodine uptake
C. Order thyroid ultrasound
D. Repeat TSH in 6 weeks
Answer: B. Check TSH receptor antibodies and radioactive iodine uptake
Rationale: Labs show primary hyperthyroidism. TSI/TSH receptor antibodies + RAIU
help differentiate Graves’ disease from toxic nodule or thyroiditis. Levothyroxine would
worsen hyperthyroidism. Ultrasound is for nodules. Repeat TSH delays treatment in
symptomatic patient.
6. Which cranial nerve is tested by asking the patient to shrug shoulders against
resistance?
A. CN VII
B. CN IX
C. CN X
D. CN XI
Answer: D. CN XI
Rationale: CN XI = spinal accessory nerve. Innervates sternocleidomastoid and
trapezius. Tested by shoulder shrug and head turn against resistance. CN VII = facial
expression. CN IX/X = gag and palate elevation.
7. A 67-year-old with COPD is prescribed azithromycin. What baseline
assessment is most critical before starting?
A. Serum creatinine
B. Liver function tests
C. QT interval on ECG
D. CBC with differential
Answer: C. QT interval on ECG
Rationale: Azithromycin is a macrolide that can prolong QT and precipitate torsades de
With 100% verified Answers
Overview:
NURS 572 typically covers advanced health assessment, pathophysiology,
pharmacology foundations, and clinical reasoning for nurse practitioners. This practice
set focuses on high-yield topics: HEENT, cardiovascular, respiratory, GI, neuro, and
pharmacology principles. Use it to test recall, application, and prioritization. All Correct
Answers are highlighted in bold and green.
1. A 58-year-old male presents with sudden onset “worst headache of my life,”
nuchal rigidity, and photophobia. BP 188/100. What is the most appropriate initial
diagnostic test?
A. CT scan of the head without contrast
B. Lumbar puncture
C. MRI brain with contrast
D. ESR and CRP
Answer: A. CT scan of the head without contrast
Rationale: The presentation suggests subarachnoid hemorrhage. Non-contrast CT is
the fastest, most sensitive initial test in the first 6-12 hours. LP is done only if CT is
negative but suspicion remains high. MRI takes longer and is less sensitive for acute
bleed. ESR/CRP assess for temporal arteritis, which is less likely with this acuity.
2. Which heart sound is best heard at the left lower sternal border with the patient
sitting up, leaning forward, and holding expiration?
A. Aortic regurgitation murmur
B. Mitral stenosis murmur
C. S3 gallop
D. Pericardial friction rub
Answer: A. Aortic regurgitation murmur
Rationale: AR produces a diastolic, decrescendo murmur best heard at LSB or right 2nd
ICS with the patient leaning forward in full expiration. This position brings the aorta
closer to the chest wall. Mitral stenosis is a diastolic rumble at the apex in left lateral
decubitus. S3 is low-pitched at apex. Friction rub is scratchy and heard best at LLSB,
but not specific to expiration.
3. A patient on lisinopril develops a persistent dry cough. What is the
mechanism?
A. Bradykinin accumulation
B. Histamine release
C. Direct bronchial irritation
D. Beta-2 receptor blockade
Answer: A. Bradykinin accumulation
Rationale: ACE inhibitors prevent bradykinin degradation. Increased bradykinin in lungs
, stimulates C-fibers, causing dry cough. Occurs in 5-20% of patients. Switching to ARB
is appropriate since ARBs don’t affect bradykinin.
4. When assessing a patient with suspected pneumonia, which finding is most
consistent with lung consolidation?
A. Hyperresonance on percussion
B. Decreased tactile fremitus
C. Bronchophony and egophony
D. Diminished breath sounds
Answer: C. Bronchophony and egophony
Rationale: Consolidation makes lung tissue solid, so it transmits sound better.
Bronchophony = clearer voice sounds, egophony = “E” to “A” change. Hyperresonance
and decreased fremitus occur with pneumothorax. Diminished sounds suggest pleural
effusion or obstruction.
5. A 45-year-old female has TSH 0.08 mIU/L, free T4 2.8 ng/dL. She reports
palpitations, weight loss, and heat intolerance. What is the next best step?
A. Start levothyroxine
B. Check TSH receptor antibodies and radioactive iodine uptake
C. Order thyroid ultrasound
D. Repeat TSH in 6 weeks
Answer: B. Check TSH receptor antibodies and radioactive iodine uptake
Rationale: Labs show primary hyperthyroidism. TSI/TSH receptor antibodies + RAIU
help differentiate Graves’ disease from toxic nodule or thyroiditis. Levothyroxine would
worsen hyperthyroidism. Ultrasound is for nodules. Repeat TSH delays treatment in
symptomatic patient.
6. Which cranial nerve is tested by asking the patient to shrug shoulders against
resistance?
A. CN VII
B. CN IX
C. CN X
D. CN XI
Answer: D. CN XI
Rationale: CN XI = spinal accessory nerve. Innervates sternocleidomastoid and
trapezius. Tested by shoulder shrug and head turn against resistance. CN VII = facial
expression. CN IX/X = gag and palate elevation.
7. A 67-year-old with COPD is prescribed azithromycin. What baseline
assessment is most critical before starting?
A. Serum creatinine
B. Liver function tests
C. QT interval on ECG
D. CBC with differential
Answer: C. QT interval on ECG
Rationale: Azithromycin is a macrolide that can prolong QT and precipitate torsades de
