MSN 674 FINAL EXAMINATION COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR JUST RELEASED
Tested Content Areas (Short Summary)
1. Advanced Health Assessment
o Comprehensive history-taking, physical examination, diagnostic reasoning, and
documentation across the lifespan.
2. Diagnostic Reasoning & Clinical Decision-Making
o Differential diagnoses, interpretation of clinical findings, prioritization, and evidence-
based management.
3. Pharmacology & Therapeutics
o Drug classifications, prescribing principles, adverse effects, contraindications, patient
education, and medication safety.
4. Management of Common Acute Conditions
o Assessment, diagnosis, treatment, referral criteria, and follow-up of common acute
illnesses.
5. Management of Chronic Diseases
o Hypertension, diabetes, COPD, asthma, heart failure, chronic kidney disease, thyroid
disorders, and hyperlipidemia.
6. Laboratory & Diagnostic Testing
o Interpretation of CBC, CMP, lipid panels, thyroid studies, ECGs, urinalysis, imaging, and
other diagnostic tests.
7. Health Promotion & Disease Prevention
o Screening guidelines, immunizations, patient counseling, lifestyle modification, and
preventive care.
8. Women's, Men's & Geriatric Health
o Age-specific assessment, preventive care, reproductive health, prostate disorders,
menopause, and geriatric syndromes.
9. Evidence-Based Practice & Professional Issues
o Research utilization, quality improvement, ethics, legal standards, patient safety, and
interprofessional collaboration.
10. Clinical Guidelines & Patient Education
Current practice guidelines, shared decision-making, cultural competence, health literacy, and
discharge planning.
,MSN 674 FINAL Examination
Question 1
A 58-year-old patient with long-standing hypertension presents for routine
follow-up with consistently elevated home blood pressure readings despite
medication adherence. Which intervention should the advanced practice nurse
prioritize before intensifying pharmacologic therapy?
A. Immediately prescribe a second antihypertensive medication without further
evaluation.
B. Confirm proper blood pressure measurement technique, assess adherence,
identify secondary causes, and review lifestyle factors.
C. Discontinue the current antihypertensive medication and begin combination
therapy immediately.
D. Recommend emergency department evaluation regardless of symptoms.
Answer: B
Rationale: Accurate blood pressure assessment, medication adherence,
secondary causes, and lifestyle contributors should be evaluated before
modifying treatment to avoid unnecessary medication escalation.
Question 2
A patient with poorly controlled type 2 diabetes reports increased thirst, frequent
urination, and unexplained weight loss despite taking prescribed medications
consistently. Which laboratory study provides the best assessment of long-term
glycemic control?
A. Random blood glucose
B. Fasting insulin
C. Hemoglobin A1C
D. Urine ketones
Answer: C
,Rationale: Hemoglobin A1C reflects average blood glucose over approximately
three months and is the standard indicator of long-term glycemic control.
Question 3
During a comprehensive cardiovascular examination, which assessment finding
most strongly suggests left-sided heart failure requiring additional diagnostic
evaluation and treatment planning?
A. Bilateral pulmonary crackles with exertional dyspnea
B. Warm extremities without edema
C. Normal jugular venous pressure
D. Bradycardia during sleep
Answer: A
Rationale: Pulmonary crackles and exertional dyspnea are classic manifestations
of pulmonary congestion associated with left-sided heart failure.
Question 4
Which patient education strategy is most effective for improving medication
adherence among adults managing multiple chronic illnesses requiring several
daily prescription medications?
A. Provide lengthy written instructions without discussion.
B. Encourage patients to discontinue medications causing inconvenience.
C. Use teach-back, simplify schedules when possible, and involve patients in
shared decision-making.
D. Recommend taking all medications together regardless of prescribing
instructions.
Answer: C
, Rationale: Teach-back, simplified regimens, and shared decision-making improve
understanding, adherence, and overall medication safety.
Question 5
A patient presents with acute onset unilateral facial drooping, arm weakness, and
slurred speech beginning approximately thirty minutes ago. What should be the
advanced practice nurse's immediate priority?
A. Schedule outpatient imaging next week.
B. Begin oral antibiotics.
C. Activate emergency stroke protocols and arrange immediate transport for
urgent evaluation.
D. Recommend observation at home.
Answer: C
Rationale: Acute neurologic deficits require rapid stroke evaluation because early
intervention significantly improves patient outcomes.
Question 6
Which laboratory abnormality most strongly supports a diagnosis of iron
deficiency anemia in an adult presenting with fatigue and pallor?
A. Elevated ferritin
B. Low ferritin with microcytic, hypochromic anemia
C. Elevated vitamin B12
D. Increased platelet count alone
Answer: B
Rationale: Low ferritin combined with microcytic hypochromic anemia strongly
supports iron deficiency anemia.
QUESTIONS AND DETAILED SOLUTIONS LATEST
UPDATE THIS YEAR JUST RELEASED
Tested Content Areas (Short Summary)
1. Advanced Health Assessment
o Comprehensive history-taking, physical examination, diagnostic reasoning, and
documentation across the lifespan.
2. Diagnostic Reasoning & Clinical Decision-Making
o Differential diagnoses, interpretation of clinical findings, prioritization, and evidence-
based management.
3. Pharmacology & Therapeutics
o Drug classifications, prescribing principles, adverse effects, contraindications, patient
education, and medication safety.
4. Management of Common Acute Conditions
o Assessment, diagnosis, treatment, referral criteria, and follow-up of common acute
illnesses.
5. Management of Chronic Diseases
o Hypertension, diabetes, COPD, asthma, heart failure, chronic kidney disease, thyroid
disorders, and hyperlipidemia.
6. Laboratory & Diagnostic Testing
o Interpretation of CBC, CMP, lipid panels, thyroid studies, ECGs, urinalysis, imaging, and
other diagnostic tests.
7. Health Promotion & Disease Prevention
o Screening guidelines, immunizations, patient counseling, lifestyle modification, and
preventive care.
8. Women's, Men's & Geriatric Health
o Age-specific assessment, preventive care, reproductive health, prostate disorders,
menopause, and geriatric syndromes.
9. Evidence-Based Practice & Professional Issues
o Research utilization, quality improvement, ethics, legal standards, patient safety, and
interprofessional collaboration.
10. Clinical Guidelines & Patient Education
Current practice guidelines, shared decision-making, cultural competence, health literacy, and
discharge planning.
,MSN 674 FINAL Examination
Question 1
A 58-year-old patient with long-standing hypertension presents for routine
follow-up with consistently elevated home blood pressure readings despite
medication adherence. Which intervention should the advanced practice nurse
prioritize before intensifying pharmacologic therapy?
A. Immediately prescribe a second antihypertensive medication without further
evaluation.
B. Confirm proper blood pressure measurement technique, assess adherence,
identify secondary causes, and review lifestyle factors.
C. Discontinue the current antihypertensive medication and begin combination
therapy immediately.
D. Recommend emergency department evaluation regardless of symptoms.
Answer: B
Rationale: Accurate blood pressure assessment, medication adherence,
secondary causes, and lifestyle contributors should be evaluated before
modifying treatment to avoid unnecessary medication escalation.
Question 2
A patient with poorly controlled type 2 diabetes reports increased thirst, frequent
urination, and unexplained weight loss despite taking prescribed medications
consistently. Which laboratory study provides the best assessment of long-term
glycemic control?
A. Random blood glucose
B. Fasting insulin
C. Hemoglobin A1C
D. Urine ketones
Answer: C
,Rationale: Hemoglobin A1C reflects average blood glucose over approximately
three months and is the standard indicator of long-term glycemic control.
Question 3
During a comprehensive cardiovascular examination, which assessment finding
most strongly suggests left-sided heart failure requiring additional diagnostic
evaluation and treatment planning?
A. Bilateral pulmonary crackles with exertional dyspnea
B. Warm extremities without edema
C. Normal jugular venous pressure
D. Bradycardia during sleep
Answer: A
Rationale: Pulmonary crackles and exertional dyspnea are classic manifestations
of pulmonary congestion associated with left-sided heart failure.
Question 4
Which patient education strategy is most effective for improving medication
adherence among adults managing multiple chronic illnesses requiring several
daily prescription medications?
A. Provide lengthy written instructions without discussion.
B. Encourage patients to discontinue medications causing inconvenience.
C. Use teach-back, simplify schedules when possible, and involve patients in
shared decision-making.
D. Recommend taking all medications together regardless of prescribing
instructions.
Answer: C
, Rationale: Teach-back, simplified regimens, and shared decision-making improve
understanding, adherence, and overall medication safety.
Question 5
A patient presents with acute onset unilateral facial drooping, arm weakness, and
slurred speech beginning approximately thirty minutes ago. What should be the
advanced practice nurse's immediate priority?
A. Schedule outpatient imaging next week.
B. Begin oral antibiotics.
C. Activate emergency stroke protocols and arrange immediate transport for
urgent evaluation.
D. Recommend observation at home.
Answer: C
Rationale: Acute neurologic deficits require rapid stroke evaluation because early
intervention significantly improves patient outcomes.
Question 6
Which laboratory abnormality most strongly supports a diagnosis of iron
deficiency anemia in an adult presenting with fatigue and pallor?
A. Elevated ferritin
B. Low ferritin with microcytic, hypochromic anemia
C. Elevated vitamin B12
D. Increased platelet count alone
Answer: B
Rationale: Low ferritin combined with microcytic hypochromic anemia strongly
supports iron deficiency anemia.
