NUR 602 FINAL EXAM/FINAL EXAM NUR 602 NEWEST
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS A
NEW UPDATED VERSION LATEST 2026-2027 (CORRECT
VERIFIED SOLUTIONS) NUR 602 FINAL EXAM EDITION
2026 GUARANTEED PASS A+ |INSTANT DOWNLOAD PDF
A 72-year-old patient with heart failure and preserved ejection fraction is
admitted with acute decompensated heart failure. Which intravenous diuretic
regimen is most appropriate for initial management in this patient with a
serum creatinine of 2.1 mg/dL?
A) Bolus furosemide 40 mg intravenous push
B) Continuous infusion of furosemide at 10 mg/hour
C) Bolus furosemide 80 mg intravenous push
D) Continuous infusion of bumetanide at 2 mg/hour
Correct Answer: C) Bolus furosemide 80 mg intravenous push
Rationale: In acute decompensated heart failure, the initial intravenous
diuretic dose should be at least equivalent to the patient's home oral dose.
For a patient with renal impairment (creatinine 2.1 mg/dL), higher doses
are needed because diuretic resistance is common. An 80 mg IV bolus is
appropriate for a patient on a moderate oral dose; continuous infusion is not
superior to bolus in most studies and is reserved for refractory cases.
Bumetanide is a potent loop diuretic but starting at 2 mg/hour is too high
without prior bolus.
,A 65-year-old male with chronic obstructive pulmonary disease presents with
worsening dyspnea, purulent sputum, and fever. Arterial blood gas shows pH
7.28, PaCO2 68 mmHg, PaO2 55 mmHg, HCO3 26 mEq/L. Which
intervention is the priority?
A) Initiate noninvasive positive pressure ventilation
B) Administer high-flow oxygen via non-rebreather mask
C) Start broad-spectrum antibiotics
D) Administer nebulized albuterol and ipratropium
Correct Answer: A) Initiate noninvasive positive pressure ventilation
Rationale: This patient has acute hypercapnic respiratory failure due to COPD
exacerbation, with a pH below 7.30 indicating severe acidosis. Noninvasive
positive pressure ventilation (NPPV) is the first-line intervention to reduce
PaCO2 and improve pH, avoiding intubation. High-flow oxygen may suppress
respiratory drive. Antibiotics and bronchodilators are important but do not
immediately correct the life-threatening acidosis. NPPV should be initiated
concurrently with other therapies.
A 48-year-old woman with systemic lupus erythematosus develops progressive
shortness of breath and pleuritic chest pain. ECG shows sinus tachycardia with
low-voltage QRS complexes. Echocardiogram reveals a large pericardial
effusion with early diastolic collapse of the right ventricle. What is the most
appropriate immediate management?
A) Oral colchicine and high-dose ibuprofen
B) Pericardiocentesis under echocardiographic guidance
C) Intravenous methylprednisolone 1 gram daily
D) Placement of a pericardial window
Correct Answer: B) Pericardiocentesis under echocardiographic guidance
,Rationale: Early diastolic collapse of the right ventricle indicates cardiac
tamponade, a life-threatening complication. Emergent pericardiocentesis is
indicated to relieve pressure and confirm diagnosis. Medical therapy with
NSAIDs or steroids is insufficient for tamponade. A pericardial window is
reserved for recurrent effusions or when percutaneous drainage is not
feasible. Steroids may exacerbate SLE and should be used cautiously post -
drainage.
A 56-year-old diabetic patient with end-stage renal disease on hemodialysis
presents with acute onset of right-sided chest pain and hemoptysis. Vital signs:
HR 110, BP 88/54, RR 28, SpO2 88% on room air. Which diagnostic test
should be performed first?
A) CT pulmonary angiography
B) Ventilation-perfusion scan
C) Bedside echocardiography
D) D-dimer assay
Correct Answer: A) CT pulmonary angiography
Rationale: This patient is hemodynamically unstable with suspected
pulmonary embolism (PE) given chest pain, hemoptysis, and hypoxia. CT
pulmonary angiography is the gold standard and should be obtained
emergently if the patient can be stabilized. V/Q scan takes longer and is less
specific in renal disease. D-dimer is unreliable in ESRD and takes time.
Echocardiography may show right heart strain but does not confirm PE.
A 34-year-old postpartum woman presents with fever, right lower quadrant
pain, and rebound tenderness. She is 10 days post-cesarean section. Ultrasound
shows a complex fluid collection in the right adnexa. Which organism is most
likely responsible?
A) Escherichia coli
, B) Staphylococcus aureus
C) Bacteroides fragilis
D) Chlamydia trachomatis
Correct Answer: C) Bacteroides fragilis
Rationale: Post-cesarean pelvic abscesses are often polymicrobial, but
Bacteroides fragilis is the most common anaerobic pathogen in pelvic
infections. It is part of the normal vaginal flora and causes abscess
formation. E. coli is common in urinary tract infections but less so in pelvic
abscesses. S. aureus is more common in surgical site infections. Chlamydia
is a cause of cervicitis but not acute abscess in this setting.
A 70-year-old man with Parkinson's disease is started on carbidopa-levodopa.
He develops dyskinesias and orthostatic hypotension. Which medication
adjustment is most appropriate?
A) Increase the dose of levodopa
B) Add entacapone
C) Reduce the dose of levodopa
D) Switch to pramipexole
Correct Answer: C) Reduce the dose of levodopa
Rationale: Dyskinesias and orthostatic hypotension are common dose-related
side effects of levodopa. Reducing the dose can alleviate these symptoms while
maintaining some benefit. Increasing the dose worsens side effects.
Entacapone prolongs the effect of levodopa but does not reduce dyskinesias
and may worsen orthostatic hypotension. Pramipexole is a dopamine agonist
and would not directly address current side effects.
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS A
NEW UPDATED VERSION LATEST 2026-2027 (CORRECT
VERIFIED SOLUTIONS) NUR 602 FINAL EXAM EDITION
2026 GUARANTEED PASS A+ |INSTANT DOWNLOAD PDF
A 72-year-old patient with heart failure and preserved ejection fraction is
admitted with acute decompensated heart failure. Which intravenous diuretic
regimen is most appropriate for initial management in this patient with a
serum creatinine of 2.1 mg/dL?
A) Bolus furosemide 40 mg intravenous push
B) Continuous infusion of furosemide at 10 mg/hour
C) Bolus furosemide 80 mg intravenous push
D) Continuous infusion of bumetanide at 2 mg/hour
Correct Answer: C) Bolus furosemide 80 mg intravenous push
Rationale: In acute decompensated heart failure, the initial intravenous
diuretic dose should be at least equivalent to the patient's home oral dose.
For a patient with renal impairment (creatinine 2.1 mg/dL), higher doses
are needed because diuretic resistance is common. An 80 mg IV bolus is
appropriate for a patient on a moderate oral dose; continuous infusion is not
superior to bolus in most studies and is reserved for refractory cases.
Bumetanide is a potent loop diuretic but starting at 2 mg/hour is too high
without prior bolus.
,A 65-year-old male with chronic obstructive pulmonary disease presents with
worsening dyspnea, purulent sputum, and fever. Arterial blood gas shows pH
7.28, PaCO2 68 mmHg, PaO2 55 mmHg, HCO3 26 mEq/L. Which
intervention is the priority?
A) Initiate noninvasive positive pressure ventilation
B) Administer high-flow oxygen via non-rebreather mask
C) Start broad-spectrum antibiotics
D) Administer nebulized albuterol and ipratropium
Correct Answer: A) Initiate noninvasive positive pressure ventilation
Rationale: This patient has acute hypercapnic respiratory failure due to COPD
exacerbation, with a pH below 7.30 indicating severe acidosis. Noninvasive
positive pressure ventilation (NPPV) is the first-line intervention to reduce
PaCO2 and improve pH, avoiding intubation. High-flow oxygen may suppress
respiratory drive. Antibiotics and bronchodilators are important but do not
immediately correct the life-threatening acidosis. NPPV should be initiated
concurrently with other therapies.
A 48-year-old woman with systemic lupus erythematosus develops progressive
shortness of breath and pleuritic chest pain. ECG shows sinus tachycardia with
low-voltage QRS complexes. Echocardiogram reveals a large pericardial
effusion with early diastolic collapse of the right ventricle. What is the most
appropriate immediate management?
A) Oral colchicine and high-dose ibuprofen
B) Pericardiocentesis under echocardiographic guidance
C) Intravenous methylprednisolone 1 gram daily
D) Placement of a pericardial window
Correct Answer: B) Pericardiocentesis under echocardiographic guidance
,Rationale: Early diastolic collapse of the right ventricle indicates cardiac
tamponade, a life-threatening complication. Emergent pericardiocentesis is
indicated to relieve pressure and confirm diagnosis. Medical therapy with
NSAIDs or steroids is insufficient for tamponade. A pericardial window is
reserved for recurrent effusions or when percutaneous drainage is not
feasible. Steroids may exacerbate SLE and should be used cautiously post -
drainage.
A 56-year-old diabetic patient with end-stage renal disease on hemodialysis
presents with acute onset of right-sided chest pain and hemoptysis. Vital signs:
HR 110, BP 88/54, RR 28, SpO2 88% on room air. Which diagnostic test
should be performed first?
A) CT pulmonary angiography
B) Ventilation-perfusion scan
C) Bedside echocardiography
D) D-dimer assay
Correct Answer: A) CT pulmonary angiography
Rationale: This patient is hemodynamically unstable with suspected
pulmonary embolism (PE) given chest pain, hemoptysis, and hypoxia. CT
pulmonary angiography is the gold standard and should be obtained
emergently if the patient can be stabilized. V/Q scan takes longer and is less
specific in renal disease. D-dimer is unreliable in ESRD and takes time.
Echocardiography may show right heart strain but does not confirm PE.
A 34-year-old postpartum woman presents with fever, right lower quadrant
pain, and rebound tenderness. She is 10 days post-cesarean section. Ultrasound
shows a complex fluid collection in the right adnexa. Which organism is most
likely responsible?
A) Escherichia coli
, B) Staphylococcus aureus
C) Bacteroides fragilis
D) Chlamydia trachomatis
Correct Answer: C) Bacteroides fragilis
Rationale: Post-cesarean pelvic abscesses are often polymicrobial, but
Bacteroides fragilis is the most common anaerobic pathogen in pelvic
infections. It is part of the normal vaginal flora and causes abscess
formation. E. coli is common in urinary tract infections but less so in pelvic
abscesses. S. aureus is more common in surgical site infections. Chlamydia
is a cause of cervicitis but not acute abscess in this setting.
A 70-year-old man with Parkinson's disease is started on carbidopa-levodopa.
He develops dyskinesias and orthostatic hypotension. Which medication
adjustment is most appropriate?
A) Increase the dose of levodopa
B) Add entacapone
C) Reduce the dose of levodopa
D) Switch to pramipexole
Correct Answer: C) Reduce the dose of levodopa
Rationale: Dyskinesias and orthostatic hypotension are common dose-related
side effects of levodopa. Reducing the dose can alleviate these symptoms while
maintaining some benefit. Increasing the dose worsens side effects.
Entacapone prolongs the effect of levodopa but does not reduce dyskinesias
and may worsen orthostatic hypotension. Pramipexole is a dopamine agonist
and would not directly address current side effects.
