NRNP 6541 WALDEN UNIVERSITY WEEK II FINAL EXAM – QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | EXAM TESTBANK | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
1. Advanced Health Assessment
2. Pathophysiology Across the Lifespan
3. Pharmacology and Therapeutics
4. Evidence-Based Practice and Research
5. Healthcare Policy, Ethics, and Legal Issues
6. Leadership and Interprofessional Collaboration
7. Health Promotion and Disease Prevention
8. Psychosocial and Cultural Competence
Introduction
This comprehensive examination is designed to rigorously assess the advanced
knowledge and clinical reasoning skills essential for the advanced practice nurse.
The questions evaluate the synthesis of foundational theory with practical, real-
world application, covering a broad spectrum of core domains including
pathophysiology, pharmacology, and health assessment. The exam utilizes multiple-
choice and scenario-based questions to foster critical thinking and clinical decision-
making. Emphasis is placed on the learner's ability to apply evidence-based
guidelines, navigate complex ethical and legal situations, and collaborate effectively
within an interprofessional team to deliver patient-centered care.
SECTION ONE: QUESTIONS 1–50
1. An 82-year-old patient reports a sudden onset of severe headache and
photophobia. On examination, you note nuchal rigidity. Which of the following
is the priority diagnostic test to confirm your suspicion?
,A. CT scan of the head without contrast
B. Magnetic resonance venography (MRV)
C. Lumbar puncture
D. Carotid duplex ultrasound
🟢 Correct Answer: A. CT scan of the head without contrast
🔴 Explanation: A CT scan of the head without contrast is the priority initial
diagnostic test to evaluate for a subarachnoid hemorrhage, which is the primary
concern in an elderly patient presenting with a sudden severe headache and
nuchal rigidity. A lumbar puncture is often performed after a negative or
inconclusive CT scan to rule out meningitis.
2. The nurse practitioner is performing a well-child examination on a 9-month-
old infant. Which of the following developmental milestones is expected at this
age?
A. Pincer grasp
B. Walking independently
C. Saying three to five words
D. Playing pat-a-cake
🟢 Correct Answer: D. Playing pat-a-cake
🔴 Explanation: Playing pat-a-cake is an expected social/play milestone for a 9-
month-old. A pincer grasp is typically present by 10-11 months, walking
independently by 12-15 months, and speaking 3-5 words by 18 months.
3. A 55-year-old male with a history of hypertension presents with a chief
complaint of nocturia and a weak urinary stream. His digital rectal exam reveals
an enlarged, smooth, and rubbery prostate. A PSA level is drawn and is 4.8
ng/mL. What is the most appropriate next step in management?
A. Prescribe an alpha-blocker
B. Refer the patient for a transrectal ultrasound-guided biopsy
,C. Repeat the PSA in three months
D. Perform a urinalysis to check for infection
🟢 Correct Answer: B. Refer the patient for a transrectal ultrasound-guided
biopsy
🔴 Explanation: An elevated PSA level, especially in a patient with an enlarged
prostate and lower urinary tract symptoms, could be suggestive of prostate
cancer. A prostate biopsy is the definitive diagnostic procedure to confirm the
presence of cancer.
4. The nurse practitioner is reviewing the laboratory results of a 35-year-old
woman who is 28 weeks pregnant. Her hemoglobin is 10.2 g/dL and hematocrit
is 31.5%. Which of the following supplements is most indicated for this patient?
A. Iron
B. Folic acid
C. Vitamin B12
D. Vitamin K
🟢 Correct Answer: A. Iron
🔴 Explanation: This patient's laboratory values indicate anemia, which is
common in pregnancy. Iron supplementation is the first-line treatment for iron
deficiency anemia, which is the most common cause of anemia in pregnancy.
5. A 47-year-old female patient presents with complaints of fatigue, weight
gain, cold intolerance, and constipation for the past few months. Physical
examination reveals a bradycardia and a non-pitting edema in the lower
extremities. Which of the following laboratory findings would most likely
support the suspected diagnosis?
A. Low T4 and high TSH
B. High T4 and low TSH
C. High T3 and normal TSH
D. Low T4 and low TSH
, 🟢 Correct Answer: A. Low T4 and high TSH
🔴 Explanation: The patient's symptoms are classic for hypothyroidism. A low T4
level with a high TSH is the hallmark laboratory finding of primary
hypothyroidism, indicating the thyroid gland is not producing enough thyroid
hormone in response to the pituitary's stimulation.
6. A 16-year-old male is brought to the clinic by his mother because of his
increasing aggressive behavior, poor school performance, and frequent lying.
Over the past six months, he has been bullying other children and has shown a
disregard for rules. Which of the following is the most likely diagnosis?
A. Oppositional Defiant Disorder (ODD)
B. Attention-Deficit/Hyperactivity Disorder (ADHD)
C. Intermittent Explosive Disorder
D. Conduct Disorder (CD)
🟢 Correct Answer: D. Conduct Disorder (CD)
🔴 Explanation: Conduct Disorder is characterized by a repetitive and persistent
pattern of behavior that violates the basic rights of others or major age-
appropriate societal norms or rules. The patient's symptoms of aggression,
bullying, and deceitfulness are consistent with this diagnosis.
7. A 62-year-old post-menopausal woman presents with a new onset of vaginal
bleeding. She has not had a period for 10 years. What is the initial imaging
study of choice to evaluate this patient's uterine cavity?
A. Pelvic ultrasound
B. Computed tomography (CT) scan of the pelvis
C. Hysterosalpingography
D. Magnetic resonance imaging (MRI) of the pelvis
🟢 Correct Answer: A. Pelvic ultrasound
🔴 Explanation: A pelvic ultrasound is the initial, non-invasive imaging study of
choice to evaluate postmenopausal bleeding. It can assess endometrial thickness
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | EXAM TESTBANK | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
1. Advanced Health Assessment
2. Pathophysiology Across the Lifespan
3. Pharmacology and Therapeutics
4. Evidence-Based Practice and Research
5. Healthcare Policy, Ethics, and Legal Issues
6. Leadership and Interprofessional Collaboration
7. Health Promotion and Disease Prevention
8. Psychosocial and Cultural Competence
Introduction
This comprehensive examination is designed to rigorously assess the advanced
knowledge and clinical reasoning skills essential for the advanced practice nurse.
The questions evaluate the synthesis of foundational theory with practical, real-
world application, covering a broad spectrum of core domains including
pathophysiology, pharmacology, and health assessment. The exam utilizes multiple-
choice and scenario-based questions to foster critical thinking and clinical decision-
making. Emphasis is placed on the learner's ability to apply evidence-based
guidelines, navigate complex ethical and legal situations, and collaborate effectively
within an interprofessional team to deliver patient-centered care.
SECTION ONE: QUESTIONS 1–50
1. An 82-year-old patient reports a sudden onset of severe headache and
photophobia. On examination, you note nuchal rigidity. Which of the following
is the priority diagnostic test to confirm your suspicion?
,A. CT scan of the head without contrast
B. Magnetic resonance venography (MRV)
C. Lumbar puncture
D. Carotid duplex ultrasound
🟢 Correct Answer: A. CT scan of the head without contrast
🔴 Explanation: A CT scan of the head without contrast is the priority initial
diagnostic test to evaluate for a subarachnoid hemorrhage, which is the primary
concern in an elderly patient presenting with a sudden severe headache and
nuchal rigidity. A lumbar puncture is often performed after a negative or
inconclusive CT scan to rule out meningitis.
2. The nurse practitioner is performing a well-child examination on a 9-month-
old infant. Which of the following developmental milestones is expected at this
age?
A. Pincer grasp
B. Walking independently
C. Saying three to five words
D. Playing pat-a-cake
🟢 Correct Answer: D. Playing pat-a-cake
🔴 Explanation: Playing pat-a-cake is an expected social/play milestone for a 9-
month-old. A pincer grasp is typically present by 10-11 months, walking
independently by 12-15 months, and speaking 3-5 words by 18 months.
3. A 55-year-old male with a history of hypertension presents with a chief
complaint of nocturia and a weak urinary stream. His digital rectal exam reveals
an enlarged, smooth, and rubbery prostate. A PSA level is drawn and is 4.8
ng/mL. What is the most appropriate next step in management?
A. Prescribe an alpha-blocker
B. Refer the patient for a transrectal ultrasound-guided biopsy
,C. Repeat the PSA in three months
D. Perform a urinalysis to check for infection
🟢 Correct Answer: B. Refer the patient for a transrectal ultrasound-guided
biopsy
🔴 Explanation: An elevated PSA level, especially in a patient with an enlarged
prostate and lower urinary tract symptoms, could be suggestive of prostate
cancer. A prostate biopsy is the definitive diagnostic procedure to confirm the
presence of cancer.
4. The nurse practitioner is reviewing the laboratory results of a 35-year-old
woman who is 28 weeks pregnant. Her hemoglobin is 10.2 g/dL and hematocrit
is 31.5%. Which of the following supplements is most indicated for this patient?
A. Iron
B. Folic acid
C. Vitamin B12
D. Vitamin K
🟢 Correct Answer: A. Iron
🔴 Explanation: This patient's laboratory values indicate anemia, which is
common in pregnancy. Iron supplementation is the first-line treatment for iron
deficiency anemia, which is the most common cause of anemia in pregnancy.
5. A 47-year-old female patient presents with complaints of fatigue, weight
gain, cold intolerance, and constipation for the past few months. Physical
examination reveals a bradycardia and a non-pitting edema in the lower
extremities. Which of the following laboratory findings would most likely
support the suspected diagnosis?
A. Low T4 and high TSH
B. High T4 and low TSH
C. High T3 and normal TSH
D. Low T4 and low TSH
, 🟢 Correct Answer: A. Low T4 and high TSH
🔴 Explanation: The patient's symptoms are classic for hypothyroidism. A low T4
level with a high TSH is the hallmark laboratory finding of primary
hypothyroidism, indicating the thyroid gland is not producing enough thyroid
hormone in response to the pituitary's stimulation.
6. A 16-year-old male is brought to the clinic by his mother because of his
increasing aggressive behavior, poor school performance, and frequent lying.
Over the past six months, he has been bullying other children and has shown a
disregard for rules. Which of the following is the most likely diagnosis?
A. Oppositional Defiant Disorder (ODD)
B. Attention-Deficit/Hyperactivity Disorder (ADHD)
C. Intermittent Explosive Disorder
D. Conduct Disorder (CD)
🟢 Correct Answer: D. Conduct Disorder (CD)
🔴 Explanation: Conduct Disorder is characterized by a repetitive and persistent
pattern of behavior that violates the basic rights of others or major age-
appropriate societal norms or rules. The patient's symptoms of aggression,
bullying, and deceitfulness are consistent with this diagnosis.
7. A 62-year-old post-menopausal woman presents with a new onset of vaginal
bleeding. She has not had a period for 10 years. What is the initial imaging
study of choice to evaluate this patient's uterine cavity?
A. Pelvic ultrasound
B. Computed tomography (CT) scan of the pelvis
C. Hysterosalpingography
D. Magnetic resonance imaging (MRI) of the pelvis
🟢 Correct Answer: A. Pelvic ultrasound
🔴 Explanation: A pelvic ultrasound is the initial, non-invasive imaging study of
choice to evaluate postmenopausal bleeding. It can assess endometrial thickness
