NU 673 Midterm Exam 2026–2027 Study
Guide: 100 Original Exam-Style Questions
& Answers with Detailed Rationales |
Comprehensive Practice Test for A+
Preparation
A nurse practitioner is evaluating a patient with fatigue, weight gain, cold
intolerance, and constipation. Which laboratory finding is most consistent with
primary hypothyroidism?
Answer: Elevated TSH with decreased free T4.
Rationale: Primary hypothyroidism results from thyroid gland dysfunction, causing
decreased thyroid hormone production. The pituitary responds by increasing TSH
secretion.
A patient with hyperthyroidism reports palpitations, anxiety, heat intolerance, and
weight loss. Which medication is commonly used to control adrenergic symptoms?
Answer: Propranolol.
Rationale: Beta blockers such as propranolol reduce tachycardia, tremor, and other
sympathetic symptoms associated with hyperthyroidism. They do not correct the
underlying thyroid dysfunction.
Which finding is most characteristic of Cushing syndrome?
Answer: Central obesity with relatively thin extremities.
Rationale: Excess cortisol causes fat redistribution, producing truncal obesity,
facial rounding, and often a dorsocervical fat pad while the extremities may remain
relatively thin.
,A patient presents with polyuria, polydipsia, and unexplained weight loss. Which
condition should be strongly considered?
Answer: Diabetes mellitus.
Rationale: Hyperglycemia causes osmotic diuresis, producing polyuria. Increased
thirst and unexplained weight loss are classic manifestations of diabetes.
Which test is commonly used to assess long-term glycemic control?
Answer: Hemoglobin A1c.
Rationale: HbA1c reflects average blood glucose over approximately the previous
2–3 months because glucose becomes attached to circulating hemoglobin.
A patient with diabetes becomes sweaty, confused, and tremulous. Which
condition is most likely?
Answer: Hypoglycemia.
Rationale: Adrenergic manifestations such as sweating, tremor, palpitations, and
anxiety can occur with low blood glucose. Confusion indicates neuroglycopenia.
Which finding is most concerning for diabetic ketoacidosis?
Answer: Kussmaul respirations.
Rationale: Kussmaul respirations are deep, rapid respirations that represent
respiratory compensation for metabolic acidosis caused by accumulation of ketone
bodies.
A patient with type 2 diabetes has an elevated urine albumin-to-creatinine ratio.
What complication does this suggest?
Answer: Diabetic kidney disease.
Rationale: Persistent albuminuria is an early marker of diabetic renal injury and
may precede significant decreases in glomerular filtration.
Which cardiovascular risk factor is modifiable?
Answer: Hypertension.
, Rationale: Blood pressure can be modified through lifestyle interventions and
medications. Age and genetic predisposition are examples of nonmodifiable
factors.
Which lipid abnormality is most strongly associated with atherosclerotic
cardiovascular disease?
Answer: Elevated LDL cholesterol.
Rationale: LDL contributes to cholesterol deposition within arterial walls and is a
major therapeutic target for cardiovascular risk reduction.
A patient presents with crushing substernal chest pain radiating to the left arm and
diaphoresis. What diagnosis should be considered immediately?
Answer: Acute coronary syndrome.
Rationale: New or severe pressure-like chest discomfort with radiation and
autonomic symptoms is highly concerning for myocardial ischemia and requires
urgent evaluation.
Which biomarker is most specific for myocardial injury?
Answer: Cardiac troponin.
Rationale: Troponin I and T are highly sensitive and specific markers of
myocardial injury and are central to the evaluation of suspected acute coronary
syndrome.
A patient with heart failure develops worsening dyspnea, orthopnea, and bilateral
lower-extremity edema. What does this most likely indicate?
Answer: Fluid volume overload.
Rationale: Increased venous and pulmonary congestion commonly produces
peripheral edema, orthopnea, and worsening shortness of breath in heart failure.
Which symptom is particularly characteristic of left-sided heart failure?
Answer: Pulmonary congestion.
Guide: 100 Original Exam-Style Questions
& Answers with Detailed Rationales |
Comprehensive Practice Test for A+
Preparation
A nurse practitioner is evaluating a patient with fatigue, weight gain, cold
intolerance, and constipation. Which laboratory finding is most consistent with
primary hypothyroidism?
Answer: Elevated TSH with decreased free T4.
Rationale: Primary hypothyroidism results from thyroid gland dysfunction, causing
decreased thyroid hormone production. The pituitary responds by increasing TSH
secretion.
A patient with hyperthyroidism reports palpitations, anxiety, heat intolerance, and
weight loss. Which medication is commonly used to control adrenergic symptoms?
Answer: Propranolol.
Rationale: Beta blockers such as propranolol reduce tachycardia, tremor, and other
sympathetic symptoms associated with hyperthyroidism. They do not correct the
underlying thyroid dysfunction.
Which finding is most characteristic of Cushing syndrome?
Answer: Central obesity with relatively thin extremities.
Rationale: Excess cortisol causes fat redistribution, producing truncal obesity,
facial rounding, and often a dorsocervical fat pad while the extremities may remain
relatively thin.
,A patient presents with polyuria, polydipsia, and unexplained weight loss. Which
condition should be strongly considered?
Answer: Diabetes mellitus.
Rationale: Hyperglycemia causes osmotic diuresis, producing polyuria. Increased
thirst and unexplained weight loss are classic manifestations of diabetes.
Which test is commonly used to assess long-term glycemic control?
Answer: Hemoglobin A1c.
Rationale: HbA1c reflects average blood glucose over approximately the previous
2–3 months because glucose becomes attached to circulating hemoglobin.
A patient with diabetes becomes sweaty, confused, and tremulous. Which
condition is most likely?
Answer: Hypoglycemia.
Rationale: Adrenergic manifestations such as sweating, tremor, palpitations, and
anxiety can occur with low blood glucose. Confusion indicates neuroglycopenia.
Which finding is most concerning for diabetic ketoacidosis?
Answer: Kussmaul respirations.
Rationale: Kussmaul respirations are deep, rapid respirations that represent
respiratory compensation for metabolic acidosis caused by accumulation of ketone
bodies.
A patient with type 2 diabetes has an elevated urine albumin-to-creatinine ratio.
What complication does this suggest?
Answer: Diabetic kidney disease.
Rationale: Persistent albuminuria is an early marker of diabetic renal injury and
may precede significant decreases in glomerular filtration.
Which cardiovascular risk factor is modifiable?
Answer: Hypertension.
, Rationale: Blood pressure can be modified through lifestyle interventions and
medications. Age and genetic predisposition are examples of nonmodifiable
factors.
Which lipid abnormality is most strongly associated with atherosclerotic
cardiovascular disease?
Answer: Elevated LDL cholesterol.
Rationale: LDL contributes to cholesterol deposition within arterial walls and is a
major therapeutic target for cardiovascular risk reduction.
A patient presents with crushing substernal chest pain radiating to the left arm and
diaphoresis. What diagnosis should be considered immediately?
Answer: Acute coronary syndrome.
Rationale: New or severe pressure-like chest discomfort with radiation and
autonomic symptoms is highly concerning for myocardial ischemia and requires
urgent evaluation.
Which biomarker is most specific for myocardial injury?
Answer: Cardiac troponin.
Rationale: Troponin I and T are highly sensitive and specific markers of
myocardial injury and are central to the evaluation of suspected acute coronary
syndrome.
A patient with heart failure develops worsening dyspnea, orthopnea, and bilateral
lower-extremity edema. What does this most likely indicate?
Answer: Fluid volume overload.
Rationale: Increased venous and pulmonary congestion commonly produces
peripheral edema, orthopnea, and worsening shortness of breath in heart failure.
Which symptom is particularly characteristic of left-sided heart failure?
Answer: Pulmonary congestion.
