Chamberlain University
SUMMARY NR667
NR 667 VISE Study Guide
Examination
Latest Update 2026/2027
Comprehensive 150-Question Study Guide with Rationales
Aligned with NR 667 Course Syllabus
AACN Essentials of Master's Education
Advanced Practice Family Nursing Competencies
USPSTF | ACOG | AAP | CDC | ADA Clinical Guidelines
Examination Structure
Section Topic Questions
Section 1 VISE Case Studies & Clinical Reasoning 25
Section 2 Assessment & Diagnostic Reasoning 20
Section 3 Differential Diagnosis & Clinical Decision-Making 20
Section 4 Pharmacological Management 20
Section 5 Non-Pharmacological Management & Patient Education 15
Section 6 Health Promotion & Disease Prevention 15
NR 667 VISE Study Guide Examination - 2026/2027 Page 1
,Chamberlain University | NR 667 VISE Summary NR667 - Latest Update 2026/2027
Section 7 Documentation, Coding, & Billing 15
Section 8 Professional Practice, Ethics, & Healthcare Policy 10
Section 9 Comprehensive Practice Questions & Test-Taking Strategies 10
Total Questions 150
Cognitive Levels: 20% Recall | 50% Application | 30% Analysis (clinical reasoning)
Question Style: 80% Scenario-Based (VISE) | 20% Direct Knowledge
NR 667 VISE Study Guide Examination - 2026/2027 Page 2
,Chamberlain University | NR 667 VISE Summary NR667 - Latest Update 2026/2027
Section 1: VISE Case Studies & Clinical Reasoning
25 questions addressing virtual integrated simulation scenarios, hypothesis-driven clinical
reasoning, differential diagnosis, and AACN-aligned VISE documentation.
Q1. A 52-year-old female with Type 2 diabetes, hypertension, and obesity presents to a
virtual visit reporting 3 weeks of progressive fatigue, increased urination, and blurred
vision. VISE scenario reveals HbA1c 9.8%, fasting glucose 178 mg/dL, BP 152/94, BMI 34. She
takes metformin 1000 mg BID and lisinopril 20 mg daily. Which clinical reasoning step
should the APRN prioritize first in the VISE SOAP documentation?
A. Adjust the metformin dose to 1500 mg BID and recheck HbA1c in 6 months.
B. Generate a prioritized differential diagnosis anchored to her worsening glycemic
control and volume-related symptoms, then identify red flags for hyperosmolar states.
*[CORRECT]*
C. Immediately prescribe a GLP-1 receptor agonist without further workup based on HbA1c
threshold.
D. Defer intervention until next quarterly visit to avoid polypharmacy.
Correct Answer: B
Rationale: The AACN Essentials and NR 667 VISE framework require the APRN to first generate and
prioritize differentials anchored to the chief concern, screen for red flags (e.g., hyperosmolar
hyperglycemic state), and document the clinical reasoning. Adjusting medications without
diagnostic reasoning (A, C) skips the hypothesis-driven step, while deferral (D) ignores actionable
evidence of poor control.
Q2. During a VISE telehealth encounter, a 68-year-old male with heart failure reports a 4-lb
weight gain over 3 days, dyspnea on exertion, and bilateral ankle edema. Which VISE
documentation element most clearly reflects hypothesis-driven clinical reasoning aligned
with AACN Essentials?
A. Documenting 'patient appears volume overloaded' in the objective section only.
B. Documenting an assessment that links the weight gain, dyspnea, and edema to a
unifying hypothesis of heart failure exacerbation with planned diuretic titration and
24-hour follow-up. *[CORRECT]*
C. Listing all cardiovascular diagnoses from the problem list without linking them to
today's data.
D. Deferring the assessment to the cardiologist without an APRN interpretation.
Correct Answer: B
Rationale: Hypothesis-driven reasoning in the AACN-aligned VISE requires the assessment to
explicitly connect subjective/objective data to a unifying hypothesis, plan, and follow-up. Vague
descriptors (A), problem-list dumps (C), and deferral without APRN interpretation (D) fail to
demonstrate the cognitive work expected at the master's-prepared APRN level.
NR 667 VISE Study Guide Examination - 2026/2027 Page 3
, Chamberlain University | NR 667 VISE Summary NR667 - Latest Update 2026/2027
Q3. A 34-year-old immigrant female presents via VISE with chronic pelvic pain,
dysmenorrhea, and dyspareunia. She speaks limited English and uses her 14-year-old
daughter as interpreter. Which VISE action best demonstrates cultural competence and
shared decision-making?
A. Proceed with the visit using the daughter to maintain efficiency.
B. Reschedule the visit, arrange a certified medical interpreter, and explore the
patient's illness narrative, treatment goals, and cultural beliefs before initiating
diagnostic workup. *[CORRECT]*
C. Refer directly to gynecology without further assessment since language is a barrier.
D. Use a translation app on a smartphone to complete the encounter.
Correct Answer: B
Rationale: AACN Essentials and CLAS Standards require certified interpreters (not family members
or apps) for accurate communication. Culturally competent VISE practice explores the patient's
illness narrative and goals before testing (B). Using a minor as interpreter (A), bypassing assessment
(C), and unvalidated app translation (D) compromise autonomy, accuracy, and consent.
Q4. A VISE case presents a 47-year-old male with 2 weeks of unilateral lower back pain
radiating to the posterior thigh after lifting boxes at work. Straight leg raise reproduces
pain at 30 degrees; patellar and Achilles reflexes are 2+ and symmetric. Which VISE step
represents the highest-priority clinical reasoning action?
A. Prescribe a 6-day prednisone taper and refer to physical therapy without imaging.
B. Screen for red flags (cauda equina, progressive neurologic deficit, infection,
malignancy) before initiating conservative management. *[CORRECT]*
C. Order an immediate lumbar MRI to confirm herniated disc.
D. Refer to pain management for epidural steroid injection.
Correct Answer: B
Rationale: Per ACP and NR 667 VISE guidance, the first reasoning step in low back pain is red-flag
screening (B). Absent red flags, conservative management without immediate imaging (A) is
appropriate. Routine MRI (C) is not indicated without neurologic deficits or red flags, and specialty
referral (D) precedes failure of conservative care.
NR 667 VISE Study Guide Examination - 2026/2027 Page 4
SUMMARY NR667
NR 667 VISE Study Guide
Examination
Latest Update 2026/2027
Comprehensive 150-Question Study Guide with Rationales
Aligned with NR 667 Course Syllabus
AACN Essentials of Master's Education
Advanced Practice Family Nursing Competencies
USPSTF | ACOG | AAP | CDC | ADA Clinical Guidelines
Examination Structure
Section Topic Questions
Section 1 VISE Case Studies & Clinical Reasoning 25
Section 2 Assessment & Diagnostic Reasoning 20
Section 3 Differential Diagnosis & Clinical Decision-Making 20
Section 4 Pharmacological Management 20
Section 5 Non-Pharmacological Management & Patient Education 15
Section 6 Health Promotion & Disease Prevention 15
NR 667 VISE Study Guide Examination - 2026/2027 Page 1
,Chamberlain University | NR 667 VISE Summary NR667 - Latest Update 2026/2027
Section 7 Documentation, Coding, & Billing 15
Section 8 Professional Practice, Ethics, & Healthcare Policy 10
Section 9 Comprehensive Practice Questions & Test-Taking Strategies 10
Total Questions 150
Cognitive Levels: 20% Recall | 50% Application | 30% Analysis (clinical reasoning)
Question Style: 80% Scenario-Based (VISE) | 20% Direct Knowledge
NR 667 VISE Study Guide Examination - 2026/2027 Page 2
,Chamberlain University | NR 667 VISE Summary NR667 - Latest Update 2026/2027
Section 1: VISE Case Studies & Clinical Reasoning
25 questions addressing virtual integrated simulation scenarios, hypothesis-driven clinical
reasoning, differential diagnosis, and AACN-aligned VISE documentation.
Q1. A 52-year-old female with Type 2 diabetes, hypertension, and obesity presents to a
virtual visit reporting 3 weeks of progressive fatigue, increased urination, and blurred
vision. VISE scenario reveals HbA1c 9.8%, fasting glucose 178 mg/dL, BP 152/94, BMI 34. She
takes metformin 1000 mg BID and lisinopril 20 mg daily. Which clinical reasoning step
should the APRN prioritize first in the VISE SOAP documentation?
A. Adjust the metformin dose to 1500 mg BID and recheck HbA1c in 6 months.
B. Generate a prioritized differential diagnosis anchored to her worsening glycemic
control and volume-related symptoms, then identify red flags for hyperosmolar states.
*[CORRECT]*
C. Immediately prescribe a GLP-1 receptor agonist without further workup based on HbA1c
threshold.
D. Defer intervention until next quarterly visit to avoid polypharmacy.
Correct Answer: B
Rationale: The AACN Essentials and NR 667 VISE framework require the APRN to first generate and
prioritize differentials anchored to the chief concern, screen for red flags (e.g., hyperosmolar
hyperglycemic state), and document the clinical reasoning. Adjusting medications without
diagnostic reasoning (A, C) skips the hypothesis-driven step, while deferral (D) ignores actionable
evidence of poor control.
Q2. During a VISE telehealth encounter, a 68-year-old male with heart failure reports a 4-lb
weight gain over 3 days, dyspnea on exertion, and bilateral ankle edema. Which VISE
documentation element most clearly reflects hypothesis-driven clinical reasoning aligned
with AACN Essentials?
A. Documenting 'patient appears volume overloaded' in the objective section only.
B. Documenting an assessment that links the weight gain, dyspnea, and edema to a
unifying hypothesis of heart failure exacerbation with planned diuretic titration and
24-hour follow-up. *[CORRECT]*
C. Listing all cardiovascular diagnoses from the problem list without linking them to
today's data.
D. Deferring the assessment to the cardiologist without an APRN interpretation.
Correct Answer: B
Rationale: Hypothesis-driven reasoning in the AACN-aligned VISE requires the assessment to
explicitly connect subjective/objective data to a unifying hypothesis, plan, and follow-up. Vague
descriptors (A), problem-list dumps (C), and deferral without APRN interpretation (D) fail to
demonstrate the cognitive work expected at the master's-prepared APRN level.
NR 667 VISE Study Guide Examination - 2026/2027 Page 3
, Chamberlain University | NR 667 VISE Summary NR667 - Latest Update 2026/2027
Q3. A 34-year-old immigrant female presents via VISE with chronic pelvic pain,
dysmenorrhea, and dyspareunia. She speaks limited English and uses her 14-year-old
daughter as interpreter. Which VISE action best demonstrates cultural competence and
shared decision-making?
A. Proceed with the visit using the daughter to maintain efficiency.
B. Reschedule the visit, arrange a certified medical interpreter, and explore the
patient's illness narrative, treatment goals, and cultural beliefs before initiating
diagnostic workup. *[CORRECT]*
C. Refer directly to gynecology without further assessment since language is a barrier.
D. Use a translation app on a smartphone to complete the encounter.
Correct Answer: B
Rationale: AACN Essentials and CLAS Standards require certified interpreters (not family members
or apps) for accurate communication. Culturally competent VISE practice explores the patient's
illness narrative and goals before testing (B). Using a minor as interpreter (A), bypassing assessment
(C), and unvalidated app translation (D) compromise autonomy, accuracy, and consent.
Q4. A VISE case presents a 47-year-old male with 2 weeks of unilateral lower back pain
radiating to the posterior thigh after lifting boxes at work. Straight leg raise reproduces
pain at 30 degrees; patellar and Achilles reflexes are 2+ and symmetric. Which VISE step
represents the highest-priority clinical reasoning action?
A. Prescribe a 6-day prednisone taper and refer to physical therapy without imaging.
B. Screen for red flags (cauda equina, progressive neurologic deficit, infection,
malignancy) before initiating conservative management. *[CORRECT]*
C. Order an immediate lumbar MRI to confirm herniated disc.
D. Refer to pain management for epidural steroid injection.
Correct Answer: B
Rationale: Per ACP and NR 667 VISE guidance, the first reasoning step in low back pain is red-flag
screening (B). Absent red flags, conservative management without immediate imaging (A) is
appropriate. Routine MRI (C) is not indicated without neurologic deficits or red flags, and specialty
referral (D) precedes failure of conservative care.
NR 667 VISE Study Guide Examination - 2026/2027 Page 4
