Page 1 of 133
Advance Nursing Updated Exam 2026/27
Questions And Verified Answers, 100%
Guaranteed Pass ||Complete A+ Guide
1. A 58-year-old male with type 2 diabetes presents with
fatigue, weight loss, and night sweats. Labs: HbA1c 8.5%,
WBC 18,000/µL with 20% bands, ESR 110 mm/hr. What is
the most likely diagnosis?
A) Diabetic ketoacidosis
B) Tuberculosis
C) Lymphoma
D) Osteomyelitis
Answer: C) Lymphoma
Rationale: B-symptoms (night sweats, weight loss, fatigue) +
elevated ESR and leukocytosis with left shift suggest
,Page 2 of 133
malignancy. TB (B) is possible but less likely without cough or
exposure. DKA (A) presents with hyperglycemia and acidosis.
2. A patient with heart failure (EF 30%) develops
worsening dyspnea, JVD, and S3 gallop after starting
pioglitazone. What is the mechanism?
A) Increased afterload
B) Sodium and water retention
C) Direct myocardial toxicity
D) Beta-receptor blockade
Answer: B) Sodium and water retention
Rationale: Thiazolidinediones (pioglitazone) cause fluid
retention, worsening HF. Avoid in NYHA class III–IV.
3. Scenario: A 72-year-old woman on lisinopril, metoprolol,
and furosemide presents with syncope. BP 85/50, HR 38,
K+ 5.9, Cr 2.5 (baseline 1.0). ECG shows wide QRS and
,Page 3 of 133
peaked T waves. What is the priority intervention?
A) IV furosemide
B) IV calcium gluconate
C) IV atropine
D) Hold lisinopril
Answer: B) IV calcium gluconate
Rationale: Hyperkalemia (K+ 5.9) with ECG changes requires
immediate myocardial stabilization with calcium. Then
insulin+glucose, albuterol, kayexalate.
4. A 34-year-old woman presents with palpitations, heat
intolerance, and weight loss. TSH <0.01, Free T4 4.5. Which
finding is most specific for Graves’ disease?
A) Exophthalmos
B) Pretibial myxedema
C) Thyroid bruit
D) Thyroid peroxidase antibodies
, Page 4 of 133
Answer: A) Exophthalmos M. M.
Rationale: Exophthalmos is pathognomonic for Graves’.
M. M. M. M. M.
M. Pretibial myxedema is also specific but less common. Thyroid
M. M. M. M. M. M. M. M.
M . bruit suggests hyperthyroidism but not specific to Graves’.
M. M. M. M. M. M. M.
5. A patient with cirrhosis develops asterixis, confusion,
M. M. M. M. M. M.
M. and hyperammonemia. What is the first-line treatment?
M. M. M. M. M. M.
A) Neomycin
B) Lactulose
C) Rifaximin
D) IV albumin M.
Answer: B) Lactulose M. M.
Rationale: Lactulose acidifies the colon, traps ammonium as
M. M. M. M. M. M. M.
M. NH4+, and promotes excretion. Rifaximin is adjunctive.
M. M. M. M. M. M.
6. Scenario: A 45-year-old male with hypertension presents
M. M. M. M. M. M.
M. with acute severe flank pain radiating to groin, hematuria,
M. M. M. M. M. M. M. M.
Advance Nursing Updated Exam 2026/27
Questions And Verified Answers, 100%
Guaranteed Pass ||Complete A+ Guide
1. A 58-year-old male with type 2 diabetes presents with
fatigue, weight loss, and night sweats. Labs: HbA1c 8.5%,
WBC 18,000/µL with 20% bands, ESR 110 mm/hr. What is
the most likely diagnosis?
A) Diabetic ketoacidosis
B) Tuberculosis
C) Lymphoma
D) Osteomyelitis
Answer: C) Lymphoma
Rationale: B-symptoms (night sweats, weight loss, fatigue) +
elevated ESR and leukocytosis with left shift suggest
,Page 2 of 133
malignancy. TB (B) is possible but less likely without cough or
exposure. DKA (A) presents with hyperglycemia and acidosis.
2. A patient with heart failure (EF 30%) develops
worsening dyspnea, JVD, and S3 gallop after starting
pioglitazone. What is the mechanism?
A) Increased afterload
B) Sodium and water retention
C) Direct myocardial toxicity
D) Beta-receptor blockade
Answer: B) Sodium and water retention
Rationale: Thiazolidinediones (pioglitazone) cause fluid
retention, worsening HF. Avoid in NYHA class III–IV.
3. Scenario: A 72-year-old woman on lisinopril, metoprolol,
and furosemide presents with syncope. BP 85/50, HR 38,
K+ 5.9, Cr 2.5 (baseline 1.0). ECG shows wide QRS and
,Page 3 of 133
peaked T waves. What is the priority intervention?
A) IV furosemide
B) IV calcium gluconate
C) IV atropine
D) Hold lisinopril
Answer: B) IV calcium gluconate
Rationale: Hyperkalemia (K+ 5.9) with ECG changes requires
immediate myocardial stabilization with calcium. Then
insulin+glucose, albuterol, kayexalate.
4. A 34-year-old woman presents with palpitations, heat
intolerance, and weight loss. TSH <0.01, Free T4 4.5. Which
finding is most specific for Graves’ disease?
A) Exophthalmos
B) Pretibial myxedema
C) Thyroid bruit
D) Thyroid peroxidase antibodies
, Page 4 of 133
Answer: A) Exophthalmos M. M.
Rationale: Exophthalmos is pathognomonic for Graves’.
M. M. M. M. M.
M. Pretibial myxedema is also specific but less common. Thyroid
M. M. M. M. M. M. M. M.
M . bruit suggests hyperthyroidism but not specific to Graves’.
M. M. M. M. M. M. M.
5. A patient with cirrhosis develops asterixis, confusion,
M. M. M. M. M. M.
M. and hyperammonemia. What is the first-line treatment?
M. M. M. M. M. M.
A) Neomycin
B) Lactulose
C) Rifaximin
D) IV albumin M.
Answer: B) Lactulose M. M.
Rationale: Lactulose acidifies the colon, traps ammonium as
M. M. M. M. M. M. M.
M. NH4+, and promotes excretion. Rifaximin is adjunctive.
M. M. M. M. M. M.
6. Scenario: A 45-year-old male with hypertension presents
M. M. M. M. M. M.
M. with acute severe flank pain radiating to groin, hematuria,
M. M. M. M. M. M. M. M.
