NRNP 6531 EXAM 2: ADVANCED
PRACTICE CARE OF ADULTS
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A 65-year-old male presents with a history of heart failure (NYHA Class III). He is currently
taking Lisinopril 20mg daily and Carvedilol 12.5mg twice daily. Despite these, he remains
symptomatic with pedal edema and orthopnea. What is the most appropriate next step in
pharmacological management?
A. Increase Carvedilol to 25mg twice daily
B. Start Digoxin 0.125mg daily
C. Switch Lisinopril to Losartan
D. Add a loop diuretic such as Furosemide
Answer: D
Conceptual Explanation: Diuretics are indicated in patients with heart failure who have
evidence of fluid retention (pedal edema, orthopnea) to achieve and maintain euvolemia.
2. Which of the following EKG findings is most characteristic of Atrial Fibrillation?
A. Absent P waves and irregularly irregular QRR intervals
B. PR interval greater than 0.20 seconds
,C. Sawtooth pattern in leads II, III, and aVF
D. Delta wave at the start of the QRS complex
Answer: A
Conceptual Explanation: Atrial fibrillation is characterized by the absence of organized P
waves and an irregularly irregular ventricular response.
3. A 45-year-old patient with Asthma is currently using a Short-Acting Beta Agonist (SABA) as
needed. He reports using the inhaler 4 times a week and waking up twice a month due to
symptoms. According to GINA guidelines, what is the next step?
A. Continue current PRN SABA only
B. Add a Long-Acting Beta Agonist (LABA) only
C. Add a daily Low-dose Inhaled Corticosteroid (ICS)
D. Start oral prednisone for 5 days
Answer: C
Conceptual Explanation: Symptoms occurring more than twice a month warrant the
initiation of a daily low-dose ICS or PRN low-dose ICS-formoterol to prevent exacerbations.
4. A patient tests positive for H. Pylori via urea breath test. He has no known allergies. What
is the recommended first-line ‘clarithromycin-based triple therapy’?
A. Amoxicillin and Metronidazole
B. Metronidazole, Clarithromycin, and a PPI
, C. Bismuth, Metronidazole, and Tetracycline
D. Amoxicillin, Clarithromycin, and a Proton Pump Inhibitor (PPI)
Answer: D
Conceptual Explanation: Standard triple therapy consists of a PPI, Clarithromycin, and
either Amoxicillin or Metronidazole (Amoxicillin is preferred if no allergy exists).
5. A 58-year-old diabetic patient has a blood pressure reading of 148/92 mmHg at his visit
and 146/90 mmHg at home. Which medication class is the preferred first-line treatment for
this patient?
A. Beta-blocker
B. Calcium Channel Blocker
C. ACE Inhibitor or ARB
D. Thiazide Diuretic
Answer: C
Conceptual Explanation: In patients with diabetes and hypertension, ACE inhibitors or
ARBs are first-line because they provide renal protection.
6. According to the GOLD criteria, which assessment is necessary to confirm the diagnosis of
Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray showing hyperinflation
B. Oxygen saturation less than 92% on room air
PRACTICE CARE OF ADULTS
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A 65-year-old male presents with a history of heart failure (NYHA Class III). He is currently
taking Lisinopril 20mg daily and Carvedilol 12.5mg twice daily. Despite these, he remains
symptomatic with pedal edema and orthopnea. What is the most appropriate next step in
pharmacological management?
A. Increase Carvedilol to 25mg twice daily
B. Start Digoxin 0.125mg daily
C. Switch Lisinopril to Losartan
D. Add a loop diuretic such as Furosemide
Answer: D
Conceptual Explanation: Diuretics are indicated in patients with heart failure who have
evidence of fluid retention (pedal edema, orthopnea) to achieve and maintain euvolemia.
2. Which of the following EKG findings is most characteristic of Atrial Fibrillation?
A. Absent P waves and irregularly irregular QRR intervals
B. PR interval greater than 0.20 seconds
,C. Sawtooth pattern in leads II, III, and aVF
D. Delta wave at the start of the QRS complex
Answer: A
Conceptual Explanation: Atrial fibrillation is characterized by the absence of organized P
waves and an irregularly irregular ventricular response.
3. A 45-year-old patient with Asthma is currently using a Short-Acting Beta Agonist (SABA) as
needed. He reports using the inhaler 4 times a week and waking up twice a month due to
symptoms. According to GINA guidelines, what is the next step?
A. Continue current PRN SABA only
B. Add a Long-Acting Beta Agonist (LABA) only
C. Add a daily Low-dose Inhaled Corticosteroid (ICS)
D. Start oral prednisone for 5 days
Answer: C
Conceptual Explanation: Symptoms occurring more than twice a month warrant the
initiation of a daily low-dose ICS or PRN low-dose ICS-formoterol to prevent exacerbations.
4. A patient tests positive for H. Pylori via urea breath test. He has no known allergies. What
is the recommended first-line ‘clarithromycin-based triple therapy’?
A. Amoxicillin and Metronidazole
B. Metronidazole, Clarithromycin, and a PPI
, C. Bismuth, Metronidazole, and Tetracycline
D. Amoxicillin, Clarithromycin, and a Proton Pump Inhibitor (PPI)
Answer: D
Conceptual Explanation: Standard triple therapy consists of a PPI, Clarithromycin, and
either Amoxicillin or Metronidazole (Amoxicillin is preferred if no allergy exists).
5. A 58-year-old diabetic patient has a blood pressure reading of 148/92 mmHg at his visit
and 146/90 mmHg at home. Which medication class is the preferred first-line treatment for
this patient?
A. Beta-blocker
B. Calcium Channel Blocker
C. ACE Inhibitor or ARB
D. Thiazide Diuretic
Answer: C
Conceptual Explanation: In patients with diabetes and hypertension, ACE inhibitors or
ARBs are first-line because they provide renal protection.
6. According to the GOLD criteria, which assessment is necessary to confirm the diagnosis of
Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray showing hyperinflation
B. Oxygen saturation less than 92% on room air
