NURS 6531 EXAM 4: ADVANCED
PRACTICE NURSING COMPREHENSIVE
REVIEW QUESTIONS AND VERIFIED
ANSWERS| GRADE A+|WALDEN
UNIVERSITY
1. A 68-year-old male presents with exertional chest pain and syncope. Physical exam reveals
a harsh systolic crescendo-decrescendo murmur at the right upper sternal border radiating to
the carotids. Which is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: B
Conceptual Explanation: Aortic stenosis is characterized by the classic triad of chest pain,
heart failure, and syncope, presenting with a systolic murmur at the RUSB radiating to the
neck.
2. According to the GOLD 2023 guidelines, which of the following is the preferred initial
treatment for a patient in COPD Group E?
A. SABA as needed
,B. LAMA monotherapy
C. LABA + LAMA combination
D. Inhaled Corticosteroids monotherapy
Answer: C
Conceptual Explanation: For Group E (high exacerbation risk regardless of symptoms),
the current recommendation is starting with a LABA + LAMA combination.
3. A 24-year-old female presents with acute right lower quadrant pain, rebound tenderness,
and a positive Rovsing sign. What is the most appropriate next step?
A. Abdominal X-ray
B. Wait and watch for 24 hours
C. CT scan of the abdomen and pelvis with contrast
D. Colonoscopy
Answer: C
Conceptual Explanation: CT with contrast is the gold standard for diagnosing appendicitis
in adults due to high sensitivity and specificity.
4. Which physical exam finding is most specific for a diagnosis of Acute Cholecystitis?
A. McBurney’s sign
B. Grey Turner’s sign
, C. Murphy’s sign
D. Cullen’s sign
Answer: C
Conceptual Explanation: Murphy’s sign, defined as inspiratory arrest during deep
palpation of the RUQ, is highly specific for gallbladder inflammation.
5. A patient presents with a ‘curtain coming down’ over their vision in one eye. This symptom
is most indicative of:
A. Acute Glaucoma
B. Cataracts
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Conceptual Explanation: Retinal detachment often presents with floaters, flashes of light,
and a progressive shadow or curtain in the visual field.
6. Which of the following laboratory results is consistent with primary hypothyroidism?
A. Low TSH, Low T4
B. Low TSH, High T4
C. High TSH, Low T4
PRACTICE NURSING COMPREHENSIVE
REVIEW QUESTIONS AND VERIFIED
ANSWERS| GRADE A+|WALDEN
UNIVERSITY
1. A 68-year-old male presents with exertional chest pain and syncope. Physical exam reveals
a harsh systolic crescendo-decrescendo murmur at the right upper sternal border radiating to
the carotids. Which is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: B
Conceptual Explanation: Aortic stenosis is characterized by the classic triad of chest pain,
heart failure, and syncope, presenting with a systolic murmur at the RUSB radiating to the
neck.
2. According to the GOLD 2023 guidelines, which of the following is the preferred initial
treatment for a patient in COPD Group E?
A. SABA as needed
,B. LAMA monotherapy
C. LABA + LAMA combination
D. Inhaled Corticosteroids monotherapy
Answer: C
Conceptual Explanation: For Group E (high exacerbation risk regardless of symptoms),
the current recommendation is starting with a LABA + LAMA combination.
3. A 24-year-old female presents with acute right lower quadrant pain, rebound tenderness,
and a positive Rovsing sign. What is the most appropriate next step?
A. Abdominal X-ray
B. Wait and watch for 24 hours
C. CT scan of the abdomen and pelvis with contrast
D. Colonoscopy
Answer: C
Conceptual Explanation: CT with contrast is the gold standard for diagnosing appendicitis
in adults due to high sensitivity and specificity.
4. Which physical exam finding is most specific for a diagnosis of Acute Cholecystitis?
A. McBurney’s sign
B. Grey Turner’s sign
, C. Murphy’s sign
D. Cullen’s sign
Answer: C
Conceptual Explanation: Murphy’s sign, defined as inspiratory arrest during deep
palpation of the RUQ, is highly specific for gallbladder inflammation.
5. A patient presents with a ‘curtain coming down’ over their vision in one eye. This symptom
is most indicative of:
A. Acute Glaucoma
B. Cataracts
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Conceptual Explanation: Retinal detachment often presents with floaters, flashes of light,
and a progressive shadow or curtain in the visual field.
6. Which of the following laboratory results is consistent with primary hypothyroidism?
A. Low TSH, Low T4
B. Low TSH, High T4
C. High TSH, Low T4
