CMN 574 FINAL EXAM AND STUDY GUIDE NEWEST
2026 TEST BANK| COMPLETE 450 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+| CMN 574 FINAL
EXAM REVIEW 2025 (BRAND NEW!!)
1. A 68-year-old male with CKD stage 3a presents with new-
onset atrial fibrillation. Which anticoagulant is most
appropriate?
A) Warfarin
B) Apixaban
C) Dabigatran
D) Rivaroxaban
Answer: B) Apixaban
Rationale: Apixaban is partially renally cleared but safe in CKD
3a. Rivaroxaban and dabigatran have higher renal
1
,accumulation; warfarin is effective but requires frequent
monitoring and has more interactions.
2. A 45-year-old female reports fatigue, cold intolerance, and
weight gain. TSH is 12.4 mIU/L (ref 0.4–4.0), free T4 is 0.6
ng/dL. What is the next best step?
A) Check TPO antibodies
B) Start levothyroxine 1.6 mcg/kg/day
C) Repeat TSH in 6 weeks
D) Order thyroid ultrasound
Answer: B) Start levothyroxine 1.6 mcg/kg/day
Rationale: Overt hypothyroidism (high TSH, low free T4) requires
treatment. Antibodies confirm autoimmune cause but don’t
change initial management. Delaying treatment is inappropriate.
2
,3. Which finding is most specific for alcoholic liver disease?
A) AST > ALT with AST/ALT ratio > 1.5
B) ALT > AST with ratio < 1
C) Isolated elevation of GGT
D) Normal AST with elevated alkaline phosphatase
Answer: A) AST > ALT with AST/ALT ratio > 1.5
Rationale: In alcoholic liver disease, AST is typically elevated
more than ALT (ratio often >1.5–2). ALT > AST suggests viral
hepatitis. GGT is sensitive but not specific.
4. A 72-year-old male on hydrochlorothiazide presents with
muscle weakness, fatigue, and serum K+ 2.9 mEq/L. EKG
shows U waves. What is the most appropriate acute
management?
A) IV potassium chloride 40 mEq over 2 hours
B) Oral potassium 20 mEq once daily
3
, C) Hold thiazide and give IV potassium 10 mEq/hour cardiac
mn mn mn mn mn mn mn mn
mn monitored
D) Magnesium sulfate 2g IV mn mn mn
Answer: C) Hold thiazide and give IV potassium 10 mEq/hour
mn mn mn mn mn mn mn mn mn
mn cardiac monitored mn
Rationale: Severe hypokalemia with EKG changes requires
mn mn mn mn mn mn
mn cardiac monitoring and cautious IV repletion (max 10 mEq/hour
mn mn mn mn mn mn mn mn
mn peripherally). Oral is too slow. Magnesium should be checked but
mn mn mn mn mn mn mn mn mn
mn isn’t first-line without known deficiency.
mn mn mn mn
5. A 62-year-old with HFrEF (EF 30%) on lisinopril, carvedilol,
mn mn mn mn mn mn mn mn
mn furosemide, and spironolactone has K+ 5.8 mEq/L. Creatinine
mn mn mn mn mn mn mn
1.4 mg/dL (baseline 1.0). What is the best next step?
mn mn mn mn mn mn mn mn mn
A) Continue all meds, repeat BMP in 1 week
mn mn mn mn mn mn mn
B) Hold spironolactone and lisinopril, monitor potassium
mn mn mn mn mn
4
2026 TEST BANK| COMPLETE 450 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+| CMN 574 FINAL
EXAM REVIEW 2025 (BRAND NEW!!)
1. A 68-year-old male with CKD stage 3a presents with new-
onset atrial fibrillation. Which anticoagulant is most
appropriate?
A) Warfarin
B) Apixaban
C) Dabigatran
D) Rivaroxaban
Answer: B) Apixaban
Rationale: Apixaban is partially renally cleared but safe in CKD
3a. Rivaroxaban and dabigatran have higher renal
1
,accumulation; warfarin is effective but requires frequent
monitoring and has more interactions.
2. A 45-year-old female reports fatigue, cold intolerance, and
weight gain. TSH is 12.4 mIU/L (ref 0.4–4.0), free T4 is 0.6
ng/dL. What is the next best step?
A) Check TPO antibodies
B) Start levothyroxine 1.6 mcg/kg/day
C) Repeat TSH in 6 weeks
D) Order thyroid ultrasound
Answer: B) Start levothyroxine 1.6 mcg/kg/day
Rationale: Overt hypothyroidism (high TSH, low free T4) requires
treatment. Antibodies confirm autoimmune cause but don’t
change initial management. Delaying treatment is inappropriate.
2
,3. Which finding is most specific for alcoholic liver disease?
A) AST > ALT with AST/ALT ratio > 1.5
B) ALT > AST with ratio < 1
C) Isolated elevation of GGT
D) Normal AST with elevated alkaline phosphatase
Answer: A) AST > ALT with AST/ALT ratio > 1.5
Rationale: In alcoholic liver disease, AST is typically elevated
more than ALT (ratio often >1.5–2). ALT > AST suggests viral
hepatitis. GGT is sensitive but not specific.
4. A 72-year-old male on hydrochlorothiazide presents with
muscle weakness, fatigue, and serum K+ 2.9 mEq/L. EKG
shows U waves. What is the most appropriate acute
management?
A) IV potassium chloride 40 mEq over 2 hours
B) Oral potassium 20 mEq once daily
3
, C) Hold thiazide and give IV potassium 10 mEq/hour cardiac
mn mn mn mn mn mn mn mn
mn monitored
D) Magnesium sulfate 2g IV mn mn mn
Answer: C) Hold thiazide and give IV potassium 10 mEq/hour
mn mn mn mn mn mn mn mn mn
mn cardiac monitored mn
Rationale: Severe hypokalemia with EKG changes requires
mn mn mn mn mn mn
mn cardiac monitoring and cautious IV repletion (max 10 mEq/hour
mn mn mn mn mn mn mn mn
mn peripherally). Oral is too slow. Magnesium should be checked but
mn mn mn mn mn mn mn mn mn
mn isn’t first-line without known deficiency.
mn mn mn mn
5. A 62-year-old with HFrEF (EF 30%) on lisinopril, carvedilol,
mn mn mn mn mn mn mn mn
mn furosemide, and spironolactone has K+ 5.8 mEq/L. Creatinine
mn mn mn mn mn mn mn
1.4 mg/dL (baseline 1.0). What is the best next step?
mn mn mn mn mn mn mn mn mn
A) Continue all meds, repeat BMP in 1 week
mn mn mn mn mn mn mn
B) Hold spironolactone and lisinopril, monitor potassium
mn mn mn mn mn
4
