NR.210.605 Diagnostic Skills & Procedures for
Advanced Practice Nursing
Comprehensive Final Exam (Qns & Ans)
2025
1. Case Scenario:
A 62‑year‑old patient presents with new‑onset shortness of breath
and chest discomfort. The advanced practice nurse orders an
echocardiogram. Which parameter is most critical in assessing the
patient’s left ventricular systolic function?
A. Left ventricular end-diastolic diameter
B. Left ventricular ejection fraction
C. Mitral valve area
D. Aortic flow velocity
ANS: B. Left ventricular ejection fraction
©2025
, Rationale: The ejection fraction is the primary indicator of
systolic function, quantifying the percentage of blood ejected
from the left ventricle with each beat. This measurement is
essential in diagnosing conditions such as heart failure and
guiding management.
---
2. Case Scenario:
A 55‑year‑old patient with atypical chest pain is scheduled for
coronary computed tomography angiography (CTA). Before the
procedure, the nurse practitioner recommends administration of a
beta blocker. What is the primary purpose of this intervention?
A. To reduce coronary calcium scoring
B. To lower the patient’s heart rate below 60 bpm for optimal
image quality
C. To prevent contrast-induced nephropathy
D. To dilate the coronary arteries
ANS: B. To lower the patient’s heart rate below 60 bpm for
optimal image quality
Rationale: A lower heart rate minimizes motion artifacts during
CTA, thereby improving the spatial resolution of the coronary
images.
©2025
,---
3. Case Scenario:
A patient suspected of pulmonary embolism undergoes a
ventilation/perfusion (V/Q) scan. Which finding on this scan is
most indicative of a pulmonary embolism?
A. Matched ventilation and perfusion defects
B. Diffuse perfusion abnormalities with normal ventilation
C. A ventilation–perfusion mismatch
D. Uniform tracer distribution in both ventilation and perfusion
phases
ANS: C. A ventilation–perfusion mismatch
Rationale: In pulmonary embolism, areas of the lung may be
ventilated normally but are perfused poorly, resulting in a classic
mismatch diagnostic of the embolic process.
---
4. Case Scenario:
©2025
, A patient with suspected deep vein thrombosis undergoes a
venous duplex ultrasound. Which principle underlies the
functionality of this diagnostic tool?
A. Reflection of X‑rays by different tissues
B. Transmission of magnetic fields through the body
C. The Doppler shift phenomenon to assess blood flow
D. Acoustic impedance differences measured by thermography
ANS: C. The Doppler shift phenomenon to assess blood flow
Rationale: Duplex ultrasound combines traditional B‑mode
imaging with Doppler analysis, which utilizes the change in
frequency (Doppler shift) of sound waves reflecting off moving
blood cells to evaluate venous flow and detect obstructions.
---
5. Case Scenario:
A 68‑year‑old patient is evaluated in the emergency department
with acute neurologic deficits. An emergent non-contrast CT scan
of the head reveals no hemorrhage but a hyperdense vessel sign in
the left middle cerebral artery. What is the most likely diagnosis?
A. Hemorrhagic stroke
B. Acute ischemic stroke due to thrombus
©2025
Advanced Practice Nursing
Comprehensive Final Exam (Qns & Ans)
2025
1. Case Scenario:
A 62‑year‑old patient presents with new‑onset shortness of breath
and chest discomfort. The advanced practice nurse orders an
echocardiogram. Which parameter is most critical in assessing the
patient’s left ventricular systolic function?
A. Left ventricular end-diastolic diameter
B. Left ventricular ejection fraction
C. Mitral valve area
D. Aortic flow velocity
ANS: B. Left ventricular ejection fraction
©2025
, Rationale: The ejection fraction is the primary indicator of
systolic function, quantifying the percentage of blood ejected
from the left ventricle with each beat. This measurement is
essential in diagnosing conditions such as heart failure and
guiding management.
---
2. Case Scenario:
A 55‑year‑old patient with atypical chest pain is scheduled for
coronary computed tomography angiography (CTA). Before the
procedure, the nurse practitioner recommends administration of a
beta blocker. What is the primary purpose of this intervention?
A. To reduce coronary calcium scoring
B. To lower the patient’s heart rate below 60 bpm for optimal
image quality
C. To prevent contrast-induced nephropathy
D. To dilate the coronary arteries
ANS: B. To lower the patient’s heart rate below 60 bpm for
optimal image quality
Rationale: A lower heart rate minimizes motion artifacts during
CTA, thereby improving the spatial resolution of the coronary
images.
©2025
,---
3. Case Scenario:
A patient suspected of pulmonary embolism undergoes a
ventilation/perfusion (V/Q) scan. Which finding on this scan is
most indicative of a pulmonary embolism?
A. Matched ventilation and perfusion defects
B. Diffuse perfusion abnormalities with normal ventilation
C. A ventilation–perfusion mismatch
D. Uniform tracer distribution in both ventilation and perfusion
phases
ANS: C. A ventilation–perfusion mismatch
Rationale: In pulmonary embolism, areas of the lung may be
ventilated normally but are perfused poorly, resulting in a classic
mismatch diagnostic of the embolic process.
---
4. Case Scenario:
©2025
, A patient with suspected deep vein thrombosis undergoes a
venous duplex ultrasound. Which principle underlies the
functionality of this diagnostic tool?
A. Reflection of X‑rays by different tissues
B. Transmission of magnetic fields through the body
C. The Doppler shift phenomenon to assess blood flow
D. Acoustic impedance differences measured by thermography
ANS: C. The Doppler shift phenomenon to assess blood flow
Rationale: Duplex ultrasound combines traditional B‑mode
imaging with Doppler analysis, which utilizes the change in
frequency (Doppler shift) of sound waves reflecting off moving
blood cells to evaluate venous flow and detect obstructions.
---
5. Case Scenario:
A 68‑year‑old patient is evaluated in the emergency department
with acute neurologic deficits. An emergent non-contrast CT scan
of the head reveals no hemorrhage but a hyperdense vessel sign in
the left middle cerebral artery. What is the most likely diagnosis?
A. Hemorrhagic stroke
B. Acute ischemic stroke due to thrombus
©2025
