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NRNP 6540 FINAL EXAM 2025
ACCURATE SPRING-SUMMER
QUARTER COMPLETE EXAM
CITED AND REFERENCED EXAM
(GUARANTEED PASS)
Below is a set of 100 multiple-choice questions for the NRNP 6540 Final Exam for the 2024
Spring-Summer Quarter, aligned with Walden University’s Advanced Practice Care of Older
Adults curriculum. The questions cover systems-based physical assessments, SOAP
documentation, cultural competence, and diagnostic tools, reflecting key competencies for
advanced practice nurses. Each question includes four answer options, with the correct answer
and an expert-level, evidence-based rationale supported by APA citations where applicable. The
questions are designed to test critical thinking, clinical decision-making, and cultural sensitivity
in the care of older adults.
1. Why is a comprehensive physical assessment necessary for a 75-year-old patient
presenting with weakness and dehydration?
a) Symptoms are likely due to aging
b) All body systems interact, and symptoms may indicate various diagnoses
c) The patient may not report all symptoms
d) It satisfies Medicare requirements
Correct Answer: b) All body systems interact, and symptoms may indicate various
diagnoses
Rationale: In older adults, symptoms like weakness and dehydration can stem from
multiple interacting systems (e.g., renal, cardiovascular). A comprehensive assessment is
critical to identify underlying causes, as symptoms are not solely attributable to aging
(Kennedy-Malone et al., 2019).
2. A 70-year-old patient with renal disease shows elevated serum creatinine. Which
laboratory value is essential before prescribing medications?
a) Complete blood count (CBC)
b) Culture and sensitivity of urine
c) Creatinine clearance
d) Uric acid levels
Correct Answer: c) Creatinine clearance
Rationale: Creatinine clearance estimates renal function, guiding safe medication dosing
in renal impairment. CBC and uric acid levels are less specific, and urine culture is
relevant only for infection (Kennedy-Malone et al., 2019).
, 2
3. What is a key consideration when ordering diagnostic tests for an older adult?
a) Tests should always be invasive
b) Tests must alter diagnosis or management
c) Tests should focus on patient preferences only
d) Tests are unnecessary in older adults
Correct Answer: b) Tests must alter diagnosis or management
Rationale: Diagnostic tests should influence clinical decision-making, balancing risks,
benefits, and evidence-based practice while considering patient wishes (Kennedy-Malone
et al., 2019).
4. A nurse practitioner assesses a patient with diarrhea and left upper quadrant pain.
What is a possible diagnosis?
a) Hirschsprung’s disease
b) Pancreatitis
c) Appendicitis
d) Gastrointestinal inflammatory bowel disease
Correct Answer: d) Gastrointestinal inflammatory bowel disease
Rationale: Left upper quadrant pain and diarrhea suggest inflammatory bowel disease,
which may present differently in older adults. Hirschsprung’s disease is congenital,
appendicitis typically causes right-sided pain, and diarrhea is not typical in pancreatitis
(Kennedy-Malone et al., 2019).
5. What does a comprehensive geriatric assessment (CGA) primarily aim to achieve?
a) Satisfy Medicare documentation
b) Identify care needs and plan outcomes
c) Focus only on medical history
d) Limit assessment to internal organs
Correct Answer: b) Identify care needs and plan outcomes
Rationale: The CGA is a multidimensional, interdisciplinary process to assess physical,
psychological, and social needs, guiding care planning for older adults (Kennedy-Malone
et al., 2019).
6. Which domains are included in a comprehensive geriatric assessment (CGA)?
a) Internal organ health only
b) Family history only
c) Physical and psychological health, plus other facets
d) Social habits only
Correct Answer: c) Physical and psychological health, plus other facets
Rationale: The CGA evaluates physical, psychological, functional, and social domains to
provide holistic care, per WGU C493 competencies (Kennedy-Malone et al., 2019).
7. A 60-year-old patient presents with coughing, shortness of breath, and purulent
sputum. What is the likely diagnosis?
a) Acute bronchitis
b) GERD
c) Chronic bronchitis
d) Bacterial pneumonia
Correct Answer: c) Chronic bronchitis
Rationale: Chronic bronchitis presents with productive cough and shortness of breath,
, 3
often requiring antibiotics and nebulizers. Acute bronchitis is viral, GERD lacks purulent
sputum, and bacterial pneumonia typically includes fever (Kennedy-Malone et al., 2019).
8. Which diagnostic test is most appropriate for a 69-year-old male with dysuria to
rule out prostate cancer?
a) Complete blood count (CBC)
b) Prostate-specific antigen (PSA)
c) Creatinine clearance
d) Uric acid levels
Correct Answer: b) Prostate-specific antigen (PSA)
Rationale: PSA testing screens for prostate cancer in men with dysuria, while other tests
are less specific for this condition (Kennedy-Malone et al., 2019).
9. A 82-year-old patient has second- and third-degree burns on her hand. What is the
initial treatment?
a) Clean with strong detergent
b) Rinse with cool tap water
c) Apply heat to reduce swelling
d) Ignore pain management
Correct Answer: b) Rinse with cool tap water
Rationale: Cool tap water stops the burn process and reduces tissue damage in second -
and third-degree burns. Strong detergents are harmful, and pain management is essential
(Kennedy-Malone et al., 2019).
10. What is a key feature of SOAP documentation for older adults?
a) Focus only on subjective data
b) Include objective and subjective data systematically
c) Exclude assessment findings
d) Avoid planning interventions
Correct Answer: b) Include objective and subjective data systematically
Rationale: SOAP (Subjective, Objective, Assessment, Plan) documentation organizes
comprehensive patient data to guide care, per nursing standards (Ball et al., 2015).
11. A patient reports weight loss and fatigue. Which diagnostic test assesses thyroid
function?
a) CT scan
b) TSH, Free T3, and Free T4
c) Scintigraphy
d) Myelogram
Correct Answer: b) TSH, Free T3, and Free T4
Rationale: Thyroid function tests (TSH, Free T3, Free T4) evaluate weight loss and
fatigue, common in thyroid disorders. Other tests are less relevant (Ankar & Kumar,
2021).
12. What cultural competence principle should guide care for a non-English-speaking
older adult?
a) Assume understanding based on gestures
b) Use a certified medical interpreter
c) Rely on family members for translation
d) Avoid addressing cultural beliefs
Correct Answer: b) Use a certified medical interpreter
NRNP 6540 FINAL EXAM 2025
ACCURATE SPRING-SUMMER
QUARTER COMPLETE EXAM
CITED AND REFERENCED EXAM
(GUARANTEED PASS)
Below is a set of 100 multiple-choice questions for the NRNP 6540 Final Exam for the 2024
Spring-Summer Quarter, aligned with Walden University’s Advanced Practice Care of Older
Adults curriculum. The questions cover systems-based physical assessments, SOAP
documentation, cultural competence, and diagnostic tools, reflecting key competencies for
advanced practice nurses. Each question includes four answer options, with the correct answer
and an expert-level, evidence-based rationale supported by APA citations where applicable. The
questions are designed to test critical thinking, clinical decision-making, and cultural sensitivity
in the care of older adults.
1. Why is a comprehensive physical assessment necessary for a 75-year-old patient
presenting with weakness and dehydration?
a) Symptoms are likely due to aging
b) All body systems interact, and symptoms may indicate various diagnoses
c) The patient may not report all symptoms
d) It satisfies Medicare requirements
Correct Answer: b) All body systems interact, and symptoms may indicate various
diagnoses
Rationale: In older adults, symptoms like weakness and dehydration can stem from
multiple interacting systems (e.g., renal, cardiovascular). A comprehensive assessment is
critical to identify underlying causes, as symptoms are not solely attributable to aging
(Kennedy-Malone et al., 2019).
2. A 70-year-old patient with renal disease shows elevated serum creatinine. Which
laboratory value is essential before prescribing medications?
a) Complete blood count (CBC)
b) Culture and sensitivity of urine
c) Creatinine clearance
d) Uric acid levels
Correct Answer: c) Creatinine clearance
Rationale: Creatinine clearance estimates renal function, guiding safe medication dosing
in renal impairment. CBC and uric acid levels are less specific, and urine culture is
relevant only for infection (Kennedy-Malone et al., 2019).
, 2
3. What is a key consideration when ordering diagnostic tests for an older adult?
a) Tests should always be invasive
b) Tests must alter diagnosis or management
c) Tests should focus on patient preferences only
d) Tests are unnecessary in older adults
Correct Answer: b) Tests must alter diagnosis or management
Rationale: Diagnostic tests should influence clinical decision-making, balancing risks,
benefits, and evidence-based practice while considering patient wishes (Kennedy-Malone
et al., 2019).
4. A nurse practitioner assesses a patient with diarrhea and left upper quadrant pain.
What is a possible diagnosis?
a) Hirschsprung’s disease
b) Pancreatitis
c) Appendicitis
d) Gastrointestinal inflammatory bowel disease
Correct Answer: d) Gastrointestinal inflammatory bowel disease
Rationale: Left upper quadrant pain and diarrhea suggest inflammatory bowel disease,
which may present differently in older adults. Hirschsprung’s disease is congenital,
appendicitis typically causes right-sided pain, and diarrhea is not typical in pancreatitis
(Kennedy-Malone et al., 2019).
5. What does a comprehensive geriatric assessment (CGA) primarily aim to achieve?
a) Satisfy Medicare documentation
b) Identify care needs and plan outcomes
c) Focus only on medical history
d) Limit assessment to internal organs
Correct Answer: b) Identify care needs and plan outcomes
Rationale: The CGA is a multidimensional, interdisciplinary process to assess physical,
psychological, and social needs, guiding care planning for older adults (Kennedy-Malone
et al., 2019).
6. Which domains are included in a comprehensive geriatric assessment (CGA)?
a) Internal organ health only
b) Family history only
c) Physical and psychological health, plus other facets
d) Social habits only
Correct Answer: c) Physical and psychological health, plus other facets
Rationale: The CGA evaluates physical, psychological, functional, and social domains to
provide holistic care, per WGU C493 competencies (Kennedy-Malone et al., 2019).
7. A 60-year-old patient presents with coughing, shortness of breath, and purulent
sputum. What is the likely diagnosis?
a) Acute bronchitis
b) GERD
c) Chronic bronchitis
d) Bacterial pneumonia
Correct Answer: c) Chronic bronchitis
Rationale: Chronic bronchitis presents with productive cough and shortness of breath,
, 3
often requiring antibiotics and nebulizers. Acute bronchitis is viral, GERD lacks purulent
sputum, and bacterial pneumonia typically includes fever (Kennedy-Malone et al., 2019).
8. Which diagnostic test is most appropriate for a 69-year-old male with dysuria to
rule out prostate cancer?
a) Complete blood count (CBC)
b) Prostate-specific antigen (PSA)
c) Creatinine clearance
d) Uric acid levels
Correct Answer: b) Prostate-specific antigen (PSA)
Rationale: PSA testing screens for prostate cancer in men with dysuria, while other tests
are less specific for this condition (Kennedy-Malone et al., 2019).
9. A 82-year-old patient has second- and third-degree burns on her hand. What is the
initial treatment?
a) Clean with strong detergent
b) Rinse with cool tap water
c) Apply heat to reduce swelling
d) Ignore pain management
Correct Answer: b) Rinse with cool tap water
Rationale: Cool tap water stops the burn process and reduces tissue damage in second -
and third-degree burns. Strong detergents are harmful, and pain management is essential
(Kennedy-Malone et al., 2019).
10. What is a key feature of SOAP documentation for older adults?
a) Focus only on subjective data
b) Include objective and subjective data systematically
c) Exclude assessment findings
d) Avoid planning interventions
Correct Answer: b) Include objective and subjective data systematically
Rationale: SOAP (Subjective, Objective, Assessment, Plan) documentation organizes
comprehensive patient data to guide care, per nursing standards (Ball et al., 2015).
11. A patient reports weight loss and fatigue. Which diagnostic test assesses thyroid
function?
a) CT scan
b) TSH, Free T3, and Free T4
c) Scintigraphy
d) Myelogram
Correct Answer: b) TSH, Free T3, and Free T4
Rationale: Thyroid function tests (TSH, Free T3, Free T4) evaluate weight loss and
fatigue, common in thyroid disorders. Other tests are less relevant (Ankar & Kumar,
2021).
12. What cultural competence principle should guide care for a non-English-speaking
older adult?
a) Assume understanding based on gestures
b) Use a certified medical interpreter
c) Rely on family members for translation
d) Avoid addressing cultural beliefs
Correct Answer: b) Use a certified medical interpreter
