200+ VERIFIED NURSING & PMHNP EXAM QUESTIONS 2026–2027 |
TCAR POST, NR507, NRNP, NR509 COMPLETE A+ STUDY GUIDE
Q1.
A 45-year-old man presents with sudden-onset left leg pain, pallor, and
pulselessness. He has a history of atrial fibrillation. Most likely cause?
A. Deep vein thrombosis
B. Acute arterial embolism
C. Chronic peripheral artery disease
D. Cellulitis
Answer: B. Acute arterial embolism
Rationale: Sudden limb ischemia with atrial fibrillation suggests embolic arterial
occlusion.
Q2.
A 60-year-old woman presents with severe carotid bruit, transient right-sided
weakness, and slurred speech that resolved within 15 minutes. Likely diagnosis?
A. Hemorrhagic stroke
B. Transient ischemic attack (TIA)
C. Migraine with aura
D. Seizure
Answer: B. Transient ischemic attack (TIA)
Rationale: Transient neurologic deficits resolving within 24 hours indicate TIA.
Q3.
A 70-year-old man with severe carotid stenosis presents with dizziness, amaurosis
fugax, and recent TIA. What is the most appropriate intervention?
A. Lifestyle modification only
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B. Carotid endarterectomy
C. Antihypertensive therapy alone
D. Observation
Answer: B. Carotid endarterectomy
Rationale: Symptomatic severe carotid stenosis (>70%) warrants surgical
intervention to prevent stroke.
Q4.
A 65-year-old woman presents with pain and numbness in the right leg while
walking 100 meters, relieved with rest. Diagnosis?
A. Neuropathy
B. DVT
C. Intermittent claudication
D. Osteoarthritis
Answer: C. Intermittent claudication
Rationale: Pain with exertion relieved by rest is classic for peripheral artery
disease.
Q5.
A 72-year-old man presents with sudden right-sided weakness, aphasia, and facial
droop. CT scan shows middle cerebral artery thrombus. Most appropriate initial
therapy?
A. Aspirin only
B. IV thrombolysis (tPA) if within window
C. Heparin infusion
D. Carotid stenting immediately
Answer: B. IV thrombolysis
Rationale: Acute ischemic stroke within therapeutic window is treated with IV tPA
unless contraindicated.
Q6.
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A 68-year-old woman presents with sudden-onset severe headache, vomiting, and
neck stiffness. CT shows subarachnoid hemorrhage. Most likely etiology?
A. Ischemic stroke
B. Migraine
C. Ruptured cerebral aneurysm
D. Hypertensive encephalopathy
Answer: C. Ruptured cerebral aneurysm
Rationale: Sudden severe headache (“worst headache of life”) and CT findings
suggest aneurysmal SAH.
Q7.
A 55-year-old man presents with carotid bruit, hypertension, and dizziness.
Doppler shows 80% stenosis of the left internal carotid artery. Next best step?
A. Observation
B. Antiplatelet therapy only
C. Carotid endarterectomy
D. Carotid stenting only if symptomatic
Answer: C. Carotid endarterectomy
Rationale: Symptomatic severe carotid stenosis warrants surgical intervention to
prevent ischemic stroke.
Q8.
A 60-year-old woman presents with leg swelling, redness, and tenderness along the
calf. Ultrasound confirms thrombus in the deep femoral vein. Most appropriate
initial therapy?
A. Immediate surgery
B. Anticoagulation therapy
C. Compression only
D. Observation
Answer: B. Anticoagulation therapy
Rationale: DVT is treated with anticoagulation to prevent propagation and
pulmonary embolism.
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Q9.
A 72-year-old man presents with dizziness, syncope, and carotid bruit. Carotid
duplex shows 95% stenosis with recurrent TIAs. Best management?
A. Medical therapy alone
B. Urgent carotid endarterectomy
C. Observation
D. Anticoagulation only
Answer: B. Urgent carotid endarterectomy
Rationale: Severe symptomatic carotid stenosis requires urgent surgical
intervention to prevent major stroke.
Q10.
A 65-year-old woman presents with rest pain in her left foot, non-healing ulcers,
and absent distal pulses. Diagnosis?
A. Neuropathy
B. Venous insufficiency
C. Critical limb ischemia
D. Cellulitis
Answer: C. Critical limb ischemia
Rationale: Rest pain, ulcers, and absent pulses indicate advanced peripheral
arterial disease.
Q11.
A 70-year-old man presents with severe headache, vomiting, and sudden left-sided
weakness. CT shows intracerebral hemorrhage. First priority?
A. IV tPA
B. Airway, breathing, circulation stabilization
C. Carotid endarterectomy
D. Observation only
Answer: B. ABC stabilization