NURS 6521 (ADVANCED NURSING PRACTICE, PHARMACOLOGY,
PATHOPHYSIOLOGY, RESEARCH METHODS AND EVIDENCE-
BASED PRACTICE) MIDTERM EXAM QUESTIONS AND ANSWERS
VERIFIED ANSWERS PLUS RATIONALES
ADVANCED NURSING PRACTICE MIDTERM | | |
1. Which of the following best describes the primary goal of advanced nursing
| | | | | | | | | | |
practice?
|
A. Administer medications efficiently | |
B. Provide direct patient care only | | | |
C. Integrate evidence-based practice to improve patient outcomes
| | | | | |
D. Document care accurately | |
Answer: C |
Rationale: Advanced nursing practice emphasizes the integration of clinical
| | | | | | | |
expertise with research evidence to optimize patient outcomes.
| | | | | | | |
2. An advanced practice nurse (APN) is assessing a patient with hypertension.
| | | | | | | | | |
Which of the following interventions is most evidence-based for initial
| | | | | | | | | |
management?
|
A. Initiate beta-blockers in all patients
| | | |
B. Recommend lifestyle modifications and monitor blood pressure | | | | | |
C. Prescribe diuretics without evaluation | | |
D. Refer immediately to cardiology
| | |
Answer: B |
Rationale: Evidence-based guidelines recommend lifestyle modification as first-
| | | | | | |
line management in most hypertensive patients before pharmacologic
| | | | | | | |
intervention.
|
3. Which model best guides clinical decision-making by integrating patient
| | | | | | | |
preferences, clinical expertise, and research evidence?
| | | | | |
A. Health Belief Model | |
B. PICO Framework |
C. Evidence-Based Practice Model | |
D. Maslow’s Hierarchy of Needs | | |
,Answer: C |
Rationale: The Evidence-Based Practice Model combines best research
| | | | | | |
evidence, clinical expertise, and patient values for optimal care.
| | | | | | | | |
4. A patient presents with chronic pain unresponsive to non-opioid therapy. The
| | | | | | | | | |
APN considers initiating opioid therapy. What is the most important next step?
| | | | | | | | | | | |
A. Prescribe a long-acting opioid immediately | | | |
B. Evaluate risk factors for opioid misuse | | | | |
C. Refer the patient to physical therapy only
| | | | | |
D. Document pain and continue current therapy | | | | |
Answer: B |
Rationale: Assessing risk factors for opioid misuse is critical to ensure safe and
| | | | | | | | | | | |
effective pain management.
| | |
5. Which of the following is a core competency for advanced practice nurses
| | | | | | | | | | |
according to the AACN?
| | | |
A. Independent practice without collaboration | | |
B. Leadership in patient care and system improvement | | | | | |
C. Administrative documentation only | |
D. Sole reliance on standardized protocols
| | | |
Answer: B |
Rationale: Leadership in patient care, systems improvement, and quality
| | | | | | | |
enhancement is a core competency for APNs.
| | | | | | |
6. AnAPN is considering telehealth for a rural patient with diabetes. Which is a
| | | | | | | | | | | | |
primary advantage of telehealth in this scenario?
| | | | | | |
A. Replaces in-person visits entirely | | |
B. Reduces access to care | | |
C. Enhances patient monitoring and education | | | |
D. Limits patient engagement | |
Answer: C |
Rationale: Telehealth improves access, monitoring, and patient education,
| | | | | | |
especially in underserved areas.
| | | |
7. In implementing evidence-based practice, the PICO framework is used to:
| | | | | | | | |
A. Identify financial resources | |
B. Formulate clinical questions | |
C. Replace clinical judgment | |
D. Create patient satisfaction surveys
| | |
,Answer: B |
Rationale: PICO (Population, Intervention, Comparison, Outcome) is used to
| | | | | | | |
develop focused clinical questions for evidence-based practice.
| | | | | | |
8. When managing a patient with multiple comorbidities, theAPN should
| | | | | | | | |
prioritize interventions based on:
| | | |
A. Patient preference only | |
B. Disease severity and potential for harm | | | | |
C. Available hospital resources | |
D. Protocols regardless of context | | |
Answer: B |
Rationale: Prioritization is based on severity, potential harm, and overall impact
| | | | | | | | | |
on patient outcomes.
| | |
9. Which ethical principle emphasizes the obligation to do good for the patient?
| | | | | | | | | | |
A. Autonomy
B. Justice
C. Beneficence
D. Nonmaleficence
Answer: C |
Rationale: Beneficence refers to promoting good and acting in the best interest of
| | | | | | | | | | | |
the patient.
| |
10. Apatient refuses a recommended blood transfusion due to religious beliefs.
| | | | | | | | | |
The APN should:
| | |
A. Ignore the refusal and proceed | | | |
B. Respect autonomy and explore alternative therapies
| | | | |
C. Coerce the patient to consent | | | |
D. Document refusal but do nothing else | | | | |
Answer: B |
Rationale: Respecting patient autonomy while providing information and
| | | | | | |
alternatives is ethically required.
| | | |
11. TheAPN role includes prescriptive authority. Which factor is most critical to
| | | | | | | | | | |
safe prescribing?
| |
A. Familiarity with hospital formulary only | | | |
B. Comprehensive patient assessment | |
C. Prescribing based on patient request | | | |
D. Limiting prescriptions to over-the-counter medications
| | | |
, Answer: B |
Rationale: Safe prescribing relies on thorough assessment of the patient’s health
| | | | | | | | | |
status, comorbidities, and medication interactions.
| | | | |
12. Which type of research provides the highest level of evidence for clinical
| | | | | | | | | | |
decision-making?
|
A. Case series|
B. Randomized controlled trials (RCTs) | | |
C. Expert opinion |
D. Observational studies |
Answer: B |
Rationale: RCTs reduce bias and provide high-quality evidence for causality and
| | | | | | | | | |
effectiveness.
|
13. Which statement best describes shared decision-making in advanced
| | | | | | |
practice nursing?
| |
A. TheAPN makes decisions without patient input
| | | | | |
B. The patient makes all decisions independently
| | | | |
C. APN and patient collaborate, using evidence and patient values
| | | | | | | |
D. Family members dictate treatment plans
| | | |
Answer: C |
Rationale: Shared decision-making combines clinical evidence with patient
| | | | | | |
preferences and values.
| | |
14. AnAPN is treating a patient with early-stage heart failure. Which non-
| | | | | | | | | | |
pharmacologic intervention has strong evidence for improving outcomes?
| | | | | | | |
A. Daily high-sodium diet
| |
B. Structured exercise and fluid management | | | |
C. Complete bed rest | |
D. Ignoring weight monitoring | |
Answer: B |
Rationale: Exercise, fluid restriction, and daily weight monitoring are evidence-
| | | | | | | | |
based interventions for heart failure management.
| | | | | |
15. Which assessment tool is most appropriate for evaluating depression
| | | | | | | |
severity in adults?
| | |
A. MMSE
B. PHQ-9
C. GAD-7
D. Braden Scale |
PATHOPHYSIOLOGY, RESEARCH METHODS AND EVIDENCE-
BASED PRACTICE) MIDTERM EXAM QUESTIONS AND ANSWERS
VERIFIED ANSWERS PLUS RATIONALES
ADVANCED NURSING PRACTICE MIDTERM | | |
1. Which of the following best describes the primary goal of advanced nursing
| | | | | | | | | | |
practice?
|
A. Administer medications efficiently | |
B. Provide direct patient care only | | | |
C. Integrate evidence-based practice to improve patient outcomes
| | | | | |
D. Document care accurately | |
Answer: C |
Rationale: Advanced nursing practice emphasizes the integration of clinical
| | | | | | | |
expertise with research evidence to optimize patient outcomes.
| | | | | | | |
2. An advanced practice nurse (APN) is assessing a patient with hypertension.
| | | | | | | | | |
Which of the following interventions is most evidence-based for initial
| | | | | | | | | |
management?
|
A. Initiate beta-blockers in all patients
| | | |
B. Recommend lifestyle modifications and monitor blood pressure | | | | | |
C. Prescribe diuretics without evaluation | | |
D. Refer immediately to cardiology
| | |
Answer: B |
Rationale: Evidence-based guidelines recommend lifestyle modification as first-
| | | | | | |
line management in most hypertensive patients before pharmacologic
| | | | | | | |
intervention.
|
3. Which model best guides clinical decision-making by integrating patient
| | | | | | | |
preferences, clinical expertise, and research evidence?
| | | | | |
A. Health Belief Model | |
B. PICO Framework |
C. Evidence-Based Practice Model | |
D. Maslow’s Hierarchy of Needs | | |
,Answer: C |
Rationale: The Evidence-Based Practice Model combines best research
| | | | | | |
evidence, clinical expertise, and patient values for optimal care.
| | | | | | | | |
4. A patient presents with chronic pain unresponsive to non-opioid therapy. The
| | | | | | | | | |
APN considers initiating opioid therapy. What is the most important next step?
| | | | | | | | | | | |
A. Prescribe a long-acting opioid immediately | | | |
B. Evaluate risk factors for opioid misuse | | | | |
C. Refer the patient to physical therapy only
| | | | | |
D. Document pain and continue current therapy | | | | |
Answer: B |
Rationale: Assessing risk factors for opioid misuse is critical to ensure safe and
| | | | | | | | | | | |
effective pain management.
| | |
5. Which of the following is a core competency for advanced practice nurses
| | | | | | | | | | |
according to the AACN?
| | | |
A. Independent practice without collaboration | | |
B. Leadership in patient care and system improvement | | | | | |
C. Administrative documentation only | |
D. Sole reliance on standardized protocols
| | | |
Answer: B |
Rationale: Leadership in patient care, systems improvement, and quality
| | | | | | | |
enhancement is a core competency for APNs.
| | | | | | |
6. AnAPN is considering telehealth for a rural patient with diabetes. Which is a
| | | | | | | | | | | | |
primary advantage of telehealth in this scenario?
| | | | | | |
A. Replaces in-person visits entirely | | |
B. Reduces access to care | | |
C. Enhances patient monitoring and education | | | |
D. Limits patient engagement | |
Answer: C |
Rationale: Telehealth improves access, monitoring, and patient education,
| | | | | | |
especially in underserved areas.
| | | |
7. In implementing evidence-based practice, the PICO framework is used to:
| | | | | | | | |
A. Identify financial resources | |
B. Formulate clinical questions | |
C. Replace clinical judgment | |
D. Create patient satisfaction surveys
| | |
,Answer: B |
Rationale: PICO (Population, Intervention, Comparison, Outcome) is used to
| | | | | | | |
develop focused clinical questions for evidence-based practice.
| | | | | | |
8. When managing a patient with multiple comorbidities, theAPN should
| | | | | | | | |
prioritize interventions based on:
| | | |
A. Patient preference only | |
B. Disease severity and potential for harm | | | | |
C. Available hospital resources | |
D. Protocols regardless of context | | |
Answer: B |
Rationale: Prioritization is based on severity, potential harm, and overall impact
| | | | | | | | | |
on patient outcomes.
| | |
9. Which ethical principle emphasizes the obligation to do good for the patient?
| | | | | | | | | | |
A. Autonomy
B. Justice
C. Beneficence
D. Nonmaleficence
Answer: C |
Rationale: Beneficence refers to promoting good and acting in the best interest of
| | | | | | | | | | | |
the patient.
| |
10. Apatient refuses a recommended blood transfusion due to religious beliefs.
| | | | | | | | | |
The APN should:
| | |
A. Ignore the refusal and proceed | | | |
B. Respect autonomy and explore alternative therapies
| | | | |
C. Coerce the patient to consent | | | |
D. Document refusal but do nothing else | | | | |
Answer: B |
Rationale: Respecting patient autonomy while providing information and
| | | | | | |
alternatives is ethically required.
| | | |
11. TheAPN role includes prescriptive authority. Which factor is most critical to
| | | | | | | | | | |
safe prescribing?
| |
A. Familiarity with hospital formulary only | | | |
B. Comprehensive patient assessment | |
C. Prescribing based on patient request | | | |
D. Limiting prescriptions to over-the-counter medications
| | | |
, Answer: B |
Rationale: Safe prescribing relies on thorough assessment of the patient’s health
| | | | | | | | | |
status, comorbidities, and medication interactions.
| | | | |
12. Which type of research provides the highest level of evidence for clinical
| | | | | | | | | | |
decision-making?
|
A. Case series|
B. Randomized controlled trials (RCTs) | | |
C. Expert opinion |
D. Observational studies |
Answer: B |
Rationale: RCTs reduce bias and provide high-quality evidence for causality and
| | | | | | | | | |
effectiveness.
|
13. Which statement best describes shared decision-making in advanced
| | | | | | |
practice nursing?
| |
A. TheAPN makes decisions without patient input
| | | | | |
B. The patient makes all decisions independently
| | | | |
C. APN and patient collaborate, using evidence and patient values
| | | | | | | |
D. Family members dictate treatment plans
| | | |
Answer: C |
Rationale: Shared decision-making combines clinical evidence with patient
| | | | | | |
preferences and values.
| | |
14. AnAPN is treating a patient with early-stage heart failure. Which non-
| | | | | | | | | | |
pharmacologic intervention has strong evidence for improving outcomes?
| | | | | | | |
A. Daily high-sodium diet
| |
B. Structured exercise and fluid management | | | |
C. Complete bed rest | |
D. Ignoring weight monitoring | |
Answer: B |
Rationale: Exercise, fluid restriction, and daily weight monitoring are evidence-
| | | | | | | | |
based interventions for heart failure management.
| | | | | |
15. Which assessment tool is most appropriate for evaluating depression
| | | | | | | |
severity in adults?
| | |
A. MMSE
B. PHQ-9
C. GAD-7
D. Braden Scale |
