NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
NR 508 Final Exam questions and verified answers
for 2026 2027 update
Question 1
pts
A patient who has diabetes reports intense discomfort when needing to void. Aurinalysis
is normal. To treat this, the primary care NP should consider prescribing:
flavoxate (Urispas).
bethanechol (Urecholine).
phenazopyridine (Pyridium).
oxybutynin chloride (Ditropan XL).
This patient is describing urge incontinence, or overactive bladder, which occurs when
the detrusor muscle is hyperactive, causing an intense urge to void before the bladder is
full. Urge incontinence is associated with many conditions, including diabetes.
Oxybutynin chloride, which is an anticholinergic, acts to decrease detrusor overactivity
and is indicated for treatment of urge incontinence. Flavoxate is used to treat dysuria
associated with UTI. Bethanecholis indicated for urinary retention. Phenazopyridine is
used to treat dysuria.
Question 2
pts
A patient reports difficulty returning to sleep after getting up to go to the bathroomevery
night. A physical examination and a sleep hygiene history are noncontributory. The
pg. 1
, NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
primary care NP should prescribe:
zaleplon.
ZolpiMist.
ramelteon.
chloral hydrate.
ZolpiMist oral spray is useful for patients who have trouble returning to sleep in the
middle of the night. Zaleplon and ramelteon are used for insomnia caused bydifficulty
with sleep onset. Chloral hydrate is not typically used as outpatient therapy.
Question 3
pts
A 5-year-old child who has no previous history of otitis media is seen in clinic witha
temperature of 100° F. The primary care NP visualizes bilateral erythematous,
nonbulging, intact tympanic membranes. The child is taking fluids well and is playing
with toys in the examination room. The NP should:
prescribe azithromycin once daily for 5 days.
prescribe amoxicillin twice daily for 10 days.
prescribe amoxicillin-clavulanate twice daily for 10 days.
pg. 2
, NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
initiate antibiotic therapy if the child’s condition worsens.
Signs and symptoms of otitis media that indicate a need for antibiotic treatment include
otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a
low-grade fever, no history of otitis media, a nonbulging tympanicmembrane, and no
otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is
the drug of choice.
Question 4
pts
An 80-year-old patient with congestive heart failure has a viral upper respiratory
infection. The patient asks the primary care NP about treating the fever, which is38.5° C.
The NP should:
recommend acetaminophen.
recommend high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high. tell the
patient a fever less than 40° C does not need to be treated.
Patients with congestive heart failure may have tachycardia from fever that aggravates
their symptoms, so fever should be treated. High doses should be given with caution in
elderly patients because of possible decreased hepatic function. Antibiotics should not be
given without evidence of bacterial infection.
Question 5
pts
A patient who takes levodopa and carbidopa for Parkinson’s disease reports
experiencing freezing episodes between doses. The primary care NP shouldconsider
pg. 3
, NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
using:
selegiline.
amantadine.
apomorphine.
modified-release levodopa.
Apomorphine injection is used for acute treatment of immobility known as
“freezing.”
Question 6
pts
A patient is being tapered from long-term therapy with prednisolone and reportsweight
loss and fatigue. The primary care NP should counsel this patient to:
consume foods high in vitamin D and calcium.
begin taking dexamethasone because it has longer effects.
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
Sudden discontinuation or rapid tapering of glucocorticoids in patients who have
pg. 4
UPDATE
NR 508 Final Exam questions and verified answers
for 2026 2027 update
Question 1
pts
A patient who has diabetes reports intense discomfort when needing to void. Aurinalysis
is normal. To treat this, the primary care NP should consider prescribing:
flavoxate (Urispas).
bethanechol (Urecholine).
phenazopyridine (Pyridium).
oxybutynin chloride (Ditropan XL).
This patient is describing urge incontinence, or overactive bladder, which occurs when
the detrusor muscle is hyperactive, causing an intense urge to void before the bladder is
full. Urge incontinence is associated with many conditions, including diabetes.
Oxybutynin chloride, which is an anticholinergic, acts to decrease detrusor overactivity
and is indicated for treatment of urge incontinence. Flavoxate is used to treat dysuria
associated with UTI. Bethanecholis indicated for urinary retention. Phenazopyridine is
used to treat dysuria.
Question 2
pts
A patient reports difficulty returning to sleep after getting up to go to the bathroomevery
night. A physical examination and a sleep hygiene history are noncontributory. The
pg. 1
, NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
primary care NP should prescribe:
zaleplon.
ZolpiMist.
ramelteon.
chloral hydrate.
ZolpiMist oral spray is useful for patients who have trouble returning to sleep in the
middle of the night. Zaleplon and ramelteon are used for insomnia caused bydifficulty
with sleep onset. Chloral hydrate is not typically used as outpatient therapy.
Question 3
pts
A 5-year-old child who has no previous history of otitis media is seen in clinic witha
temperature of 100° F. The primary care NP visualizes bilateral erythematous,
nonbulging, intact tympanic membranes. The child is taking fluids well and is playing
with toys in the examination room. The NP should:
prescribe azithromycin once daily for 5 days.
prescribe amoxicillin twice daily for 10 days.
prescribe amoxicillin-clavulanate twice daily for 10 days.
pg. 2
, NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
initiate antibiotic therapy if the child’s condition worsens.
Signs and symptoms of otitis media that indicate a need for antibiotic treatment include
otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a
low-grade fever, no history of otitis media, a nonbulging tympanicmembrane, and no
otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is
the drug of choice.
Question 4
pts
An 80-year-old patient with congestive heart failure has a viral upper respiratory
infection. The patient asks the primary care NP about treating the fever, which is38.5° C.
The NP should:
recommend acetaminophen.
recommend high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high. tell the
patient a fever less than 40° C does not need to be treated.
Patients with congestive heart failure may have tachycardia from fever that aggravates
their symptoms, so fever should be treated. High doses should be given with caution in
elderly patients because of possible decreased hepatic function. Antibiotics should not be
given without evidence of bacterial infection.
Question 5
pts
A patient who takes levodopa and carbidopa for Parkinson’s disease reports
experiencing freezing episodes between doses. The primary care NP shouldconsider
pg. 3
, NR 508 FINAL EXAM QUESTIONS AND VERIFIED ANSWERS FOR 2026 2027
UPDATE
using:
selegiline.
amantadine.
apomorphine.
modified-release levodopa.
Apomorphine injection is used for acute treatment of immobility known as
“freezing.”
Question 6
pts
A patient is being tapered from long-term therapy with prednisolone and reportsweight
loss and fatigue. The primary care NP should counsel this patient to:
consume foods high in vitamin D and calcium.
begin taking dexamethasone because it has longer effects.
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
Sudden discontinuation or rapid tapering of glucocorticoids in patients who have
pg. 4
