1
NUR 612 - FINAL EXAM UPDATED ACTUAL Questions
and CORRECT Answers
NUR 612 practice final
1. A patient with type 2 diabetes on basal insulin has fasting glucose at goal but
persistent postprandial hyperglycemia. Best next step?
A. Increase basal insulin
B. Add prandial insulin with largest meal
C. Stop insulin and start metformin
D. Add bedtime NPH only
Answer: B
Rationale: Controlled fasting glucose with high post-meal readings suggests
inadequate mealtime coverage, so add prandial insulin.
2. Which finding most strongly supports iron deficiency anemia?
A. High ferritin
B. Low TIBC
C. Low MCV with low ferritin
D. High reticulocyte count
Answer: C
Rationale: Iron deficiency classically shows microcytosis and low ferritin.
3. First-line treatment for uncomplicated cystitis in a nonpregnant adult
commonly includes:
A. Vancomycin
B. Nitrofurantoin
C. Meropenem
D. Azithromycin
pg. 1
, 2
Answer: B
Rationale: Nitrofurantoin is a common first-line option for uncomplicated cystitis
when appropriate.
4. Which medication should generally be avoided in pregnancy because of fetal
toxicity?
A. Labetalol
B. Nifedipine
C. Lisinopril
D. Methyldopa
Answer: C
Rationale: ACE inhibitors are associated with fetal harm and are generally avoided
in pregnancy.
5. A patient on warfarin starts an antibiotic and now has bleeding gums. Priority
lab?
A. BNP
B. INR
C. A1c
D. TSH
Answer: B
Rationale: Antibiotics can raise warfarin effect; INR is the key first check.
6. Which thyroid pattern suggests primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. Low TSH, low free T4
D. Normal TSH, high free T3
Answer: B
Rationale: Primary hypothyroidism reflects thyroid gland failure, so TSH rises
while free T4 falls.
7. Red-flag symptom in low back pain requiring urgent evaluation:
pg. 2
, 3
A. Pain worse after lifting
B. Paraspinal tenderness
C. Saddle anesthesia
D. Relief with NSAIDs
Answer: C
Rationale: Saddle anesthesia raises concern for cauda equina syndrome.
8. Which patient most clearly meets criteria for hypertensive urgency rather
than emergency?
A. BP 210/120 with papilledema
B. BP 200/110 with chest pain
C. BP 198/108 without acute end-organ symptoms
D. BP 190/100 with pulmonary edema
Answer: C
Rationale: Severe BP elevation without acute target-organ damage is urgency, not
emergency.
9. Most appropriate initial medication for persistent asthma controller therapy:
A. Albuterol daily only
B. Inhaled corticosteroid
C. Oral prednisone indefinitely
D. Ipratropium alone
Answer: B
Rationale: Inhaled corticosteroids are the standard controller foundation for
persistent asthma.
10. Which exam finding is most consistent with acute otitis media?
A. Retracted tympanic membrane without effusion
B. Bulging erythematous tympanic membrane with decreased mobility
C. Pearly gray tympanic membrane with landmarks visible
D. Pain with tragus movement only
Answer: B
Rationale: Bulging TM with impaired mobility supports middle ear infection.
pg. 3
, 4
11. A patient has unilateral leg swelling after a long flight. Best initial diagnostic
test?
A. Chest x-ray
B. Venous duplex ultrasound
C. Echocardiogram
D. MRI brain
Answer: B
Rationale: Suspected DVT is commonly evaluated first with duplex ultrasound.
12. Which lipid-lowering drug class is first-line for ASCVD risk reduction?
A. Fibrates
B. Statins
C. Niacin
D. Bile acid sequestrants
Answer: B
Rationale: Statins have the strongest evidence for reducing ASCVD events.
13. An adult with community-acquired pneumonia has confusion, hypotension,
and tachypnea. Best disposition?
A. Home with oral antibiotics
B. Routine follow-up in 1 week
C. Emergency evaluation/hospital-level care
D. No treatment needed
Answer: C
Rationale: These are severe features requiring urgent higher-level care.
14. Which test best monitors long-term glycemic control over about 3 months?
A. Fasting insulin
B. Serum ketones
C. Hemoglobin A1c
D. Random cortisol
Answer: C
Rationale: A1c reflects average glycemia over roughly 2-3 months.
pg. 4
NUR 612 - FINAL EXAM UPDATED ACTUAL Questions
and CORRECT Answers
NUR 612 practice final
1. A patient with type 2 diabetes on basal insulin has fasting glucose at goal but
persistent postprandial hyperglycemia. Best next step?
A. Increase basal insulin
B. Add prandial insulin with largest meal
C. Stop insulin and start metformin
D. Add bedtime NPH only
Answer: B
Rationale: Controlled fasting glucose with high post-meal readings suggests
inadequate mealtime coverage, so add prandial insulin.
2. Which finding most strongly supports iron deficiency anemia?
A. High ferritin
B. Low TIBC
C. Low MCV with low ferritin
D. High reticulocyte count
Answer: C
Rationale: Iron deficiency classically shows microcytosis and low ferritin.
3. First-line treatment for uncomplicated cystitis in a nonpregnant adult
commonly includes:
A. Vancomycin
B. Nitrofurantoin
C. Meropenem
D. Azithromycin
pg. 1
, 2
Answer: B
Rationale: Nitrofurantoin is a common first-line option for uncomplicated cystitis
when appropriate.
4. Which medication should generally be avoided in pregnancy because of fetal
toxicity?
A. Labetalol
B. Nifedipine
C. Lisinopril
D. Methyldopa
Answer: C
Rationale: ACE inhibitors are associated with fetal harm and are generally avoided
in pregnancy.
5. A patient on warfarin starts an antibiotic and now has bleeding gums. Priority
lab?
A. BNP
B. INR
C. A1c
D. TSH
Answer: B
Rationale: Antibiotics can raise warfarin effect; INR is the key first check.
6. Which thyroid pattern suggests primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. Low TSH, low free T4
D. Normal TSH, high free T3
Answer: B
Rationale: Primary hypothyroidism reflects thyroid gland failure, so TSH rises
while free T4 falls.
7. Red-flag symptom in low back pain requiring urgent evaluation:
pg. 2
, 3
A. Pain worse after lifting
B. Paraspinal tenderness
C. Saddle anesthesia
D. Relief with NSAIDs
Answer: C
Rationale: Saddle anesthesia raises concern for cauda equina syndrome.
8. Which patient most clearly meets criteria for hypertensive urgency rather
than emergency?
A. BP 210/120 with papilledema
B. BP 200/110 with chest pain
C. BP 198/108 without acute end-organ symptoms
D. BP 190/100 with pulmonary edema
Answer: C
Rationale: Severe BP elevation without acute target-organ damage is urgency, not
emergency.
9. Most appropriate initial medication for persistent asthma controller therapy:
A. Albuterol daily only
B. Inhaled corticosteroid
C. Oral prednisone indefinitely
D. Ipratropium alone
Answer: B
Rationale: Inhaled corticosteroids are the standard controller foundation for
persistent asthma.
10. Which exam finding is most consistent with acute otitis media?
A. Retracted tympanic membrane without effusion
B. Bulging erythematous tympanic membrane with decreased mobility
C. Pearly gray tympanic membrane with landmarks visible
D. Pain with tragus movement only
Answer: B
Rationale: Bulging TM with impaired mobility supports middle ear infection.
pg. 3
, 4
11. A patient has unilateral leg swelling after a long flight. Best initial diagnostic
test?
A. Chest x-ray
B. Venous duplex ultrasound
C. Echocardiogram
D. MRI brain
Answer: B
Rationale: Suspected DVT is commonly evaluated first with duplex ultrasound.
12. Which lipid-lowering drug class is first-line for ASCVD risk reduction?
A. Fibrates
B. Statins
C. Niacin
D. Bile acid sequestrants
Answer: B
Rationale: Statins have the strongest evidence for reducing ASCVD events.
13. An adult with community-acquired pneumonia has confusion, hypotension,
and tachypnea. Best disposition?
A. Home with oral antibiotics
B. Routine follow-up in 1 week
C. Emergency evaluation/hospital-level care
D. No treatment needed
Answer: C
Rationale: These are severe features requiring urgent higher-level care.
14. Which test best monitors long-term glycemic control over about 3 months?
A. Fasting insulin
B. Serum ketones
C. Hemoglobin A1c
D. Random cortisol
Answer: C
Rationale: A1c reflects average glycemia over roughly 2-3 months.
pg. 4
