NURS 753 MIDTERM EXAM – QUESTIONS AND
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1. A 58-year-old patient with hypertension and type 2 diabetes asks why strict
blood pressure control is important. Which explanation is most accurate?
A. It eliminates the need for glucose control.
B. It reduces the risk of cardiovascular and renal complications.
C. It prevents all diabetic neuropathy.
D. It cures chronic kidney disease.
RATIONALE: Effective blood pressure management lowers the risk of stroke,
myocardial infarction, heart failure, and progression of diabetic kidney disease.
The other options overstate the effects of blood pressure control.
2. A family nurse practitioner evaluates a patient with crushing substernal
chest pain radiating to the left arm. What is the priority action?
A. Schedule a stress test for next week.
B. Prescribe a proton pump inhibitor.
C. Activate emergency evaluation for possible acute coronary syndrome.
D. Recommend increased fluid intake.
RATIONALE: Classic symptoms of acute coronary syndrome require immediate
emergency assessment. Delaying evaluation could result in significant morbidity
or mortality.
3. Which laboratory test best reflects average blood glucose over the previous
2–3 months?
,A. Fasting plasma glucose
B. Random plasma glucose
C. Hemoglobin A1c
D. Oral glucose tolerance test
RATIONALE: Hemoglobin A1c reflects long-term glycemic control by measuring
glycated hemoglobin over the lifespan of red blood cells.
4. During an annual examination, which intervention represents primary
prevention?
A. Ordering a biopsy of a suspicious lesion
B. Administering an influenza vaccine
C. Prescribing chemotherapy
D. Managing complications of heart failure
RATIONALE: Primary prevention aims to prevent disease before it occurs.
Vaccination is a classic example.
5. A patient with community-acquired pneumonia has increasing respiratory
distress and oxygen saturation of 86% on room air. What is the most
appropriate immediate intervention?
A. Reassure the patient and recheck tomorrow.
B. Initiate supplemental oxygen and urgent evaluation.
C. Recommend over-the-counter cough medication only.
D. Delay treatment pending sputum culture results.
RATIONALE: Hypoxemia requires prompt oxygen therapy and further assessment
to prevent respiratory failure.
6. Which lipid abnormality is most strongly associated with increased risk of
atherosclerotic cardiovascular disease?
,A. Elevated HDL cholesterol
B. Low LDL cholesterol
C. Elevated LDL cholesterol
D. Low triglycerides
RATIONALE: Elevated LDL cholesterol contributes significantly to atherosclerotic
plaque formation and cardiovascular risk.
7. A patient taking warfarin begins a new antibiotic and develops an elevated
INR. What is the best interpretation?
A. The antibiotic may have increased warfarin's anticoagulant effect.
B. The patient is resistant to warfarin.
C. The INR has no clinical significance.
D. The antibiotic reversed anticoagulation.
RATIONALE: Many antibiotics interact with warfarin, increasing bleeding risk
through elevated INR values.
8. Which finding is most consistent with iron deficiency anemia?
A. Elevated mean corpuscular volume (MCV)
B. Macrocytic red blood cells
C. Microcytic, hypochromic anemia
D. Elevated vitamin B12 level
RATIONALE: Iron deficiency classically produces microcytic, hypochromic red
blood cells due to impaired hemoglobin synthesis.
9. Which ethical principle is demonstrated when a competent patient refuses
treatment after receiving complete information?
A. Beneficence
B. Justice
, C. Autonomy
D. Fidelity
RATIONALE: Respect for patient autonomy includes honoring informed decisions,
including refusal of treatment.
10. Which physical examination finding is most concerning in a patient
presenting with severe headache?
A. Mild scalp tenderness
B. Nuchal rigidity with fever
C. Seasonal allergies
D. Dry skin
RATIONALE:Neck stiffness with fever raises concern for meningitis and warrants
immediate evaluation.
11. A 67-year-old patient with chronic obstructive pulmonary disease (COPD)
reports worsening dyspnea, increased sputum production, and purulent
sputum for two days. Which intervention is most appropriate?
A. Reassure the patient and continue current medications only.
B. Evaluate for an acute COPD exacerbation and initiate evidence-based treatment.
C. Schedule routine follow-up in three months.
D. Discontinue all bronchodilators.
RATIONALE: Increased dyspnea, sputum volume, and sputum purulence are
classic features of an acute COPD exacerbation. Prompt evaluation and
guideline-directed therapy can reduce complications.
12. A patient with type 2 diabetes has an HbA1c of 9.8% despite adherence to
metformin therapy. What is the next best step?
A. Discontinue all diabetes medications.
B. Intensify therapy based on current clinical guidelines and patient-specific
factors.
ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST | DOWNLOAD
INSTANT PDF
1. A 58-year-old patient with hypertension and type 2 diabetes asks why strict
blood pressure control is important. Which explanation is most accurate?
A. It eliminates the need for glucose control.
B. It reduces the risk of cardiovascular and renal complications.
C. It prevents all diabetic neuropathy.
D. It cures chronic kidney disease.
RATIONALE: Effective blood pressure management lowers the risk of stroke,
myocardial infarction, heart failure, and progression of diabetic kidney disease.
The other options overstate the effects of blood pressure control.
2. A family nurse practitioner evaluates a patient with crushing substernal
chest pain radiating to the left arm. What is the priority action?
A. Schedule a stress test for next week.
B. Prescribe a proton pump inhibitor.
C. Activate emergency evaluation for possible acute coronary syndrome.
D. Recommend increased fluid intake.
RATIONALE: Classic symptoms of acute coronary syndrome require immediate
emergency assessment. Delaying evaluation could result in significant morbidity
or mortality.
3. Which laboratory test best reflects average blood glucose over the previous
2–3 months?
,A. Fasting plasma glucose
B. Random plasma glucose
C. Hemoglobin A1c
D. Oral glucose tolerance test
RATIONALE: Hemoglobin A1c reflects long-term glycemic control by measuring
glycated hemoglobin over the lifespan of red blood cells.
4. During an annual examination, which intervention represents primary
prevention?
A. Ordering a biopsy of a suspicious lesion
B. Administering an influenza vaccine
C. Prescribing chemotherapy
D. Managing complications of heart failure
RATIONALE: Primary prevention aims to prevent disease before it occurs.
Vaccination is a classic example.
5. A patient with community-acquired pneumonia has increasing respiratory
distress and oxygen saturation of 86% on room air. What is the most
appropriate immediate intervention?
A. Reassure the patient and recheck tomorrow.
B. Initiate supplemental oxygen and urgent evaluation.
C. Recommend over-the-counter cough medication only.
D. Delay treatment pending sputum culture results.
RATIONALE: Hypoxemia requires prompt oxygen therapy and further assessment
to prevent respiratory failure.
6. Which lipid abnormality is most strongly associated with increased risk of
atherosclerotic cardiovascular disease?
,A. Elevated HDL cholesterol
B. Low LDL cholesterol
C. Elevated LDL cholesterol
D. Low triglycerides
RATIONALE: Elevated LDL cholesterol contributes significantly to atherosclerotic
plaque formation and cardiovascular risk.
7. A patient taking warfarin begins a new antibiotic and develops an elevated
INR. What is the best interpretation?
A. The antibiotic may have increased warfarin's anticoagulant effect.
B. The patient is resistant to warfarin.
C. The INR has no clinical significance.
D. The antibiotic reversed anticoagulation.
RATIONALE: Many antibiotics interact with warfarin, increasing bleeding risk
through elevated INR values.
8. Which finding is most consistent with iron deficiency anemia?
A. Elevated mean corpuscular volume (MCV)
B. Macrocytic red blood cells
C. Microcytic, hypochromic anemia
D. Elevated vitamin B12 level
RATIONALE: Iron deficiency classically produces microcytic, hypochromic red
blood cells due to impaired hemoglobin synthesis.
9. Which ethical principle is demonstrated when a competent patient refuses
treatment after receiving complete information?
A. Beneficence
B. Justice
, C. Autonomy
D. Fidelity
RATIONALE: Respect for patient autonomy includes honoring informed decisions,
including refusal of treatment.
10. Which physical examination finding is most concerning in a patient
presenting with severe headache?
A. Mild scalp tenderness
B. Nuchal rigidity with fever
C. Seasonal allergies
D. Dry skin
RATIONALE:Neck stiffness with fever raises concern for meningitis and warrants
immediate evaluation.
11. A 67-year-old patient with chronic obstructive pulmonary disease (COPD)
reports worsening dyspnea, increased sputum production, and purulent
sputum for two days. Which intervention is most appropriate?
A. Reassure the patient and continue current medications only.
B. Evaluate for an acute COPD exacerbation and initiate evidence-based treatment.
C. Schedule routine follow-up in three months.
D. Discontinue all bronchodilators.
RATIONALE: Increased dyspnea, sputum volume, and sputum purulence are
classic features of an acute COPD exacerbation. Prompt evaluation and
guideline-directed therapy can reduce complications.
12. A patient with type 2 diabetes has an HbA1c of 9.8% despite adherence to
metformin therapy. What is the next best step?
A. Discontinue all diabetes medications.
B. Intensify therapy based on current clinical guidelines and patient-specific
factors.
