NUR 6111 Exam 3 V3 | NUR 6111 Advanced Practice Nursing I | Q&A with Rationale
(NUR6111 Exam 3) | William Paterson University
1. A 62-year-old patient with a history of hypertension and diabetes presents for a follow-up.
According to the JNC 8 guidelines, what is the blood pressure goal for this patient?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 150/90 mmHg
D. < 120/80 mmHg
Answer: B
Rationale: The JNC 8 guidelines specify a target blood pressure of less than 140/90 mmHg
for adult patients with diabetes or chronic kidney disease. This recommendation aims to
reduce the risk of cardiovascular complications in high-risk populations. Clinical
management should focus on both lifestyle modifications and pharmacological
interventions to achieve this target.
2. Which of the following physical exam findings is most characteristic of a patient with aortic
stenosis?
A. A holosystolic murmur at the apex
B. A diastolic rumble at the 5th intercostal space
C. A harsh systolic crescendo-decrescendo murmur at the second right intercostal space
,D. A blowing diastolic murmur at the left sternal border
Answer: C
Rationale: Aortic stenosis typically presents as a harsh systolic crescendo-decrescendo
murmur heard best at the right second intercostal space. This murmur often radiates to the
carotid arteries as the stenosis becomes more severe. Advanced practice nurses must
differentiate this from mitral regurgitation, which is usually holosystolic and heard at the
apex.
3. A 45-year-old female presents with fatigue, cold intolerance, and weight gain. Her TSH is
12.5 mIU/L and her Free T4 is low. What is the most appropriate initial treatment?
A. Levothyroxine 50 mcg daily
B. Methimazole 10 mg daily
C. Liothyronine 5 mcg daily
D. Observation and retest in 3 months
Answer: A
Rationale: The patient’s lab results indicate primary hypothyroidism, which requires
replacement therapy with Levothyroxine. The initial dose is often calculated based on
weight and the presence of underlying cardiac disease. Ongoing monitoring of TSH levels
every 6 to 8 weeks is necessary until a euthyroid state is achieved.
, 4. In the management of Chronic Obstructive Pulmonary Disease (COPD), which class of
medication is considered the mainstay for patients in GOLD Group B?
A. Short-acting beta-agonists as needed
B. Inhaled corticosteroids only
C. Theophylline
D. Long-acting bronchodilators (LAMA or LABA)
Answer: D
Rationale: GOLD guidelines recommend a long-acting muscarinic antagonist (LAMA) or a
long-acting beta-agonist (LABA) for patients in Group B. These medications provide
sustained bronchodilation and help reduce the frequency of symptoms. Effective
management also includes smoking cessation and pulmonary rehabilitation as part of a
comprehensive plan.
5. A patient presents with a ‘curtain-like’ loss of vision in the right eye. This symptom is most
highly suggestive of which condition?
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Cataracts
D. Retinal detachment
Answer: D
(NUR6111 Exam 3) | William Paterson University
1. A 62-year-old patient with a history of hypertension and diabetes presents for a follow-up.
According to the JNC 8 guidelines, what is the blood pressure goal for this patient?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 150/90 mmHg
D. < 120/80 mmHg
Answer: B
Rationale: The JNC 8 guidelines specify a target blood pressure of less than 140/90 mmHg
for adult patients with diabetes or chronic kidney disease. This recommendation aims to
reduce the risk of cardiovascular complications in high-risk populations. Clinical
management should focus on both lifestyle modifications and pharmacological
interventions to achieve this target.
2. Which of the following physical exam findings is most characteristic of a patient with aortic
stenosis?
A. A holosystolic murmur at the apex
B. A diastolic rumble at the 5th intercostal space
C. A harsh systolic crescendo-decrescendo murmur at the second right intercostal space
,D. A blowing diastolic murmur at the left sternal border
Answer: C
Rationale: Aortic stenosis typically presents as a harsh systolic crescendo-decrescendo
murmur heard best at the right second intercostal space. This murmur often radiates to the
carotid arteries as the stenosis becomes more severe. Advanced practice nurses must
differentiate this from mitral regurgitation, which is usually holosystolic and heard at the
apex.
3. A 45-year-old female presents with fatigue, cold intolerance, and weight gain. Her TSH is
12.5 mIU/L and her Free T4 is low. What is the most appropriate initial treatment?
A. Levothyroxine 50 mcg daily
B. Methimazole 10 mg daily
C. Liothyronine 5 mcg daily
D. Observation and retest in 3 months
Answer: A
Rationale: The patient’s lab results indicate primary hypothyroidism, which requires
replacement therapy with Levothyroxine. The initial dose is often calculated based on
weight and the presence of underlying cardiac disease. Ongoing monitoring of TSH levels
every 6 to 8 weeks is necessary until a euthyroid state is achieved.
, 4. In the management of Chronic Obstructive Pulmonary Disease (COPD), which class of
medication is considered the mainstay for patients in GOLD Group B?
A. Short-acting beta-agonists as needed
B. Inhaled corticosteroids only
C. Theophylline
D. Long-acting bronchodilators (LAMA or LABA)
Answer: D
Rationale: GOLD guidelines recommend a long-acting muscarinic antagonist (LAMA) or a
long-acting beta-agonist (LABA) for patients in Group B. These medications provide
sustained bronchodilation and help reduce the frequency of symptoms. Effective
management also includes smoking cessation and pulmonary rehabilitation as part of a
comprehensive plan.
5. A patient presents with a ‘curtain-like’ loss of vision in the right eye. This symptom is most
highly suggestive of which condition?
A. Acute angle-closure glaucoma
B. Macular degeneration
C. Cataracts
D. Retinal detachment
Answer: D
