NUR 6130 Exam 4 V1 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 4) | William
Paterson University
1. A 72-year-old male presents with a resting tremor, bradykinesia, and postural instability.
Which neurotransmitter deficiency is primarily responsible for these clinical manifestations?
A. Acetylcholine
B. Serotonin
C. GABA
D. Dopamine
Answer: D
Rationale: Parkinson’s disease is characterized by the progressive loss of dopaminergic
neurons in the substantia nigra. This deficiency leads to an imbalance between dopamine
and acetylcholine in the basal ganglia, resulting in motor symptoms. The pharmacological
goal is to restore dopamine levels or block cholinergic effects to improve patient function.
2. When evaluating a patient with suspected pernicious anemia, which diagnostic finding is
most pathognomonic for this condition?
A. Positive intrinsic factor antibodies
B. Low serum iron levels
,C. Decreased total iron-binding capacity
D. Microcytic red blood cells
Answer: A
Rationale: Pernicious anemia is an autoimmune disorder where the body fails to produce
intrinsic factor, which is necessary for vitamin B12 absorption. A positive test for intrinsic
factor antibodies confirms the diagnosis in the presence of megaloblastic anemia. This
condition requires lifelong parenteral vitamin B12 supplementation to prevent
neurological complications.
3. A patient with a history of atrial fibrillation presents with sudden onset of hemiparesis and
aphasia. The symptoms resolve completely within 4 hours. How should this event be
categorized?
A. Ischemic Stroke
B. Reversible Ischemic Neurological Deficit
C. Hemorrhagic Stroke
D. Transient Ischemic Attack (TIA)
Answer: D
Rationale: A Transient Ischemic Attack (TIA) is defined by neurological deficit that
resolves typically within 24 hours without evidence of acute infarction on imaging. Even
though symptoms resolved, the patient is at high risk for a major stroke in the immediate
,future. The NP must initiate an urgent workup including neuroimaging and carotid studies
to address the underlying cause.
4. Which pharmacological agent is considered the first-line prophylactic treatment for a
patient experiencing frequent, debilitating migraine headaches?
A. Propranolol
B. Sumatriptan
C. Oxycodone
D. Acetaminophen
Answer: A
Rationale: Beta-blockers such as Propranolol are evidence-based first-line options for
migraine prophylaxis when patients experience two or more attacks per month that impair
quality of life. Unlike triptans, which are used for acute abortive therapy, prophylactic
agents aim to reduce the frequency and severity of attacks. Careful monitoring for
bradycardia and hypotension is required when initiating this therapy.
5. A 65-year-old female reports a ‘curtain coming down’ over her right eye. She denies pain
but notes flashing lights and floaters earlier in the day. What is the most likely diagnosis?
A. Acute Angle-Closure Glaucoma
B. Cataract
C. Macular Degeneration
, D. Retinal Detachment
Answer: D
Rationale: The classic description of a ‘curtain’ descending over the visual field is
indicative of retinal detachment. This is a medical emergency that requires immediate
referral to an ophthalmologist to prevent permanent vision loss. The preceding flashes
(photopsia) and floaters often signal the initial tear or traction on the retina.
6. An elderly patient presents with gradual loss of central vision, while peripheral vision
remains intact. Which condition is the most likely cause?
A. Open-angle Glaucoma
B. Presbyopia
C. Age-related Macular Degeneration
D. Diabetic Retinopathy
Answer: C
Rationale: Age-related Macular Degeneration (AMD) specifically affects the macula, which
is responsible for central vision and fine detail. In contrast, glaucoma typically affects
peripheral vision first (tunnel vision). The use of the Amsler grid is a common screening
tool for monitoring the progression of AMD.
7. Which of the following laboratory values is most characteristic of Iron Deficiency Anemia?
A. Low Serum Ferritin
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 4) | William
Paterson University
1. A 72-year-old male presents with a resting tremor, bradykinesia, and postural instability.
Which neurotransmitter deficiency is primarily responsible for these clinical manifestations?
A. Acetylcholine
B. Serotonin
C. GABA
D. Dopamine
Answer: D
Rationale: Parkinson’s disease is characterized by the progressive loss of dopaminergic
neurons in the substantia nigra. This deficiency leads to an imbalance between dopamine
and acetylcholine in the basal ganglia, resulting in motor symptoms. The pharmacological
goal is to restore dopamine levels or block cholinergic effects to improve patient function.
2. When evaluating a patient with suspected pernicious anemia, which diagnostic finding is
most pathognomonic for this condition?
A. Positive intrinsic factor antibodies
B. Low serum iron levels
,C. Decreased total iron-binding capacity
D. Microcytic red blood cells
Answer: A
Rationale: Pernicious anemia is an autoimmune disorder where the body fails to produce
intrinsic factor, which is necessary for vitamin B12 absorption. A positive test for intrinsic
factor antibodies confirms the diagnosis in the presence of megaloblastic anemia. This
condition requires lifelong parenteral vitamin B12 supplementation to prevent
neurological complications.
3. A patient with a history of atrial fibrillation presents with sudden onset of hemiparesis and
aphasia. The symptoms resolve completely within 4 hours. How should this event be
categorized?
A. Ischemic Stroke
B. Reversible Ischemic Neurological Deficit
C. Hemorrhagic Stroke
D. Transient Ischemic Attack (TIA)
Answer: D
Rationale: A Transient Ischemic Attack (TIA) is defined by neurological deficit that
resolves typically within 24 hours without evidence of acute infarction on imaging. Even
though symptoms resolved, the patient is at high risk for a major stroke in the immediate
,future. The NP must initiate an urgent workup including neuroimaging and carotid studies
to address the underlying cause.
4. Which pharmacological agent is considered the first-line prophylactic treatment for a
patient experiencing frequent, debilitating migraine headaches?
A. Propranolol
B. Sumatriptan
C. Oxycodone
D. Acetaminophen
Answer: A
Rationale: Beta-blockers such as Propranolol are evidence-based first-line options for
migraine prophylaxis when patients experience two or more attacks per month that impair
quality of life. Unlike triptans, which are used for acute abortive therapy, prophylactic
agents aim to reduce the frequency and severity of attacks. Careful monitoring for
bradycardia and hypotension is required when initiating this therapy.
5. A 65-year-old female reports a ‘curtain coming down’ over her right eye. She denies pain
but notes flashing lights and floaters earlier in the day. What is the most likely diagnosis?
A. Acute Angle-Closure Glaucoma
B. Cataract
C. Macular Degeneration
, D. Retinal Detachment
Answer: D
Rationale: The classic description of a ‘curtain’ descending over the visual field is
indicative of retinal detachment. This is a medical emergency that requires immediate
referral to an ophthalmologist to prevent permanent vision loss. The preceding flashes
(photopsia) and floaters often signal the initial tear or traction on the retina.
6. An elderly patient presents with gradual loss of central vision, while peripheral vision
remains intact. Which condition is the most likely cause?
A. Open-angle Glaucoma
B. Presbyopia
C. Age-related Macular Degeneration
D. Diabetic Retinopathy
Answer: C
Rationale: Age-related Macular Degeneration (AMD) specifically affects the macula, which
is responsible for central vision and fine detail. In contrast, glaucoma typically affects
peripheral vision first (tunnel vision). The use of the Amsler grid is a common screening
tool for monitoring the progression of AMD.
7. Which of the following laboratory values is most characteristic of Iron Deficiency Anemia?
A. Low Serum Ferritin
