NUR 6130 Exam 4 V2 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 4) | William
Paterson University
1. A 74-year-old female presents with acute onset confusion, inattention, and a fluctuating
level of consciousness. Her medical history includes well-controlled hypertension. What is the
most likely diagnosis based on this clinical presentation?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Major Depression
Answer: C
Rationale: The acute onset and fluctuating course are hallmark features of delirium,
whereas dementia involves a progressive and gradual decline. Delirium often indicates an
underlying medical emergency such as infection or metabolic imbalance in elderly patients.
Clinicians must utilize tools like the Confusion Assessment Method (CAM) to differentiate
this from chronic cognitive impairment.
,2. When evaluating a patient for Microcytic Anemia, the nurse practitioner notes a low Serum
Ferritin and a high Total Iron Binding Capacity (TIBC). These findings are most characteristic of
which condition?
A. Thalassemia Trait
B. Iron Deficiency Anemia
C. Anemia of Chronic Disease
D. Sideroblastic Anemia
Answer: B
Rationale: Iron Deficiency Anemia is defined by low iron stores, which results in a
decreased ferritin level and a compensatory increase in TIBC. This lab profile distinguishes
it from Anemia of Chronic Disease, where ferritin is usually normal or elevated. Further
investigation is required to identify the source of iron loss, such as occult gastrointestinal
bleeding in older adults.
3. A 68-year-old male presents with a resting tremor, bradykinesia, and rigidity. Which
neurotransmitter deficiency is primarily responsible for these clinical manifestations in
Parkinson’s Disease?
A. Acetylcholine
B. Dopamine
C. Serotonin
D. GABA
, Answer: B
Rationale: Parkinson’s Disease involves the progressive loss of dopaminergic neurons in
the substantia nigra. This deficiency leads to the characteristic motor symptoms including
postural instability and shuffling gait. Treatment strategies typically focus on dopamine
replacement or mimicking dopamine’s effect within the central nervous system.
4. A patient presents with a ‘curtain-like’ shadowing over their vision in the right eye,
accompanied by floaters and flashes of light. This is an ocular emergency known as:
A. Retinal Detachment
B. Macular Degeneration
C. Cataracts
D. Glaucoma
Answer: A
Rationale: Retinal detachment often presents as sudden visual changes including flashes
(photopsia) and a sensation of a curtain closing. This condition requires immediate referral
to an ophthalmologist to prevent permanent vision loss. The NP must recognize these red
flags during the physical assessment of the eye.
5. Which of the following findings on a peripheral blood smear is most suggestive of Vitamin
B12 deficiency?
A. Hypochromic microcytes
B. Target cells
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 4) | William
Paterson University
1. A 74-year-old female presents with acute onset confusion, inattention, and a fluctuating
level of consciousness. Her medical history includes well-controlled hypertension. What is the
most likely diagnosis based on this clinical presentation?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Major Depression
Answer: C
Rationale: The acute onset and fluctuating course are hallmark features of delirium,
whereas dementia involves a progressive and gradual decline. Delirium often indicates an
underlying medical emergency such as infection or metabolic imbalance in elderly patients.
Clinicians must utilize tools like the Confusion Assessment Method (CAM) to differentiate
this from chronic cognitive impairment.
,2. When evaluating a patient for Microcytic Anemia, the nurse practitioner notes a low Serum
Ferritin and a high Total Iron Binding Capacity (TIBC). These findings are most characteristic of
which condition?
A. Thalassemia Trait
B. Iron Deficiency Anemia
C. Anemia of Chronic Disease
D. Sideroblastic Anemia
Answer: B
Rationale: Iron Deficiency Anemia is defined by low iron stores, which results in a
decreased ferritin level and a compensatory increase in TIBC. This lab profile distinguishes
it from Anemia of Chronic Disease, where ferritin is usually normal or elevated. Further
investigation is required to identify the source of iron loss, such as occult gastrointestinal
bleeding in older adults.
3. A 68-year-old male presents with a resting tremor, bradykinesia, and rigidity. Which
neurotransmitter deficiency is primarily responsible for these clinical manifestations in
Parkinson’s Disease?
A. Acetylcholine
B. Dopamine
C. Serotonin
D. GABA
, Answer: B
Rationale: Parkinson’s Disease involves the progressive loss of dopaminergic neurons in
the substantia nigra. This deficiency leads to the characteristic motor symptoms including
postural instability and shuffling gait. Treatment strategies typically focus on dopamine
replacement or mimicking dopamine’s effect within the central nervous system.
4. A patient presents with a ‘curtain-like’ shadowing over their vision in the right eye,
accompanied by floaters and flashes of light. This is an ocular emergency known as:
A. Retinal Detachment
B. Macular Degeneration
C. Cataracts
D. Glaucoma
Answer: A
Rationale: Retinal detachment often presents as sudden visual changes including flashes
(photopsia) and a sensation of a curtain closing. This condition requires immediate referral
to an ophthalmologist to prevent permanent vision loss. The NP must recognize these red
flags during the physical assessment of the eye.
5. Which of the following findings on a peripheral blood smear is most suggestive of Vitamin
B12 deficiency?
A. Hypochromic microcytes
B. Target cells
