EXAM 2: NUR 6111
ADVANCED PRACTICE NURSING I
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST
WILLIAM PATERSON UNIVERSITY
1. A 58-year-old patient with chronic cough and dyspnea undergoes pulmonary
function testing. Which finding confirms the gold-standard diagnosis of COPD?
A. Decreased DLCO alone
B. FEV1/FVC ratio < 0.70 post-bronchodilator
C. Reduced peak expiratory flow
D. Hyperinflation on chest X-ray
Answer: B
Rationale: COPD is confirmed by spirometry showing a persistent post-
bronchodilator FEV1/FVC < 0.70.
2. Which medication is most appropriate for immediate symptom relief in acute
asthma exacerbation?
A. Inhaled corticosteroid
B. Long-acting beta-agonist
C. Short-acting beta-agonist
D. Leukotriene receptor antagonist
Answer: C
Rationale: SABAs (e.g., albuterol) provide rapid bronchodilation and are first-line
for acute symptoms.
,3. A patient with moderate COPD remains symptomatic despite LABA therapy.
What is the most appropriate next step?
A. Add inhaled corticosteroid
B. Add long-acting muscarinic antagonist
C. Discontinue LABA
D. Start oral corticosteroids
Answer: B
Rationale: Dual bronchodilation with LABA + LAMA improves symptoms and
reduces exacerbations.
4. Which symptom most strongly differentiates acute bronchitis from pneumonia?
A. Fever
B. Productive cough
C. Dyspnea
D. Persistent cough without focal findings
Answer: D
Rationale: Cough is the hallmark of acute bronchitis; pneumonia requires
radiographic confirmation.
5. The diagnosis of community-acquired pneumonia is confirmed by:
A. Elevated WBC count
B. Positive sputum culture
C. Chest radiograph showing infiltrate
D. Fever > 38°C
Answer: C
Rationale: Radiographic infiltrate is required to confirm pneumonia.
,6. Which patient meets criteria for lung cancer screening with low-dose CT?
A. 45-year-old current smoker, 10 pack-years
B. 55-year-old former smoker, quit 20 years ago, 25 pack-years
C. 62-year-old current smoker, 30 pack-years
D. 70-year-old nonsmoker with chronic cough
Answer: C
Rationale: Screening is recommended for adults aged 50–80 with ≥20 pack-year
history who currently smoke or quit within 15 years.
7. Approximately what percentage of lung cancer cases are attributed to smoking?
A. 50–60%
B. 65–70%
C. 75–80%
D. 85–90%
Answer: D
Rationale: Smoking accounts for approximately 85–90% of lung cancer cases.
8. A patient develops sudden dyspnea and pleuritic chest pain after a long flight.
Which EKG finding supports pulmonary embolism?
A. ST elevation in inferior leads
B. S1Q3T3 pattern
C. Left bundle branch block
D. Prolonged QT interval
Answer: B
Rationale: The S1Q3T3 pattern, though not sensitive, is classically associated
with PE.
, 9. Which clinical finding is most concerning for pulmonary embolism?
A. Gradual onset cough
B. Wheezing relieved by bronchodilator
C. Sudden unexplained hypoxia
D. Chronic fatigue
Answer: C
Rationale: Sudden hypoxia without explanation is a red flag for PE.
10. A patient presents with sore throat, fever, and tonsillar exudates without cough.
Based on Centor criteria, what is the best next step?
A. Symptomatic treatment only
B. Prescribe azithromycin
C. Rapid strep testing
D. Immediate CT scan
Answer: C
Rationale: Centor criteria guide testing; confirmatory testing is indicated before
antibiotics.
11. First-line treatment for confirmed streptococcal pharyngitis is:
A. Amoxicillin
B. Cephalexin
C. Azithromycin
D. Clindamycin
Answer: A
Rationale: Amoxicillin or Penicillin VK is first-line for strep pharyngitis.
12. Sudden eye pain, halos around lights, and loss of peripheral vision suggest:
A. Chronic open-angle glaucoma
B. Macular degeneration
C. Acute closed-angle glaucoma
D. Diabetic retinopathy
ADVANCED PRACTICE NURSING I
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST
WILLIAM PATERSON UNIVERSITY
1. A 58-year-old patient with chronic cough and dyspnea undergoes pulmonary
function testing. Which finding confirms the gold-standard diagnosis of COPD?
A. Decreased DLCO alone
B. FEV1/FVC ratio < 0.70 post-bronchodilator
C. Reduced peak expiratory flow
D. Hyperinflation on chest X-ray
Answer: B
Rationale: COPD is confirmed by spirometry showing a persistent post-
bronchodilator FEV1/FVC < 0.70.
2. Which medication is most appropriate for immediate symptom relief in acute
asthma exacerbation?
A. Inhaled corticosteroid
B. Long-acting beta-agonist
C. Short-acting beta-agonist
D. Leukotriene receptor antagonist
Answer: C
Rationale: SABAs (e.g., albuterol) provide rapid bronchodilation and are first-line
for acute symptoms.
,3. A patient with moderate COPD remains symptomatic despite LABA therapy.
What is the most appropriate next step?
A. Add inhaled corticosteroid
B. Add long-acting muscarinic antagonist
C. Discontinue LABA
D. Start oral corticosteroids
Answer: B
Rationale: Dual bronchodilation with LABA + LAMA improves symptoms and
reduces exacerbations.
4. Which symptom most strongly differentiates acute bronchitis from pneumonia?
A. Fever
B. Productive cough
C. Dyspnea
D. Persistent cough without focal findings
Answer: D
Rationale: Cough is the hallmark of acute bronchitis; pneumonia requires
radiographic confirmation.
5. The diagnosis of community-acquired pneumonia is confirmed by:
A. Elevated WBC count
B. Positive sputum culture
C. Chest radiograph showing infiltrate
D. Fever > 38°C
Answer: C
Rationale: Radiographic infiltrate is required to confirm pneumonia.
,6. Which patient meets criteria for lung cancer screening with low-dose CT?
A. 45-year-old current smoker, 10 pack-years
B. 55-year-old former smoker, quit 20 years ago, 25 pack-years
C. 62-year-old current smoker, 30 pack-years
D. 70-year-old nonsmoker with chronic cough
Answer: C
Rationale: Screening is recommended for adults aged 50–80 with ≥20 pack-year
history who currently smoke or quit within 15 years.
7. Approximately what percentage of lung cancer cases are attributed to smoking?
A. 50–60%
B. 65–70%
C. 75–80%
D. 85–90%
Answer: D
Rationale: Smoking accounts for approximately 85–90% of lung cancer cases.
8. A patient develops sudden dyspnea and pleuritic chest pain after a long flight.
Which EKG finding supports pulmonary embolism?
A. ST elevation in inferior leads
B. S1Q3T3 pattern
C. Left bundle branch block
D. Prolonged QT interval
Answer: B
Rationale: The S1Q3T3 pattern, though not sensitive, is classically associated
with PE.
, 9. Which clinical finding is most concerning for pulmonary embolism?
A. Gradual onset cough
B. Wheezing relieved by bronchodilator
C. Sudden unexplained hypoxia
D. Chronic fatigue
Answer: C
Rationale: Sudden hypoxia without explanation is a red flag for PE.
10. A patient presents with sore throat, fever, and tonsillar exudates without cough.
Based on Centor criteria, what is the best next step?
A. Symptomatic treatment only
B. Prescribe azithromycin
C. Rapid strep testing
D. Immediate CT scan
Answer: C
Rationale: Centor criteria guide testing; confirmatory testing is indicated before
antibiotics.
11. First-line treatment for confirmed streptococcal pharyngitis is:
A. Amoxicillin
B. Cephalexin
C. Azithromycin
D. Clindamycin
Answer: A
Rationale: Amoxicillin or Penicillin VK is first-line for strep pharyngitis.
12. Sudden eye pain, halos around lights, and loss of peripheral vision suggest:
A. Chronic open-angle glaucoma
B. Macular degeneration
C. Acute closed-angle glaucoma
D. Diabetic retinopathy
