NUR 6111 Exam 2 | Advanced Practice Nursing I | 120+
Practice Questions & Answers | Latest 2025/2026
Complete Exam Study Guide – Pulmonary, Infectious,
ENT, Vision, & Advanced Pathophysiology William
Paterson University!
This comprehensive document contains 120+ practice questions for the NUR 6111 Exam
2, covering pulmonary disorders, infectious diseases, ENT conditions, vision disorders, and
advanced pathophysiology topics. Each question includes the correct answer in bold with
a detailed rationale aligned with 20262027 standards.
SECTION 1: PULMONARY DISORDERS (Questions 1–35)
1. A 65-year-old patient with a 40-pack-year smoking history presents with a new
persistent cough. According to USPSTF guidelines, which of the following is the
most appropriate next step?
A) Annual chest x-ray
B) Annual low-dose computed tomography (LDCT)
C) Sputum cytology every 6 months
D) Observation with annual physical exam
Answer: B
The USPSTF recommends annual screening for lung cancer with LDCT in adults aged 50-
80 years who have a 20-pack-year smoking history and currently smoke or have quit within
the past 15 years. Chest x-ray is not recommended for screening .
2. A patient is diagnosed with latent tuberculosis infection (LTBI) based on a positive
QuantiFERON-TB Gold test and a normal chest x-ray. Before initiating isoniazid (INH)
therapy, which laboratory test is most important to order?
,A) Complete blood count (CBC)
B) Liver function tests (LFTs)
C) Renal function panel
D) Thyroid function tests
Answer: B
Isoniazid (INH) is associated with hepatotoxicity. Baseline and periodic liver function tests
are essential before starting therapy to monitor for drug-induced liver injury .
3. A patient with COPD has an FEV1/FVC ratio of 0.65. This finding indicates:
A) Restrictive lung disease
B) Obstructive lung disease
C) Normal lung function
D) Mixed obstructive-restrictive disease
Answer: B
A post-bronchodilator FEV1/FVC ratio less than 0.70 is diagnostic of airflow obstruction,
which is the hallmark of COPD. Restrictive lung disease typically shows a normal or
increased FEV1/FVC ratio with reduced total lung capacity .
4. Which of the following medications is used as a rescue bronchodilator in acute
asthma exacerbations?
A) Fluticasone (Flovent)
B) Salmeterol (Serevent)
C) Albuterol (ProAir)
D) Tiotropium (Spiriva)
Answer: C
Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid bronchodilation and is
the first-line rescue medication for acute asthma symptoms. Fluticasone is an inhaled
corticosteroid (controller), salmeterol is a LABA, and tiotropium is a long-acting
anticholinergic .
,5. A patient with COPD has a pulse oximetry reading of 88% on room air. Which of the
following is the most appropriate next action?
A) Administer oxygen at 2 L/min via nasal cannula
B) Obtain an arterial blood gas (ABG)
C) Start a bronchodilator nebulizer treatment
D) Discharge home with follow-up
Answer: A
Hypoxemia (SpO2 < 90%) requires oxygen supplementation. While ABG may be needed for
further evaluation, the immediate action is to administer oxygen to improve oxygenation .
6. A patient with suspected tuberculosis has a positive tuberculin skin test (PPD) with
15 mm induration. The patient has no risk factors and a normal chest x-ray. What is
the most appropriate next step?
A) Start isoniazid for latent TB
B) Obtain a QuantiFERON-TB Gold test
C) Start four-drug therapy for active TB
D) Repeat the PPD in 6 months
Answer: B
For patients with a positive PPD but normal chest x-ray and no symptoms, confirmatory
testing with an interferon-gamma release assay (IGRA) such as QuantiFERON-TB Gold is
recommended to rule out false positives, especially in BCG-vaccinated individuals .
7. A patient with community-acquired pneumonia is treated with azithromycin. Which
of the following is a common adverse effect of macrolide antibiotics?
A) QT prolongation
B) Nephrotoxicity
C) Hepatotoxicity
D) Ototoxicity
Answer: A
, Macrolides (azithromycin, clarithromycin) can cause QT prolongation, increasing the risk of
torsade de pointes. This is particularly important in patients with underlying cardiac disease
or those taking other QT-prolonging medications .
8. A patient with COPD has a long history of smoking and has tried to quit multiple
times. Which medication has been shown to improve smoking cessation rates?
A) Bupropion (Zyban)
B) Fluoxetine (Prozac)
C) Metformin (Glucophage)
D) Prednisone
Answer: A
Bupropion is FDA-approved for smoking cessation and has been shown to improve quit
rates. Varenicline and nicotine replacement therapy are also first-line options .
9. A patient with pneumonia has a chest x-ray showing a right lower lobe infiltrate.
Which of the following physical exam findings is most consistent with this
diagnosis?
A) Egophony and crackles
B) Hyperresonance on percussion
C) Diminished breath sounds with wheezing
D) Clear lung fields with forced expiratory wheeze
Answer: A
Pneumonia typically presents with crackles, dullness to percussion, and egophony (E-to-A
change) on auscultation. Hyperresonance suggests pneumothorax or hyperinflation .
10. A patient with suspected pulmonary embolism presents with tachypnea,
hemoptysis, and jugular venous distention. What is the classic EKG finding
associated with this condition?
A) ST-segment elevation in leads V1-V4
B) S1Q3T3 pattern
Practice Questions & Answers | Latest 2025/2026
Complete Exam Study Guide – Pulmonary, Infectious,
ENT, Vision, & Advanced Pathophysiology William
Paterson University!
This comprehensive document contains 120+ practice questions for the NUR 6111 Exam
2, covering pulmonary disorders, infectious diseases, ENT conditions, vision disorders, and
advanced pathophysiology topics. Each question includes the correct answer in bold with
a detailed rationale aligned with 20262027 standards.
SECTION 1: PULMONARY DISORDERS (Questions 1–35)
1. A 65-year-old patient with a 40-pack-year smoking history presents with a new
persistent cough. According to USPSTF guidelines, which of the following is the
most appropriate next step?
A) Annual chest x-ray
B) Annual low-dose computed tomography (LDCT)
C) Sputum cytology every 6 months
D) Observation with annual physical exam
Answer: B
The USPSTF recommends annual screening for lung cancer with LDCT in adults aged 50-
80 years who have a 20-pack-year smoking history and currently smoke or have quit within
the past 15 years. Chest x-ray is not recommended for screening .
2. A patient is diagnosed with latent tuberculosis infection (LTBI) based on a positive
QuantiFERON-TB Gold test and a normal chest x-ray. Before initiating isoniazid (INH)
therapy, which laboratory test is most important to order?
,A) Complete blood count (CBC)
B) Liver function tests (LFTs)
C) Renal function panel
D) Thyroid function tests
Answer: B
Isoniazid (INH) is associated with hepatotoxicity. Baseline and periodic liver function tests
are essential before starting therapy to monitor for drug-induced liver injury .
3. A patient with COPD has an FEV1/FVC ratio of 0.65. This finding indicates:
A) Restrictive lung disease
B) Obstructive lung disease
C) Normal lung function
D) Mixed obstructive-restrictive disease
Answer: B
A post-bronchodilator FEV1/FVC ratio less than 0.70 is diagnostic of airflow obstruction,
which is the hallmark of COPD. Restrictive lung disease typically shows a normal or
increased FEV1/FVC ratio with reduced total lung capacity .
4. Which of the following medications is used as a rescue bronchodilator in acute
asthma exacerbations?
A) Fluticasone (Flovent)
B) Salmeterol (Serevent)
C) Albuterol (ProAir)
D) Tiotropium (Spiriva)
Answer: C
Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid bronchodilation and is
the first-line rescue medication for acute asthma symptoms. Fluticasone is an inhaled
corticosteroid (controller), salmeterol is a LABA, and tiotropium is a long-acting
anticholinergic .
,5. A patient with COPD has a pulse oximetry reading of 88% on room air. Which of the
following is the most appropriate next action?
A) Administer oxygen at 2 L/min via nasal cannula
B) Obtain an arterial blood gas (ABG)
C) Start a bronchodilator nebulizer treatment
D) Discharge home with follow-up
Answer: A
Hypoxemia (SpO2 < 90%) requires oxygen supplementation. While ABG may be needed for
further evaluation, the immediate action is to administer oxygen to improve oxygenation .
6. A patient with suspected tuberculosis has a positive tuberculin skin test (PPD) with
15 mm induration. The patient has no risk factors and a normal chest x-ray. What is
the most appropriate next step?
A) Start isoniazid for latent TB
B) Obtain a QuantiFERON-TB Gold test
C) Start four-drug therapy for active TB
D) Repeat the PPD in 6 months
Answer: B
For patients with a positive PPD but normal chest x-ray and no symptoms, confirmatory
testing with an interferon-gamma release assay (IGRA) such as QuantiFERON-TB Gold is
recommended to rule out false positives, especially in BCG-vaccinated individuals .
7. A patient with community-acquired pneumonia is treated with azithromycin. Which
of the following is a common adverse effect of macrolide antibiotics?
A) QT prolongation
B) Nephrotoxicity
C) Hepatotoxicity
D) Ototoxicity
Answer: A
, Macrolides (azithromycin, clarithromycin) can cause QT prolongation, increasing the risk of
torsade de pointes. This is particularly important in patients with underlying cardiac disease
or those taking other QT-prolonging medications .
8. A patient with COPD has a long history of smoking and has tried to quit multiple
times. Which medication has been shown to improve smoking cessation rates?
A) Bupropion (Zyban)
B) Fluoxetine (Prozac)
C) Metformin (Glucophage)
D) Prednisone
Answer: A
Bupropion is FDA-approved for smoking cessation and has been shown to improve quit
rates. Varenicline and nicotine replacement therapy are also first-line options .
9. A patient with pneumonia has a chest x-ray showing a right lower lobe infiltrate.
Which of the following physical exam findings is most consistent with this
diagnosis?
A) Egophony and crackles
B) Hyperresonance on percussion
C) Diminished breath sounds with wheezing
D) Clear lung fields with forced expiratory wheeze
Answer: A
Pneumonia typically presents with crackles, dullness to percussion, and egophony (E-to-A
change) on auscultation. Hyperresonance suggests pneumothorax or hyperinflation .
10. A patient with suspected pulmonary embolism presents with tachypnea,
hemoptysis, and jugular venous distention. What is the classic EKG finding
associated with this condition?
A) ST-segment elevation in leads V1-V4
B) S1Q3T3 pattern
