NURS 5432 Exam 4 V2 | NURS 5432 Family
I (FNP 1) | Actual Q&A with Rationale
(NURS5432 Exam 4) | The University of
Texas at Arlington
1. A 32-year-old female presents with a unilateral, pulsating headache associated with
photophobia and nausea. She reports these occur three times a month and last for 24 hours.
Which medication is most appropriate for acute treatment?
A. Propranolol
B. Sumatriptan
C. Amitriptyline
D. Lisinopril
Answer: B
Rationale: Triptans are the first-line choice for the abortive treatment of moderate to
severe migraines. Propranolol and amitriptyline are used for prophylaxis rather than acute
relief. The clinician must ensure the patient does not have contraindications such as
uncontrolled hypertension or ischemic heart disease.
2. Which laboratory finding is most characteristic of iron deficiency anemia in its early
symptomatic stage?
A. Increased Ferritin
,B. Decreased Total Iron Binding Capacity (TIBC)
C. Decreased Serum Ferritin
D. Increased Mean Corpuscular Volume (MCV)
Answer: C
Rationale: Serum ferritin is the most sensitive indicator of iron stores and is the first lab
value to decrease in iron deficiency. As the condition progresses, TIBC will increase and
MCV will eventually decrease, signifying microcytosis. Identifying low ferritin levels allows
for early intervention before significant anemia develops.
3. A 68-year-old male exhibits a resting tremor, bradykinesia, and postural instability. What is
the primary neurotransmitter deficiency associated with this condition?
A. Acetylcholine
B. Serotonin
C. Dopamine
D. Norepinephrine
Answer: C
Rationale: Parkinson’s disease is caused by the degeneration of dopaminergic neurons in
the substantia nigra. This depletion leads to the classic motor symptoms observed during
the clinical examination. Management focus is on restoring dopamine levels or mimicking
its effects in the brain.
, 4. An elderly patient presents with sudden onset confusion, visual hallucinations, and a
fluctuating level of consciousness. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Rationale: Delirium is characterized by an acute onset and a fluctuating course of cognitive
impairment. Unlike dementia, which is progressive and stable, delirium is often reversible
and triggered by an underlying medical issue or medication. A thorough investigation for
infection or metabolic imbalance is necessary for these patients.
5. Which of the following is considered a ‘red flag’ in a patient presenting with new-onset low
back pain?
A. Pain that improves with rest
B. Unexplained weight loss
C. Muscle soreness after exercise
D. Pain duration of two days
Answer: B
I (FNP 1) | Actual Q&A with Rationale
(NURS5432 Exam 4) | The University of
Texas at Arlington
1. A 32-year-old female presents with a unilateral, pulsating headache associated with
photophobia and nausea. She reports these occur three times a month and last for 24 hours.
Which medication is most appropriate for acute treatment?
A. Propranolol
B. Sumatriptan
C. Amitriptyline
D. Lisinopril
Answer: B
Rationale: Triptans are the first-line choice for the abortive treatment of moderate to
severe migraines. Propranolol and amitriptyline are used for prophylaxis rather than acute
relief. The clinician must ensure the patient does not have contraindications such as
uncontrolled hypertension or ischemic heart disease.
2. Which laboratory finding is most characteristic of iron deficiency anemia in its early
symptomatic stage?
A. Increased Ferritin
,B. Decreased Total Iron Binding Capacity (TIBC)
C. Decreased Serum Ferritin
D. Increased Mean Corpuscular Volume (MCV)
Answer: C
Rationale: Serum ferritin is the most sensitive indicator of iron stores and is the first lab
value to decrease in iron deficiency. As the condition progresses, TIBC will increase and
MCV will eventually decrease, signifying microcytosis. Identifying low ferritin levels allows
for early intervention before significant anemia develops.
3. A 68-year-old male exhibits a resting tremor, bradykinesia, and postural instability. What is
the primary neurotransmitter deficiency associated with this condition?
A. Acetylcholine
B. Serotonin
C. Dopamine
D. Norepinephrine
Answer: C
Rationale: Parkinson’s disease is caused by the degeneration of dopaminergic neurons in
the substantia nigra. This depletion leads to the classic motor symptoms observed during
the clinical examination. Management focus is on restoring dopamine levels or mimicking
its effects in the brain.
, 4. An elderly patient presents with sudden onset confusion, visual hallucinations, and a
fluctuating level of consciousness. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Rationale: Delirium is characterized by an acute onset and a fluctuating course of cognitive
impairment. Unlike dementia, which is progressive and stable, delirium is often reversible
and triggered by an underlying medical issue or medication. A thorough investigation for
infection or metabolic imbalance is necessary for these patients.
5. Which of the following is considered a ‘red flag’ in a patient presenting with new-onset low
back pain?
A. Pain that improves with rest
B. Unexplained weight loss
C. Muscle soreness after exercise
D. Pain duration of two days
Answer: B
