NURS 6531 FINAL EXAM] – QUESTIONS AND ANSWERS | VERIFIED
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1. A 62-year-old patient with a history of hypertension presents with a new onset of
intermittent claudication in the right calf. Which initial diagnostic test is most appropriate
to confirm the presence of peripheral artery disease (PAD)?
A. Computed tomography angiography (CTA)
B. Ankle-brachial index (ABI)
C. Magnetic resonance angiography (MRA)
D. Venous Doppler ultrasound
The ankle-brachial index is the non-invasive gold standard for the initial screening and
diagnosis of PAD. CTA and MRA are typically reserved for surgical planning, while venous
Doppler is used to assess for deep vein thrombosis, not arterial insufficiency.
2. Which of the following laboratory findings is most characteristic of iron deficiency
anemia in a chronic disease setting?
A. Elevated serum ferritin
B. Decreased total iron-binding capacity (TIBC)
C. Microcytic, hypochromic red blood cells
D. Increased mean corpuscular volume (MCV)
Iron deficiency anemia is classically characterized by microcytic (small) and hypochromic
(pale) red blood cells. Elevated ferritin and decreased TIBC are often seen in anemia of
chronic disease, not pure iron deficiency.
3. A patient presents with a butterfly-shaped rash across the bridge of the nose and cheeks.
Which autoantibody test is most specific for the diagnosis of systemic lupus erythematosus
(SLE)?
A. Anti-double-stranded DNA (anti-dsDNA)
B. Antinuclear antibody (ANA)
C. Rheumatoid factor (RF)
D. Anti-cyclic citrullinated peptide (anti-CCP)
While ANA is sensitive for SLE, it is not specific. Anti-dsDNA is highly specific for SLE. RF
and anti-CCP are markers for rheumatoid arthritis.
4. A 45-year-old female reports fatigue, cold intolerance, and weight gain. Physical exam
reveals dry skin and delayed relaxation of deep tendon reflexes. Which lab result is
expected?
,A. Elevated TSH, low Free T4
B. Low TSH, high Free T4
C. Elevated TSH, high Free T4
D. Low TSH, low Free T4
The symptoms and findings are consistent with primary hypothyroidism. An elevated TSH
indicates the pituitary is working to stimulate the thyroid, while the low Free T4 confirms a
lack of thyroid hormone production.
5. Which medication class is the first-line treatment for a patient newly diagnosed with
essential hypertension and type 2 diabetes mellitus with albuminuria?
A. Calcium channel blockers
B. Thiazide diuretics
C. Angiotensin-converting enzyme (ACE) inhibitors
D. Beta-blockers
Correct Answer: C. Angiotensin-converting enzyme (ACE) inhibitors ACE inhibitors are the
preferred agents for patients with diabetes and albuminuria because they provide
renoprotective effects by reducing intraglomerular pressure.
6. A patient presents with a painful, erythematous, warm, and swollen first
metatarsophalangeal joint. What is the most likely diagnosis?
A. Osteoarthritis
B. Septic arthritis
C. Gouty arthritis
D. Pseudogout
Podagra, or inflammation of the first metatarsophalangeal joint, is the classic presentation
for an acute gout flare. While septic arthritis must be ruled out, the location and clinical
presentation strongly favor gout.
7. Which of the following is the most appropriate primary prevention strategy for
osteoporosis in a postmenopausal female?
A. Daily calcium and vitamin D supplementation
B. Bisphosphonate therapy
C. Hormone replacement therapy (HRT)
D. Calcitonin nasal spray
Calcium and vitamin D are the foundation of primary prevention for bone health.
Bisphosphonates are treatment options for diagnosed osteoporosis or osteopenia with high
fracture risk. HRT is no longer recommended solely for osteoporosis prevention.
, 8. A 30-year-old male presents with a cough productive of rust-colored sputum, fever, and
pleuritic chest pain. Which organism is the most common cause of community-acquired
pneumonia in this patient?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Legionella pneumophila
D. Haemophilus influenzae
Streptococcus pneumoniae is the most common bacterial cause of community-acquired
pneumonia and is frequently associated with rust-colored sputum.
9. When evaluating a patient for metabolic syndrome, which criteria must be met?
A. Elevated blood pressure, high triglycerides, low HDL, elevated fasting glucose, and
abdominal obesity
B. Elevated blood pressure and BMI > 30
C. Elevated LDL, low HDL, and history of smoking
D. High triglycerides and elevated C-reactive protein
Metabolic syndrome is defined by the presence of at least three of these five clinical factors:
elevated blood pressure, high triglycerides, low HDL cholesterol, elevated fasting glucose, and
central/abdominal obesity.
10. A patient with asthma is using their rescue inhaler four times a week and reports
waking up at night with symptoms twice a month. How is this asthma classified?
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Mild persistent asthma is defined by symptoms occurring more than twice a week but less
than once a day, and nighttime awakenings occurring 3–4 times a month.
11. Which diagnostic imaging is the most appropriate first-line choice for a patient
suspected of having cholelithiasis?
A. Abdominal CT scan
B. HIDA scan
C. Abdominal ultrasound
D. Magnetic resonance cholangiopancreatography (MRCP)
Abdominal ultrasound is highly sensitive and specific for detecting gallstones (cholelithiasis)
and is the standard initial imaging modality.
AND WELL DETAILED ANSWERS PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST | DOWNLOAD INSTANT PDF
1. A 62-year-old patient with a history of hypertension presents with a new onset of
intermittent claudication in the right calf. Which initial diagnostic test is most appropriate
to confirm the presence of peripheral artery disease (PAD)?
A. Computed tomography angiography (CTA)
B. Ankle-brachial index (ABI)
C. Magnetic resonance angiography (MRA)
D. Venous Doppler ultrasound
The ankle-brachial index is the non-invasive gold standard for the initial screening and
diagnosis of PAD. CTA and MRA are typically reserved for surgical planning, while venous
Doppler is used to assess for deep vein thrombosis, not arterial insufficiency.
2. Which of the following laboratory findings is most characteristic of iron deficiency
anemia in a chronic disease setting?
A. Elevated serum ferritin
B. Decreased total iron-binding capacity (TIBC)
C. Microcytic, hypochromic red blood cells
D. Increased mean corpuscular volume (MCV)
Iron deficiency anemia is classically characterized by microcytic (small) and hypochromic
(pale) red blood cells. Elevated ferritin and decreased TIBC are often seen in anemia of
chronic disease, not pure iron deficiency.
3. A patient presents with a butterfly-shaped rash across the bridge of the nose and cheeks.
Which autoantibody test is most specific for the diagnosis of systemic lupus erythematosus
(SLE)?
A. Anti-double-stranded DNA (anti-dsDNA)
B. Antinuclear antibody (ANA)
C. Rheumatoid factor (RF)
D. Anti-cyclic citrullinated peptide (anti-CCP)
While ANA is sensitive for SLE, it is not specific. Anti-dsDNA is highly specific for SLE. RF
and anti-CCP are markers for rheumatoid arthritis.
4. A 45-year-old female reports fatigue, cold intolerance, and weight gain. Physical exam
reveals dry skin and delayed relaxation of deep tendon reflexes. Which lab result is
expected?
,A. Elevated TSH, low Free T4
B. Low TSH, high Free T4
C. Elevated TSH, high Free T4
D. Low TSH, low Free T4
The symptoms and findings are consistent with primary hypothyroidism. An elevated TSH
indicates the pituitary is working to stimulate the thyroid, while the low Free T4 confirms a
lack of thyroid hormone production.
5. Which medication class is the first-line treatment for a patient newly diagnosed with
essential hypertension and type 2 diabetes mellitus with albuminuria?
A. Calcium channel blockers
B. Thiazide diuretics
C. Angiotensin-converting enzyme (ACE) inhibitors
D. Beta-blockers
Correct Answer: C. Angiotensin-converting enzyme (ACE) inhibitors ACE inhibitors are the
preferred agents for patients with diabetes and albuminuria because they provide
renoprotective effects by reducing intraglomerular pressure.
6. A patient presents with a painful, erythematous, warm, and swollen first
metatarsophalangeal joint. What is the most likely diagnosis?
A. Osteoarthritis
B. Septic arthritis
C. Gouty arthritis
D. Pseudogout
Podagra, or inflammation of the first metatarsophalangeal joint, is the classic presentation
for an acute gout flare. While septic arthritis must be ruled out, the location and clinical
presentation strongly favor gout.
7. Which of the following is the most appropriate primary prevention strategy for
osteoporosis in a postmenopausal female?
A. Daily calcium and vitamin D supplementation
B. Bisphosphonate therapy
C. Hormone replacement therapy (HRT)
D. Calcitonin nasal spray
Calcium and vitamin D are the foundation of primary prevention for bone health.
Bisphosphonates are treatment options for diagnosed osteoporosis or osteopenia with high
fracture risk. HRT is no longer recommended solely for osteoporosis prevention.
, 8. A 30-year-old male presents with a cough productive of rust-colored sputum, fever, and
pleuritic chest pain. Which organism is the most common cause of community-acquired
pneumonia in this patient?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Legionella pneumophila
D. Haemophilus influenzae
Streptococcus pneumoniae is the most common bacterial cause of community-acquired
pneumonia and is frequently associated with rust-colored sputum.
9. When evaluating a patient for metabolic syndrome, which criteria must be met?
A. Elevated blood pressure, high triglycerides, low HDL, elevated fasting glucose, and
abdominal obesity
B. Elevated blood pressure and BMI > 30
C. Elevated LDL, low HDL, and history of smoking
D. High triglycerides and elevated C-reactive protein
Metabolic syndrome is defined by the presence of at least three of these five clinical factors:
elevated blood pressure, high triglycerides, low HDL cholesterol, elevated fasting glucose, and
central/abdominal obesity.
10. A patient with asthma is using their rescue inhaler four times a week and reports
waking up at night with symptoms twice a month. How is this asthma classified?
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Mild persistent asthma is defined by symptoms occurring more than twice a week but less
than once a day, and nighttime awakenings occurring 3–4 times a month.
11. Which diagnostic imaging is the most appropriate first-line choice for a patient
suspected of having cholelithiasis?
A. Abdominal CT scan
B. HIDA scan
C. Abdominal ultrasound
D. Magnetic resonance cholangiopancreatography (MRCP)
Abdominal ultrasound is highly sensitive and specific for detecting gallstones (cholelithiasis)
and is the standard initial imaging modality.
