Chamberlain NR 607 Midterm & Final Exam Master
Bundle Advanced Clinical Diagnosis & Management |
Complete Prep Practice Questions 2026-2027
1. A 55-year-old male presents with crushing substernal chest
pain, diaphoresis, and shortness of breath. The ECG shows ST-
segment elevation in leads II, III, and aVF. Which area of the
heart is experiencing an acute myocardial infarction?
A) Anterior wall
B) Lateral wall
C) Inferior wall
D) Septal wall
">Answer: C) Inferior wall</span>
Rationale: ST-segment elevation in leads II, III, and aVF is the
classic ECG finding for an acute inferior wall myocardial
infarction, typically caused by occlusion of the right coronary
artery (RCA).
2. A 45-year-old female presents with fatigue, weight gain, cold
intolerance, and bradycardia. Her TSH is 14.0 mIU/L (normal:
,0.4-4.0) and free T4 is low. What is the most appropriate first-
line pharmacological treatment?
A) Levothyroxine (Synthroid)
B) Methimazole (Tapazole)
C) Prednisone
D) Radioactive iodine
">Answer: A) Levothyroxine (Synthroid)</span>
Rationale: The patient presents with classic primary
hypothyroidism (elevated TSH, low free T4). Levothyroxine is
the standard replacement therapy. Methimazole and
radioactive iodine are treatments for hyperthyroidism.
3. According to the Eighth Joint National Committee (JNC 8)
guidelines, what is the blood pressure target for a 68-year-old
African American male with hypertension and no other
comorbidities?
A) < 120/80 mmHg
B) < 130/80 mmHg
C) < 140/90 mmHg
D) < 150/90 mmHg
;">Answer: C) < 140/90 mmHg</span>
,Rationale: JNC 8 guidelines recommend a blood pressure target
of < 140/90 mmHg for African American adults (including those
with diabetes) and < 150/90 mmHg for the general population
aged 60 and older. Note: While ACC/AHA updated targets to <
130/80, JNC 8 is still heavily tested on NP boards for specific
demographic thresholds.
4. A 32-year-old female presents with a 2-day history of dysuria,
urinary frequency, and urgency. She is afebrile, has no flank
pain, and has no vaginal discharge. Urinalysis is positive for
leukocyte esterase and nitrites. What is the most appropriate
treatment?
A) Ciprofloxacin 500 mg PO BID x 3 days
B) Nitrofurantoin 100 mg PO BID x 5 days
C) Azithromycin 1 g PO once
D) Doxycycline 100 mg PO BID x 7 days
<span style="color:red;">Answer: B) Nitrofurantoin 100 mg PO
BID x 5 days</span>
Rationale: The patient has uncomplicated cystitis.
Nitrofurantoin is a first-line treatment for uncomplicated UTIs
and is safe in pregnancy. Azithromycin and Doxycycline are used
for STIs. Fluoroquinolones are reserved for complicated UTIs
due to side effect profiles.
, 5. A 60-year-old male with a history of chronic heart failure
(HFrEF) presents with worsening dyspnea and bilateral lower
extremity edema. He is currently on a beta-blocker and an ACE
inhibitor. Which medication should be added to improve long-
term survival and reduce hospitalizations?
A) Furosemide (Lasix)
B) Spironolactone (Aldactone)
C) Digoxin (Lanoxin)
D) Nifedipine (Procardia)
<span style="color:red;">Answer: B) Spironolactone
(Aldactone)</span>
Rationale: Spironolactone is an aldosterone antagonist that has
been shown to reduce mortality and hospitalizations in patients
with HFrEF (NYHA Class II-IV). Furosemide is for symptom relief
but does not improve mortality. Digoxin reduces
hospitalizations but not mortality. CCBs like nifedipine are
contraindicated in HFrEF.
6. A 28-year-old female presents with a 1-week history of
severe sore throat, fever, and fatigue. Physical exam reveals
exudative tonsillitis, posterior cervical lymphadenopathy, and
Bundle Advanced Clinical Diagnosis & Management |
Complete Prep Practice Questions 2026-2027
1. A 55-year-old male presents with crushing substernal chest
pain, diaphoresis, and shortness of breath. The ECG shows ST-
segment elevation in leads II, III, and aVF. Which area of the
heart is experiencing an acute myocardial infarction?
A) Anterior wall
B) Lateral wall
C) Inferior wall
D) Septal wall
">Answer: C) Inferior wall</span>
Rationale: ST-segment elevation in leads II, III, and aVF is the
classic ECG finding for an acute inferior wall myocardial
infarction, typically caused by occlusion of the right coronary
artery (RCA).
2. A 45-year-old female presents with fatigue, weight gain, cold
intolerance, and bradycardia. Her TSH is 14.0 mIU/L (normal:
,0.4-4.0) and free T4 is low. What is the most appropriate first-
line pharmacological treatment?
A) Levothyroxine (Synthroid)
B) Methimazole (Tapazole)
C) Prednisone
D) Radioactive iodine
">Answer: A) Levothyroxine (Synthroid)</span>
Rationale: The patient presents with classic primary
hypothyroidism (elevated TSH, low free T4). Levothyroxine is
the standard replacement therapy. Methimazole and
radioactive iodine are treatments for hyperthyroidism.
3. According to the Eighth Joint National Committee (JNC 8)
guidelines, what is the blood pressure target for a 68-year-old
African American male with hypertension and no other
comorbidities?
A) < 120/80 mmHg
B) < 130/80 mmHg
C) < 140/90 mmHg
D) < 150/90 mmHg
;">Answer: C) < 140/90 mmHg</span>
,Rationale: JNC 8 guidelines recommend a blood pressure target
of < 140/90 mmHg for African American adults (including those
with diabetes) and < 150/90 mmHg for the general population
aged 60 and older. Note: While ACC/AHA updated targets to <
130/80, JNC 8 is still heavily tested on NP boards for specific
demographic thresholds.
4. A 32-year-old female presents with a 2-day history of dysuria,
urinary frequency, and urgency. She is afebrile, has no flank
pain, and has no vaginal discharge. Urinalysis is positive for
leukocyte esterase and nitrites. What is the most appropriate
treatment?
A) Ciprofloxacin 500 mg PO BID x 3 days
B) Nitrofurantoin 100 mg PO BID x 5 days
C) Azithromycin 1 g PO once
D) Doxycycline 100 mg PO BID x 7 days
<span style="color:red;">Answer: B) Nitrofurantoin 100 mg PO
BID x 5 days</span>
Rationale: The patient has uncomplicated cystitis.
Nitrofurantoin is a first-line treatment for uncomplicated UTIs
and is safe in pregnancy. Azithromycin and Doxycycline are used
for STIs. Fluoroquinolones are reserved for complicated UTIs
due to side effect profiles.
, 5. A 60-year-old male with a history of chronic heart failure
(HFrEF) presents with worsening dyspnea and bilateral lower
extremity edema. He is currently on a beta-blocker and an ACE
inhibitor. Which medication should be added to improve long-
term survival and reduce hospitalizations?
A) Furosemide (Lasix)
B) Spironolactone (Aldactone)
C) Digoxin (Lanoxin)
D) Nifedipine (Procardia)
<span style="color:red;">Answer: B) Spironolactone
(Aldactone)</span>
Rationale: Spironolactone is an aldosterone antagonist that has
been shown to reduce mortality and hospitalizations in patients
with HFrEF (NYHA Class II-IV). Furosemide is for symptom relief
but does not improve mortality. Digoxin reduces
hospitalizations but not mortality. CCBs like nifedipine are
contraindicated in HFrEF.
6. A 28-year-old female presents with a 1-week history of
severe sore throat, fever, and fatigue. Physical exam reveals
exudative tonsillitis, posterior cervical lymphadenopathy, and
