NR 601 Primary Care of Adults Complete Course
Bundle | Exams 1-3, Midterm, Final & Comprehensive
Exam Study Guide (2026/2027) | Complete Nursing
Exam Study Guide MOST TESTED QUESTIONS FROM
PAST PAPERS WITH CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||NEWEST VERSION REVIEW
Contents
Exam 1 ................................................................................................................ 1
Exam 2 ........................................................................................................... 49
Exam 3........................................................................................................ 86
Midterm Exam ................................................................................................ 146
Final Exam ................................................................................................... 176
Exam 1
Question 1
A 64-year-old man with diabetes and CKD (eGFR 45 mL/min) presents with BPs averaging
152/88 mmHg. He is not on antihypertensives. Which initial regimen is most appropriate?
A. Thiazide diuretic alone
B. ACE inhibitor or ARB as first-line therapy
C. Beta-blocker only
D. Alpha-blocker only
,Correct Answer: B
Rationale:
In adults with diabetes and CKD, ACEIs or ARBs are preferred first-line due to kidney protection
and cardiovascular benefit. Thiazides can be added, but RAAS blockade is foundational.
Question 2
A 58-year-old woman on lisinopril and HCTZ for HTN has a new persistent dry cough. BP is
well-controlled. How should the NP interpret and manage this?
A. Cough is unrelated; no change needed.
B. Likely ACE inhibitor-induced cough; switch to an ARB.
C. Start high-dose opioids.
D. Stop all BP medications abruptly.
Correct Answer: B
Rationale:
ACE inhibitor-induced cough is common and often resolves with discontinuation. ARBs provide
similar BP and renal benefits with much lower risk of cough.
Question 3
A 70-year-old man with AF and CHADS₂ score of 2 (HTN and age >75) has never been
anticoagulated. He fears bleeding. Which statement best reflects current evidence?
A. Bleeding risk always outweighs stroke risk; avoid anticoagulation.
B. Stroke risk is substantial; anticoagulation usually provides net benefit and should be
discussed with shared decision-making.
C. Aspirin alone is superior to anticoagulation.
D. Only rate control is needed.
Correct Answer: B
Rationale:
Patients with CHADS₂ or CHA₂DS₂-VASc scores ≥2 have significant stroke risk; oral
,anticoagulation usually offers net benefit, but decisions should incorporate patient preferences
and bleeding risk.
Question 4
A 68-year-old woman on warfarin for AF has INR 1.4 on two checks. She reports strict
adherence. What is the safest next step?
A. Decrease warfarin dose.
B. Increase warfarin dose gradually and review diet, med interactions, and adherence.
C. Stop warfarin.
D. Ignore low INRs.
Correct Answer: B
Rationale:
Subtherapeutic INR increases stroke risk. Warfarin dose should be carefully increased while
exploring causes (e.g., vitamin K intake, new meds) to reach target 2.0–3.0.
Question 5
A 72-year-old with HFrEF (EF 30%) is on ACEI and diuretic. The NP adds a beta-blocker. What is
the key counseling point?
A. Expect immediate symptom relief in 1–2 days.
B. Symptoms may transiently worsen; dose is started low and titrated up slowly for long-term
survival benefit.
C. Beta-blockers cure heart failure.
D. Stop ACEI when starting beta-blocker.
Correct Answer: B
Rationale:
Evidence-based beta-blockers improve survival in HFrEF, but must be started low and gradually
up-titrated. Patients may feel more fatigued initially, so counseling improves adherence.
, Question 6
A 65-year-old man with HFpEF has persistent exertional dyspnea and edema. His BP is 160/92.
Which intervention is most important to improve prognosis?
A. Increase NSAIDs for pain control.
B. Optimize BP control with guideline-directed therapy and manage volume status.
C. Avoid all medications.
D. Increase sodium intake.
Correct Answer: B
Rationale:
HFpEF management focuses on controlling BP, treating comorbidities, and managing volume
overload; NSAIDs and high sodium worsen HF.
Question 7
A 58-year-old heavy smoker presents with chronic cough and exertional dyspnea. Spirometry
shows FEV1/FVC 0.63 and FEV1 48% predicted with minimal bronchodilator response.
Diagnosis?
A. Normal spirometry
B. Asthma only
C. Severe irreversible obstruction consistent with COPD
D. Restrictive lung disease
Correct Answer: C
Rationale:
FEV1/FVC <0.70 indicates obstruction; FEV1 <50% indicates severe severity; minimal
bronchodilator response suggests irreversible COPD rather than asthma.
Question 8
Which spirometry pattern is most consistent with restrictive disease?
A. Low FEV1, low FVC, FEV1/FVC normal or high
B. Low FEV1/FVC and normal TLC
Bundle | Exams 1-3, Midterm, Final & Comprehensive
Exam Study Guide (2026/2027) | Complete Nursing
Exam Study Guide MOST TESTED QUESTIONS FROM
PAST PAPERS WITH CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+||NEWEST VERSION REVIEW
Contents
Exam 1 ................................................................................................................ 1
Exam 2 ........................................................................................................... 49
Exam 3........................................................................................................ 86
Midterm Exam ................................................................................................ 146
Final Exam ................................................................................................... 176
Exam 1
Question 1
A 64-year-old man with diabetes and CKD (eGFR 45 mL/min) presents with BPs averaging
152/88 mmHg. He is not on antihypertensives. Which initial regimen is most appropriate?
A. Thiazide diuretic alone
B. ACE inhibitor or ARB as first-line therapy
C. Beta-blocker only
D. Alpha-blocker only
,Correct Answer: B
Rationale:
In adults with diabetes and CKD, ACEIs or ARBs are preferred first-line due to kidney protection
and cardiovascular benefit. Thiazides can be added, but RAAS blockade is foundational.
Question 2
A 58-year-old woman on lisinopril and HCTZ for HTN has a new persistent dry cough. BP is
well-controlled. How should the NP interpret and manage this?
A. Cough is unrelated; no change needed.
B. Likely ACE inhibitor-induced cough; switch to an ARB.
C. Start high-dose opioids.
D. Stop all BP medications abruptly.
Correct Answer: B
Rationale:
ACE inhibitor-induced cough is common and often resolves with discontinuation. ARBs provide
similar BP and renal benefits with much lower risk of cough.
Question 3
A 70-year-old man with AF and CHADS₂ score of 2 (HTN and age >75) has never been
anticoagulated. He fears bleeding. Which statement best reflects current evidence?
A. Bleeding risk always outweighs stroke risk; avoid anticoagulation.
B. Stroke risk is substantial; anticoagulation usually provides net benefit and should be
discussed with shared decision-making.
C. Aspirin alone is superior to anticoagulation.
D. Only rate control is needed.
Correct Answer: B
Rationale:
Patients with CHADS₂ or CHA₂DS₂-VASc scores ≥2 have significant stroke risk; oral
,anticoagulation usually offers net benefit, but decisions should incorporate patient preferences
and bleeding risk.
Question 4
A 68-year-old woman on warfarin for AF has INR 1.4 on two checks. She reports strict
adherence. What is the safest next step?
A. Decrease warfarin dose.
B. Increase warfarin dose gradually and review diet, med interactions, and adherence.
C. Stop warfarin.
D. Ignore low INRs.
Correct Answer: B
Rationale:
Subtherapeutic INR increases stroke risk. Warfarin dose should be carefully increased while
exploring causes (e.g., vitamin K intake, new meds) to reach target 2.0–3.0.
Question 5
A 72-year-old with HFrEF (EF 30%) is on ACEI and diuretic. The NP adds a beta-blocker. What is
the key counseling point?
A. Expect immediate symptom relief in 1–2 days.
B. Symptoms may transiently worsen; dose is started low and titrated up slowly for long-term
survival benefit.
C. Beta-blockers cure heart failure.
D. Stop ACEI when starting beta-blocker.
Correct Answer: B
Rationale:
Evidence-based beta-blockers improve survival in HFrEF, but must be started low and gradually
up-titrated. Patients may feel more fatigued initially, so counseling improves adherence.
, Question 6
A 65-year-old man with HFpEF has persistent exertional dyspnea and edema. His BP is 160/92.
Which intervention is most important to improve prognosis?
A. Increase NSAIDs for pain control.
B. Optimize BP control with guideline-directed therapy and manage volume status.
C. Avoid all medications.
D. Increase sodium intake.
Correct Answer: B
Rationale:
HFpEF management focuses on controlling BP, treating comorbidities, and managing volume
overload; NSAIDs and high sodium worsen HF.
Question 7
A 58-year-old heavy smoker presents with chronic cough and exertional dyspnea. Spirometry
shows FEV1/FVC 0.63 and FEV1 48% predicted with minimal bronchodilator response.
Diagnosis?
A. Normal spirometry
B. Asthma only
C. Severe irreversible obstruction consistent with COPD
D. Restrictive lung disease
Correct Answer: C
Rationale:
FEV1/FVC <0.70 indicates obstruction; FEV1 <50% indicates severe severity; minimal
bronchodilator response suggests irreversible COPD rather than asthma.
Question 8
Which spirometry pattern is most consistent with restrictive disease?
A. Low FEV1, low FVC, FEV1/FVC normal or high
B. Low FEV1/FVC and normal TLC
