EXAM 2: NUR 6111
Advanced Practice Nursing I
Questions and 100% Verified Answers with Rationales
Graded A+ Latest
William Paterson University
1. A 58-year-old patient with chronic cough and dyspnea undergoes pulmonary
function testing. Which finding confirms the gold-standard diagnosis of COPD?
A. Decreased DLCO alone
B. FEV1/FVC ratio < 0.70 post-bronchodilator
C. Reduced peak expiratory flow
D. Hyperinflation on chest X-ray
Answer: B
Rationale: COPD is confirmed by spirometry showing a persistent post-
bronchodilator FEV1/FVC < 0.70.
2. Which medication is most appropriate for immediate symptom relief in an acute
asthma exacerbation?
A. Inhaled corticosteroid
B. Long-acting beta-agonist
C. Short-acting beta-agonist
D. Leukotriene receptor antagonist
Answer: C
Rationale: Short-acting beta-agonists (SABAs), such as albuterol, provide rapid
bronchodilation and are the first-line treatment for acute asthma symptoms.
,3. A patient with moderate COPD remains symptomatic despite LABA therapy.
What is the most appropriate next step?
A. Add inhaled corticosteroid
B. Add long-acting muscarinic antagonist
C. Discontinue LABA
D. Start oral corticosteroids
Answer: B
Rationale: Dual bronchodilation with a LABA plus a LAMA improves symptoms
and reduces COPD exacerbations.
4. Which symptom most strongly differentiates acute bronchitis from pneumonia?
A. Fever
B. Productive cough
C. Dyspnea
D. Persistent cough without focal findings
Answer: D
Rationale: Cough is the hallmark of acute bronchitis; pneumonia requires
radiographic confirmation.
5. The diagnosis of community-acquired pneumonia is confirmed by:
A. Elevated WBC count
B. Positive sputum culture
C. Chest radiograph showing infiltrate
D. Fever >38°C
Answer: C
Rationale: A radiographic infiltrate is required to confirm pneumonia.
,6. Which patient meets criteria for lung cancer screening with low-dose CT?
A. 45-year-old current smoker, 10 pack-years
B. 55-year-old former smoker, quit 20 years ago, 25 pack-years
C. 62-year-old current smoker, 30 pack-years
D. 70-year-old nonsmoker with chronic cough
Answer: C
Rationale: Screening is recommended for adults aged 50–80 years with a ≥20
pack-year smoking history who currently smoke or have quit within the past 15
years.
7. Approximately what percentage of lung cancer cases are attributed to smoking?
A. 50–60%
B. 65–70%
C. 75–80%
D. 85–90%
Answer: D
Rationale: Smoking accounts for approximately 85–90% of lung cancer cases.
8. A patient develops sudden dyspnea and pleuritic chest pain after a long flight.
Which EKG finding supports pulmonary embolism?
A. ST elevation in inferior leads
B. S1Q3T3 pattern
C. Left bundle branch block
D. Prolonged QT interval
Answer: B
Rationale: The S1Q3T3 pattern, though not sensitive, is classically associated
with pulmonary embolism (PE).
, 9. Which clinical finding is most concerning for pulmonary embolism?
A. Gradual onset cough
B. Wheezing relieved by bronchodilator
C. Sudden unexplained hypoxia
D. Chronic fatigue
Answer: C
Rationale: Sudden hypoxia without another explanation is a red flag for
pulmonary embolism.
10. A patient presents with sore throat, fever, and tonsillar exudates without cough.
Based on Centor criteria, what is the best next step?
A. Symptomatic treatment only
B. Prescribe azithromycin
C. Rapid strep testing
D. Immediate CT scan
Answer: C
Rationale: Centor criteria guide testing; confirmatory testing is recommended
before starting antibiotics.
11. First-line treatment for confirmed streptococcal pharyngitis is:
A. Amoxicillin
B. Cephalexin
C. Azithromycin
D. Clindamycin
Answer: A
Rationale: Amoxicillin or Penicillin VK is the first-line treatment for
streptococcal pharyngitis.
Advanced Practice Nursing I
Questions and 100% Verified Answers with Rationales
Graded A+ Latest
William Paterson University
1. A 58-year-old patient with chronic cough and dyspnea undergoes pulmonary
function testing. Which finding confirms the gold-standard diagnosis of COPD?
A. Decreased DLCO alone
B. FEV1/FVC ratio < 0.70 post-bronchodilator
C. Reduced peak expiratory flow
D. Hyperinflation on chest X-ray
Answer: B
Rationale: COPD is confirmed by spirometry showing a persistent post-
bronchodilator FEV1/FVC < 0.70.
2. Which medication is most appropriate for immediate symptom relief in an acute
asthma exacerbation?
A. Inhaled corticosteroid
B. Long-acting beta-agonist
C. Short-acting beta-agonist
D. Leukotriene receptor antagonist
Answer: C
Rationale: Short-acting beta-agonists (SABAs), such as albuterol, provide rapid
bronchodilation and are the first-line treatment for acute asthma symptoms.
,3. A patient with moderate COPD remains symptomatic despite LABA therapy.
What is the most appropriate next step?
A. Add inhaled corticosteroid
B. Add long-acting muscarinic antagonist
C. Discontinue LABA
D. Start oral corticosteroids
Answer: B
Rationale: Dual bronchodilation with a LABA plus a LAMA improves symptoms
and reduces COPD exacerbations.
4. Which symptom most strongly differentiates acute bronchitis from pneumonia?
A. Fever
B. Productive cough
C. Dyspnea
D. Persistent cough without focal findings
Answer: D
Rationale: Cough is the hallmark of acute bronchitis; pneumonia requires
radiographic confirmation.
5. The diagnosis of community-acquired pneumonia is confirmed by:
A. Elevated WBC count
B. Positive sputum culture
C. Chest radiograph showing infiltrate
D. Fever >38°C
Answer: C
Rationale: A radiographic infiltrate is required to confirm pneumonia.
,6. Which patient meets criteria for lung cancer screening with low-dose CT?
A. 45-year-old current smoker, 10 pack-years
B. 55-year-old former smoker, quit 20 years ago, 25 pack-years
C. 62-year-old current smoker, 30 pack-years
D. 70-year-old nonsmoker with chronic cough
Answer: C
Rationale: Screening is recommended for adults aged 50–80 years with a ≥20
pack-year smoking history who currently smoke or have quit within the past 15
years.
7. Approximately what percentage of lung cancer cases are attributed to smoking?
A. 50–60%
B. 65–70%
C. 75–80%
D. 85–90%
Answer: D
Rationale: Smoking accounts for approximately 85–90% of lung cancer cases.
8. A patient develops sudden dyspnea and pleuritic chest pain after a long flight.
Which EKG finding supports pulmonary embolism?
A. ST elevation in inferior leads
B. S1Q3T3 pattern
C. Left bundle branch block
D. Prolonged QT interval
Answer: B
Rationale: The S1Q3T3 pattern, though not sensitive, is classically associated
with pulmonary embolism (PE).
, 9. Which clinical finding is most concerning for pulmonary embolism?
A. Gradual onset cough
B. Wheezing relieved by bronchodilator
C. Sudden unexplained hypoxia
D. Chronic fatigue
Answer: C
Rationale: Sudden hypoxia without another explanation is a red flag for
pulmonary embolism.
10. A patient presents with sore throat, fever, and tonsillar exudates without cough.
Based on Centor criteria, what is the best next step?
A. Symptomatic treatment only
B. Prescribe azithromycin
C. Rapid strep testing
D. Immediate CT scan
Answer: C
Rationale: Centor criteria guide testing; confirmatory testing is recommended
before starting antibiotics.
11. First-line treatment for confirmed streptococcal pharyngitis is:
A. Amoxicillin
B. Cephalexin
C. Azithromycin
D. Clindamycin
Answer: A
Rationale: Amoxicillin or Penicillin VK is the first-line treatment for
streptococcal pharyngitis.
