NURS 5432 FINAL EXAM UPDATED ACTUAL
EXAM QUESTIONS AND CORRECT ANSWERS
NURS 5432 Practice Clinical Case Studies
Case 1: Acute Chest Pain
A 62-year-old man presents to the clinic complaining of chest
pressure that began 30 minutes ago while mowing his lawn. The
pain radiates to his left shoulder and jaw. He has hypertension,
hyperlipidemia, and type 2 diabetes.
Vital Signs
• BP: 158/92 mmHg
• HR: 104 bpm
• RR: 22
• SpO₂: 95%
Question
What is the priority action?
A. Prescribe nitroglycerin and schedule outpatient stress testing
B. Obtain an ECG within 10 minutes and activate emergency
transport
C. Order a chest x-ray
D. Prescribe omeprazole
,Answer
B
Rationale
The patient's symptoms are classic for acute coronary syndrome.
Immediate ECG evaluation and emergency referral are priorities
because time-sensitive reperfusion therapy significantly improves
outcomes.
Case 2: Altered Mental Status
An 81-year-old woman is brought by family because she became
confused over the past day.
History:
• Normally independent
• No dementia history
• Complains of burning with urination
Vitals
• Temp 101.4°F
• HR 108
• BP 102/64
Question
Most likely diagnosis?
A. Alzheimer's disease
,B. Delirium secondary to urinary tract infection
C. Depression
D. Normal aging
Answer
B
Rationale
Acute onset, fluctuating confusion, fever, and urinary symptoms
strongly suggest delirium due to infection.
Case 3: Shortness of Breath
A 70-year-old patient with heart failure reports worsening
dyspnea, orthopnea, and a 6-pound weight gain over four days.
Exam:
• Bilateral crackles
• JVD
• 2+ edema
Question
Priority diagnosis?
A. Stable CHF
B. Acute decompensated heart failure
C. Pneumonia
, D. Pulmonary embolism
Answer
B
Rationale
Rapid weight gain, pulmonary congestion, and fluid overload
indicate acute decompensated heart failure requiring urgent
treatment.
Case 4: Diabetes
A 58-year-old woman with Type 2 diabetes
Current medications:
• Metformin
• Glipizide
Labs
• A1C 9.4%
• eGFR 78
• BMI 35
• BP controlled
Question
Most appropriate next medication?
A. Glyburide
EXAM QUESTIONS AND CORRECT ANSWERS
NURS 5432 Practice Clinical Case Studies
Case 1: Acute Chest Pain
A 62-year-old man presents to the clinic complaining of chest
pressure that began 30 minutes ago while mowing his lawn. The
pain radiates to his left shoulder and jaw. He has hypertension,
hyperlipidemia, and type 2 diabetes.
Vital Signs
• BP: 158/92 mmHg
• HR: 104 bpm
• RR: 22
• SpO₂: 95%
Question
What is the priority action?
A. Prescribe nitroglycerin and schedule outpatient stress testing
B. Obtain an ECG within 10 minutes and activate emergency
transport
C. Order a chest x-ray
D. Prescribe omeprazole
,Answer
B
Rationale
The patient's symptoms are classic for acute coronary syndrome.
Immediate ECG evaluation and emergency referral are priorities
because time-sensitive reperfusion therapy significantly improves
outcomes.
Case 2: Altered Mental Status
An 81-year-old woman is brought by family because she became
confused over the past day.
History:
• Normally independent
• No dementia history
• Complains of burning with urination
Vitals
• Temp 101.4°F
• HR 108
• BP 102/64
Question
Most likely diagnosis?
A. Alzheimer's disease
,B. Delirium secondary to urinary tract infection
C. Depression
D. Normal aging
Answer
B
Rationale
Acute onset, fluctuating confusion, fever, and urinary symptoms
strongly suggest delirium due to infection.
Case 3: Shortness of Breath
A 70-year-old patient with heart failure reports worsening
dyspnea, orthopnea, and a 6-pound weight gain over four days.
Exam:
• Bilateral crackles
• JVD
• 2+ edema
Question
Priority diagnosis?
A. Stable CHF
B. Acute decompensated heart failure
C. Pneumonia
, D. Pulmonary embolism
Answer
B
Rationale
Rapid weight gain, pulmonary congestion, and fluid overload
indicate acute decompensated heart failure requiring urgent
treatment.
Case 4: Diabetes
A 58-year-old woman with Type 2 diabetes
Current medications:
• Metformin
• Glipizide
Labs
• A1C 9.4%
• eGFR 78
• BMI 35
• BP controlled
Question
Most appropriate next medication?
A. Glyburide
