NU 578 Units 1–5 Exam verified with correct answers and rationales 2026/2027
version A+ Graded
1. Which component of evidence-based practice is most essential when
developing a patient care plan?
A. Current best evidence, clinical expertise, and patient preferences
B. Clinical experience only
C. Hospital policy only
D. Provider preference only
Correct Answer: A
Rationale: Evidence-based practice integrates the best available research evidence, clinician
expertise, and patient values to achieve optimal outcomes.
2. Which laboratory test best reflects long-term glycemic control in a patient
with diabetes mellitus?
A. Hemoglobin A1C
B. Random blood glucose
C. Fasting insulin level
D. Serum ketones
Correct Answer: A
Rationale: Hemoglobin A1C reflects average blood glucose levels over the previous 2–3 months.
3. A patient has a blood pressure of 168/96 mmHg on two separate visits. Which
diagnosis is most appropriate?
A. Hypertension
B. Hypotension
C. Orthostatic hypotension
D. Normal blood pressure
Correct Answer: A
Rationale: Persistent blood pressure readings ≥140/90 mmHg meet criteria for hypertension in
many clinical settings, though current guideline thresholds and treatment decisions depend on
the clinical context.
,4. Which lipid abnormality is the strongest modifiable risk factor for
atherosclerotic cardiovascular disease?
A. Elevated LDL cholesterol
B. Elevated HDL cholesterol
C. Low triglycerides
D. Low total cholesterol
Correct Answer: A
Rationale: Elevated LDL cholesterol contributes significantly to atherosclerotic plaque
formation and cardiovascular disease.
5. Which assessment finding is most concerning in a patient presenting with chest
pain?
A. Chest pain radiating to the left arm with diaphoresis
B. Mild chest wall tenderness after exercise
C. Pain relieved by repositioning
D. Pain reproducible with palpation
Correct Answer: A
Rationale: Chest pain radiating to the left arm with diaphoresis is highly suggestive of acute
coronary syndrome.
6. Which electrolyte imbalance is most likely to cause peaked T waves on an
ECG?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypocalcemia
Correct Answer: A
Rationale: Hyperkalemia characteristically produces peaked T waves and may progress to life-
threatening arrhythmias.
,7. Which medication is considered first-line therapy for most patients with type 2
diabetes who have no contraindications?
A. Metformin
B. Regular insulin
C. Prednisone
D. Digoxin
Correct Answer: A
Rationale: Metformin is commonly recommended as initial pharmacologic therapy because of its
efficacy, safety profile, and cardiovascular benefits in many patients.
8. Which patient should receive immediate evaluation?
A. Patient with sudden facial droop and unilateral weakness
B. Patient with seasonal allergic rhinitis
C. Patient with chronic low back pain
D. Patient requesting medication refills
Correct Answer: A
Rationale: These findings suggest an acute stroke, requiring immediate assessment and
intervention.
9. Which organism most commonly causes uncomplicated urinary tract
infections in women?
A. Escherichia coli
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Candida albicans
Correct Answer: A
Rationale: Escherichia coli is responsible for the majority of uncomplicated urinary tract
infections.
, 10. Which physical examination technique should be performed first?
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
Correct Answer: A
Rationale: Inspection is generally the first step of the physical examination.
11. Which cranial nerve is responsible for visual acuity?
A. Cranial Nerve II (Optic)
B. Cranial Nerve III (Oculomotor)
C. Cranial Nerve VII (Facial)
D. Cranial Nerve X (Vagus)
Correct Answer: A
Rationale: The optic nerve transmits visual information from the retina to the brain.
12. Which finding is consistent with left-sided heart failure?
A. Pulmonary crackles and orthopnea
B. Hepatomegaly and peripheral edema only
C. Ascites only
D. Jugular venous distention only
Correct Answer: A
Rationale: Left-sided heart failure commonly results in pulmonary congestion, dyspnea, and
orthopnea.
13. Which medication is contraindicated during pregnancy because of fetal
toxicity?
A. Lisinopril
B. Acetaminophen
version A+ Graded
1. Which component of evidence-based practice is most essential when
developing a patient care plan?
A. Current best evidence, clinical expertise, and patient preferences
B. Clinical experience only
C. Hospital policy only
D. Provider preference only
Correct Answer: A
Rationale: Evidence-based practice integrates the best available research evidence, clinician
expertise, and patient values to achieve optimal outcomes.
2. Which laboratory test best reflects long-term glycemic control in a patient
with diabetes mellitus?
A. Hemoglobin A1C
B. Random blood glucose
C. Fasting insulin level
D. Serum ketones
Correct Answer: A
Rationale: Hemoglobin A1C reflects average blood glucose levels over the previous 2–3 months.
3. A patient has a blood pressure of 168/96 mmHg on two separate visits. Which
diagnosis is most appropriate?
A. Hypertension
B. Hypotension
C. Orthostatic hypotension
D. Normal blood pressure
Correct Answer: A
Rationale: Persistent blood pressure readings ≥140/90 mmHg meet criteria for hypertension in
many clinical settings, though current guideline thresholds and treatment decisions depend on
the clinical context.
,4. Which lipid abnormality is the strongest modifiable risk factor for
atherosclerotic cardiovascular disease?
A. Elevated LDL cholesterol
B. Elevated HDL cholesterol
C. Low triglycerides
D. Low total cholesterol
Correct Answer: A
Rationale: Elevated LDL cholesterol contributes significantly to atherosclerotic plaque
formation and cardiovascular disease.
5. Which assessment finding is most concerning in a patient presenting with chest
pain?
A. Chest pain radiating to the left arm with diaphoresis
B. Mild chest wall tenderness after exercise
C. Pain relieved by repositioning
D. Pain reproducible with palpation
Correct Answer: A
Rationale: Chest pain radiating to the left arm with diaphoresis is highly suggestive of acute
coronary syndrome.
6. Which electrolyte imbalance is most likely to cause peaked T waves on an
ECG?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypocalcemia
Correct Answer: A
Rationale: Hyperkalemia characteristically produces peaked T waves and may progress to life-
threatening arrhythmias.
,7. Which medication is considered first-line therapy for most patients with type 2
diabetes who have no contraindications?
A. Metformin
B. Regular insulin
C. Prednisone
D. Digoxin
Correct Answer: A
Rationale: Metformin is commonly recommended as initial pharmacologic therapy because of its
efficacy, safety profile, and cardiovascular benefits in many patients.
8. Which patient should receive immediate evaluation?
A. Patient with sudden facial droop and unilateral weakness
B. Patient with seasonal allergic rhinitis
C. Patient with chronic low back pain
D. Patient requesting medication refills
Correct Answer: A
Rationale: These findings suggest an acute stroke, requiring immediate assessment and
intervention.
9. Which organism most commonly causes uncomplicated urinary tract
infections in women?
A. Escherichia coli
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Candida albicans
Correct Answer: A
Rationale: Escherichia coli is responsible for the majority of uncomplicated urinary tract
infections.
, 10. Which physical examination technique should be performed first?
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
Correct Answer: A
Rationale: Inspection is generally the first step of the physical examination.
11. Which cranial nerve is responsible for visual acuity?
A. Cranial Nerve II (Optic)
B. Cranial Nerve III (Oculomotor)
C. Cranial Nerve VII (Facial)
D. Cranial Nerve X (Vagus)
Correct Answer: A
Rationale: The optic nerve transmits visual information from the retina to the brain.
12. Which finding is consistent with left-sided heart failure?
A. Pulmonary crackles and orthopnea
B. Hepatomegaly and peripheral edema only
C. Ascites only
D. Jugular venous distention only
Correct Answer: A
Rationale: Left-sided heart failure commonly results in pulmonary congestion, dyspnea, and
orthopnea.
13. Which medication is contraindicated during pregnancy because of fetal
toxicity?
A. Lisinopril
B. Acetaminophen
