NRNP 6531 MIDTERM EXAM 2026
LATEST VERSION QUESTIONS AND ANSWERS
(VERIFIED ANSWERS)|AGRADE
MIDTERM 6531
0 out of 0 points
Question 1
When completing this quiz, did you comply with Walden University's Code of Conduct including the expectations for academic
integrity?
A) Yes
B) No
Correct Answer: A
Expert Rationale
Academic integrity is a fundamental principle of higher education that requires students to complete their work honestly, fairly, and
without cheating, plagiarism, or other forms of academic dishonesty. Walden University's Code of Conduct explicitly outlines
expectations for academic integrity, which include completing quizzes and examinations independently, accurately representing
one's own work, and adhering to all institutional policies. Selecting "Yes" indicates an acknowledgment of and compliance with
these ethical standards. This question serves as a reminder of the importance of academic honesty and the consequences of
violating institutional policies. Maintaining academic integrity ensures that the assessment accurately reflects the student's
knowledge and competencies, which is essential for both personal and professional development.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Academic Integrity
MSC: Professional Standards
Question 2
,The most common cancer found on the auricle is:
A) Actinic keratosis
B) Basal cell carcinoma
C) Squamous cell carcinoma
D) Acral-lentiginous melanoma
Correct Answer: B
Expert Rationale
Basal cell carcinoma (BCC) is the most common cancer found on the auricle (external ear). BCC is the most frequently occurring skin
cancer overall, accounting for approximately 80% of all non-melanoma skin cancers. It typically presents as a pearly, translucent
papule with telangiectasias and a rolled border. The auricle is a common site for BCC due to chronic sun exposure. Actinic keratosis
is a premalignant lesion, not a cancer. Squamous cell carcinoma can also occur on the auricle but is less common than BCC. Acral-
lentiginous melanoma is a type of melanoma that occurs on the palms, soles, and nail beds and is not the most common cancer on
the auricle. Early detection and treatment of BCC are essential to prevent local tissue destruction, as BCC rarely metastasizes but
can be locally invasive.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Dermatology: Skin Cancers
MSC: NCLEX: Health Promotion and Maintenance
Question 3
Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute
to ventilation-perfusion mismatch in the patient?
A) Xanthines
B) Antihistamines
C) Steroids
D) Anticholinergics
Correct Answer: B
Expert Rationale
Antihistamines should be avoided in patients with acute or chronic bronchitis because they can contribute to ventilation-perfusion
(V/Q) mismatch. Antihistamines have anticholinergic effects that can dry and thicken respiratory secretions, impairing mucociliary
clearance. This leads to mucus plugging, which can cause airway obstruction and subsequent V/Q mismatch. Xanthines (such as
theophylline) are bronchodilators that can improve airflow. Steroids reduce inflammation and are beneficial in bronchitis.
Anticholinergics (such as ipratropium) are bronchodilators that are actually used in the treatment of COPD and bronchitis. In acute
bronchitis, the use of antihistamines is generally not recommended because they can worsen symptoms by drying secretions.
Clinicians should be cautious when prescribing antihistamines to patients with underlying respiratory conditions.
,DIF: Cognitive Level: Apply (Application)
TOP: Pulmonology: Bronchitis Management
MSC: NCLEX: Pharmacological and Parenteral Therapies
Question 4
A 47-year-old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On
examination, external hemorrhoids are noted. How should the nurse practitioner proceed?
A) Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet.
B) Order a topical hemorrhoid cream along with a stool softener.
C) Refer the patient for a barium enema and sigmoidoscopy.
D) Refer the patient for a surgical hemorrhoidectomy.
Correct Answer: C
Expert Rationale
Bright red rectal bleeding, even in the presence of external hemorrhoids, requires further investigation to rule out more serious
causes such as colorectal cancer, polyps, or diverticular disease. The presence of hemorrhoids does not exclude other pathologies.
The most appropriate action is to refer the patient for a barium enema and sigmoidoscopy to evaluate the entire colon and rectum.
This is especially important in a patient over 40 years of age presenting with new-onset rectal bleeding. Instructing the patient on
preventive measures or prescribing topical treatments without further evaluation could delay the diagnosis of a potentially serious
condition. Surgical hemorrhoidectomy is reserved for severe, recurrent, or complicated hemorrhoids after conservative measures
have failed. The nurse practitioner should not assume that hemorrhoids are the sole cause of the bleeding without a thorough
diagnostic workup.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Gastroenterology: Rectal Bleeding
MSC: NCLEX: Physiological Integrity / Reduction of Risk Potential
Question 5
Which of the following patient characteristics are associated with chronic bronchitis?
A) Overweight, cyanosis, and normal or slightly increased respiratory rate
B) Underweight, pink skin, and increased respiratory rate
C) Overweight, pink skin, and normal or slightly increased respiratory rate
D) Normal weight, cyanosis, and greatly increased respiratory rate
Correct Answer: A
, Expert Rationale
Chronic bronchitis is characterized by a chronic productive cough for at least 3 months in two consecutive years. Patients with
chronic bronchitis are often overweight, have cyanosis (bluish discoloration of the skin due to hypoxemia), and have a normal or
slightly increased respiratory rate. This presentation is sometimes referred to as "blue bloaters" because of the cyanosis and fluid
retention. In contrast, patients with emphysema are often underweight, have pink skin due to hyperventilation, and have an
increased respiratory rate ("pink puffers"). Understanding these classic presentations helps clinicians differentiate between chronic
bronchitis and emphysema, which are the two main types of chronic obstructive pulmonary disease (COPD). Management
strategies for chronic bronchitis focus on airway clearance, bronchodilation, and oxygen therapy.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Pulmonology: Chronic Bronchitis
MSC: NCLEX: Physiological Integrity / Physiological Adaptation
Question 6
A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent
care with new onset left lower quadrant pain. Her current medications include omeprazole 20 mg PO daily, lisinopril 20 mg PO daily,
simvastatin 20 mg PO daily, and prednisone 12 mg PO daily. The nurse practitioner suspects acute diverticulitis and possibly an
abscess. The most appropriate diagnostic test for this patient at this time is:
A) CBC with differential
B) Erythrocyte sedimentation rate
C) Abdominal ultrasound
D) CT scan
Correct Answer: D
Expert Rationale
A CT scan of the abdomen and pelvis with intravenous contrast is the most appropriate diagnostic test for a patient with suspected
acute diverticulitis and possible abscess. CT scan has a high sensitivity and specificity for diagnosing diverticulitis and can identify
complications such as abscess, perforation, or fistula formation. It also helps guide management decisions, including whether the
patient requires surgical intervention or percutaneous drainage. A CBC with differential and erythrocyte sedimentation rate may
show signs of infection and inflammation but are not definitive for diverticulitis or abscess. Abdominal ultrasound may be useful in
some cases but is operator-dependent and less sensitive than CT for detecting diverticular disease. The CT scan provides the most
comprehensive evaluation and is the gold standard for diagnosing diverticulitis.
DIF: Cognitive Level: Apply (Application)
TOP: Gastroenterology: Diverticulitis
MSC: NCLEX: Physiological Integrity / Reduction of Risk Potential
LATEST VERSION QUESTIONS AND ANSWERS
(VERIFIED ANSWERS)|AGRADE
MIDTERM 6531
0 out of 0 points
Question 1
When completing this quiz, did you comply with Walden University's Code of Conduct including the expectations for academic
integrity?
A) Yes
B) No
Correct Answer: A
Expert Rationale
Academic integrity is a fundamental principle of higher education that requires students to complete their work honestly, fairly, and
without cheating, plagiarism, or other forms of academic dishonesty. Walden University's Code of Conduct explicitly outlines
expectations for academic integrity, which include completing quizzes and examinations independently, accurately representing
one's own work, and adhering to all institutional policies. Selecting "Yes" indicates an acknowledgment of and compliance with
these ethical standards. This question serves as a reminder of the importance of academic honesty and the consequences of
violating institutional policies. Maintaining academic integrity ensures that the assessment accurately reflects the student's
knowledge and competencies, which is essential for both personal and professional development.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Academic Integrity
MSC: Professional Standards
Question 2
,The most common cancer found on the auricle is:
A) Actinic keratosis
B) Basal cell carcinoma
C) Squamous cell carcinoma
D) Acral-lentiginous melanoma
Correct Answer: B
Expert Rationale
Basal cell carcinoma (BCC) is the most common cancer found on the auricle (external ear). BCC is the most frequently occurring skin
cancer overall, accounting for approximately 80% of all non-melanoma skin cancers. It typically presents as a pearly, translucent
papule with telangiectasias and a rolled border. The auricle is a common site for BCC due to chronic sun exposure. Actinic keratosis
is a premalignant lesion, not a cancer. Squamous cell carcinoma can also occur on the auricle but is less common than BCC. Acral-
lentiginous melanoma is a type of melanoma that occurs on the palms, soles, and nail beds and is not the most common cancer on
the auricle. Early detection and treatment of BCC are essential to prevent local tissue destruction, as BCC rarely metastasizes but
can be locally invasive.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Dermatology: Skin Cancers
MSC: NCLEX: Health Promotion and Maintenance
Question 3
Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute
to ventilation-perfusion mismatch in the patient?
A) Xanthines
B) Antihistamines
C) Steroids
D) Anticholinergics
Correct Answer: B
Expert Rationale
Antihistamines should be avoided in patients with acute or chronic bronchitis because they can contribute to ventilation-perfusion
(V/Q) mismatch. Antihistamines have anticholinergic effects that can dry and thicken respiratory secretions, impairing mucociliary
clearance. This leads to mucus plugging, which can cause airway obstruction and subsequent V/Q mismatch. Xanthines (such as
theophylline) are bronchodilators that can improve airflow. Steroids reduce inflammation and are beneficial in bronchitis.
Anticholinergics (such as ipratropium) are bronchodilators that are actually used in the treatment of COPD and bronchitis. In acute
bronchitis, the use of antihistamines is generally not recommended because they can worsen symptoms by drying secretions.
Clinicians should be cautious when prescribing antihistamines to patients with underlying respiratory conditions.
,DIF: Cognitive Level: Apply (Application)
TOP: Pulmonology: Bronchitis Management
MSC: NCLEX: Pharmacological and Parenteral Therapies
Question 4
A 47-year-old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On
examination, external hemorrhoids are noted. How should the nurse practitioner proceed?
A) Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet.
B) Order a topical hemorrhoid cream along with a stool softener.
C) Refer the patient for a barium enema and sigmoidoscopy.
D) Refer the patient for a surgical hemorrhoidectomy.
Correct Answer: C
Expert Rationale
Bright red rectal bleeding, even in the presence of external hemorrhoids, requires further investigation to rule out more serious
causes such as colorectal cancer, polyps, or diverticular disease. The presence of hemorrhoids does not exclude other pathologies.
The most appropriate action is to refer the patient for a barium enema and sigmoidoscopy to evaluate the entire colon and rectum.
This is especially important in a patient over 40 years of age presenting with new-onset rectal bleeding. Instructing the patient on
preventive measures or prescribing topical treatments without further evaluation could delay the diagnosis of a potentially serious
condition. Surgical hemorrhoidectomy is reserved for severe, recurrent, or complicated hemorrhoids after conservative measures
have failed. The nurse practitioner should not assume that hemorrhoids are the sole cause of the bleeding without a thorough
diagnostic workup.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Gastroenterology: Rectal Bleeding
MSC: NCLEX: Physiological Integrity / Reduction of Risk Potential
Question 5
Which of the following patient characteristics are associated with chronic bronchitis?
A) Overweight, cyanosis, and normal or slightly increased respiratory rate
B) Underweight, pink skin, and increased respiratory rate
C) Overweight, pink skin, and normal or slightly increased respiratory rate
D) Normal weight, cyanosis, and greatly increased respiratory rate
Correct Answer: A
, Expert Rationale
Chronic bronchitis is characterized by a chronic productive cough for at least 3 months in two consecutive years. Patients with
chronic bronchitis are often overweight, have cyanosis (bluish discoloration of the skin due to hypoxemia), and have a normal or
slightly increased respiratory rate. This presentation is sometimes referred to as "blue bloaters" because of the cyanosis and fluid
retention. In contrast, patients with emphysema are often underweight, have pink skin due to hyperventilation, and have an
increased respiratory rate ("pink puffers"). Understanding these classic presentations helps clinicians differentiate between chronic
bronchitis and emphysema, which are the two main types of chronic obstructive pulmonary disease (COPD). Management
strategies for chronic bronchitis focus on airway clearance, bronchodilation, and oxygen therapy.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Pulmonology: Chronic Bronchitis
MSC: NCLEX: Physiological Integrity / Physiological Adaptation
Question 6
A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent
care with new onset left lower quadrant pain. Her current medications include omeprazole 20 mg PO daily, lisinopril 20 mg PO daily,
simvastatin 20 mg PO daily, and prednisone 12 mg PO daily. The nurse practitioner suspects acute diverticulitis and possibly an
abscess. The most appropriate diagnostic test for this patient at this time is:
A) CBC with differential
B) Erythrocyte sedimentation rate
C) Abdominal ultrasound
D) CT scan
Correct Answer: D
Expert Rationale
A CT scan of the abdomen and pelvis with intravenous contrast is the most appropriate diagnostic test for a patient with suspected
acute diverticulitis and possible abscess. CT scan has a high sensitivity and specificity for diagnosing diverticulitis and can identify
complications such as abscess, perforation, or fistula formation. It also helps guide management decisions, including whether the
patient requires surgical intervention or percutaneous drainage. A CBC with differential and erythrocyte sedimentation rate may
show signs of infection and inflammation but are not definitive for diverticulitis or abscess. Abdominal ultrasound may be useful in
some cases but is operator-dependent and less sensitive than CT for detecting diverticular disease. The CT scan provides the most
comprehensive evaluation and is the gold standard for diagnosing diverticulitis.
DIF: Cognitive Level: Apply (Application)
TOP: Gastroenterology: Diverticulitis
MSC: NCLEX: Physiological Integrity / Reduction of Risk Potential
