NUR 6111 ADVANCED PRACTICE
NURSING I - EXAM 2 STUDY GUIDE
1. A 65-year-old African American male presents with a blood pressure of 155/95 mmHg.
According to JNC 8 guidelines, which of the following is the most appropriate initial therapy?
A. Lisinopril
B. Losartan
C. Amlodipine
D. Metoprolol
Answer: C
Conceptual Explanation: For the general African American population, including those
with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or
calcium channel blocker (CCB). Amlodipine is a CCB.
2. Which heart sound is most commonly associated with heart failure and fluid volume
overload in an adult patient?
A. S3
B. S4
,C. Ejection click
D. Mid-systolic click
Answer: A
Conceptual Explanation: S3 is a ventricular gallop occurring in early diastole and is often
a sign of fluid overload or heart failure in adults, whereas S4 is associated with stiff
ventricles or hypertrophy.
3. An APRN is evaluating a patient with a suspected thyroid disorder. The TSH is elevated and
the Free T4 is low. What is the most likely diagnosis?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Subclinical hypothyroidism
D. Hyperthyroidism
Answer: A
Conceptual Explanation: Primary hypothyroidism is characterized by an elevated TSH
(due to lack of negative feedback) and a low Free T4 level.
4. Which of the following physical exam findings is most suggestive of Aortic Stenosis?
A. Holosystolic murmur radiating to the axilla
B. Mid-systolic click
C. Diastolic blowing murmur at the left sternal border
, D. Harsh systolic crescendo-decrescendo murmur radiating to the carotids
Answer: D
Conceptual Explanation: Aortic stenosis typically presents as a harsh systolic murmur
heard best at the right second intercostal space that radiates to the neck/carotids.
5. In the management of COPD, which classification of medication is the mainstay of long-
term maintenance therapy for patients in GOLD Category B?
A. Short-acting beta-agonists (SABA) only
B. Oral prednisone
C. Inhaled corticosteroids (ICS) monotherapy
D. Long-acting bronchodilators (LABA or LAMA)
Answer: D
Conceptual Explanation: GOLD guidelines recommend long-acting bronchodilators (LABA
or LAMA) as the initial maintenance therapy for patients in Category B.
6. A patient presents with a ‘curtain-like’ loss of vision in one eye. This is a classic symptom
of:
A. Acute angle-closure glaucoma
B. Cataracts
C. Retinal detachment
D. Macular degeneration
NURSING I - EXAM 2 STUDY GUIDE
1. A 65-year-old African American male presents with a blood pressure of 155/95 mmHg.
According to JNC 8 guidelines, which of the following is the most appropriate initial therapy?
A. Lisinopril
B. Losartan
C. Amlodipine
D. Metoprolol
Answer: C
Conceptual Explanation: For the general African American population, including those
with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or
calcium channel blocker (CCB). Amlodipine is a CCB.
2. Which heart sound is most commonly associated with heart failure and fluid volume
overload in an adult patient?
A. S3
B. S4
,C. Ejection click
D. Mid-systolic click
Answer: A
Conceptual Explanation: S3 is a ventricular gallop occurring in early diastole and is often
a sign of fluid overload or heart failure in adults, whereas S4 is associated with stiff
ventricles or hypertrophy.
3. An APRN is evaluating a patient with a suspected thyroid disorder. The TSH is elevated and
the Free T4 is low. What is the most likely diagnosis?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Subclinical hypothyroidism
D. Hyperthyroidism
Answer: A
Conceptual Explanation: Primary hypothyroidism is characterized by an elevated TSH
(due to lack of negative feedback) and a low Free T4 level.
4. Which of the following physical exam findings is most suggestive of Aortic Stenosis?
A. Holosystolic murmur radiating to the axilla
B. Mid-systolic click
C. Diastolic blowing murmur at the left sternal border
, D. Harsh systolic crescendo-decrescendo murmur radiating to the carotids
Answer: D
Conceptual Explanation: Aortic stenosis typically presents as a harsh systolic murmur
heard best at the right second intercostal space that radiates to the neck/carotids.
5. In the management of COPD, which classification of medication is the mainstay of long-
term maintenance therapy for patients in GOLD Category B?
A. Short-acting beta-agonists (SABA) only
B. Oral prednisone
C. Inhaled corticosteroids (ICS) monotherapy
D. Long-acting bronchodilators (LABA or LAMA)
Answer: D
Conceptual Explanation: GOLD guidelines recommend long-acting bronchodilators (LABA
or LAMA) as the initial maintenance therapy for patients in Category B.
6. A patient presents with a ‘curtain-like’ loss of vision in one eye. This is a classic symptom
of:
A. Acute angle-closure glaucoma
B. Cataracts
C. Retinal detachment
D. Macular degeneration
