NUR 6111 - ADVANCED PRACTICE
NURSING I - EXAM 3 STUDY GUIDE
1. A 62-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
presents for a follow-up. He is currently taking lisinopril and carvedilol. Which of the
following physical exam findings would most likely indicate the need for an increase in his
diuretic dose?
A. A Grade II/VI systolic murmur at the apex
B. Reduced tactile fremitus at the lung bases
C. Presence of a third heart sound (S3)
D. Presence of a fourth heart sound (S4)
Answer: C
Conceptual Explanation: An S3 gallop is a sign of ventricular filling into a dilated, non-
compliant chamber and is a classic sign of fluid overload in heart failure.
,2. A 45-year-old patient presents with a persistent cough and night sweats. A chest X-ray
reveals a cavitary lesion in the right upper lobe. Which diagnostic test is the most appropriate
next step?
A. Sputum for acid-fast bacilli (AFB) smear and culture
B. Sputum culture for Streptococcus pneumoniae
C. Serum Mycoplasma IgM
D. Bronchoscopy with biopsy
Answer: A
Conceptual Explanation: Upper lobe cavitary lesions combined with constitutional
symptoms like night sweats are highly suggestive of pulmonary tuberculosis, requiring AFB
testing.
3. A patient presents with sudden onset of severe eye pain, blurred vision, and seeing halos
around lights. On exam, the pupil is mid-dilated and non-reactive. What is the most likely
diagnosis?
A. Acute angle-closure glaucoma
B. Open-angle glaucoma
C. Cataracts
D. Retinal detachment
Answer: A
, Conceptual Explanation: Acute angle-closure glaucoma is an ocular emergency
characterized by sudden pain, halos, and a mid-dilated pupil due to rapid increase in
intraocular pressure.
4. In the management of Community-Acquired Pneumonia (CAP) for a healthy adult with no
recent antibiotic use, which is the preferred first-line outpatient treatment according to
current ATS/IDSA guidelines?
A. Levofloxacin
B. Ceftriaxone
C. Amoxicillin or Doxycycline
D. Ciprofloxacin
Answer: C
Conceptual Explanation: For healthy outpatients without comorbidities, high-dose
amoxicillin or doxycycline are now preferred over macrolides due to resistance patterns.
5. A 30-year-old female presents with palpitations and heat intolerance. Her TSH is 0.01
mIU/L and Free T4 is elevated. Which physical finding would specifically point to Graves’
Disease?
A. Generalized weight gain
B. Exophthalmos and pretibial myxedema
C. Tender thyroid gland upon palpation
NURSING I - EXAM 3 STUDY GUIDE
1. A 62-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
presents for a follow-up. He is currently taking lisinopril and carvedilol. Which of the
following physical exam findings would most likely indicate the need for an increase in his
diuretic dose?
A. A Grade II/VI systolic murmur at the apex
B. Reduced tactile fremitus at the lung bases
C. Presence of a third heart sound (S3)
D. Presence of a fourth heart sound (S4)
Answer: C
Conceptual Explanation: An S3 gallop is a sign of ventricular filling into a dilated, non-
compliant chamber and is a classic sign of fluid overload in heart failure.
,2. A 45-year-old patient presents with a persistent cough and night sweats. A chest X-ray
reveals a cavitary lesion in the right upper lobe. Which diagnostic test is the most appropriate
next step?
A. Sputum for acid-fast bacilli (AFB) smear and culture
B. Sputum culture for Streptococcus pneumoniae
C. Serum Mycoplasma IgM
D. Bronchoscopy with biopsy
Answer: A
Conceptual Explanation: Upper lobe cavitary lesions combined with constitutional
symptoms like night sweats are highly suggestive of pulmonary tuberculosis, requiring AFB
testing.
3. A patient presents with sudden onset of severe eye pain, blurred vision, and seeing halos
around lights. On exam, the pupil is mid-dilated and non-reactive. What is the most likely
diagnosis?
A. Acute angle-closure glaucoma
B. Open-angle glaucoma
C. Cataracts
D. Retinal detachment
Answer: A
, Conceptual Explanation: Acute angle-closure glaucoma is an ocular emergency
characterized by sudden pain, halos, and a mid-dilated pupil due to rapid increase in
intraocular pressure.
4. In the management of Community-Acquired Pneumonia (CAP) for a healthy adult with no
recent antibiotic use, which is the preferred first-line outpatient treatment according to
current ATS/IDSA guidelines?
A. Levofloxacin
B. Ceftriaxone
C. Amoxicillin or Doxycycline
D. Ciprofloxacin
Answer: C
Conceptual Explanation: For healthy outpatients without comorbidities, high-dose
amoxicillin or doxycycline are now preferred over macrolides due to resistance patterns.
5. A 30-year-old female presents with palpitations and heat intolerance. Her TSH is 0.01
mIU/L and Free T4 is elevated. Which physical finding would specifically point to Graves’
Disease?
A. Generalized weight gain
B. Exophthalmos and pretibial myxedema
C. Tender thyroid gland upon palpation
