NUR 6111 ADVANCED PRACTICE
NURSING I - EXAM 2 QUESTIONS AND
ANSWERS
1. According to the JNC 8 guidelines, what is the blood pressure threshold for initiating
pharmacological treatment in patients aged 60 years or older without diabetes or chronic
kidney disease?
A. 150/90 mmHg
B. 140/90 mmHg
C. 130/80 mmHg
D. 160/100 mmHg
Answer: A
Conceptual Explanation: For patients aged 60 or older without DM or CKD, the JNC 8 goal
is <150/90 mmHg; treatment starts at or above this level.
,2. A 45-year-old patient presents with a history of persistent heartburn and regurgitation.
During endoscopy, Barrett’s esophagus is identified. This condition is characterized by which
histological change?
A. Squamous cell hyperplasia
B. Dysplasia of the gastric mucosa
C. Metaplasia from squamous to columnar epithelium
D. Atrophy of the esophageal sphincter
Answer: C
Conceptual Explanation: Barrett’s esophagus involves intestinal metaplasia, where the
normal stratified squamous epithelium is replaced by simple columnar epithelium.
3. In the management of Community-Acquired Pneumonia (CAP) in a previously healthy adult
with no recent antibiotic use, which is the preferred first-line empirical treatment?
A. Levofloxacin
B. Amoxicillin or Doxycycline
C. Ceftriaxone plus Azithromycin
D. Vancomycin
Answer: B
, Conceptual Explanation: For outpatient CAP in healthy individuals without comorbidities,
monotherapy with high-dose Amoxicillin, Doxycycline, or a Macrolide (if local resistance is
low) is recommended.
4. Which physical exam finding is most suggestive of Acute Cholecystitis?
A. Rovsing’s sign
B. Murphy’s sign
C. Cullen’s sign
D. Grey Turner’s sign
Answer: B
Conceptual Explanation: Murphy’s sign (arrest of inspiration on deep palpation of the
RUQ) is highly specific for acute cholecystitis.
5. A patient with heart failure with reduced ejection fraction (HFrEF) is already taking an ACE
inhibitor and a Beta-blocker but remains symptomatic (NYHA Class II). Which medication
should be added next to reduce mortality?
A. Furosemide
B. Mineralocorticoid receptor antagonist (MRA)
C. Digoxin
D. Amlodipine
Answer: B
NURSING I - EXAM 2 QUESTIONS AND
ANSWERS
1. According to the JNC 8 guidelines, what is the blood pressure threshold for initiating
pharmacological treatment in patients aged 60 years or older without diabetes or chronic
kidney disease?
A. 150/90 mmHg
B. 140/90 mmHg
C. 130/80 mmHg
D. 160/100 mmHg
Answer: A
Conceptual Explanation: For patients aged 60 or older without DM or CKD, the JNC 8 goal
is <150/90 mmHg; treatment starts at or above this level.
,2. A 45-year-old patient presents with a history of persistent heartburn and regurgitation.
During endoscopy, Barrett’s esophagus is identified. This condition is characterized by which
histological change?
A. Squamous cell hyperplasia
B. Dysplasia of the gastric mucosa
C. Metaplasia from squamous to columnar epithelium
D. Atrophy of the esophageal sphincter
Answer: C
Conceptual Explanation: Barrett’s esophagus involves intestinal metaplasia, where the
normal stratified squamous epithelium is replaced by simple columnar epithelium.
3. In the management of Community-Acquired Pneumonia (CAP) in a previously healthy adult
with no recent antibiotic use, which is the preferred first-line empirical treatment?
A. Levofloxacin
B. Amoxicillin or Doxycycline
C. Ceftriaxone plus Azithromycin
D. Vancomycin
Answer: B
, Conceptual Explanation: For outpatient CAP in healthy individuals without comorbidities,
monotherapy with high-dose Amoxicillin, Doxycycline, or a Macrolide (if local resistance is
low) is recommended.
4. Which physical exam finding is most suggestive of Acute Cholecystitis?
A. Rovsing’s sign
B. Murphy’s sign
C. Cullen’s sign
D. Grey Turner’s sign
Answer: B
Conceptual Explanation: Murphy’s sign (arrest of inspiration on deep palpation of the
RUQ) is highly specific for acute cholecystitis.
5. A patient with heart failure with reduced ejection fraction (HFrEF) is already taking an ACE
inhibitor and a Beta-blocker but remains symptomatic (NYHA Class II). Which medication
should be added next to reduce mortality?
A. Furosemide
B. Mineralocorticoid receptor antagonist (MRA)
C. Digoxin
D. Amlodipine
Answer: B
