NUR 6111 ADVANCED PRACTICE
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a harsh, crescendo-decrescendo systolic murmur heard
best at the right second intercostal space, radiating to the carotids. What is the most likely
diagnosis?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis typically presents as a crescendo-decrescendo
systolic murmur at the right upper sternal border radiating to the neck. Mitral
regurgitation is holosystolic at the apex.
2. Which of the following physical exam findings is most suggestive of a pleural effusion?
A. Increased tactile fremitus
,B. Hyperresonance on percussion
C. Wheezing and prolonged expiration
D. Dullness to percussion and decreased breath sounds
Answer: D
Conceptual Explanation: Pleural effusion causes fluid to accumulate in the pleural space,
which acts as a barrier, leading to dullness on percussion and muffled or absent breath
sounds.
3. When assessing a patient for possible meningitis, you flex the patient’s neck and observe
involuntary flexion of the hips and knees. This is known as:
A. Kernig’s sign
B. Babinski’s sign
C. Brudzinski’s sign
D. Murphy’s sign
Answer: C
Conceptual Explanation: Brudzinski’s sign is a clinical sign of meningitis where neck
flexion causes hip/knee flexion. Kernig’s sign involves pain when the leg is extended at the
knee.
, 4. In the pharmacological management of heart failure with reduced ejection fraction (HFrEF),
which class of medication is contraindicated in patients with a history of angioedema?
A. Beta-blockers
B. ACE Inhibitors
C. Calcium Channel Blockers
D. Loop Diuretics
Answer: B
Conceptual Explanation: ACE Inhibitors are strictly contraindicated in patients who have
previously experienced angioedema due to the risk of life-threatening airway obstruction.
5. A patient presents with a ‘curtain-like’ loss of vision in one eye. This is a medical
emergency most consistent with:
A. Macular Degeneration
B. Retinal Detachment
C. Cataracts
D. Glaucoma
Answer: B
Conceptual Explanation: Retinal detachment often presents as sudden, painless vision
loss described as a ‘curtain’ or ‘shade’ coming down over the visual field.
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a harsh, crescendo-decrescendo systolic murmur heard
best at the right second intercostal space, radiating to the carotids. What is the most likely
diagnosis?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis typically presents as a crescendo-decrescendo
systolic murmur at the right upper sternal border radiating to the neck. Mitral
regurgitation is holosystolic at the apex.
2. Which of the following physical exam findings is most suggestive of a pleural effusion?
A. Increased tactile fremitus
,B. Hyperresonance on percussion
C. Wheezing and prolonged expiration
D. Dullness to percussion and decreased breath sounds
Answer: D
Conceptual Explanation: Pleural effusion causes fluid to accumulate in the pleural space,
which acts as a barrier, leading to dullness on percussion and muffled or absent breath
sounds.
3. When assessing a patient for possible meningitis, you flex the patient’s neck and observe
involuntary flexion of the hips and knees. This is known as:
A. Kernig’s sign
B. Babinski’s sign
C. Brudzinski’s sign
D. Murphy’s sign
Answer: C
Conceptual Explanation: Brudzinski’s sign is a clinical sign of meningitis where neck
flexion causes hip/knee flexion. Kernig’s sign involves pain when the leg is extended at the
knee.
, 4. In the pharmacological management of heart failure with reduced ejection fraction (HFrEF),
which class of medication is contraindicated in patients with a history of angioedema?
A. Beta-blockers
B. ACE Inhibitors
C. Calcium Channel Blockers
D. Loop Diuretics
Answer: B
Conceptual Explanation: ACE Inhibitors are strictly contraindicated in patients who have
previously experienced angioedema due to the risk of life-threatening airway obstruction.
5. A patient presents with a ‘curtain-like’ loss of vision in one eye. This is a medical
emergency most consistent with:
A. Macular Degeneration
B. Retinal Detachment
C. Cataracts
D. Glaucoma
Answer: B
Conceptual Explanation: Retinal detachment often presents as sudden, painless vision
loss described as a ‘curtain’ or ‘shade’ coming down over the visual field.
