NSG 6020 Week 10 Final Exam Prep Document |
2026/2027 Edition | 50 Verified Questions
About This Exam Bank
This comprehensive exam preparation document is meticulously curated for
nursing students enrolled in NSG 6020 at South University, covering the entire
curriculum for the Week 10 Final Exam. It features 50 verified questions with
revised answers and rationales, ensuring alignment with the latest 2026/2027
academic guidelines. Designed to reinforce advanced nursing concepts, this
resource facilitates mastery of complex clinical scenarios and theoretical
frameworks essential for success. With a focus on evidence-based practice and
critical thinking, it serves as an indispensable tool for achieving a top grade.
Keywords
NSG 6020, Final Exam, South University, Advanced Nursing, Clinical
Reasoning, Evidence-Based Practice, Pharmacology, Health Assessment, NSG
6020, Final Exam, South University, Advanced Nursing, NSG 6020, Final
Exam, South University, Advanced Nursing, Clinical Reasoning,
Evidence-Based Practice
PART 1: EXAM QUESTIONS, ANSWERS AND RATIONALES
1. A patient presents with acute-onset severe headache, neck stiffness, and
photophobia. CSF analysis shows elevated opening pressure, neutrophilic
pleocytosis, elevated protein, and low glucose. Which additional finding would
most strongly support a specific etiologic diagnosis over empiric management?
A) Positive Gram stain showing gram-negative diplococci
B) Elevated CSF lactate >4 mmol/L
C) Positive polymerase chain reaction for enterovirus
D) Peripheral blood leukocytosis with left shift
' Correct Answer: A
Rationale: A positive Gram stain with gram-negative diplococci identifies
Neisseria meningitidis, allowing targeted antimicrobial therapy and
Page 1
,chemoprophylaxis for contacts. Elevated CSF lactate supports bacterial
meningitis but is not etiologic. Enterovirus PCR indicates viral meningitis, and
peripheral leukocytosis is nonspecific.
Why the other answers are wrong:
B) Elevated CSF lactate is sensitive for bacterial meningitis but does not
identify the specific organism.
C) Enterovirus PCR would suggest viral meningitis, which typically has a
different CSF profile (lymphocytic pleocytosis, normal glucose).
D) Peripheral leukocytosis is a systemic inflammatory response and does not
differentiate bacterial from other causes.
Reference: Mandell, Douglas, and Bennett's Principles and Practice of
Infectious Diseases, 9th Ed., Ch. 85
2. A 65-year-old with type 2 diabetes and chronic kidney disease (eGFR 35
mL/min/1.73m²) is started on an SGLT2 inhibitor. Which laboratory monitoring
is most critical within the first 2 weeks of initiation?
A) Hemoglobin A1c
B) Serum creatinine and electrolytes
C) Liver function tests
D) Lipid panel
' Correct Answer: B
Rationale: SGLT2 inhibitors can cause an acute drop in eGFR and electrolyte
disturbances, especially in patients with pre-existing CKD. Monitoring serum
creatinine and electrolytes within 1-2 weeks is recommended to detect acute
kidney injury or hyperkalemia. A1c, LFTs, and lipids are not the most
immediate monitoring priorities.
Why the other answers are wrong:
A) A1c reflects long-term glycemic control and is not needed for short-term
safety monitoring.
C) SGLT2 inhibitors are not associated with significant hepatotoxicity;
routine LFT monitoring is not required.
D) Lipid panel is unrelated to SGLT2 inhibitor initiation and not a safety
parameter.
Page 2
, Reference: American Diabetes Association. Standards of Care in
Diabetes-2026. Diabetes Care; 49(Suppl 1):S112-S118.
3. A patient with heart failure with reduced ejection fraction (HFrEF) is on
sacubitril/valsartan, metoprolol succinate, spironolactone, and furosemide.
Which finding would warrant immediate discontinuation of sacubitril/valsartan?
A) Serum potassium of 5.2 mEq/L
B) Symptomatic hypotension with systolic BP 90 mmHg
C) Serum creatinine increase of 0.3 mg/dL from baseline
D) Angioedema involving the tongue and lips
' Correct Answer: D
Rationale: Angioedema is a life-threatening adverse reaction to
sacubitril/valsartan and mandates immediate discontinuation and emergency
management. Hyperkalemia, hypotension, and mild creatinine elevation may be
managed with dose adjustment or diuretic modification, but are not absolute
indications for stopping the drug.
Why the other answers are wrong:
A) Hyperkalemia is a concern but can be managed by dose reduction or
holding spironolactone; not an immediate indication to stop
sacubitril/valsartan.
B) Hypotension is common and often managed by adjusting diuretics or
other vasodilators, not by discontinuing sacubitril/valsartan.
C) A small creatinine rise is expected due to hemodynamic changes and is
not a contraindication unless progressive or severe.
Reference: Heidenreich, P.A., et al. 2022 AHA/ACC/HFSA Guideline for the
Management of Heart Failure. Circulation. 2022;145:e895-e1032.
4. A 45-year-old with a history of recurrent calcium oxalate kidney stones is
found to have a 24-hour urine calcium of 350 mg/day and serum calcium of 9.8
mg/dL. Which additional finding would most strongly suggest primary
hyperparathyroidism as the underlying cause?
A) Low serum phosphorus and elevated intact PTH
B) High serum phosphorus and low intact PTH
C) Low 25-hydroxyvitamin D level
Page 3
2026/2027 Edition | 50 Verified Questions
About This Exam Bank
This comprehensive exam preparation document is meticulously curated for
nursing students enrolled in NSG 6020 at South University, covering the entire
curriculum for the Week 10 Final Exam. It features 50 verified questions with
revised answers and rationales, ensuring alignment with the latest 2026/2027
academic guidelines. Designed to reinforce advanced nursing concepts, this
resource facilitates mastery of complex clinical scenarios and theoretical
frameworks essential for success. With a focus on evidence-based practice and
critical thinking, it serves as an indispensable tool for achieving a top grade.
Keywords
NSG 6020, Final Exam, South University, Advanced Nursing, Clinical
Reasoning, Evidence-Based Practice, Pharmacology, Health Assessment, NSG
6020, Final Exam, South University, Advanced Nursing, NSG 6020, Final
Exam, South University, Advanced Nursing, Clinical Reasoning,
Evidence-Based Practice
PART 1: EXAM QUESTIONS, ANSWERS AND RATIONALES
1. A patient presents with acute-onset severe headache, neck stiffness, and
photophobia. CSF analysis shows elevated opening pressure, neutrophilic
pleocytosis, elevated protein, and low glucose. Which additional finding would
most strongly support a specific etiologic diagnosis over empiric management?
A) Positive Gram stain showing gram-negative diplococci
B) Elevated CSF lactate >4 mmol/L
C) Positive polymerase chain reaction for enterovirus
D) Peripheral blood leukocytosis with left shift
' Correct Answer: A
Rationale: A positive Gram stain with gram-negative diplococci identifies
Neisseria meningitidis, allowing targeted antimicrobial therapy and
Page 1
,chemoprophylaxis for contacts. Elevated CSF lactate supports bacterial
meningitis but is not etiologic. Enterovirus PCR indicates viral meningitis, and
peripheral leukocytosis is nonspecific.
Why the other answers are wrong:
B) Elevated CSF lactate is sensitive for bacterial meningitis but does not
identify the specific organism.
C) Enterovirus PCR would suggest viral meningitis, which typically has a
different CSF profile (lymphocytic pleocytosis, normal glucose).
D) Peripheral leukocytosis is a systemic inflammatory response and does not
differentiate bacterial from other causes.
Reference: Mandell, Douglas, and Bennett's Principles and Practice of
Infectious Diseases, 9th Ed., Ch. 85
2. A 65-year-old with type 2 diabetes and chronic kidney disease (eGFR 35
mL/min/1.73m²) is started on an SGLT2 inhibitor. Which laboratory monitoring
is most critical within the first 2 weeks of initiation?
A) Hemoglobin A1c
B) Serum creatinine and electrolytes
C) Liver function tests
D) Lipid panel
' Correct Answer: B
Rationale: SGLT2 inhibitors can cause an acute drop in eGFR and electrolyte
disturbances, especially in patients with pre-existing CKD. Monitoring serum
creatinine and electrolytes within 1-2 weeks is recommended to detect acute
kidney injury or hyperkalemia. A1c, LFTs, and lipids are not the most
immediate monitoring priorities.
Why the other answers are wrong:
A) A1c reflects long-term glycemic control and is not needed for short-term
safety monitoring.
C) SGLT2 inhibitors are not associated with significant hepatotoxicity;
routine LFT monitoring is not required.
D) Lipid panel is unrelated to SGLT2 inhibitor initiation and not a safety
parameter.
Page 2
, Reference: American Diabetes Association. Standards of Care in
Diabetes-2026. Diabetes Care; 49(Suppl 1):S112-S118.
3. A patient with heart failure with reduced ejection fraction (HFrEF) is on
sacubitril/valsartan, metoprolol succinate, spironolactone, and furosemide.
Which finding would warrant immediate discontinuation of sacubitril/valsartan?
A) Serum potassium of 5.2 mEq/L
B) Symptomatic hypotension with systolic BP 90 mmHg
C) Serum creatinine increase of 0.3 mg/dL from baseline
D) Angioedema involving the tongue and lips
' Correct Answer: D
Rationale: Angioedema is a life-threatening adverse reaction to
sacubitril/valsartan and mandates immediate discontinuation and emergency
management. Hyperkalemia, hypotension, and mild creatinine elevation may be
managed with dose adjustment or diuretic modification, but are not absolute
indications for stopping the drug.
Why the other answers are wrong:
A) Hyperkalemia is a concern but can be managed by dose reduction or
holding spironolactone; not an immediate indication to stop
sacubitril/valsartan.
B) Hypotension is common and often managed by adjusting diuretics or
other vasodilators, not by discontinuing sacubitril/valsartan.
C) A small creatinine rise is expected due to hemodynamic changes and is
not a contraindication unless progressive or severe.
Reference: Heidenreich, P.A., et al. 2022 AHA/ACC/HFSA Guideline for the
Management of Heart Failure. Circulation. 2022;145:e895-e1032.
4. A 45-year-old with a history of recurrent calcium oxalate kidney stones is
found to have a 24-hour urine calcium of 350 mg/day and serum calcium of 9.8
mg/dL. Which additional finding would most strongly suggest primary
hyperparathyroidism as the underlying cause?
A) Low serum phosphorus and elevated intact PTH
B) High serum phosphorus and low intact PTH
C) Low 25-hydroxyvitamin D level
Page 3
