NSG 527 ADVANCED PRACTICE
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a crescendo-decrescendo systolic murmur heard best
at the second right intercostal space, radiating to the carotids. What is the most likely
diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Valve Prolapse
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a systolic ejection murmur
at the right upper sternal border that radiates to the neck.
2. Which of the following laboratory findings is most characteristic of Graves’ disease?
A. Elevated TSH, Low Free T4
B. Low TSH, Low Free T4
,C. Elevated TSH, Elevated Free T4
D. Low TSH, Elevated Free T4
Answer: D
Conceptual Explanation: Graves’ disease is a form of hyperthyroidism, characterized by
suppressed TSH and elevated thyroid hormones due to stimulating antibodies.
3. In the management of Chronic Obstructive Pulmonary Disease (COPD), which criteria
defines Stage III (Severe) according to GOLD guidelines?
A. FEV1/FVC < 0.70 and FEV1 30% to 49% predicted
B. FEV1/FVC < 0.70 and FEV1 < 30% predicted
C. FEV1/FVC < 0.70 and FEV1 50% to 79% predicted
D. FEV1/FVC < 0.70 and FEV1 > 80% predicted
Answer: A
Conceptual Explanation: GOLD Stage III (Severe) is defined by an FEV1 between 30% and
49% of the predicted value.
4. Which pharmacological agent is considered the first-line treatment for a patient diagnosed
with generalized anxiety disorder (GAD)?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Benzodiazepines
C. Beta-Blockers
, D. Monoamine Oxidase Inhibitors (MAOIs)
Answer: A
Conceptual Explanation: SSRIs are first-line for GAD due to their safety profile and
efficacy in long-term management compared to benzodiazepines.
5. A patient with a history of hypertension presents with a dry, persistent cough. Which
medication is the most likely culprit?
A. Losartan
B. Lisinopril
C. Amlodipine
D. Hydrochlorothiazide
Answer: B
Conceptual Explanation: ACE inhibitors like Lisinopril are well-known for causing a dry
cough due to the accumulation of bradykinin in the lungs.
6. According to JNC 8, what is the blood pressure goal for an adult aged 60 or older without
diabetes or chronic kidney disease?
A. <120/80 mmHg
B. <150/90 mmHg
C. <140/90 mmHg
D. <130/80 mmHg
NURSING COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a crescendo-decrescendo systolic murmur heard best
at the second right intercostal space, radiating to the carotids. What is the most likely
diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Valve Prolapse
D. Aortic Regurgitation
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a systolic ejection murmur
at the right upper sternal border that radiates to the neck.
2. Which of the following laboratory findings is most characteristic of Graves’ disease?
A. Elevated TSH, Low Free T4
B. Low TSH, Low Free T4
,C. Elevated TSH, Elevated Free T4
D. Low TSH, Elevated Free T4
Answer: D
Conceptual Explanation: Graves’ disease is a form of hyperthyroidism, characterized by
suppressed TSH and elevated thyroid hormones due to stimulating antibodies.
3. In the management of Chronic Obstructive Pulmonary Disease (COPD), which criteria
defines Stage III (Severe) according to GOLD guidelines?
A. FEV1/FVC < 0.70 and FEV1 30% to 49% predicted
B. FEV1/FVC < 0.70 and FEV1 < 30% predicted
C. FEV1/FVC < 0.70 and FEV1 50% to 79% predicted
D. FEV1/FVC < 0.70 and FEV1 > 80% predicted
Answer: A
Conceptual Explanation: GOLD Stage III (Severe) is defined by an FEV1 between 30% and
49% of the predicted value.
4. Which pharmacological agent is considered the first-line treatment for a patient diagnosed
with generalized anxiety disorder (GAD)?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Benzodiazepines
C. Beta-Blockers
, D. Monoamine Oxidase Inhibitors (MAOIs)
Answer: A
Conceptual Explanation: SSRIs are first-line for GAD due to their safety profile and
efficacy in long-term management compared to benzodiazepines.
5. A patient with a history of hypertension presents with a dry, persistent cough. Which
medication is the most likely culprit?
A. Losartan
B. Lisinopril
C. Amlodipine
D. Hydrochlorothiazide
Answer: B
Conceptual Explanation: ACE inhibitors like Lisinopril are well-known for causing a dry
cough due to the accumulation of bradykinin in the lungs.
6. According to JNC 8, what is the blood pressure goal for an adult aged 60 or older without
diabetes or chronic kidney disease?
A. <120/80 mmHg
B. <150/90 mmHg
C. <140/90 mmHg
D. <130/80 mmHg
