NURS 5432 FAMILY 1 ADVANCED
NURSING PRACTICE COMPREHENSIVE
EXAM
1. A 65-year-old patient with Stage 3 Chronic Kidney Disease (CKD) and hypertension presents
with a blood pressure of 152/96 mmHg. According to current evidence-based guidelines,
which medication class is most appropriate for initial therapy or intensification?
A. ACE Inhibitors or ARBs
B. Calcium Channel Blockers
C. Thiazide Diuretics
D. Beta-Blockers
Answer: A
Conceptual Explanation: ACE inhibitors or ARBs are preferred for patients with CKD
because they provide renoprotective effects by reducing intraglomerular pressure and
albuminuria.
,2. A 45-year-old female presents with fatigue and cold intolerance. Her TSH is 12.4 mIU/L
(normal: 0.4-4.0) and Free T4 is 0.6 ng/dL (normal: 0.8-1.8). What is the most appropriate
initial dose of Levothyroxine for this patient who has no cardiac history?
A. 12.5 mcg daily
B. 25 mcg daily
C. 1.6 mcg/kg/day
D. 100 mcg daily regardless of weight
Answer: C
Conceptual Explanation: In young to middle-aged healthy adults with overt
hypothyroidism, the replacement dose is typically calculated at 1.6 mcg/kg/day based on
ideal body weight.
3. A 12-month-old infant is brought in for a well-child visit. The mother asks about the MMR
and Varicella vaccines. Which of the following is a contraindication for these live vaccines?
A. Recent administration of an antibody-containing blood product
B. Current mild upper respiratory infection
C. Family history of seizures
D. Living with a pregnant woman
Answer: A
, Conceptual Explanation: Live vaccines should be delayed following the administration of
blood products containing antibodies, as the antibodies may interfere with the immune
response to the vaccine.
4. A 32-year-old female patient presents with a ‘strawberry cervix’ and a thin, malodorous
yellow-green vaginal discharge. What is the gold standard diagnostic test for the suspected
condition?
A. NAAT (Nucleic Acid Amplification Test)
B. Wet mount microscopy
C. Whiff test with KOH
D. Vaginal pH testing
Answer: A
Conceptual Explanation: The patient likely has Trichomoniasis. While wet mount is often
used, NAAT is the gold standard due to its significantly higher sensitivity.
5. According to the GINA guidelines, a patient with asthma who experiences symptoms more
than twice a month but less than daily (Step 2) should ideally be prescribed:
A. SABA as needed only
B. Daily LAMA
C. Daily medium-dose ICS
D. Low-dose ICS-formoterol as needed
NURSING PRACTICE COMPREHENSIVE
EXAM
1. A 65-year-old patient with Stage 3 Chronic Kidney Disease (CKD) and hypertension presents
with a blood pressure of 152/96 mmHg. According to current evidence-based guidelines,
which medication class is most appropriate for initial therapy or intensification?
A. ACE Inhibitors or ARBs
B. Calcium Channel Blockers
C. Thiazide Diuretics
D. Beta-Blockers
Answer: A
Conceptual Explanation: ACE inhibitors or ARBs are preferred for patients with CKD
because they provide renoprotective effects by reducing intraglomerular pressure and
albuminuria.
,2. A 45-year-old female presents with fatigue and cold intolerance. Her TSH is 12.4 mIU/L
(normal: 0.4-4.0) and Free T4 is 0.6 ng/dL (normal: 0.8-1.8). What is the most appropriate
initial dose of Levothyroxine for this patient who has no cardiac history?
A. 12.5 mcg daily
B. 25 mcg daily
C. 1.6 mcg/kg/day
D. 100 mcg daily regardless of weight
Answer: C
Conceptual Explanation: In young to middle-aged healthy adults with overt
hypothyroidism, the replacement dose is typically calculated at 1.6 mcg/kg/day based on
ideal body weight.
3. A 12-month-old infant is brought in for a well-child visit. The mother asks about the MMR
and Varicella vaccines. Which of the following is a contraindication for these live vaccines?
A. Recent administration of an antibody-containing blood product
B. Current mild upper respiratory infection
C. Family history of seizures
D. Living with a pregnant woman
Answer: A
, Conceptual Explanation: Live vaccines should be delayed following the administration of
blood products containing antibodies, as the antibodies may interfere with the immune
response to the vaccine.
4. A 32-year-old female patient presents with a ‘strawberry cervix’ and a thin, malodorous
yellow-green vaginal discharge. What is the gold standard diagnostic test for the suspected
condition?
A. NAAT (Nucleic Acid Amplification Test)
B. Wet mount microscopy
C. Whiff test with KOH
D. Vaginal pH testing
Answer: A
Conceptual Explanation: The patient likely has Trichomoniasis. While wet mount is often
used, NAAT is the gold standard due to its significantly higher sensitivity.
5. According to the GINA guidelines, a patient with asthma who experiences symptoms more
than twice a month but less than daily (Step 2) should ideally be prescribed:
A. SABA as needed only
B. Daily LAMA
C. Daily medium-dose ICS
D. Low-dose ICS-formoterol as needed
