SOUTH UNIVERSITY-NSG 6020 ADVANCED NURSING EXAM |
ALL 200+ QUESTIONS AND ANSWERS 2026/2027 | VERIFIED
ANSWERS PLUS RATIONALES | GRADED Q&A
COMPREHENSIVE STUDY GUIDE | VERIFIED LATEST 2027
1. An advanced practice nurse is evaluating a patient with persistent hypertension despite
adherence to three antihypertensive medications, including a diuretic. Which condition
should be considered as a secondary cause of hypertension?
A. Seasonal allergic rhinitis
B. Osteoarthritis
C. Obstructive sleep apnea
D. Tension headache
Answer: C
Obstructive sleep apnea is a recognized contributor to resistant hypertension. Evaluation for
secondary causes is appropriate when blood pressure remains uncontrolled despite an
adequate multidrug regimen.
2. A 58-year-old patient with type 2 diabetes has an A1C of 9.2% despite adherence to
metformin. The patient also has established atherosclerotic cardiovascular disease. Which
treatment principle is most appropriate?
A. Consider an agent with demonstrated cardiovascular benefit
B. Stop metformin immediately
C. Avoid all additional pharmacotherapy
D. Treat only the fasting glucose
Answer: A
In patients with type 2 diabetes and established cardiovascular disease, medication selection
should incorporate cardiovascular risk reduction in addition to glucose lowering.
3. A patient taking lisinopril develops swelling of the tongue and difficulty breathing. What
is the priority intervention?
A. Administer the next dose of lisinopril
B. Schedule outpatient allergy testing
C. Recommend oral fluids
D. Initiate emergency airway assessment and management
Answer: D
ACE inhibitor-associated angioedema can rapidly compromise the airway. Tongue swelling
and respiratory difficulty require immediate emergency management.
,4. A 67-year-old patient reports sudden onset of right-sided weakness and difficulty
speaking that began 30 minutes ago. Which action is most appropriate?
A. Schedule a routine neurology consultation
B. Activate emergency stroke evaluation
C. Administer an oral sedative
D. Reassess the patient in 24 hours
Answer: B
Sudden focal neurologic deficits are concerning for acute ischemic stroke. Rapid emergency
evaluation is essential because time-sensitive interventions may be available.
5. A patient with diabetes reports burning pain and numbness in both feet that has
gradually progressed over several years. Which diagnosis is most likely?
A. Diabetic distal symmetric polyneuropathy
B. Acute arterial occlusion
C. Septic arthritis
D. Cauda equina syndrome
Answer: A
Gradual, symmetric distal sensory symptoms are characteristic of diabetic peripheral
neuropathy. Assessment should also include protective sensation and foot-injury prevention.
6. A patient with chronic kidney disease asks why NSAIDs should generally be avoided
unless specifically indicated. Which explanation is best?
A. NSAIDs always cause hypoglycemia
B. NSAIDs increase thyroid hormone production
C. NSAIDs can reduce renal perfusion and worsen kidney function
D. NSAIDs permanently improve glomerular filtration
Answer: C
NSAIDs inhibit prostaglandin synthesis and can reduce renal blood flow, increasing the risk of
acute kidney injury, especially in susceptible patients.
7. A patient with asthma reports using a short-acting bronchodilator every day and
awakening with wheezing several nights each week. What should the nurse practitioner
conclude?
A. Asthma is optimally controlled
B. Asthma control is inadequate
C. The patient no longer needs controller therapy
D. Antibiotics should automatically be prescribed
Answer: B
,Frequent rescue medication use and nighttime symptoms indicate poor asthma control and
require reassessment of adherence, inhaler technique, triggers, and controller treatment.
8. A 52-year-old patient reports painless gross hematuria on three occasions. The patient
has a long history of cigarette smoking. What is the most appropriate response?
A. Reassure the patient that hematuria is expected with aging
B. Treat empirically for cystitis without evaluation
C. Repeat urinalysis in two years
D. Initiate appropriate evaluation for urinary tract malignancy
Answer: D
Painless gross hematuria, especially in an older smoker, is a significant warning sign for
urinary tract malignancy and requires diagnostic evaluation.
9. A patient presents with fatigue, constipation, dry skin, weight gain, and cold intolerance.
Laboratory testing shows an elevated TSH and decreased free T4. Which diagnosis is most
likely?
A. Primary hypothyroidism
B. Hyperthyroidism
C. Central hypothyroidism
D. Thyroid storm
Answer: A
Primary hypothyroidism produces low circulating thyroid hormone with compensatory
elevation of TSH.
10. A patient taking warfarin presents with melena, dizziness, and a blood pressure of
86/52 mm Hg. What is the priority?
A. Recommend increased dietary vitamin K and discharge
B. Schedule routine INR follow-up
C. Arrange immediate emergency evaluation and stabilization
D. Tell the patient to take aspirin
Answer: C
Melena and hypotension in an anticoagulated patient indicate potentially life-threatening
bleeding and require emergency assessment and stabilization.
11. A 45-year-old patient reports exertional chest pressure that resolves after several
minutes of rest. Which condition should be considered first?
A. Stable angina
B. Viral bronchitis
C. Gastroenteritis
D. Migraine
, Answer: A
Predictable exertional chest pressure relieved by rest is characteristic of myocardial ischemia
and requires cardiovascular risk assessment and appropriate evaluation.
12. A patient with type 2 diabetes has persistent albuminuria. Which intervention is most
appropriate for reducing long-term renal risk when clinically indicated?
A. Encourage chronic NSAID use
B. Optimize blood pressure and diabetes management and use kidney-protective therapy when
appropriate
C. Increase sodium intake
D. Stop monitoring renal function
Answer: B
Albuminuria is an important marker of kidney and cardiovascular risk. Optimizing glycemic
and blood pressure control and using appropriate kidney-protective therapies can slow
progression.
13. A patient with heart failure reports a 3-kg weight increase over four days accompanied
by worsening ankle edema. What is the most likely explanation?
A. Increased bone mass
B. Decreased fluid volume
C. Fluid retention
D. Improved cardiac function
Answer: C
Rapid weight gain with worsening edema commonly reflects fluid accumulation and may
indicate worsening heart failure.
14. A patient taking spironolactone develops weakness and palpitations. Which laboratory
abnormality should be assessed promptly?
A. Hyperkalemia
B. Hypoglycemia
C. Hypernatremia
D. Low bilirubin
Answer: A
Spironolactone is potassium-sparing and can cause hyperkalemia, particularly in patients
with kidney dysfunction or concurrent renin-angiotensin system blockade.
15. A patient with depression states, “I have been thinking about killing myself, and I know
how I would do it.” What is the most appropriate next step?
A. Schedule routine follow-up in one month
ALL 200+ QUESTIONS AND ANSWERS 2026/2027 | VERIFIED
ANSWERS PLUS RATIONALES | GRADED Q&A
COMPREHENSIVE STUDY GUIDE | VERIFIED LATEST 2027
1. An advanced practice nurse is evaluating a patient with persistent hypertension despite
adherence to three antihypertensive medications, including a diuretic. Which condition
should be considered as a secondary cause of hypertension?
A. Seasonal allergic rhinitis
B. Osteoarthritis
C. Obstructive sleep apnea
D. Tension headache
Answer: C
Obstructive sleep apnea is a recognized contributor to resistant hypertension. Evaluation for
secondary causes is appropriate when blood pressure remains uncontrolled despite an
adequate multidrug regimen.
2. A 58-year-old patient with type 2 diabetes has an A1C of 9.2% despite adherence to
metformin. The patient also has established atherosclerotic cardiovascular disease. Which
treatment principle is most appropriate?
A. Consider an agent with demonstrated cardiovascular benefit
B. Stop metformin immediately
C. Avoid all additional pharmacotherapy
D. Treat only the fasting glucose
Answer: A
In patients with type 2 diabetes and established cardiovascular disease, medication selection
should incorporate cardiovascular risk reduction in addition to glucose lowering.
3. A patient taking lisinopril develops swelling of the tongue and difficulty breathing. What
is the priority intervention?
A. Administer the next dose of lisinopril
B. Schedule outpatient allergy testing
C. Recommend oral fluids
D. Initiate emergency airway assessment and management
Answer: D
ACE inhibitor-associated angioedema can rapidly compromise the airway. Tongue swelling
and respiratory difficulty require immediate emergency management.
,4. A 67-year-old patient reports sudden onset of right-sided weakness and difficulty
speaking that began 30 minutes ago. Which action is most appropriate?
A. Schedule a routine neurology consultation
B. Activate emergency stroke evaluation
C. Administer an oral sedative
D. Reassess the patient in 24 hours
Answer: B
Sudden focal neurologic deficits are concerning for acute ischemic stroke. Rapid emergency
evaluation is essential because time-sensitive interventions may be available.
5. A patient with diabetes reports burning pain and numbness in both feet that has
gradually progressed over several years. Which diagnosis is most likely?
A. Diabetic distal symmetric polyneuropathy
B. Acute arterial occlusion
C. Septic arthritis
D. Cauda equina syndrome
Answer: A
Gradual, symmetric distal sensory symptoms are characteristic of diabetic peripheral
neuropathy. Assessment should also include protective sensation and foot-injury prevention.
6. A patient with chronic kidney disease asks why NSAIDs should generally be avoided
unless specifically indicated. Which explanation is best?
A. NSAIDs always cause hypoglycemia
B. NSAIDs increase thyroid hormone production
C. NSAIDs can reduce renal perfusion and worsen kidney function
D. NSAIDs permanently improve glomerular filtration
Answer: C
NSAIDs inhibit prostaglandin synthesis and can reduce renal blood flow, increasing the risk of
acute kidney injury, especially in susceptible patients.
7. A patient with asthma reports using a short-acting bronchodilator every day and
awakening with wheezing several nights each week. What should the nurse practitioner
conclude?
A. Asthma is optimally controlled
B. Asthma control is inadequate
C. The patient no longer needs controller therapy
D. Antibiotics should automatically be prescribed
Answer: B
,Frequent rescue medication use and nighttime symptoms indicate poor asthma control and
require reassessment of adherence, inhaler technique, triggers, and controller treatment.
8. A 52-year-old patient reports painless gross hematuria on three occasions. The patient
has a long history of cigarette smoking. What is the most appropriate response?
A. Reassure the patient that hematuria is expected with aging
B. Treat empirically for cystitis without evaluation
C. Repeat urinalysis in two years
D. Initiate appropriate evaluation for urinary tract malignancy
Answer: D
Painless gross hematuria, especially in an older smoker, is a significant warning sign for
urinary tract malignancy and requires diagnostic evaluation.
9. A patient presents with fatigue, constipation, dry skin, weight gain, and cold intolerance.
Laboratory testing shows an elevated TSH and decreased free T4. Which diagnosis is most
likely?
A. Primary hypothyroidism
B. Hyperthyroidism
C. Central hypothyroidism
D. Thyroid storm
Answer: A
Primary hypothyroidism produces low circulating thyroid hormone with compensatory
elevation of TSH.
10. A patient taking warfarin presents with melena, dizziness, and a blood pressure of
86/52 mm Hg. What is the priority?
A. Recommend increased dietary vitamin K and discharge
B. Schedule routine INR follow-up
C. Arrange immediate emergency evaluation and stabilization
D. Tell the patient to take aspirin
Answer: C
Melena and hypotension in an anticoagulated patient indicate potentially life-threatening
bleeding and require emergency assessment and stabilization.
11. A 45-year-old patient reports exertional chest pressure that resolves after several
minutes of rest. Which condition should be considered first?
A. Stable angina
B. Viral bronchitis
C. Gastroenteritis
D. Migraine
, Answer: A
Predictable exertional chest pressure relieved by rest is characteristic of myocardial ischemia
and requires cardiovascular risk assessment and appropriate evaluation.
12. A patient with type 2 diabetes has persistent albuminuria. Which intervention is most
appropriate for reducing long-term renal risk when clinically indicated?
A. Encourage chronic NSAID use
B. Optimize blood pressure and diabetes management and use kidney-protective therapy when
appropriate
C. Increase sodium intake
D. Stop monitoring renal function
Answer: B
Albuminuria is an important marker of kidney and cardiovascular risk. Optimizing glycemic
and blood pressure control and using appropriate kidney-protective therapies can slow
progression.
13. A patient with heart failure reports a 3-kg weight increase over four days accompanied
by worsening ankle edema. What is the most likely explanation?
A. Increased bone mass
B. Decreased fluid volume
C. Fluid retention
D. Improved cardiac function
Answer: C
Rapid weight gain with worsening edema commonly reflects fluid accumulation and may
indicate worsening heart failure.
14. A patient taking spironolactone develops weakness and palpitations. Which laboratory
abnormality should be assessed promptly?
A. Hyperkalemia
B. Hypoglycemia
C. Hypernatremia
D. Low bilirubin
Answer: A
Spironolactone is potassium-sparing and can cause hyperkalemia, particularly in patients
with kidney dysfunction or concurrent renin-angiotensin system blockade.
15. A patient with depression states, “I have been thinking about killing myself, and I know
how I would do it.” What is the most appropriate next step?
A. Schedule routine follow-up in one month
