, NRNP 6566 Advanced Care of Adults
in Acute Settings I – Walden University
– Academic Year 2026/2027 – Final
Comprehensive Examination with 100
Verified Questions and Correct Answer
Rationales | rated 100% correct.
SECTION 1: CARDIOVASCULAR DISORDERS &
MANAGEMENT (Questions 1-25)
Question 1: Essential hypertension is characterized by which of the
following?
A. Known cause related to renal disease
B. Unknown cause, accounting for approximately 95% of cases
C. Related to endocrine disorders
D. Onset typically after age 55
Correct Answer: B. Unknown cause, accounting for approximately
95% of cases
Rationale: Essential (primary) hypertension has no known identifiable cause
and accounts for approximately 95% of all hypertension cases. It typically
has an onset between 25-55 years of age. Secondary hypertension, in
contrast, is related to a known cause or disease process such as renal
disease, endocrine disorders, or coarctation of the aorta .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
,Question 2: A 58-year-old patient with hypertension and type 2 diabetes
has BP 154/92 mm Hg, eGFR 72 mL/min, and elevated urine albumin-to-
creatinine ratio. Which medication class is preferred as part of the initial
treatment plan unless contraindicated?
A. Loop diuretic
B. ACE inhibitor
C. Alpha-1 blocker
D. Nitrate
Correct Answer: B. ACE inhibitor
Rationale: ACE inhibitors help lower blood pressure and provide kidney
protection (renoprotection) in patients with diabetes and albuminuria,
making them the preferred initial agent. ARBs are an alternative if ACE
inhibitors are not tolerated. Thiazide diuretics or calcium channel blockers
are preferred as first-line agents for hypertension in African American
patients .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
Question 3: Which medication class is preferred as first-line for
hypertension in African American patients?
A. ACE inhibitors
B. ARBs
C. Thiazide diuretics or calcium channel blockers
D. Beta-blockers
Correct Answer: C. Thiazide diuretics or calcium channel blockers
Rationale: Thiazide diuretics and calcium channel blockers are preferred as
first-line agents for hypertension in African American patients based on
clinical trial evidence. ACE inhibitors and ARBs are less effective as
monotherapy in this population .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
, Question 4: A patient presents with BP 182/115 mm Hg without progressive
target organ dysfunction. This is classified as:
A. Hypertensive emergency
B. Hypertensive urgency
C. Stage 1 hypertension
D. Isolated systolic hypertension
Correct Answer: B. Hypertensive urgency
Rationale: Hypertensive urgency is defined as BP >180/120 mm Hg without
evidence of progressive target organ dysfunction. Hypertensive emergency
is defined as BP >180/120 mm Hg WITH acute end-organ damage (e.g.,
encephalopathy, myocardial infarction, heart failure, acute kidney injury,
stroke, aortic dissection). Emergency requires IV medications and ICU
admission; urgency can be managed with oral medications and outpatient
follow-up .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
Question 5: A patient presents with ST-elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Correct Answer: B. Right coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an inferior
myocardial infarction, which is typically caused by occlusion of the right
coronary artery (RCA). Anterior MI presents with ST elevation in leads V1-V4
(LAD occlusion). Lateral MI involves leads I, aVL, V5-V6 (circumflex artery) .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
in Acute Settings I – Walden University
– Academic Year 2026/2027 – Final
Comprehensive Examination with 100
Verified Questions and Correct Answer
Rationales | rated 100% correct.
SECTION 1: CARDIOVASCULAR DISORDERS &
MANAGEMENT (Questions 1-25)
Question 1: Essential hypertension is characterized by which of the
following?
A. Known cause related to renal disease
B. Unknown cause, accounting for approximately 95% of cases
C. Related to endocrine disorders
D. Onset typically after age 55
Correct Answer: B. Unknown cause, accounting for approximately
95% of cases
Rationale: Essential (primary) hypertension has no known identifiable cause
and accounts for approximately 95% of all hypertension cases. It typically
has an onset between 25-55 years of age. Secondary hypertension, in
contrast, is related to a known cause or disease process such as renal
disease, endocrine disorders, or coarctation of the aorta .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
,Question 2: A 58-year-old patient with hypertension and type 2 diabetes
has BP 154/92 mm Hg, eGFR 72 mL/min, and elevated urine albumin-to-
creatinine ratio. Which medication class is preferred as part of the initial
treatment plan unless contraindicated?
A. Loop diuretic
B. ACE inhibitor
C. Alpha-1 blocker
D. Nitrate
Correct Answer: B. ACE inhibitor
Rationale: ACE inhibitors help lower blood pressure and provide kidney
protection (renoprotection) in patients with diabetes and albuminuria,
making them the preferred initial agent. ARBs are an alternative if ACE
inhibitors are not tolerated. Thiazide diuretics or calcium channel blockers
are preferred as first-line agents for hypertension in African American
patients .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
Question 3: Which medication class is preferred as first-line for
hypertension in African American patients?
A. ACE inhibitors
B. ARBs
C. Thiazide diuretics or calcium channel blockers
D. Beta-blockers
Correct Answer: C. Thiazide diuretics or calcium channel blockers
Rationale: Thiazide diuretics and calcium channel blockers are preferred as
first-line agents for hypertension in African American patients based on
clinical trial evidence. ACE inhibitors and ARBs are less effective as
monotherapy in this population .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
, Question 4: A patient presents with BP 182/115 mm Hg without progressive
target organ dysfunction. This is classified as:
A. Hypertensive emergency
B. Hypertensive urgency
C. Stage 1 hypertension
D. Isolated systolic hypertension
Correct Answer: B. Hypertensive urgency
Rationale: Hypertensive urgency is defined as BP >180/120 mm Hg without
evidence of progressive target organ dysfunction. Hypertensive emergency
is defined as BP >180/120 mm Hg WITH acute end-organ damage (e.g.,
encephalopathy, myocardial infarction, heart failure, acute kidney injury,
stroke, aortic dissection). Emergency requires IV medications and ICU
admission; urgency can be managed with oral medications and outpatient
follow-up .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
Question 5: A patient presents with ST-elevation in leads II, III, and aVF.
Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Correct Answer: B. Right coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an inferior
myocardial infarction, which is typically caused by occlusion of the right
coronary artery (RCA). Anterior MI presents with ST elevation in leads V1-V4
(LAD occlusion). Lateral MI involves leads I, aVL, V5-V6 (circumflex artery) .
Source: NRNP 6566 Advanced Clinical Management Exam Prep (Docsity)
