NURS 5220 ADVANCED PRACTICE
NURSING FINAL EXAM PREP 2026/27
QUESTIONS AND VERIFIED ANSWERS.
JUST RELEASED
1. A 65-year-old male presents with a third heart sound (S3). Which of the following
pathophysiological mechanisms best explains this finding?
A. Atrial contraction against a non-compliant ventricle
B. Forceful closure of the mitral and tricuspid valves
C. Rapid ventricular filling into a dilated, non-compliant left ventricle
D. Delayed closure of the pulmonic valve during inspiration
Answer: C
Conceptual Explanation: S3 is a low-pitched sound heard in early diastole caused by rapid
ventricular filling into a dilated or volume-overloaded ventricle, often seen in heart failure.
2. Which of the following findings is most characteristic of Nephrotic Syndrome rather than
Nephritic Syndrome?
A. Gross hematuria and RBC casts
,B. Proteinuria exceeding 3.5 grams per 24 hours
C. Rapidly progressive azotemia
D. Hypertension due to sodium retention
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, and hyperlipidemia, whereas nephritic syndrome presents
primarily with hematuria and inflammation.
3. During a neurological exam, a patient displays a positive Babinski sign. This indicates
pathology in which of the following areas?
A. Lower Motor Neuron (LMN)
B. Upper Motor Neuron (UMN)
C. Basal Ganglia
D. Cerebellum
Answer: B
Conceptual Explanation: A positive Babinski sign (dorsiflexion of the great toe) in an
adult is a classic indicator of Upper Motor Neuron lesion or corticospinal tract damage.
4. A patient with Chronic Obstructive Pulmonary Disease (COPD) presents with an arterial
blood gas showing pH 7.33, PaCO2 55, and HCO3 30. How should this be interpreted?
A. Uncompensated metabolic acidosis
, B. Fully compensated respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated respiratory acidosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory), and the
HCO3 is elevated (indicating the kidneys are attempting to compensate), but the pH is not
yet in the normal range.
5. Which immunoglobulin is primarily responsible for the Type I hypersensitivity reaction
seen in anaphylaxis?
A. IgG
B. IgE
C. IgA
D. IgM
Answer: B
Conceptual Explanation: IgE binds to mast cells and basophils; upon re-exposure to an
allergen, it triggers the release of histamine and other mediators of anaphylaxis.
6. Which physical assessment maneuver is most specific for diagnosing Acute Cholecystitis?
A. Rovsing sign
B. Psoas sign
NURSING FINAL EXAM PREP 2026/27
QUESTIONS AND VERIFIED ANSWERS.
JUST RELEASED
1. A 65-year-old male presents with a third heart sound (S3). Which of the following
pathophysiological mechanisms best explains this finding?
A. Atrial contraction against a non-compliant ventricle
B. Forceful closure of the mitral and tricuspid valves
C. Rapid ventricular filling into a dilated, non-compliant left ventricle
D. Delayed closure of the pulmonic valve during inspiration
Answer: C
Conceptual Explanation: S3 is a low-pitched sound heard in early diastole caused by rapid
ventricular filling into a dilated or volume-overloaded ventricle, often seen in heart failure.
2. Which of the following findings is most characteristic of Nephrotic Syndrome rather than
Nephritic Syndrome?
A. Gross hematuria and RBC casts
,B. Proteinuria exceeding 3.5 grams per 24 hours
C. Rapidly progressive azotemia
D. Hypertension due to sodium retention
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, and hyperlipidemia, whereas nephritic syndrome presents
primarily with hematuria and inflammation.
3. During a neurological exam, a patient displays a positive Babinski sign. This indicates
pathology in which of the following areas?
A. Lower Motor Neuron (LMN)
B. Upper Motor Neuron (UMN)
C. Basal Ganglia
D. Cerebellum
Answer: B
Conceptual Explanation: A positive Babinski sign (dorsiflexion of the great toe) in an
adult is a classic indicator of Upper Motor Neuron lesion or corticospinal tract damage.
4. A patient with Chronic Obstructive Pulmonary Disease (COPD) presents with an arterial
blood gas showing pH 7.33, PaCO2 55, and HCO3 30. How should this be interpreted?
A. Uncompensated metabolic acidosis
, B. Fully compensated respiratory alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated respiratory acidosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory), and the
HCO3 is elevated (indicating the kidneys are attempting to compensate), but the pH is not
yet in the normal range.
5. Which immunoglobulin is primarily responsible for the Type I hypersensitivity reaction
seen in anaphylaxis?
A. IgG
B. IgE
C. IgA
D. IgM
Answer: B
Conceptual Explanation: IgE binds to mast cells and basophils; upon re-exposure to an
allergen, it triggers the release of histamine and other mediators of anaphylaxis.
6. Which physical assessment maneuver is most specific for diagnosing Acute Cholecystitis?
A. Rovsing sign
B. Psoas sign
