NURS 6531 FINAL EXAM PREP 2026/2027
(CORRECT Q & A) SATISFACTION
GUARANTEED
1. A 68-year-old patient with a history of HFrEF (EF 35%) and HTN is currently on Lisinopril
20mg and Carvedilol 12.5mg BID. His BP is 148/92 and K+ is 4.2. Which medication is the most
appropriate addition to improve mortality?
A. Spironolactone 25mg
B. Amlodipine 5mg
C. Hydrochlorothiazide 25mg
D. Furosemide 20mg
Answer: A
Conceptual Explanation: Aldosterone antagonists like Spironolactone are indicated for
patients with HFrEF symptomatic despite ACEI and Beta-blocker therapy to reduce
mortality and hospitalizations.
2. Which physical exam finding is most suggestive of Aortic Stenosis in an older adult?
A. Holosystolic murmur at the apex radiating to the axilla
B. Crescendo-decrescendo systolic murmur at the right second intercostal space
C. Mid-diastolic rumble with an opening snap
,D. High-pitched blowing diastolic murmur at the left sternal border
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a harsh crescendo-
decrescendo systolic murmur heard best at the right upper sternal border, often radiating
to the carotids.
3. A 55-year-old male presents with a TSH of 12.4 mU/L and a low Free T4. He reports fatigue
and cold intolerance. What is the most appropriate initial treatment?
A. Levothyroxine 25 mcg daily
B. Methimazole 10 mg daily
C. Levothyroxine 1.6 mcg/kg/day
D. Liothyronine 5 mcg daily
Answer: C
Conceptual Explanation: For primary hypothyroidism, the standard replacement dose of
Levothyroxine is approximately 1.6 mcg/kg/day in healthy adults, though lower starting
doses may be considered in the elderly or those with cardiac disease.
4. According to the GOLD guidelines, which medication is first-line for a COPD patient in
Group D (High risk, high symptoms)?
A. SABA as needed only
B. LAMA + LABA combination
, C. LAMA monotherapy
D. Inhaled Corticosteroid (ICS) monotherapy
Answer: B
Conceptual Explanation: GOLD 2023/2024 guidelines recommend LAMA+LABA
combination therapy for Group D patients to maximize bronchodilation and reduce
exacerbation risk.
5. A 45-year-old female with Type 2 Diabetes has an A1C of 8.2% despite maximal Metformin.
She has a history of ASCVD. Which class of medication is the most appropriate next step?
A. GLP-1 receptor agonist
B. Sulfonylurea
C. DPP-4 inhibitor
D. Basal Insulin
Answer: A
Conceptual Explanation: ADA guidelines recommend GLP-1 receptor agonists or SGLT2
inhibitors with proven CVD benefit for patients with established ASCVD regardless of A1C.
6. Which of the following laboratory findings is most consistent with Iron Deficiency Anemia?
A. Low MCV, high TIBC, low Ferritin
B. High MCV, high Ferritin
C. Low MCV, low TIBC, high Ferritin
(CORRECT Q & A) SATISFACTION
GUARANTEED
1. A 68-year-old patient with a history of HFrEF (EF 35%) and HTN is currently on Lisinopril
20mg and Carvedilol 12.5mg BID. His BP is 148/92 and K+ is 4.2. Which medication is the most
appropriate addition to improve mortality?
A. Spironolactone 25mg
B. Amlodipine 5mg
C. Hydrochlorothiazide 25mg
D. Furosemide 20mg
Answer: A
Conceptual Explanation: Aldosterone antagonists like Spironolactone are indicated for
patients with HFrEF symptomatic despite ACEI and Beta-blocker therapy to reduce
mortality and hospitalizations.
2. Which physical exam finding is most suggestive of Aortic Stenosis in an older adult?
A. Holosystolic murmur at the apex radiating to the axilla
B. Crescendo-decrescendo systolic murmur at the right second intercostal space
C. Mid-diastolic rumble with an opening snap
,D. High-pitched blowing diastolic murmur at the left sternal border
Answer: B
Conceptual Explanation: Aortic stenosis typically presents as a harsh crescendo-
decrescendo systolic murmur heard best at the right upper sternal border, often radiating
to the carotids.
3. A 55-year-old male presents with a TSH of 12.4 mU/L and a low Free T4. He reports fatigue
and cold intolerance. What is the most appropriate initial treatment?
A. Levothyroxine 25 mcg daily
B. Methimazole 10 mg daily
C. Levothyroxine 1.6 mcg/kg/day
D. Liothyronine 5 mcg daily
Answer: C
Conceptual Explanation: For primary hypothyroidism, the standard replacement dose of
Levothyroxine is approximately 1.6 mcg/kg/day in healthy adults, though lower starting
doses may be considered in the elderly or those with cardiac disease.
4. According to the GOLD guidelines, which medication is first-line for a COPD patient in
Group D (High risk, high symptoms)?
A. SABA as needed only
B. LAMA + LABA combination
, C. LAMA monotherapy
D. Inhaled Corticosteroid (ICS) monotherapy
Answer: B
Conceptual Explanation: GOLD 2023/2024 guidelines recommend LAMA+LABA
combination therapy for Group D patients to maximize bronchodilation and reduce
exacerbation risk.
5. A 45-year-old female with Type 2 Diabetes has an A1C of 8.2% despite maximal Metformin.
She has a history of ASCVD. Which class of medication is the most appropriate next step?
A. GLP-1 receptor agonist
B. Sulfonylurea
C. DPP-4 inhibitor
D. Basal Insulin
Answer: A
Conceptual Explanation: ADA guidelines recommend GLP-1 receptor agonists or SGLT2
inhibitors with proven CVD benefit for patients with established ASCVD regardless of A1C.
6. Which of the following laboratory findings is most consistent with Iron Deficiency Anemia?
A. Low MCV, high TIBC, low Ferritin
B. High MCV, high Ferritin
C. Low MCV, low TIBC, high Ferritin
