NURS 6531 EXAM 4: ADVANCED
PRACTICE CARE OF ADULTS ACROSS
THE LIFESPAN (CORRECT Q & A)
SATISFACTION GUARANTEED
1. A 72-year-old male presents with sudden onset of ‘the worst headache of my life.’ A CT
scan is negative. What is the next most appropriate diagnostic step?
A. Repeat CT scan in 24 hours
B. Lumbar puncture
C. MRI of the brain
D. Initiate migraine protocol
Answer: B
Conceptual Explanation: In cases of suspected subarachnoid hemorrhage where the CT
scan is negative, a lumbar puncture is required to check for xanthochromia or red blood
cells.
2. Which clinical finding is most diagnostic of Meniere’s disease?
A. Vertigo triggered by head movement
B. Otalgia and purulent drainage
C. Sensorineural hearing loss only
,D. Tinnitus, hearing loss, and episodic vertigo
Answer: D
Conceptual Explanation: Meniere’s disease is characterized by the triad of episodic
vertigo, tinnitus, and fluctuating low-frequency sensorineural hearing loss.
3. An 80-year-old patient is experiencing acute confusion, visual hallucinations, and
fluctuating levels of consciousness. Which condition is most likely?
A. Alzheimer’s disease
B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Conceptual Explanation: Delirium is distinguished from dementia by its acute onset,
fluctuating course, and impairment in consciousness or attention.
4. Which of the following is considered a ‘red flag’ in a patient presenting with a headache?
A. Pain that is relieved by NSAIDs
B. New onset headache in a patient over age 50
C. History of similar headaches for 10 years
D. Bilateral pressure-like sensation
, Answer: B
Conceptual Explanation: New onset headaches in older adults (over 50) are red flags that
require investigation for serious causes like temporal arteritis or intracranial mass.
5. A patient presents with unilateral facial drooping, inability to close the eye on the affected
side, and loss of taste on the anterior two-thirds of the tongue. What is the most likely
diagnosis?
A. Bell’s Palsy
B. Ischemic Stroke
C. Trigeminal Neuralgia
D. Multiple Sclerosis
Answer: A
Conceptual Explanation: Bell’s Palsy is an idiopathic lower motor neuron paralysis of
Cranial Nerve VII, affecting the entire side of the face including the forehead.
6. When prescribing Lithium for a patient with Bipolar Disorder, the APRN must monitor
which laboratory value closely to prevent toxicity?
A. Liver Function Tests (LFTs)
B. Complete Blood Count (CBC)
C. Serum Creatinine and TSH
D. Coagulation profile
PRACTICE CARE OF ADULTS ACROSS
THE LIFESPAN (CORRECT Q & A)
SATISFACTION GUARANTEED
1. A 72-year-old male presents with sudden onset of ‘the worst headache of my life.’ A CT
scan is negative. What is the next most appropriate diagnostic step?
A. Repeat CT scan in 24 hours
B. Lumbar puncture
C. MRI of the brain
D. Initiate migraine protocol
Answer: B
Conceptual Explanation: In cases of suspected subarachnoid hemorrhage where the CT
scan is negative, a lumbar puncture is required to check for xanthochromia or red blood
cells.
2. Which clinical finding is most diagnostic of Meniere’s disease?
A. Vertigo triggered by head movement
B. Otalgia and purulent drainage
C. Sensorineural hearing loss only
,D. Tinnitus, hearing loss, and episodic vertigo
Answer: D
Conceptual Explanation: Meniere’s disease is characterized by the triad of episodic
vertigo, tinnitus, and fluctuating low-frequency sensorineural hearing loss.
3. An 80-year-old patient is experiencing acute confusion, visual hallucinations, and
fluctuating levels of consciousness. Which condition is most likely?
A. Alzheimer’s disease
B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Conceptual Explanation: Delirium is distinguished from dementia by its acute onset,
fluctuating course, and impairment in consciousness or attention.
4. Which of the following is considered a ‘red flag’ in a patient presenting with a headache?
A. Pain that is relieved by NSAIDs
B. New onset headache in a patient over age 50
C. History of similar headaches for 10 years
D. Bilateral pressure-like sensation
, Answer: B
Conceptual Explanation: New onset headaches in older adults (over 50) are red flags that
require investigation for serious causes like temporal arteritis or intracranial mass.
5. A patient presents with unilateral facial drooping, inability to close the eye on the affected
side, and loss of taste on the anterior two-thirds of the tongue. What is the most likely
diagnosis?
A. Bell’s Palsy
B. Ischemic Stroke
C. Trigeminal Neuralgia
D. Multiple Sclerosis
Answer: A
Conceptual Explanation: Bell’s Palsy is an idiopathic lower motor neuron paralysis of
Cranial Nerve VII, affecting the entire side of the face including the forehead.
6. When prescribing Lithium for a patient with Bipolar Disorder, the APRN must monitor
which laboratory value closely to prevent toxicity?
A. Liver Function Tests (LFTs)
B. Complete Blood Count (CBC)
C. Serum Creatinine and TSH
D. Coagulation profile
