NURS 6531: ADVANCED PRACTICE
CARE OF ADULTS FINAL EXAM
2026/2027 QUESTIONS AND VERIFIED
ANSWERS| GRADE A+|WALDEN
UNIVERSITY
1. A 67-year-old male with a history of HTN and HLD presents for a follow-up. His BP is 154/92
mmHg. According to JNC 8 guidelines, what is the target blood pressure for this patient?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 160/95 mmHg
D. < 150/90 mmHg
Answer: D
Conceptual Explanation: According to JNC 8, for patients aged 60 years or older without
CKD or diabetes, the goal blood pressure is < 150/90 mmHg.
2. Which of the following physical examination findings is most characteristic of a patient
with Chronic Obstructive Pulmonary Disease (COPD)?
A. Increased tactile fremitus
B. Dullness to percussion
,C. Pectus excavatum
D. Hyperresonance on percussion
Answer: D
Conceptual Explanation: Hyperresonance on percussion is a sign of air trapping and lung
hyperinflation, common in COPD.
3. A patient presents with a TSH of 0.1 mIU/L and a high Free T4 level. Which medication is
the preferred first-line treatment for a non-pregnant adult with Graves’ disease?
A. Levothyroxine
B. Propylthiouracil (PTU)
C. Methimazole
D. Propranolol
Answer: C
Conceptual Explanation: Methimazole is generally preferred over PTU for Graves’ disease
due to lower risk of liver toxicity, except in the first trimester of pregnancy.
4. In the management of Type 2 Diabetes, Metformin is contraindicated in patients with
which of the following conditions?
A. BMI > 35 kg/m²
B. HbA1c > 9.0%
C. eGFR < 30 mL/min/1.73m²
, D. History of gestational diabetes
Answer: C
Conceptual Explanation: Metformin is contraindicated when eGFR falls below 30 mL/min
due to the increased risk of lactic acidosis.
5. A 55-year-old female reports a sudden onset of ‘the worst headache of my life.’ Which
diagnostic test should be performed first?
A. MRI of the brain
B. Lumbar puncture
C. Non-contrast CT scan of the head
D. EEG
Answer: C
Conceptual Explanation: A non-contrast CT is the initial test of choice to rule out
subarachnoid hemorrhage for a ‘thunderclap’ headache.
6. Which heart murmur is typically characterized as a harsh, midsystolic crescendo-
decrescendo murmur heard best at the second right intercostal space?
A. Aortic stenosis
B. Mitral regurgitation
C. Aortic regurgitation
D. Mitral stenosis
CARE OF ADULTS FINAL EXAM
2026/2027 QUESTIONS AND VERIFIED
ANSWERS| GRADE A+|WALDEN
UNIVERSITY
1. A 67-year-old male with a history of HTN and HLD presents for a follow-up. His BP is 154/92
mmHg. According to JNC 8 guidelines, what is the target blood pressure for this patient?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 160/95 mmHg
D. < 150/90 mmHg
Answer: D
Conceptual Explanation: According to JNC 8, for patients aged 60 years or older without
CKD or diabetes, the goal blood pressure is < 150/90 mmHg.
2. Which of the following physical examination findings is most characteristic of a patient
with Chronic Obstructive Pulmonary Disease (COPD)?
A. Increased tactile fremitus
B. Dullness to percussion
,C. Pectus excavatum
D. Hyperresonance on percussion
Answer: D
Conceptual Explanation: Hyperresonance on percussion is a sign of air trapping and lung
hyperinflation, common in COPD.
3. A patient presents with a TSH of 0.1 mIU/L and a high Free T4 level. Which medication is
the preferred first-line treatment for a non-pregnant adult with Graves’ disease?
A. Levothyroxine
B. Propylthiouracil (PTU)
C. Methimazole
D. Propranolol
Answer: C
Conceptual Explanation: Methimazole is generally preferred over PTU for Graves’ disease
due to lower risk of liver toxicity, except in the first trimester of pregnancy.
4. In the management of Type 2 Diabetes, Metformin is contraindicated in patients with
which of the following conditions?
A. BMI > 35 kg/m²
B. HbA1c > 9.0%
C. eGFR < 30 mL/min/1.73m²
, D. History of gestational diabetes
Answer: C
Conceptual Explanation: Metformin is contraindicated when eGFR falls below 30 mL/min
due to the increased risk of lactic acidosis.
5. A 55-year-old female reports a sudden onset of ‘the worst headache of my life.’ Which
diagnostic test should be performed first?
A. MRI of the brain
B. Lumbar puncture
C. Non-contrast CT scan of the head
D. EEG
Answer: C
Conceptual Explanation: A non-contrast CT is the initial test of choice to rule out
subarachnoid hemorrhage for a ‘thunderclap’ headache.
6. Which heart murmur is typically characterized as a harsh, midsystolic crescendo-
decrescendo murmur heard best at the second right intercostal space?
A. Aortic stenosis
B. Mitral regurgitation
C. Aortic regurgitation
D. Mitral stenosis
