NR 667 ADVANCED PRACTICE
NURSING EXAM 2 PREP QUESTIONS
AND ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 65-year-old male with a history of HTN and HFrEF (LVEF 35%) presents for a follow-up. He
is currently taking Lisinopril 20mg and Carvedilol 6.25mg BID. His BP is 138/84 and HR is 72.
Which of the following is the most appropriate next step in managing his heart failure?
A. Add Furosemide 20mg daily
B. Add Spironolactone 25mg daily
C. Increase Carvedilol to 12.5mg BID
D. Switch Lisinopril to Losartan
Answer: B
Conceptual Explanation: In patients with HFrEF and LVEF <= 35% who are already on an
ACE inhibitor and Beta-blocker, the addition of an Aldosterone Antagonist like
Spironolactone is recommended to reduce mortality and morbidity.
2. A patient with Type 2 Diabetes presents with a morning fasting blood glucose of 160
mg/dL. You suspect the Dawn Phenomenon. Which of the following strategies would confirm
this diagnosis?
A. Check blood glucose at 3:00 AM; it will be elevated
,B. Check blood glucose at 3:00 AM; it will be low
C. Check A1c; it will be significantly higher than expected
D. Decrease the evening dose of NPH insulin
Answer: A
Conceptual Explanation: The Dawn Phenomenon is a result of a surge in growth hormone
in the early morning causing hyperglycemia. Testing at 3 AM will show high or normal
glucose, unlike the Somogyi effect where 3 AM glucose is low.
3. According to GOLD guidelines, which of the following criteria defines Stage 2 (Moderate)
COPD?
A. FEV1/FVC < 0.70 and FEV1 >= 80% predicted
B. FEV1/FVC < 0.70 and 30% <= FEV1 < 50% predicted
C. FEV1/FVC < 0.70 and 50% <= FEV1 < 80% predicted
D. FEV1/FVC < 0.70 and FEV1 < 30% predicted
Answer: C
Conceptual Explanation: GOLD Stage 2 (Moderate) is defined by an FEV1/FVC ratio less
than 0.70 and an FEV1 between 50% and 79% of the predicted value.
4. An 72-year-old female presents with fatigue and a CBC showing Hgb 10.2, MCV 108, and
MCHC 33. Which of the following is the most likely diagnosis?
A. Iron deficiency anemia
, B. Thalassemia
C. Vitamin B12 deficiency
D. Anemia of chronic disease
Answer: C
Conceptual Explanation: An MCV > 100 indicates macrocytic anemia. Vitamin B12 and
folate deficiencies are common causes of macrocytic anemia, whereas iron deficiency and
thalassemia are microcytic.
5. A patient presents with a TSH of 7.2 mIU/L and a normal Free T4. She complains of mild
fatigue but has no other symptoms. What is the most appropriate management?
A. Repeat TSH and Free T4 in 3-6 months
B. Initiate Methimazole 5mg daily
C. Initiate Levothyroxine 50mcg daily
D. Order a thyroid ultrasound immediately
Answer: A
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH with normal T4) often
resolves or remains stable. For TSH < 10 without severe symptoms, monitoring is generally
preferred over immediate treatment.
NURSING EXAM 2 PREP QUESTIONS
AND ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 65-year-old male with a history of HTN and HFrEF (LVEF 35%) presents for a follow-up. He
is currently taking Lisinopril 20mg and Carvedilol 6.25mg BID. His BP is 138/84 and HR is 72.
Which of the following is the most appropriate next step in managing his heart failure?
A. Add Furosemide 20mg daily
B. Add Spironolactone 25mg daily
C. Increase Carvedilol to 12.5mg BID
D. Switch Lisinopril to Losartan
Answer: B
Conceptual Explanation: In patients with HFrEF and LVEF <= 35% who are already on an
ACE inhibitor and Beta-blocker, the addition of an Aldosterone Antagonist like
Spironolactone is recommended to reduce mortality and morbidity.
2. A patient with Type 2 Diabetes presents with a morning fasting blood glucose of 160
mg/dL. You suspect the Dawn Phenomenon. Which of the following strategies would confirm
this diagnosis?
A. Check blood glucose at 3:00 AM; it will be elevated
,B. Check blood glucose at 3:00 AM; it will be low
C. Check A1c; it will be significantly higher than expected
D. Decrease the evening dose of NPH insulin
Answer: A
Conceptual Explanation: The Dawn Phenomenon is a result of a surge in growth hormone
in the early morning causing hyperglycemia. Testing at 3 AM will show high or normal
glucose, unlike the Somogyi effect where 3 AM glucose is low.
3. According to GOLD guidelines, which of the following criteria defines Stage 2 (Moderate)
COPD?
A. FEV1/FVC < 0.70 and FEV1 >= 80% predicted
B. FEV1/FVC < 0.70 and 30% <= FEV1 < 50% predicted
C. FEV1/FVC < 0.70 and 50% <= FEV1 < 80% predicted
D. FEV1/FVC < 0.70 and FEV1 < 30% predicted
Answer: C
Conceptual Explanation: GOLD Stage 2 (Moderate) is defined by an FEV1/FVC ratio less
than 0.70 and an FEV1 between 50% and 79% of the predicted value.
4. An 72-year-old female presents with fatigue and a CBC showing Hgb 10.2, MCV 108, and
MCHC 33. Which of the following is the most likely diagnosis?
A. Iron deficiency anemia
, B. Thalassemia
C. Vitamin B12 deficiency
D. Anemia of chronic disease
Answer: C
Conceptual Explanation: An MCV > 100 indicates macrocytic anemia. Vitamin B12 and
folate deficiencies are common causes of macrocytic anemia, whereas iron deficiency and
thalassemia are microcytic.
5. A patient presents with a TSH of 7.2 mIU/L and a normal Free T4. She complains of mild
fatigue but has no other symptoms. What is the most appropriate management?
A. Repeat TSH and Free T4 in 3-6 months
B. Initiate Methimazole 5mg daily
C. Initiate Levothyroxine 50mcg daily
D. Order a thyroid ultrasound immediately
Answer: A
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH with normal T4) often
resolves or remains stable. For TSH < 10 without severe symptoms, monitoring is generally
preferred over immediate treatment.
