NUR 6130 AP3 EXAM 1 V1 AND V2
FULL PRACTICE QUESTIONS AND ANSWERS —
2026/2027 STUDY REVIEW
INTRODUCTION
This comprehensive practice set is designed for graduate-level Advanced Practice
Nursing III students preparing for an Exam 1 assessment. It emphasizes clinical
reasoning, differential diagnosis, interpretation of diagnostic findings, pharmacologic
decision-making, disease management, and prioritization of care rather than simple
memorization. The questions are written as original practice scenarios and are
intended to help learners apply advanced pathophysiology and evidence-based clinical
principles to patient presentations commonly encountered in advanced practice
nursing.
The set uses four-option multiple-choice questions with one best answer and detailed
rationales. Several questions require the learner to integrate history, physical
examination findings, laboratory results, medication effects, comorbidities, and
potential complications before selecting the safest management approach. Students
should use the rationales to identify gaps in knowledge and understand why plausible
alternatives are less appropriate. Because institutional examinations can vary in
emphasis and content, this practice material should be used alongside course lectures,
assigned readings, faculty guidance, and current clinical guidelines.
CORE DOMAINS TESTED
1.
Advanced Clinical Assessment — Integration of history, physical
examination, and clinical findings.
2.
3.
Cardiovascular Disorders — Hypertension, ischemic disease, heart failure,
dysrhythmias, and vascular disease.
4.
5.
Pulmonary Disorders — Asthma, COPD, pneumonia, respiratory failure, and
pulmonary vascular disease.
6.
1
, 7.
Endocrine and Metabolic Disorders — Diabetes, thyroid disease, adrenal
disorders, and electrolyte abnormalities.
8.
9.
Renal and Genitourinary Disorders — CKD, AKI, urinary disorders,
nephrolithiasis, and electrolyte complications.
10.
11.
Gastrointestinal and Hepatic Disorders — GERD, peptic disease, liver
disease, and GI emergencies.
12.
13.
Hematologic Disorders — Common anemias, coagulation abnormalities, and
thromboembolic disease.
14.
15.
Neurologic Disorders — Stroke, headache syndromes, neuropathy, and
neurologic emergencies.
16.
17.
Musculoskeletal and Rheumatologic Disorders — Osteoarthritis,
inflammatory arthritis, gout, and osteoporosis.
18.
19.
Infectious Disease — Recognition of serious infection, antimicrobial
principles, and complications.
20.
21.
Psychiatric and Behavioral Health — Depression, anxiety, medication-
related syndromes, and safety assessment.
22.
23.
2
, Pharmacotherapeutics — Medication selection, adverse effects, interactions,
contraindications, and monitoring.
24.
25.
Patient Safety and Clinical Prioritization — Recognition of emergencies,
risk stratification, prevention, and longitudinal management.
26.
QUESTIONS 1-100
Q1: A 64-year-old patient with hypertension reports dizziness
whenever standing after sitting for several minutes. The
patient takes lisinopril, hydrochlorothiazide, and an alpha-1
blocker. Supine BP is 146/82 mm Hg and standing BP after 3
minutes is 112/66 mm Hg with reproduction of symptoms. Which
interpretation is most appropriate?
A) The patient has isolated systolic hypertension requiring immediate intensification
B) The patient has symptomatic orthostatic hypotension requiring medication
and volume-status reassessment
C) The patient has an isolated diastolic blood-pressure abnormality
D) The finding is clinically insignificant because the supine BP is elevated
Rationale: The correct answer is B because a substantial reduction in blood pressure
after standing accompanied by symptoms indicates clinically significant orthostatic
hypotension. The medication regimen includes agents that can contribute to this
problem, particularly the diuretic and alpha-1 blocker. Option A is incorrect because
intensifying antihypertensive therapy could worsen the orthostatic symptoms. Option
C is incorrect because the principal issue is the positional fall in blood pressure
rather than isolated diastolic disease. Option D is incorrect because a normal or
elevated supine pressure does not eliminate the clinical significance of symptomatic
orthostatic hypotension.
Q2: A 58-year-old patient with diabetes and hypertension has
persistent BP readings of 158/94 mm Hg despite adherence to
an ACE inhibitor, calcium-channel blocker, and thiazide-type
diuretic. Which next step is most appropriate before simply
adding another medication?
A) Assume the patient has essential hypertension with no further evaluation needed
B) Confirm adherence and measurement accuracy and evaluate for resistant or
secondary hypertension
3
, C) Discontinue all antihypertensive therapy for two weeks
D) Recommend increasing dietary sodium to improve vascular stability
Rationale: The correct answer is B because apparent resistant hypertension should
first be confirmed through accurate measurement, adherence assessment, medication
review, and evaluation for secondary causes when indicated. Option A is incorrect
because persistent uncontrolled hypertension despite multiple appropriate agents
warrants further assessment. Option C is unsafe because abrupt discontinuation may
worsen cardiovascular risk. Option D is incorrect because increased sodium intake
generally worsens hypertension rather than treating it.
Q3: A patient with hypertension has episodic severe headaches,
palpitations, diaphoresis, and marked blood-pressure
elevations. Between episodes, the BP is near normal. Which
secondary cause should be considered?
A) Primary hypothyroidism
B) Pheochromocytoma
C) Iron-deficiency anemia
D) Osteoarthritis
Rationale: The correct answer is B because episodic catecholamine excess produces
paroxysmal hypertension, headache, palpitations, and diaphoresis. Option A is
incorrect because hypothyroidism more commonly produces fatigue, cold intolerance,
and other metabolic features rather than episodic catecholamine symptoms. Option C
does not explain the episodic hypertension. Option D is unrelated to the
cardiovascular presentation.
Q4: A patient with hypertension has persistent hypokalemia
and suppressed plasma renin activity despite no diuretic use.
Which diagnosis should be investigated?
A) Primary adrenal insufficiency
B) Primary hyperaldosteronism
C) SIADH
D) Hypothyroidism
Rationale: The correct answer is B because autonomous aldosterone production
causes sodium retention, hypertension, potassium wasting, and suppression of renin.
Option A is incorrect because adrenal insufficiency typically causes hypotension and
hyperkalemia. Option C usually produces dilutional hyponatremia rather than this
pattern. Option D does not explain the combination of hypertension and hypokalemia.
Q5: A patient presents with BP 228/126 mm Hg, severe headache,
confusion, and new right-sided weakness. Which action is the
priority?
4
FULL PRACTICE QUESTIONS AND ANSWERS —
2026/2027 STUDY REVIEW
INTRODUCTION
This comprehensive practice set is designed for graduate-level Advanced Practice
Nursing III students preparing for an Exam 1 assessment. It emphasizes clinical
reasoning, differential diagnosis, interpretation of diagnostic findings, pharmacologic
decision-making, disease management, and prioritization of care rather than simple
memorization. The questions are written as original practice scenarios and are
intended to help learners apply advanced pathophysiology and evidence-based clinical
principles to patient presentations commonly encountered in advanced practice
nursing.
The set uses four-option multiple-choice questions with one best answer and detailed
rationales. Several questions require the learner to integrate history, physical
examination findings, laboratory results, medication effects, comorbidities, and
potential complications before selecting the safest management approach. Students
should use the rationales to identify gaps in knowledge and understand why plausible
alternatives are less appropriate. Because institutional examinations can vary in
emphasis and content, this practice material should be used alongside course lectures,
assigned readings, faculty guidance, and current clinical guidelines.
CORE DOMAINS TESTED
1.
Advanced Clinical Assessment — Integration of history, physical
examination, and clinical findings.
2.
3.
Cardiovascular Disorders — Hypertension, ischemic disease, heart failure,
dysrhythmias, and vascular disease.
4.
5.
Pulmonary Disorders — Asthma, COPD, pneumonia, respiratory failure, and
pulmonary vascular disease.
6.
1
, 7.
Endocrine and Metabolic Disorders — Diabetes, thyroid disease, adrenal
disorders, and electrolyte abnormalities.
8.
9.
Renal and Genitourinary Disorders — CKD, AKI, urinary disorders,
nephrolithiasis, and electrolyte complications.
10.
11.
Gastrointestinal and Hepatic Disorders — GERD, peptic disease, liver
disease, and GI emergencies.
12.
13.
Hematologic Disorders — Common anemias, coagulation abnormalities, and
thromboembolic disease.
14.
15.
Neurologic Disorders — Stroke, headache syndromes, neuropathy, and
neurologic emergencies.
16.
17.
Musculoskeletal and Rheumatologic Disorders — Osteoarthritis,
inflammatory arthritis, gout, and osteoporosis.
18.
19.
Infectious Disease — Recognition of serious infection, antimicrobial
principles, and complications.
20.
21.
Psychiatric and Behavioral Health — Depression, anxiety, medication-
related syndromes, and safety assessment.
22.
23.
2
, Pharmacotherapeutics — Medication selection, adverse effects, interactions,
contraindications, and monitoring.
24.
25.
Patient Safety and Clinical Prioritization — Recognition of emergencies,
risk stratification, prevention, and longitudinal management.
26.
QUESTIONS 1-100
Q1: A 64-year-old patient with hypertension reports dizziness
whenever standing after sitting for several minutes. The
patient takes lisinopril, hydrochlorothiazide, and an alpha-1
blocker. Supine BP is 146/82 mm Hg and standing BP after 3
minutes is 112/66 mm Hg with reproduction of symptoms. Which
interpretation is most appropriate?
A) The patient has isolated systolic hypertension requiring immediate intensification
B) The patient has symptomatic orthostatic hypotension requiring medication
and volume-status reassessment
C) The patient has an isolated diastolic blood-pressure abnormality
D) The finding is clinically insignificant because the supine BP is elevated
Rationale: The correct answer is B because a substantial reduction in blood pressure
after standing accompanied by symptoms indicates clinically significant orthostatic
hypotension. The medication regimen includes agents that can contribute to this
problem, particularly the diuretic and alpha-1 blocker. Option A is incorrect because
intensifying antihypertensive therapy could worsen the orthostatic symptoms. Option
C is incorrect because the principal issue is the positional fall in blood pressure
rather than isolated diastolic disease. Option D is incorrect because a normal or
elevated supine pressure does not eliminate the clinical significance of symptomatic
orthostatic hypotension.
Q2: A 58-year-old patient with diabetes and hypertension has
persistent BP readings of 158/94 mm Hg despite adherence to
an ACE inhibitor, calcium-channel blocker, and thiazide-type
diuretic. Which next step is most appropriate before simply
adding another medication?
A) Assume the patient has essential hypertension with no further evaluation needed
B) Confirm adherence and measurement accuracy and evaluate for resistant or
secondary hypertension
3
, C) Discontinue all antihypertensive therapy for two weeks
D) Recommend increasing dietary sodium to improve vascular stability
Rationale: The correct answer is B because apparent resistant hypertension should
first be confirmed through accurate measurement, adherence assessment, medication
review, and evaluation for secondary causes when indicated. Option A is incorrect
because persistent uncontrolled hypertension despite multiple appropriate agents
warrants further assessment. Option C is unsafe because abrupt discontinuation may
worsen cardiovascular risk. Option D is incorrect because increased sodium intake
generally worsens hypertension rather than treating it.
Q3: A patient with hypertension has episodic severe headaches,
palpitations, diaphoresis, and marked blood-pressure
elevations. Between episodes, the BP is near normal. Which
secondary cause should be considered?
A) Primary hypothyroidism
B) Pheochromocytoma
C) Iron-deficiency anemia
D) Osteoarthritis
Rationale: The correct answer is B because episodic catecholamine excess produces
paroxysmal hypertension, headache, palpitations, and diaphoresis. Option A is
incorrect because hypothyroidism more commonly produces fatigue, cold intolerance,
and other metabolic features rather than episodic catecholamine symptoms. Option C
does not explain the episodic hypertension. Option D is unrelated to the
cardiovascular presentation.
Q4: A patient with hypertension has persistent hypokalemia
and suppressed plasma renin activity despite no diuretic use.
Which diagnosis should be investigated?
A) Primary adrenal insufficiency
B) Primary hyperaldosteronism
C) SIADH
D) Hypothyroidism
Rationale: The correct answer is B because autonomous aldosterone production
causes sodium retention, hypertension, potassium wasting, and suppression of renin.
Option A is incorrect because adrenal insufficiency typically causes hypotension and
hyperkalemia. Option C usually produces dilutional hyponatremia rather than this
pattern. Option D does not explain the combination of hypertension and hypokalemia.
Q5: A patient presents with BP 228/126 mm Hg, severe headache,
confusion, and new right-sided weakness. Which action is the
priority?
4
