NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
NUR 6541 • COMPREHENSIVE FINAL EXAM
Fall 2026 | American International College | 150 Multiple-Choice Questions
Instructions: Select the single best answer (A, B, C, or D) for each question. The answer key and rationales follow
Question 150.
1. A patient develops fever, sore throat, diffuse rash, and lymphadenopathy after possible HIV
exposure. Which screening approach is described?
A. A CD4 count without initial screening
B. HIV viral-load monitoring alone as an initial screening substitute
C. Combined HIV antigen-antibody testing
D. A complete blood count alone
2. A patient has thrombocytopenia, microangiopathic hemolytic anemia, neurologic changes,
and renal dysfunction. What treatment is urgent?
A. Routine platelet transfusion as sole treatment
B. Plasma exchange for thrombotic thrombocytopenic purpura
C. Oral ferrous sulfate alone
D. Delay until symptoms resolve without treatment
3. A patient repeatedly experiences unwanted intrusive thoughts and performs a ritual to
reduce resulting anxiety. The intrusive thoughts are termed what?
A. Compulsions
B. Obsessions
C. Hypomanic episodes
D. Negative symptoms
4. Which test helps identify hemoglobinopathies such as sickle cell disease and thalassemia?
A. Peripheral smear alone
B. Reticulocyte count alone
C. Serum ferritin
D. Hemoglobin electrophoresis
5. A patient has diffuse musculoskeletal pain, unrefreshing sleep, and difficulty concentrating
with generally normal inflammatory markers. What syndrome is suggested?
A. Rheumatoid arthritis with synovitis
B. Fibromyalgia
C. Osteoarthritis restricted to one joint
D. Myalgic encephalomyelitis without prominent pain
6. Which autoantibody is highlighted in the Sjögren syndrome review?
A. Rheumatoid factor
B. Anti-CCP
C. Anti-SSA (Ro)
D. Anti-DNA antibody
Source-based mock examination • Not an official institutional exam Page 1
,NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
7. A patient receiving heparin develops a falling platelet count and new thrombosis. What is
the priority medication action?
A. Stop heparin because HIT is suspected
B. Increase the heparin dose
C. Administer aspirin alone and ignore the platelet decrease
D. Continue heparin until platelets normalize
8. A patient with symptomatic hypocalcemia undergoes electrocardiography. Which change is
expected?
A. Delta waves as the hallmark
B. Prolonged QT interval
C. Isolated ST elevation as the hallmark
D. Persistently shortened QT as the key change
9. A patient reports thoughts of suicide. Which focused sequence is emphasized to
characterize immediate risk?
A. Trauma, avoidance, intrusive thoughts, and nightmares only
B. CAGE responses without questioning intent or means
C. Thoughts, plan, intent, and available means
D. Mood, anxiety, appetite, and sleep only
10. A man's retracted foreskin is trapped behind the glans with increasing swelling. Which
condition requires urgent attention?
A. Peyronie disease
B. Phimosis
C. Balanitis
D. Paraphimosis
11. A patient discloses a specific suicide plan, current intent, and access to the proposed
means. What disposition is indicated?
A. Routine follow-up after several months
B. Urgent psychiatric or emergency department evaluation
C. Simply provide a printed sleep-hygiene handout
D. No additional assessment because disclosure was voluntary
12. A patient has experienced a clear manic episode but has no history of major depression.
Which diagnosis is supported?
A. Bipolar I disorder
B. Panic disorder
C. Bipolar II disorder
D. Generalized anxiety disorder
Source-based mock examination • Not an official institutional exam Page 2
,NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
13. A patient with bipolar disorder requests treatment using an antidepressant alone. What
does the source recommend?
A. Use an antidepressant alone as first-line mania treatment
B. Stabilize mood rather than using antidepressant monotherapy
C. Stop all mood stabilizers as soon as sleep improves
D. Treat bipolar disorder solely with prazosin
14. A patient has weight loss, palpitations, tremor, and heat intolerance. Which condition best
fits?
A. Hypothyroidism
B. Acute panic episode without abnormal thyroid function
C. Anemia producing fatigue without heat intolerance
D. Hyperthyroidism
15. A patient has been taking benzodiazepines regularly and suddenly stops. Which
complication is especially important to anticipate?
A. Withdrawal-related seizures
B. New loss of sensation as the hallmark
C. Transient appetite increase as the principal danger
D. Persistent sedation without rebound symptoms
16. A person with sickle cell disease develops excruciating limb and back pain not relieved by
repositioning. What complication is likely?
A. Bacterial bone infection as the default explanation
B. Chronic nonvascular joint disease
C. Vaso-occlusive pain crisis
D. Acute chest syndrome without pulmonary symptoms
17. A patient reports cold intolerance, weight gain, dry skin, and fatigue. What endocrine
disorder is most consistent?
A. Hyperthyroidism
B. Iron deficiency anemia
C. Hypothyroidism
D. Cushing syndrome
18. A patient has extreme hyperglycemia, marked dehydration, and hyperosmolality with little
ketoacidosis. Which crisis fits best?
A. Diabetic ketoacidosis with prominent ketones
B. Hyperosmolar hyperglycemic state
C. Symptomatic hypocalcemia
D. Thyroid nodule
Source-based mock examination • Not an official institutional exam Page 3
, NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
19. A clinician suspects acute bacterial prostatitis. Which examination technique should be
avoided?
A. Routine review of urinary symptoms
B. A focused abdominal examination
C. Assessment of vital signs
D. Vigorous prostate massage
20. A patient develops first-ever manic symptoms after age 45. What additional consideration
is specifically recommended?
A. Diagnose OCD without further assessment
B. Evaluate possible medical, thyroid, neurologic, or substance-related causes
C. Assume this always represents lifelong bipolar disorder
D. Exclude all medication and medical history
21. A patient describes gradually developing unilateral testicular pain with dysuria and
epididymal tenderness. Which diagnosis is most likely?
A. Testicular torsion
B. Prostate cancer
C. Hydrocele
D. Epididymitis
22. An A1C is 6.1% in a patient not previously diagnosed with diabetes. Which category is
described in the source?
A. Normal glycemic control below 5.7%
B. Acute hypoglycemia
C. Diabetes by A1C threshold alone
D. Prediabetes
23. A man has tender firm tissue directly under the nipple rather than generalized breast fat.
Which condition best fits?
A. A benign lipoma unrelated to glandular tissue
B. True gynecomastia
C. Pseudogynecomastia
D. A hard irregular breast mass requiring cancer evaluation
24. A hospitalized patient abruptly stops heavy alcohol use and develops tremor, sweating,
tachycardia, and agitation. Which state is most likely?
A. Alcohol withdrawal
B. Opioid overdose
C. Cannabis intoxication
D. Alcohol intoxication
Source-based mock examination • Not an official institutional exam Page 4
NUR 6541 • COMPREHENSIVE FINAL EXAM
Fall 2026 | American International College | 150 Multiple-Choice Questions
Instructions: Select the single best answer (A, B, C, or D) for each question. The answer key and rationales follow
Question 150.
1. A patient develops fever, sore throat, diffuse rash, and lymphadenopathy after possible HIV
exposure. Which screening approach is described?
A. A CD4 count without initial screening
B. HIV viral-load monitoring alone as an initial screening substitute
C. Combined HIV antigen-antibody testing
D. A complete blood count alone
2. A patient has thrombocytopenia, microangiopathic hemolytic anemia, neurologic changes,
and renal dysfunction. What treatment is urgent?
A. Routine platelet transfusion as sole treatment
B. Plasma exchange for thrombotic thrombocytopenic purpura
C. Oral ferrous sulfate alone
D. Delay until symptoms resolve without treatment
3. A patient repeatedly experiences unwanted intrusive thoughts and performs a ritual to
reduce resulting anxiety. The intrusive thoughts are termed what?
A. Compulsions
B. Obsessions
C. Hypomanic episodes
D. Negative symptoms
4. Which test helps identify hemoglobinopathies such as sickle cell disease and thalassemia?
A. Peripheral smear alone
B. Reticulocyte count alone
C. Serum ferritin
D. Hemoglobin electrophoresis
5. A patient has diffuse musculoskeletal pain, unrefreshing sleep, and difficulty concentrating
with generally normal inflammatory markers. What syndrome is suggested?
A. Rheumatoid arthritis with synovitis
B. Fibromyalgia
C. Osteoarthritis restricted to one joint
D. Myalgic encephalomyelitis without prominent pain
6. Which autoantibody is highlighted in the Sjögren syndrome review?
A. Rheumatoid factor
B. Anti-CCP
C. Anti-SSA (Ro)
D. Anti-DNA antibody
Source-based mock examination • Not an official institutional exam Page 1
,NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
7. A patient receiving heparin develops a falling platelet count and new thrombosis. What is
the priority medication action?
A. Stop heparin because HIT is suspected
B. Increase the heparin dose
C. Administer aspirin alone and ignore the platelet decrease
D. Continue heparin until platelets normalize
8. A patient with symptomatic hypocalcemia undergoes electrocardiography. Which change is
expected?
A. Delta waves as the hallmark
B. Prolonged QT interval
C. Isolated ST elevation as the hallmark
D. Persistently shortened QT as the key change
9. A patient reports thoughts of suicide. Which focused sequence is emphasized to
characterize immediate risk?
A. Trauma, avoidance, intrusive thoughts, and nightmares only
B. CAGE responses without questioning intent or means
C. Thoughts, plan, intent, and available means
D. Mood, anxiety, appetite, and sleep only
10. A man's retracted foreskin is trapped behind the glans with increasing swelling. Which
condition requires urgent attention?
A. Peyronie disease
B. Phimosis
C. Balanitis
D. Paraphimosis
11. A patient discloses a specific suicide plan, current intent, and access to the proposed
means. What disposition is indicated?
A. Routine follow-up after several months
B. Urgent psychiatric or emergency department evaluation
C. Simply provide a printed sleep-hygiene handout
D. No additional assessment because disclosure was voluntary
12. A patient has experienced a clear manic episode but has no history of major depression.
Which diagnosis is supported?
A. Bipolar I disorder
B. Panic disorder
C. Bipolar II disorder
D. Generalized anxiety disorder
Source-based mock examination • Not an official institutional exam Page 2
,NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
13. A patient with bipolar disorder requests treatment using an antidepressant alone. What
does the source recommend?
A. Use an antidepressant alone as first-line mania treatment
B. Stabilize mood rather than using antidepressant monotherapy
C. Stop all mood stabilizers as soon as sleep improves
D. Treat bipolar disorder solely with prazosin
14. A patient has weight loss, palpitations, tremor, and heat intolerance. Which condition best
fits?
A. Hypothyroidism
B. Acute panic episode without abnormal thyroid function
C. Anemia producing fatigue without heat intolerance
D. Hyperthyroidism
15. A patient has been taking benzodiazepines regularly and suddenly stops. Which
complication is especially important to anticipate?
A. Withdrawal-related seizures
B. New loss of sensation as the hallmark
C. Transient appetite increase as the principal danger
D. Persistent sedation without rebound symptoms
16. A person with sickle cell disease develops excruciating limb and back pain not relieved by
repositioning. What complication is likely?
A. Bacterial bone infection as the default explanation
B. Chronic nonvascular joint disease
C. Vaso-occlusive pain crisis
D. Acute chest syndrome without pulmonary symptoms
17. A patient reports cold intolerance, weight gain, dry skin, and fatigue. What endocrine
disorder is most consistent?
A. Hyperthyroidism
B. Iron deficiency anemia
C. Hypothyroidism
D. Cushing syndrome
18. A patient has extreme hyperglycemia, marked dehydration, and hyperosmolality with little
ketoacidosis. Which crisis fits best?
A. Diabetic ketoacidosis with prominent ketones
B. Hyperosmolar hyperglycemic state
C. Symptomatic hypocalcemia
D. Thyroid nodule
Source-based mock examination • Not an official institutional exam Page 3
, NUR 6541 / FALL 2026 AMERICAN INTERNATIONAL COLLEGE
19. A clinician suspects acute bacterial prostatitis. Which examination technique should be
avoided?
A. Routine review of urinary symptoms
B. A focused abdominal examination
C. Assessment of vital signs
D. Vigorous prostate massage
20. A patient develops first-ever manic symptoms after age 45. What additional consideration
is specifically recommended?
A. Diagnose OCD without further assessment
B. Evaluate possible medical, thyroid, neurologic, or substance-related causes
C. Assume this always represents lifelong bipolar disorder
D. Exclude all medication and medical history
21. A patient describes gradually developing unilateral testicular pain with dysuria and
epididymal tenderness. Which diagnosis is most likely?
A. Testicular torsion
B. Prostate cancer
C. Hydrocele
D. Epididymitis
22. An A1C is 6.1% in a patient not previously diagnosed with diabetes. Which category is
described in the source?
A. Normal glycemic control below 5.7%
B. Acute hypoglycemia
C. Diabetes by A1C threshold alone
D. Prediabetes
23. A man has tender firm tissue directly under the nipple rather than generalized breast fat.
Which condition best fits?
A. A benign lipoma unrelated to glandular tissue
B. True gynecomastia
C. Pseudogynecomastia
D. A hard irregular breast mass requiring cancer evaluation
24. A hospitalized patient abruptly stops heavy alcohol use and develops tremor, sweating,
tachycardia, and agitation. Which state is most likely?
A. Alcohol withdrawal
B. Opioid overdose
C. Cannabis intoxication
D. Alcohol intoxication
Source-based mock examination • Not an official institutional exam Page 4
