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NURS 684 FINAL EXAM 2025: 75
CORRECTLY ANSWERED
QUESTIONS FOR WEST COAST
UNIVERSITY
Client Care
1. A 55-year-old male presents with chest pain radiating to the left arm. The ECG shows
ST-elevation. What is the nurse practitioner’s next step?
a. Order a chest X-ray
b. Administer antibiotics
c. Administer aspirin 325 mg orally
d. Monitor vital signs only
Rationale: ST-elevation indicates acute myocardial infarction (MI). Aspirin reduces
platelet aggregation and is a first-line intervention, per 2025 AHA guidelines.
2. A client with type 2 diabetes reports polyuria and fatigue. The A1C is 8.5%. What is the
most appropriate initial management?
a. Initiate insulin therapy immediately
b. Optimize oral hypoglycemic therapy
c. Recommend a low-protein diet
d. Order a renal ultrasound
Rationale: An A1C of 8.5% indicates poor glycemic control. Optimizing oral
medications (e.g., metformin) is the first step before escalating to insulin, per ADA 2025
standards.
3. A 62-year-old female with hypertension reports dizziness. Blood pressure is 100/60
mmHg. Which medication is most likely causing this?
a. Metformin
b. Lisinopril
c. Levothyroxine
d. Albuterol
Rationale: Lisinopril, an ACE inhibitor, can cause hypotension, leading to dizziness,
especially in older adults, per JNC 8 guidelines.
4. A client with a new colostomy reports skin irritation around the stoma. What is the nurse
practitioner’s priority action?
a. Apply petroleum jelly to the area
b. Assess the stoma and appliance fit
c. Change the pouch every 12 hours
d. Use an alcohol-based cleanser
, 2
Rationale: Skin irritation is often due to an ill-fitting appliance. Assessment ensures
proper fit and prevents further damage, per WOCN 2025 guidelines.
5. A 45-year-old male with asthma reports increased wheezing despite albuterol use. What
should the nurse practitioner do next?
a. Increase albuterol frequency
b. Prescribe an inhaled corticosteroid
c. Order a chest X-ray
d. Recommend over-the-counter antihistamines
Rationale: Persistent wheezing indicates poor asthma control. Inhaled corticosteroids are
the next step for maintenance therapy, per GINA 2025 guidelines.
6. A client with heart failure reports a 4-pound weight gain in 3 days. What is the priority
action?
a. Encourage increased fluid intake
b. Notify the healthcare provider
c. Administer an extra dose of diuretic
d. Monitor oxygen saturation
Rationale: Rapid weight gain suggests fluid retention in heart failure, requiring
immediate provider notification, per AHA/ACC 2025 guidelines.
7. A 70-year-old female with osteoarthritis reports joint stiffness. Which non-pharmacologic
intervention should the nurse practitioner recommend?
a. Avoid all physical activity
b. Engage in low-impact exercise
c. Apply cold packs to joints
d. Use a high-protein diet
Rationale: Low-impact exercise (e.g., swimming) improves joint mobility and reduces
stiffness in osteoarthritis, per ACR 2025 guidelines.
8. A client with a urinary tract infection (UTI) is prescribed nitrofurantoin. Which
instruction should the nurse practitioner provide?
a. Take with grapefruit juice
b. Expect orange-colored urine
c. Stop the medication if symptoms resolve
d. Avoid drinking water
Rationale: Nitrofurantoin causes harmless urine discoloration. Educating the client
prevents alarm, per 2025 pharmacology guidelines.
9. A 50-year-old male with COPD has an oxygen saturation of 89%. What is the priority
intervention?
a. Increase oxygen to 6 L/min
b. Position in high-Fowler’s position
c. Administer a bronchodilator immediately
d. Order a pulmonary function test
Rationale: Positioning in high-Fowler’s improves lung expansion and oxygenation in
COPD, a priority before escalating interventions, per GOLD 2025 guidelines.
10. A client with a history of seizures is non-compliant with phenytoin. What should the
nurse practitioner assess first?
a. Blood glucose levels
b. Serum phenytoin levels
NURS 684 FINAL EXAM 2025: 75
CORRECTLY ANSWERED
QUESTIONS FOR WEST COAST
UNIVERSITY
Client Care
1. A 55-year-old male presents with chest pain radiating to the left arm. The ECG shows
ST-elevation. What is the nurse practitioner’s next step?
a. Order a chest X-ray
b. Administer antibiotics
c. Administer aspirin 325 mg orally
d. Monitor vital signs only
Rationale: ST-elevation indicates acute myocardial infarction (MI). Aspirin reduces
platelet aggregation and is a first-line intervention, per 2025 AHA guidelines.
2. A client with type 2 diabetes reports polyuria and fatigue. The A1C is 8.5%. What is the
most appropriate initial management?
a. Initiate insulin therapy immediately
b. Optimize oral hypoglycemic therapy
c. Recommend a low-protein diet
d. Order a renal ultrasound
Rationale: An A1C of 8.5% indicates poor glycemic control. Optimizing oral
medications (e.g., metformin) is the first step before escalating to insulin, per ADA 2025
standards.
3. A 62-year-old female with hypertension reports dizziness. Blood pressure is 100/60
mmHg. Which medication is most likely causing this?
a. Metformin
b. Lisinopril
c. Levothyroxine
d. Albuterol
Rationale: Lisinopril, an ACE inhibitor, can cause hypotension, leading to dizziness,
especially in older adults, per JNC 8 guidelines.
4. A client with a new colostomy reports skin irritation around the stoma. What is the nurse
practitioner’s priority action?
a. Apply petroleum jelly to the area
b. Assess the stoma and appliance fit
c. Change the pouch every 12 hours
d. Use an alcohol-based cleanser
, 2
Rationale: Skin irritation is often due to an ill-fitting appliance. Assessment ensures
proper fit and prevents further damage, per WOCN 2025 guidelines.
5. A 45-year-old male with asthma reports increased wheezing despite albuterol use. What
should the nurse practitioner do next?
a. Increase albuterol frequency
b. Prescribe an inhaled corticosteroid
c. Order a chest X-ray
d. Recommend over-the-counter antihistamines
Rationale: Persistent wheezing indicates poor asthma control. Inhaled corticosteroids are
the next step for maintenance therapy, per GINA 2025 guidelines.
6. A client with heart failure reports a 4-pound weight gain in 3 days. What is the priority
action?
a. Encourage increased fluid intake
b. Notify the healthcare provider
c. Administer an extra dose of diuretic
d. Monitor oxygen saturation
Rationale: Rapid weight gain suggests fluid retention in heart failure, requiring
immediate provider notification, per AHA/ACC 2025 guidelines.
7. A 70-year-old female with osteoarthritis reports joint stiffness. Which non-pharmacologic
intervention should the nurse practitioner recommend?
a. Avoid all physical activity
b. Engage in low-impact exercise
c. Apply cold packs to joints
d. Use a high-protein diet
Rationale: Low-impact exercise (e.g., swimming) improves joint mobility and reduces
stiffness in osteoarthritis, per ACR 2025 guidelines.
8. A client with a urinary tract infection (UTI) is prescribed nitrofurantoin. Which
instruction should the nurse practitioner provide?
a. Take with grapefruit juice
b. Expect orange-colored urine
c. Stop the medication if symptoms resolve
d. Avoid drinking water
Rationale: Nitrofurantoin causes harmless urine discoloration. Educating the client
prevents alarm, per 2025 pharmacology guidelines.
9. A 50-year-old male with COPD has an oxygen saturation of 89%. What is the priority
intervention?
a. Increase oxygen to 6 L/min
b. Position in high-Fowler’s position
c. Administer a bronchodilator immediately
d. Order a pulmonary function test
Rationale: Positioning in high-Fowler’s improves lung expansion and oxygenation in
COPD, a priority before escalating interventions, per GOLD 2025 guidelines.
10. A client with a history of seizures is non-compliant with phenytoin. What should the
nurse practitioner assess first?
a. Blood glucose levels
b. Serum phenytoin levels
