NURS 6541 MIDTERM EXAM ACTUAL EXAM 2026/2027
ALL 100 QUESTIONS AND CORRECT ANSWERS
(PROFESSOR VERIFIED) | ALREADY GRADED | LATEST
EDITION
Advanced Practice Care of Adults Across the Lifespan | Key Domains: Health Promotion &
Disease Prevention in Adults, Diagnostic Reasoning & Clinical Decision Making, Management of
Common Acute & Chronic Conditions (Cardiovascular, Respiratory, Endocrine, Gastrointestinal),
Pharmacology for Adult Health, Geriatric Syndromes & Aging Considerations, Health Screening
Guidelines, and Interprofessional Collaboration | Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured NURS 6541 Midterm Exam for 2026/2027 provides 100 high-quality exam-style
questions with correct answers and rationales. It emphasizes the role of the Adult-Gerontology or
Family Nurse Practitioner in assessing, diagnosing, and managing health conditions in adult
patients, integrating evidence-based guidelines, pharmacotherapeutics, and patient education to
optimize health outcomes across the adult lifespan.
Answer Format
All correct answers appear in bold and cyan blue, accompanied by concise rationales explaining
the diagnostic criteria, first-line treatment choice (per guidelines like USPSTF, AHA, ADA), key
differential consideration, or age-specific management principle, and why alternative options are
incorrect, not indicated, or not the current standard of care.
1. According to the USPSTF, at what age should routine colorectal cancer screening begin for
average-risk adults?
a) 40 years
b) 45 years
, c) 50 years
d) 60 years
The USPSTF updated its recommendation in 2021 to begin colorectal cancer screening at age 45
(Grade B recommendation) due to rising incidence in younger adults. Options include stool-based tests
(e.g., FIT annually) or direct visualization (e.g., colonoscopy every 10 years).
2. A 58-year-old male presents with substernal chest pressure radiating to his left arm,
diaphoresis, and nausea for 30 minutes. His ECG shows ST-segment elevation in leads II, III,
and aVF. The most likely diagnosis is:
a) Unstable angina
b) Inferior wall ST-elevation myocardial infarction (STEMI)
c) Pericarditis
d) Aortic dissection
ST elevation in leads II, III, and aVF indicates acute occlusion of the right coronary artery, causing an
inferior STEMI. This is a medical emergency requiring immediate reperfusion (PCI or fibrinolysis).
3. First-line pharmacologic treatment for uncomplicated hypertension in a 62-year-old Black
male with no other comorbidities is:
a) ACE inhibitor
b) Thiazide diuretic or calcium channel blocker
c) Beta-blocker
d) ARB
,Per ACC/AHA guidelines, Black patients often respond better to thiazide diuretics (e.g., chlorthalidone)
or calcium channel blockers (e.g., amlodipine) than ACE inhibitors or ARBs as monotherapy for
hypertension.
4. A 45-year-old female presents with polyuria, polydipsia, and unexplained weight loss.
Random blood glucose is 280 mg/dL. The next best diagnostic test is:
a) Fasting lipid panel
b) Hemoglobin A1c
c) Oral glucose tolerance test
d) C-peptide level
ADA criteria for diabetes diagnosis include: HbA1c ≥6.5%, fasting glucose ≥126 mg/dL, random
glucose ≥200 mg/dL with symptoms, or 2-hour OGTT ≥200 mg/dL. HbA1c is convenient, reflects
3-month glycemia, and doesn’t require fasting.
5. Which vaccine is recommended annually for all adults ≥65 years?
a) Tdap
b) Influenza
c) HPV
d) MMR
Annual influenza vaccination is recommended for all adults, especially those ≥65 years who are at
higher risk for complications. High-dose or adjuvanted formulations are preferred in this age group.
6. A 70-year-old male with a history of atrial fibrillation is being evaluated for stroke risk.
Which scoring system is used to guide anticoagulation?
a) TIMI score
, b) CHA₂DS₂-VASc score
c) GRACE score
d) Wells’ criteria
CHA₂DS₂-VASc assesses stroke risk in AF: Congestive heart failure, Hypertension, Age ≥75 (2 points),
Diabetes, Stroke/TIA (2 points), Vascular disease, Age 65–74, Sex category (female). Anticoagulation is
recommended if score ≥2 in males or ≥3 in females.
7. A 55-year-old female presents with chronic heartburn and regurgitation. She reports
symptoms worsen when lying flat. The most appropriate initial management is:
a) Immediate endoscopy
b) Lifestyle modifications and trial of proton pump inhibitor (PPI)
c) H. pylori testing
d) Esophageal manometry
Empiric PPI therapy and lifestyle changes (e.g., weight loss, elevating head of bed, avoiding late meals)
are first-line for typical GERD symptoms without alarm features (e.g., dysphagia, weight loss, anemia).
8. According to USPSTF, which screening test is recommended for abdominal aortic
aneurysm (AAA) in men aged 65–75 years who have ever smoked?
a) CT angiography
b) One-time abdominal ultrasound
c) MRI
d) Physical exam only
ALL 100 QUESTIONS AND CORRECT ANSWERS
(PROFESSOR VERIFIED) | ALREADY GRADED | LATEST
EDITION
Advanced Practice Care of Adults Across the Lifespan | Key Domains: Health Promotion &
Disease Prevention in Adults, Diagnostic Reasoning & Clinical Decision Making, Management of
Common Acute & Chronic Conditions (Cardiovascular, Respiratory, Endocrine, Gastrointestinal),
Pharmacology for Adult Health, Geriatric Syndromes & Aging Considerations, Health Screening
Guidelines, and Interprofessional Collaboration | Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured NURS 6541 Midterm Exam for 2026/2027 provides 100 high-quality exam-style
questions with correct answers and rationales. It emphasizes the role of the Adult-Gerontology or
Family Nurse Practitioner in assessing, diagnosing, and managing health conditions in adult
patients, integrating evidence-based guidelines, pharmacotherapeutics, and patient education to
optimize health outcomes across the adult lifespan.
Answer Format
All correct answers appear in bold and cyan blue, accompanied by concise rationales explaining
the diagnostic criteria, first-line treatment choice (per guidelines like USPSTF, AHA, ADA), key
differential consideration, or age-specific management principle, and why alternative options are
incorrect, not indicated, or not the current standard of care.
1. According to the USPSTF, at what age should routine colorectal cancer screening begin for
average-risk adults?
a) 40 years
b) 45 years
, c) 50 years
d) 60 years
The USPSTF updated its recommendation in 2021 to begin colorectal cancer screening at age 45
(Grade B recommendation) due to rising incidence in younger adults. Options include stool-based tests
(e.g., FIT annually) or direct visualization (e.g., colonoscopy every 10 years).
2. A 58-year-old male presents with substernal chest pressure radiating to his left arm,
diaphoresis, and nausea for 30 minutes. His ECG shows ST-segment elevation in leads II, III,
and aVF. The most likely diagnosis is:
a) Unstable angina
b) Inferior wall ST-elevation myocardial infarction (STEMI)
c) Pericarditis
d) Aortic dissection
ST elevation in leads II, III, and aVF indicates acute occlusion of the right coronary artery, causing an
inferior STEMI. This is a medical emergency requiring immediate reperfusion (PCI or fibrinolysis).
3. First-line pharmacologic treatment for uncomplicated hypertension in a 62-year-old Black
male with no other comorbidities is:
a) ACE inhibitor
b) Thiazide diuretic or calcium channel blocker
c) Beta-blocker
d) ARB
,Per ACC/AHA guidelines, Black patients often respond better to thiazide diuretics (e.g., chlorthalidone)
or calcium channel blockers (e.g., amlodipine) than ACE inhibitors or ARBs as monotherapy for
hypertension.
4. A 45-year-old female presents with polyuria, polydipsia, and unexplained weight loss.
Random blood glucose is 280 mg/dL. The next best diagnostic test is:
a) Fasting lipid panel
b) Hemoglobin A1c
c) Oral glucose tolerance test
d) C-peptide level
ADA criteria for diabetes diagnosis include: HbA1c ≥6.5%, fasting glucose ≥126 mg/dL, random
glucose ≥200 mg/dL with symptoms, or 2-hour OGTT ≥200 mg/dL. HbA1c is convenient, reflects
3-month glycemia, and doesn’t require fasting.
5. Which vaccine is recommended annually for all adults ≥65 years?
a) Tdap
b) Influenza
c) HPV
d) MMR
Annual influenza vaccination is recommended for all adults, especially those ≥65 years who are at
higher risk for complications. High-dose or adjuvanted formulations are preferred in this age group.
6. A 70-year-old male with a history of atrial fibrillation is being evaluated for stroke risk.
Which scoring system is used to guide anticoagulation?
a) TIMI score
, b) CHA₂DS₂-VASc score
c) GRACE score
d) Wells’ criteria
CHA₂DS₂-VASc assesses stroke risk in AF: Congestive heart failure, Hypertension, Age ≥75 (2 points),
Diabetes, Stroke/TIA (2 points), Vascular disease, Age 65–74, Sex category (female). Anticoagulation is
recommended if score ≥2 in males or ≥3 in females.
7. A 55-year-old female presents with chronic heartburn and regurgitation. She reports
symptoms worsen when lying flat. The most appropriate initial management is:
a) Immediate endoscopy
b) Lifestyle modifications and trial of proton pump inhibitor (PPI)
c) H. pylori testing
d) Esophageal manometry
Empiric PPI therapy and lifestyle changes (e.g., weight loss, elevating head of bed, avoiding late meals)
are first-line for typical GERD symptoms without alarm features (e.g., dysphagia, weight loss, anemia).
8. According to USPSTF, which screening test is recommended for abdominal aortic
aneurysm (AAA) in men aged 65–75 years who have ever smoked?
a) CT angiography
b) One-time abdominal ultrasound
c) MRI
d) Physical exam only
