NSG6205
Decision Making for the Advanced
Practice Nurse I
Midterm Assessment Review
(With Solutions)
2026
1
,1. Case: An NP evaluates a 65-year-old with chest pain. ECG shows ST
elevation.
Question: Which decision-making model is most appropriate?
- A. Shared decision-making
- B. Evidence-based urgent care protocol
- C. Intuition-based decision
- D. Watchful waiting
Answer: B. Evidence-based urgent care protocol
Rationale: Acute MI requires guideline-directed urgent intervention.
---
2. Case: A 45-year-old diabetic presents with foot ulcer. The NP must
decide on referral.
Question: Which factor most strongly supports vascular surgery
referral?
- A. Mild erythema only
- B. ABI <0.9
- C. Controlled glucose
- D. Patient preference
Answer: B. ABI <0.9
Rationale: Indicates peripheral arterial disease requiring specialist
input.
---
3. Case: A patient requests antibiotics for viral URI.
Question: Which ethical principle guides NP decision?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Non-maleficence
Answer: D. Non-maleficence
2
, Rationale: Avoids harm from unnecessary antibiotics.
---
4. Case: An NP must decide whether to order MRI for chronic low back
pain.
Question: Which guideline is most relevant?
- A. Imaging only if red flag symptoms present
- B. Imaging for all chronic pain
- C. Imaging after 2 weeks of pain
- D. Imaging if patient requests
Answer: A. Imaging only if red flag symptoms present
Rationale: Evidence-based guidelines limit unnecessary imaging.
---
5. Case: A 70-year-old with hypertension presents with dizziness.
Question: Which decision-making step comes first?
- A. Order CT scan
- B. Review medication list
- C. Refer to neurology
- D. Increase antihypertensive dose
Answer: B. Review medication list
Rationale: Polypharmacy often causes dizziness in older adults.
---
6. Case: An NP must decide on anticoagulation for atrial fibrillation.
Question: Which tool supports evidence-based decision?
- A. CHA₂DS₂-VASc score
- B. Wells score
- C. APGAR score
- D. Braden scale
Answer: A. CHA₂DS₂-VASc score
Rationale: Guides stroke risk stratification.
3
Decision Making for the Advanced
Practice Nurse I
Midterm Assessment Review
(With Solutions)
2026
1
,1. Case: An NP evaluates a 65-year-old with chest pain. ECG shows ST
elevation.
Question: Which decision-making model is most appropriate?
- A. Shared decision-making
- B. Evidence-based urgent care protocol
- C. Intuition-based decision
- D. Watchful waiting
Answer: B. Evidence-based urgent care protocol
Rationale: Acute MI requires guideline-directed urgent intervention.
---
2. Case: A 45-year-old diabetic presents with foot ulcer. The NP must
decide on referral.
Question: Which factor most strongly supports vascular surgery
referral?
- A. Mild erythema only
- B. ABI <0.9
- C. Controlled glucose
- D. Patient preference
Answer: B. ABI <0.9
Rationale: Indicates peripheral arterial disease requiring specialist
input.
---
3. Case: A patient requests antibiotics for viral URI.
Question: Which ethical principle guides NP decision?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Non-maleficence
Answer: D. Non-maleficence
2
, Rationale: Avoids harm from unnecessary antibiotics.
---
4. Case: An NP must decide whether to order MRI for chronic low back
pain.
Question: Which guideline is most relevant?
- A. Imaging only if red flag symptoms present
- B. Imaging for all chronic pain
- C. Imaging after 2 weeks of pain
- D. Imaging if patient requests
Answer: A. Imaging only if red flag symptoms present
Rationale: Evidence-based guidelines limit unnecessary imaging.
---
5. Case: A 70-year-old with hypertension presents with dizziness.
Question: Which decision-making step comes first?
- A. Order CT scan
- B. Review medication list
- C. Refer to neurology
- D. Increase antihypertensive dose
Answer: B. Review medication list
Rationale: Polypharmacy often causes dizziness in older adults.
---
6. Case: An NP must decide on anticoagulation for atrial fibrillation.
Question: Which tool supports evidence-based decision?
- A. CHA₂DS₂-VASc score
- B. Wells score
- C. APGAR score
- D. Braden scale
Answer: A. CHA₂DS₂-VASc score
Rationale: Guides stroke risk stratification.
3
