NUR 6121: Exam 2 Advanced Nursing Practice Master Set
1. A patient presents with polydipsia, polyuria, and polyphagia. Which diagnostic
test is the priority?
• A. Thyroid Stimulating Hormone (TSH)
• B. Fasting Plasma Glucose (FPG) ✅
• C. Serum Creatinine
• D. Liver Function Test (LFT)
• Rationale: The "3 Ps" are hallmark signs of Diabetes Mellitus. An FPG ≥ 126
mg/dL is a primary diagnostic criterion.
2. When assessing an elderly patient for frailty, the nurse practitioner should
focus on which "Geriatric Giants"?
• A. Hypertension and Diabetes
• B. Falls, Incontinence, and Cognitive Impairment ✅
• C. Hearing loss and Vision changes
• D. Obesity and Sleep Apnea
• Rationale: Frailty is defined by a decline in functional reserve, often manifesting
as mobility issues and mental status changes.
3. In what order should a physical assessment of the abdomen be performed?
• A. Inspection, Palpation, Percussion, Auscultation
• B. Inspection, Auscultation, Percussion, Palpation ✅
• C. Auscultation, Inspection, Percussion, Palpation
• D. Palpation, Percussion, Auscultation, Inspection
• Rationale: Auscultation must be done second to ensure that palpation and
percussion do not artificially stimulate or alter bowel sounds.
4. Which screening criteria justifies testing an asymptomatic adult for Type 2
Diabetes?
, • A. Age > 30 and BMI of 22
• B. BMI > 25 and HDL < 35 mg/dL ✅
• C. History of hypotension
• D. Recent weight loss
• Rationale: Risk factors for T2DM screening include obesity (BMI > 25) combined
with dyslipidemia (low HDL or high triglycerides).
5. A 75-year-old patient reports a sudden onset of confusion and agitation. The
nurse should first investigate:
• A. Early-stage Alzheimer’s
• B. Acute Urinary Tract Infection (Delirium) ✅
• C. Major Depressive Disorder
• D. Normal age-related decline
• Rationale: Acute confusion in geriatrics is often "Delirium," frequently caused by
underlying infections like UTIs or medication interactions.
6. Which lab value is most indicative of Hypothyroidism?
• A. Low TSH, High T4
• B. High TSH, Low T4 ✅
• C. Low TSH, Low T4
• D. High TSH, High T4
• Rationale: In primary hypothyroidism, the pituitary gland overproduces TSH to
stimulate a failing thyroid gland.
7. An elderly patient is on 12 different medications. This is defined as:
• A. Therapeutic duplication
• B. Polypharmacy ✅
• C. Palliative care
• D. Adherence protocol
, • Rationale: Polypharmacy increases the risk of drug-drug interactions and
adverse reactions in the elderly.
8. What is the target A1C for most non-pregnant adults with Diabetes according
to ADA guidelines?
• A. < 6.0%
• B. < 7.0% ✅
• C. < 8.0%
• D. < 9.0%
• Rationale: An A1C of < 7.0% is the standard goal to reduce microvascular
complications.
9. Which assessment tool is gold-standard for screening depression in the
elderly?
• A. Braden Scale
• B. Geriatric Depression Scale (GDS) ✅
• C. Glasgow Coma Scale
• D. Morse Fall Scale
• Rationale: The GDS is specifically designed to account for somatic complaints
that may overlap with normal aging.
10. A patient with T1DM presents with fruity breath and Kussmaul respirations.
The nurse suspects:
• A. Hypoglycemia
• B. Diabetic Ketoacidosis (DKA) ✅
• C. Hyperosmolar Hyperglycemic State (HHS)
• D. Respiratory Alkalosis
• Rationale: Fruity breath (acetone) and deep, rapid breathing (Kussmaul) are
classic signs of metabolic acidosis in DKA.
11. Which finding distinguishes Delirium from Dementia?
• A. Memory loss
, • B. Abrupt onset and fluctuating course ✅
• C. Difficulty finding words
• D. Occurs only in patients over 80
• Rationale: Delirium is acute and reversible; Dementia is chronic and
progressive.
12. The "Timed Up and Go" (TUG) test is used primarily to assess:
• A. Cognitive speed
• B. Mobility and Fall Risk ✅
• C. Medication adherence
• D. Fine motor skills
• Rationale: TUG measures the time it takes for a patient to stand, walk 3 meters,
and sit back down.
13. Which medication class is first-line for Type 2 Diabetes management?
• A. Sulfonylureas
• B. Biguanides (Metformin) ✅
• C. SGLT2 Inhibitors
• D. Insulin
• Rationale: Metformin is the preferred initial agent due to efficacy and safety
profile.
14. A patient with hyperthyroidism (Graves' Disease) is likely to exhibit:
• A. Bradycardia and weight gain
• B. Tachycardia, heat intolerance, and exophthalmos ✅
• C. Constipation and dry skin
• D. Lethargy and cold intolerance
• Rationale: Hyperthyroidism accelerates metabolism, leading to a "speeded up"
state.
1. A patient presents with polydipsia, polyuria, and polyphagia. Which diagnostic
test is the priority?
• A. Thyroid Stimulating Hormone (TSH)
• B. Fasting Plasma Glucose (FPG) ✅
• C. Serum Creatinine
• D. Liver Function Test (LFT)
• Rationale: The "3 Ps" are hallmark signs of Diabetes Mellitus. An FPG ≥ 126
mg/dL is a primary diagnostic criterion.
2. When assessing an elderly patient for frailty, the nurse practitioner should
focus on which "Geriatric Giants"?
• A. Hypertension and Diabetes
• B. Falls, Incontinence, and Cognitive Impairment ✅
• C. Hearing loss and Vision changes
• D. Obesity and Sleep Apnea
• Rationale: Frailty is defined by a decline in functional reserve, often manifesting
as mobility issues and mental status changes.
3. In what order should a physical assessment of the abdomen be performed?
• A. Inspection, Palpation, Percussion, Auscultation
• B. Inspection, Auscultation, Percussion, Palpation ✅
• C. Auscultation, Inspection, Percussion, Palpation
• D. Palpation, Percussion, Auscultation, Inspection
• Rationale: Auscultation must be done second to ensure that palpation and
percussion do not artificially stimulate or alter bowel sounds.
4. Which screening criteria justifies testing an asymptomatic adult for Type 2
Diabetes?
, • A. Age > 30 and BMI of 22
• B. BMI > 25 and HDL < 35 mg/dL ✅
• C. History of hypotension
• D. Recent weight loss
• Rationale: Risk factors for T2DM screening include obesity (BMI > 25) combined
with dyslipidemia (low HDL or high triglycerides).
5. A 75-year-old patient reports a sudden onset of confusion and agitation. The
nurse should first investigate:
• A. Early-stage Alzheimer’s
• B. Acute Urinary Tract Infection (Delirium) ✅
• C. Major Depressive Disorder
• D. Normal age-related decline
• Rationale: Acute confusion in geriatrics is often "Delirium," frequently caused by
underlying infections like UTIs or medication interactions.
6. Which lab value is most indicative of Hypothyroidism?
• A. Low TSH, High T4
• B. High TSH, Low T4 ✅
• C. Low TSH, Low T4
• D. High TSH, High T4
• Rationale: In primary hypothyroidism, the pituitary gland overproduces TSH to
stimulate a failing thyroid gland.
7. An elderly patient is on 12 different medications. This is defined as:
• A. Therapeutic duplication
• B. Polypharmacy ✅
• C. Palliative care
• D. Adherence protocol
, • Rationale: Polypharmacy increases the risk of drug-drug interactions and
adverse reactions in the elderly.
8. What is the target A1C for most non-pregnant adults with Diabetes according
to ADA guidelines?
• A. < 6.0%
• B. < 7.0% ✅
• C. < 8.0%
• D. < 9.0%
• Rationale: An A1C of < 7.0% is the standard goal to reduce microvascular
complications.
9. Which assessment tool is gold-standard for screening depression in the
elderly?
• A. Braden Scale
• B. Geriatric Depression Scale (GDS) ✅
• C. Glasgow Coma Scale
• D. Morse Fall Scale
• Rationale: The GDS is specifically designed to account for somatic complaints
that may overlap with normal aging.
10. A patient with T1DM presents with fruity breath and Kussmaul respirations.
The nurse suspects:
• A. Hypoglycemia
• B. Diabetic Ketoacidosis (DKA) ✅
• C. Hyperosmolar Hyperglycemic State (HHS)
• D. Respiratory Alkalosis
• Rationale: Fruity breath (acetone) and deep, rapid breathing (Kussmaul) are
classic signs of metabolic acidosis in DKA.
11. Which finding distinguishes Delirium from Dementia?
• A. Memory loss
, • B. Abrupt onset and fluctuating course ✅
• C. Difficulty finding words
• D. Occurs only in patients over 80
• Rationale: Delirium is acute and reversible; Dementia is chronic and
progressive.
12. The "Timed Up and Go" (TUG) test is used primarily to assess:
• A. Cognitive speed
• B. Mobility and Fall Risk ✅
• C. Medication adherence
• D. Fine motor skills
• Rationale: TUG measures the time it takes for a patient to stand, walk 3 meters,
and sit back down.
13. Which medication class is first-line for Type 2 Diabetes management?
• A. Sulfonylureas
• B. Biguanides (Metformin) ✅
• C. SGLT2 Inhibitors
• D. Insulin
• Rationale: Metformin is the preferred initial agent due to efficacy and safety
profile.
14. A patient with hyperthyroidism (Graves' Disease) is likely to exhibit:
• A. Bradycardia and weight gain
• B. Tachycardia, heat intolerance, and exophthalmos ✅
• C. Constipation and dry skin
• D. Lethargy and cold intolerance
• Rationale: Hyperthyroidism accelerates metabolism, leading to a "speeded up"
state.
