NUR 6111 Exam 3 V1 | NUR 6111
Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Exam 3) | William
Paterson University
1. A 45-year-old male presents with persistent retrosternal burning and acid regurgitation.
After failing a 4-week trial of lifestyle modifications and antacids, which is the most
appropriate next step for definitive diagnosis and evaluation of complications?
A. Barium swallow study
B. 24-hour ambulatory pH monitoring
C. Upper gastrointestinal endoscopy
D. Urea breath test
Answer: C
Rationale: Upper endoscopy is the preferred diagnostic tool for patients with persistent
GERD symptoms to evaluate for Barrett’s esophagus or erosive esophagitis. This procedure
allows for direct mucosal visualization and the ability to obtain tissue biopsies if abnormal
pathology is identified. It is especially critical in patients presenting with ‘alarm’ symptoms
such as dysphagia or weight loss.
,2. A patient presents with acute right upper quadrant (RUQ) pain that radiates to the right
scapula, accompanied by nausea and a positive Murphy’s sign. Which diagnostic imaging
modality is considered the first-line gold standard for this suspected condition?
A. Abdominal CT scan with contrast
B. Abdominal ultrasound
C. Magnetic resonance cholangiopancreatography (MRCP)
D. Hepatobiliary iminodiacetic acid (HIDA) scan
Answer: B
Rationale: Abdominal ultrasound is the initial imaging of choice for suspected acute
cholecystitis due to its high sensitivity for detecting gallstones and gallbladder wall
thickening. It is non-invasive, cost-effective, and readily available in most clinical settings.
While a HIDA scan is more sensitive for ductal obstruction, ultrasound remains the primary
screening tool.
3. Which of the following serological markers is the most specific indicator of a chronic
Hepatitis B infection?
A. Anti-HBs positive
B. HBsAg positive for more than 6 months
C. IgM anti-HBc positive
D. HBeAg negative
,Answer: B
Rationale: The persistence of Hepatitis B surface antigen (HBsAg) for more than six
months defines a chronic infection. In contrast, the presence of Anti-HBs indicates
immunity either through vaccination or recovery from a past infection. IgM anti-HBc is a
marker of acute infection, typically disappearing within six months of the initial exposure.
4. A 62-year-old smoker presents with a chronic cough productive of thick sputum for at least
3 months in two consecutive years. What is the primary pathophysiology associated with this
condition?
A. Destruction of alveolar walls and loss of elastic recoil
B. Hypertrophy of mucus-secreting glands in the bronchi
C. Reversible bronchoconstriction due to airway hyper-responsiveness
D. Permanent dilation of the bronchioles
Answer: B
Rationale: The clinical definition provided describes chronic bronchitis, which is
characterized by the hypertrophy of mucus-secreting glands and chronic inflammation of
the airways. This leads to excessive mucus production and airway obstruction,
distinguishing it from the alveolar destruction seen in emphysema. Both conditions fall
under the umbrella of Chronic Obstructive Pulmonary Disease (COPD) but have distinct
pathological mechanisms.
, 5. When interpreting pulmonary function tests (PFTs), an FEV1/FVC ratio of less than 0.70
after bronchodilator administration confirms which of the following?
A. Obstructive lung disease
B. Restrictive lung disease
C. Normal lung function
D. Pulmonary fibrosis
Answer: A
Rationale: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the diagnostic
threshold for obstructive lung disease, such as COPD. This ratio indicates that the patient
cannot expire a normal percentage of their lung volume in the first second due to airway
obstruction. Restrictive diseases usually present with a normal or increased ratio despite
decreased total lung volumes.
6. A patient with asthma uses an Albuterol inhaler 3 days per week and wakes up at night 3
times per month due to cough. How would you classify this asthma severity according to
NAEPP guidelines?
A. Intermittent
B. Severe Persistent
C. Moderate Persistent
D. Mild Persistent
Advanced Practice Nursing I | Q&A with
Rationale (NUR6111 Exam 3) | William
Paterson University
1. A 45-year-old male presents with persistent retrosternal burning and acid regurgitation.
After failing a 4-week trial of lifestyle modifications and antacids, which is the most
appropriate next step for definitive diagnosis and evaluation of complications?
A. Barium swallow study
B. 24-hour ambulatory pH monitoring
C. Upper gastrointestinal endoscopy
D. Urea breath test
Answer: C
Rationale: Upper endoscopy is the preferred diagnostic tool for patients with persistent
GERD symptoms to evaluate for Barrett’s esophagus or erosive esophagitis. This procedure
allows for direct mucosal visualization and the ability to obtain tissue biopsies if abnormal
pathology is identified. It is especially critical in patients presenting with ‘alarm’ symptoms
such as dysphagia or weight loss.
,2. A patient presents with acute right upper quadrant (RUQ) pain that radiates to the right
scapula, accompanied by nausea and a positive Murphy’s sign. Which diagnostic imaging
modality is considered the first-line gold standard for this suspected condition?
A. Abdominal CT scan with contrast
B. Abdominal ultrasound
C. Magnetic resonance cholangiopancreatography (MRCP)
D. Hepatobiliary iminodiacetic acid (HIDA) scan
Answer: B
Rationale: Abdominal ultrasound is the initial imaging of choice for suspected acute
cholecystitis due to its high sensitivity for detecting gallstones and gallbladder wall
thickening. It is non-invasive, cost-effective, and readily available in most clinical settings.
While a HIDA scan is more sensitive for ductal obstruction, ultrasound remains the primary
screening tool.
3. Which of the following serological markers is the most specific indicator of a chronic
Hepatitis B infection?
A. Anti-HBs positive
B. HBsAg positive for more than 6 months
C. IgM anti-HBc positive
D. HBeAg negative
,Answer: B
Rationale: The persistence of Hepatitis B surface antigen (HBsAg) for more than six
months defines a chronic infection. In contrast, the presence of Anti-HBs indicates
immunity either through vaccination or recovery from a past infection. IgM anti-HBc is a
marker of acute infection, typically disappearing within six months of the initial exposure.
4. A 62-year-old smoker presents with a chronic cough productive of thick sputum for at least
3 months in two consecutive years. What is the primary pathophysiology associated with this
condition?
A. Destruction of alveolar walls and loss of elastic recoil
B. Hypertrophy of mucus-secreting glands in the bronchi
C. Reversible bronchoconstriction due to airway hyper-responsiveness
D. Permanent dilation of the bronchioles
Answer: B
Rationale: The clinical definition provided describes chronic bronchitis, which is
characterized by the hypertrophy of mucus-secreting glands and chronic inflammation of
the airways. This leads to excessive mucus production and airway obstruction,
distinguishing it from the alveolar destruction seen in emphysema. Both conditions fall
under the umbrella of Chronic Obstructive Pulmonary Disease (COPD) but have distinct
pathological mechanisms.
, 5. When interpreting pulmonary function tests (PFTs), an FEV1/FVC ratio of less than 0.70
after bronchodilator administration confirms which of the following?
A. Obstructive lung disease
B. Restrictive lung disease
C. Normal lung function
D. Pulmonary fibrosis
Answer: A
Rationale: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the diagnostic
threshold for obstructive lung disease, such as COPD. This ratio indicates that the patient
cannot expire a normal percentage of their lung volume in the first second due to airway
obstruction. Restrictive diseases usually present with a normal or increased ratio despite
decreased total lung volumes.
6. A patient with asthma uses an Albuterol inhaler 3 days per week and wakes up at night 3
times per month due to cough. How would you classify this asthma severity according to
NAEPP guidelines?
A. Intermittent
B. Severe Persistent
C. Moderate Persistent
D. Mild Persistent
