NUR 6121 Exam 1 V2 | NUR 6121
Advanced Nursing II | Q&A with Rationale
(NUR6121 Exam 1) | William Paterson
University
1. A 62-year-old male with a history of hypertension and smoking presents with sudden onset
of substernal chest pain. The EKG reveals ST-segment elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left main coronary artery
C. Left circumflex artery
D. Right coronary artery
Answer: D
Rationale: ST-segment elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction. The right coronary artery (RCA) is responsible for supplying the
inferior portion of the heart in most individuals. This clinical presentation requires
immediate intervention to restore perfusion to the affected myocardium.
2. According to the ACC/AHA guidelines, what is the blood pressure threshold for diagnosing
Stage 1 Hypertension?
A. 130--89 mmHg
,B. 120-129 / <80 mmHg
C. 140--99 mmHg
D. >=160 / >=100 mmHg
Answer: A
Rationale: Stage 1 Hypertension is defined as a systolic pressure of 130-139 mmHg or a
diastolic pressure of 80-89 mmHg. The current guidelines emphasize earlier intervention
through lifestyle modifications and medication to prevent cardiovascular complications.
Practitioners must confirm these readings over multiple visits before making a formal
diagnosis.
3. Which of the following is the first-line pharmacologic treatment for a patient newly
diagnosed with Type 2 Diabetes and an A1C of 7.5%?
A. Glipizide
B. Metformin
C. Sitagliptin
D. Pioglitazone
Answer: B
Rationale: Metformin is considered the first-line agent for Type 2 Diabetes due to its
efficacy, safety profile, and low risk of hypoglycemia. It primarily works by reducing
hepatic glucose production and improving insulin sensitivity in peripheral tissues. Unless
, contraindicated by severe renal impairment, it should be initiated alongside lifestyle
modifications.
4. A patient presents with a ‘curtain-like’ shadow over their field of vision and flashes of light.
This clinical presentation is highly suggestive of:
A. Retinal detachment
B. Glaucoma
C. Cataracts
D. Macular degeneration
Answer: A
Rationale: The description of a curtain-like loss of vision and photopsia (flashes of light)
are classic symptoms of retinal detachment. This condition is an ocular emergency that
requires immediate referral to an ophthalmologist to prevent permanent vision loss. Delay
in treatment can lead to irreversible damage to the neural retina.
5. Which physical examination finding is most specific for a diagnosis of Acute Cholecystitis?
A. Rovsing’s sign
B. Murphy’s sign
C. McBurney’s sign
D. Psoas sign
Answer: B
Advanced Nursing II | Q&A with Rationale
(NUR6121 Exam 1) | William Paterson
University
1. A 62-year-old male with a history of hypertension and smoking presents with sudden onset
of substernal chest pain. The EKG reveals ST-segment elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left main coronary artery
C. Left circumflex artery
D. Right coronary artery
Answer: D
Rationale: ST-segment elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction. The right coronary artery (RCA) is responsible for supplying the
inferior portion of the heart in most individuals. This clinical presentation requires
immediate intervention to restore perfusion to the affected myocardium.
2. According to the ACC/AHA guidelines, what is the blood pressure threshold for diagnosing
Stage 1 Hypertension?
A. 130--89 mmHg
,B. 120-129 / <80 mmHg
C. 140--99 mmHg
D. >=160 / >=100 mmHg
Answer: A
Rationale: Stage 1 Hypertension is defined as a systolic pressure of 130-139 mmHg or a
diastolic pressure of 80-89 mmHg. The current guidelines emphasize earlier intervention
through lifestyle modifications and medication to prevent cardiovascular complications.
Practitioners must confirm these readings over multiple visits before making a formal
diagnosis.
3. Which of the following is the first-line pharmacologic treatment for a patient newly
diagnosed with Type 2 Diabetes and an A1C of 7.5%?
A. Glipizide
B. Metformin
C. Sitagliptin
D. Pioglitazone
Answer: B
Rationale: Metformin is considered the first-line agent for Type 2 Diabetes due to its
efficacy, safety profile, and low risk of hypoglycemia. It primarily works by reducing
hepatic glucose production and improving insulin sensitivity in peripheral tissues. Unless
, contraindicated by severe renal impairment, it should be initiated alongside lifestyle
modifications.
4. A patient presents with a ‘curtain-like’ shadow over their field of vision and flashes of light.
This clinical presentation is highly suggestive of:
A. Retinal detachment
B. Glaucoma
C. Cataracts
D. Macular degeneration
Answer: A
Rationale: The description of a curtain-like loss of vision and photopsia (flashes of light)
are classic symptoms of retinal detachment. This condition is an ocular emergency that
requires immediate referral to an ophthalmologist to prevent permanent vision loss. Delay
in treatment can lead to irreversible damage to the neural retina.
5. Which physical examination finding is most specific for a diagnosis of Acute Cholecystitis?
A. Rovsing’s sign
B. Murphy’s sign
C. McBurney’s sign
D. Psoas sign
Answer: B
