NURS 6550 Final Exam Study Guide -
Walden University - Actual Exam Questions
with Verified Correct Solutions | Latest
Update 2026/2027 | Already Graded A+
Question 1
Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was
inserted intraoperatively and remains in place. His urine output has declined markedly
despite continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL
and a creatinine of 2 mg/dL. A leading differential includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgical rhabdomyolysis causing intrarenal failure
Answer: D
Rationale: During surgery, muscles are injured, resulting in rhabdomyolysis
(breakdown of muscle tissue). This releases proteins that increase creatinine levels.
Normal creatinine ranges from 0.6-1.2 mg/dL, so Mr. Jeffers' creatinine of 2 mg/dL
indicates intrarenal damage from rhabdomyolysis.
Question 2
Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is
weak, diaphoretic, and anxious. Physical examination reveals a 5'4" 107 lb black female
who is awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood
pressure is 140/100 mm Hg. Temperature and respiratory rate are within normal limits.
The patient admits to having a "thyroid condition" but she never followed up on it. The
AGACNP anticipates a diagnosis of:
A. Hashimoto's thyroiditis
B. Cushing's syndrome
C. Grave's disease
D. Thyroid storm
Answer: C
pg. 1
,Rationale: Grave's disease is an autoimmune hyperthyroid condition characterized by
tachycardia, anxiety, diaphoresis, and hypertension. The patient's symptoms and history
of a "thyroid condition" without follow-up suggest Grave's disease.
Question 3
Systemic lupus erythematosus (SLE) is a multiorgan system autoimmune disorder that
can present with a wide variety of manifestations. Which clinical triad should prompt an
evaluation for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, fever
Answer: D
Rationale: The classic triad for SLE includes joint pain (arthritis/arthralgia), rash
(especially malar rash), and fever. These are hallmark manifestations that should
prompt evaluation for SLE.
Question 4
A patient presents with profound vertigo of acute onset yesterday. She can barely turn
her head without becoming very vertiginous; she is nauseous and just doesn't want to
move. This morning when she tried to get out of bed she felt like she was pushed back
down. The vertigo is reproducible with cervical rotation. The patient denies any hearing
loss or tinnitus, she has no fever or other symptoms. The AGACNP knows that the most
helpful intervention will probably be:
A. Meclizine
B. Diazepam
C. Bed rest
D. Epley's maneuvers
Answer: D
Rationale: The patient is likely suffering from benign paroxysmal positioning vertigo
(BPPV), indicated by inability to turn her head and get up from bed. Epley's maneuvers
effectively clear the inner ear to relieve symptoms of vertigo.
Question 5
Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental
status change from the long-term care facility. She is normally ambulatory and
pg. 2
,participates in lots of facility activities. Today a nursing assistant found her in her room,
appearing confused and disconnected from her environment. When she tried to get up
she fell down. Her vital signs are stable excepting a blood pressure of 90/60 mm Hg.
The AGACNP knows that the most likely cause of her symptoms is:
A. Osteoarthritis
B. Urinary tract infection
C. Dehydration
D. Stroke
Answer: B
Rationale: Acute mental status change in an elderly patient with hypotension is most
concerning for infection, particularly urinary tract infection, which is a common cause of
delirium in older adults.
Question 6
A patient with SIADH would be expected to demonstrate which pattern of laboratory
abnormalities?
A. Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28 mEq/L, urine
osmolality of 900 mOsm/kg
B. Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5 mEq/L, urine
osmolality of 300 mOsm/kg
C. Serum Na+ 121 mEq/L, serum osmolality 290 mEq/L, urine Na+ of 7 mEq/L, urine
osmolality of 850 mOsm/kg
D. Serum Na+ 158 mEq/L, serum osmolality 251 mEq/L, urine Na+ of 20 mEq/L, urine
osmolality of 420 mOsm/kg
Answer: A
Rationale: SIADH is characterized by dilutional hyponatremia with serum sodium
<130 mEq/L, low serum osmolality, and inappropriately concentrated urine (high urine
osmolality) with elevated urine sodium.
Question 7
Sean is a 29-year-old male who presents to the emergency department for evaluation
and treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and
removal is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein
stain is applied to the lower eyelid, and a corneal abrasion ruled out but the AGACNP
notes a positive Seidel sign. This indicates:
A. Penetration of the cornea with resultant aqueous leak
B. A rust ring remnant due to metal foreign body
pg. 3
, C. An elevated intraocular pressure
D. Paradoxical pupil dilation in response to light
Answer: A
Rationale: A positive Seidel sign indicates leakage of aqueous humor from the anterior
chamber through the cornea, confirming corneal perforation or penetrating injury.
Question 8
Mrs. Lowen is an 82-year-old female who comes to the emergency department for
evaluation of a fever of 102.9 F. She complains of a headache in the right side of her
temple and some right-sided jaw pain. A urinalysis, chest radiograph, complete blood
count, and 12-lead ECG are all non-contributory. A comprehensive metabolic panel is
significant only for a slightly elevated BUN and creatinine. The AGACNP appreciates
distinct right temple tenderness to percussion. Which laboratory test is necessary to
support the suspected diagnosis?
A. An erythrocyte sedimentation rate
B. A white blood cell differential
C. Two sets of blood cultures
D. Echocardiography
Answer: A
Rationale: Mrs. Lowen's presentation is classic for temporal arteritis (giant cell
arteritis), characterized by unilateral temporal headache, jaw pain, and temple
tenderness. Elevated ESR and CRP are diagnostic.
Question 9
Ms. Schiebel, a 31-year-old female who is brought to the emergency department by
police after being arrested for disruptive behavior in a public establishment. The
differential diagnosis includes drug and alcohol ingestion/toxicity, central nervous
system disease, severe trauma, and psychotic illness; ultimately the alcohol and
toxicology screen as well as head imaging are negative. When considering psychotic
illness, the AGACP knows that this is a physiologic imbalance that typically involves an
excess of:
A. Serotonin
B. Norepinephrine
C. Acetylcholine
D. Dopamine
Answer: B
pg. 4
Walden University - Actual Exam Questions
with Verified Correct Solutions | Latest
Update 2026/2027 | Already Graded A+
Question 1
Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was
inserted intraoperatively and remains in place. His urine output has declined markedly
despite continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL
and a creatinine of 2 mg/dL. A leading differential includes:
A. Foley lodged in the urethra causing post-renal failure
B. Decreased renal perfusion causing prerenal failure
C. Age-related decreased eGFR causing prerenal failure
D. Post-surgical rhabdomyolysis causing intrarenal failure
Answer: D
Rationale: During surgery, muscles are injured, resulting in rhabdomyolysis
(breakdown of muscle tissue). This releases proteins that increase creatinine levels.
Normal creatinine ranges from 0.6-1.2 mg/dL, so Mr. Jeffers' creatinine of 2 mg/dL
indicates intrarenal damage from rhabdomyolysis.
Question 2
Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is
weak, diaphoretic, and anxious. Physical examination reveals a 5'4" 107 lb black female
who is awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood
pressure is 140/100 mm Hg. Temperature and respiratory rate are within normal limits.
The patient admits to having a "thyroid condition" but she never followed up on it. The
AGACNP anticipates a diagnosis of:
A. Hashimoto's thyroiditis
B. Cushing's syndrome
C. Grave's disease
D. Thyroid storm
Answer: C
pg. 1
,Rationale: Grave's disease is an autoimmune hyperthyroid condition characterized by
tachycardia, anxiety, diaphoresis, and hypertension. The patient's symptoms and history
of a "thyroid condition" without follow-up suggest Grave's disease.
Question 3
Systemic lupus erythematosus (SLE) is a multiorgan system autoimmune disorder that
can present with a wide variety of manifestations. Which clinical triad should prompt an
evaluation for SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, fever
Answer: D
Rationale: The classic triad for SLE includes joint pain (arthritis/arthralgia), rash
(especially malar rash), and fever. These are hallmark manifestations that should
prompt evaluation for SLE.
Question 4
A patient presents with profound vertigo of acute onset yesterday. She can barely turn
her head without becoming very vertiginous; she is nauseous and just doesn't want to
move. This morning when she tried to get out of bed she felt like she was pushed back
down. The vertigo is reproducible with cervical rotation. The patient denies any hearing
loss or tinnitus, she has no fever or other symptoms. The AGACNP knows that the most
helpful intervention will probably be:
A. Meclizine
B. Diazepam
C. Bed rest
D. Epley's maneuvers
Answer: D
Rationale: The patient is likely suffering from benign paroxysmal positioning vertigo
(BPPV), indicated by inability to turn her head and get up from bed. Epley's maneuvers
effectively clear the inner ear to relieve symptoms of vertigo.
Question 5
Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental
status change from the long-term care facility. She is normally ambulatory and
pg. 2
,participates in lots of facility activities. Today a nursing assistant found her in her room,
appearing confused and disconnected from her environment. When she tried to get up
she fell down. Her vital signs are stable excepting a blood pressure of 90/60 mm Hg.
The AGACNP knows that the most likely cause of her symptoms is:
A. Osteoarthritis
B. Urinary tract infection
C. Dehydration
D. Stroke
Answer: B
Rationale: Acute mental status change in an elderly patient with hypotension is most
concerning for infection, particularly urinary tract infection, which is a common cause of
delirium in older adults.
Question 6
A patient with SIADH would be expected to demonstrate which pattern of laboratory
abnormalities?
A. Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L, urine Na+ of 28 mEq/L, urine
osmolality of 900 mOsm/kg
B. Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L, urine Na+ of 5 mEq/L, urine
osmolality of 300 mOsm/kg
C. Serum Na+ 121 mEq/L, serum osmolality 290 mEq/L, urine Na+ of 7 mEq/L, urine
osmolality of 850 mOsm/kg
D. Serum Na+ 158 mEq/L, serum osmolality 251 mEq/L, urine Na+ of 20 mEq/L, urine
osmolality of 420 mOsm/kg
Answer: A
Rationale: SIADH is characterized by dilutional hyponatremia with serum sodium
<130 mEq/L, low serum osmolality, and inappropriately concentrated urine (high urine
osmolality) with elevated urine sodium.
Question 7
Sean is a 29-year-old male who presents to the emergency department for evaluation
and treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and
removal is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein
stain is applied to the lower eyelid, and a corneal abrasion ruled out but the AGACNP
notes a positive Seidel sign. This indicates:
A. Penetration of the cornea with resultant aqueous leak
B. A rust ring remnant due to metal foreign body
pg. 3
, C. An elevated intraocular pressure
D. Paradoxical pupil dilation in response to light
Answer: A
Rationale: A positive Seidel sign indicates leakage of aqueous humor from the anterior
chamber through the cornea, confirming corneal perforation or penetrating injury.
Question 8
Mrs. Lowen is an 82-year-old female who comes to the emergency department for
evaluation of a fever of 102.9 F. She complains of a headache in the right side of her
temple and some right-sided jaw pain. A urinalysis, chest radiograph, complete blood
count, and 12-lead ECG are all non-contributory. A comprehensive metabolic panel is
significant only for a slightly elevated BUN and creatinine. The AGACNP appreciates
distinct right temple tenderness to percussion. Which laboratory test is necessary to
support the suspected diagnosis?
A. An erythrocyte sedimentation rate
B. A white blood cell differential
C. Two sets of blood cultures
D. Echocardiography
Answer: A
Rationale: Mrs. Lowen's presentation is classic for temporal arteritis (giant cell
arteritis), characterized by unilateral temporal headache, jaw pain, and temple
tenderness. Elevated ESR and CRP are diagnostic.
Question 9
Ms. Schiebel, a 31-year-old female who is brought to the emergency department by
police after being arrested for disruptive behavior in a public establishment. The
differential diagnosis includes drug and alcohol ingestion/toxicity, central nervous
system disease, severe trauma, and psychotic illness; ultimately the alcohol and
toxicology screen as well as head imaging are negative. When considering psychotic
illness, the AGACP knows that this is a physiologic imbalance that typically involves an
excess of:
A. Serotonin
B. Norepinephrine
C. Acetylcholine
D. Dopamine
Answer: B
pg. 4
