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NURS 753 EXAM / ACTUAL NURS 753 MIDTERM Exam 2026-
2027 BANK QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXAM QUESTIONS WILL COME FROM HERE
(100% Latest Already Graded A+
Question 1
A 68-year-old male with a history of hypertension and type 2 diabetes
mellitus presents to the emergency department with acute onset of
severe, tearing chest pain radiating to the back. His blood pressure is
185/110 mmHg in the right arm and 140/90 mmHg in the left arm.
Which of the following is the most appropriate initial diagnostic study?
A) Transthoracic echocardiogram
B) Computed tomography angiography of the chest
C) Standard 12-lead electrocardiogram
D) Serum troponin I level
Answer: B) Computed tomography angiography of the chest
Explanation: The presentation is classic for acute aortic dissection. CT
angiography is the preferred initial imaging modality due to its high
sensitivity and specificity, rapid availability, and ability to define the
extent of dissection. While echocardiography may be useful, it is
operator-dependent and less definitive in the acute setting. ECG and
troponin are useful to rule out myocardial infarction but do not
diagnose dissection.
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Question 2
A 55-year-old female with a history of mitral valve prolapse is
undergoing a routine preoperative evaluation. On auscultation, you
note a mid-systolic click followed by a late systolic murmur at the apex.
Which of the following maneuvers would most likely increase the
intensity of the murmur?
A) Squatting
B) Handgrip exercise
C) Valsalva maneuver
D) Rapid standing from a squatting position
Answer: C) Valsalva maneuver
Explanation: In mitral valve prolapse, the murmur is due to mitral
regurgitation, which is augmented by maneuvers that decrease left
ventricular volume, such as the Valsalva maneuver or standing. These
maneuvers allow the mitral valve leaflets to prolapse more, increasing
regurgitation. Squatting and handgrip increase afterload and left
ventricular volume, which tend to decrease the murmur.
Question 3
A 72-year-old male with chronic obstructive pulmonary disease (COPD)
is admitted with an acute exacerbation. Arterial blood gas on room air
shows pH 7.28, PaCO2 65 mmHg, PaO2 55 mmHg, and HCO3- 28
mEq/L. Which of the following best describes his acid-base status?
A) Acute respiratory acidosis with metabolic compensation
B) Chronic respiratory acidosis with renal compensation
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C) Acute respiratory acidosis without compensation
D) Mixed respiratory acidosis and metabolic alkalosis
Answer: A) Acute respiratory acidosis with metabolic compensation
Explanation: The pH is low, indicating acidemia. The PaCO2 is elevated,
consistent with respiratory acidosis. The HCO3- is elevated above 24,
suggesting metabolic compensation. However, the expected HCO3- for
chronic respiratory acidosis would be higher (approximately 1 mEq/L
increase per 10 mmHg increase in PaCO2). Here, the HCO3- is only 28,
indicating acute or partially compensated respiratory acidosis. In acute
settings, renal compensation takes 24-48 hours.
Question 4
A 45-year-old woman with systemic lupus erythematosus presents with
pleuritic chest pain and shortness of breath. A pericardial friction rub is
heard. An echocardiogram reveals a moderate pericardial effusion
without hemodynamic compromise. Which of the following is the most
appropriate initial management?
A) Pericardiocentesis
B) High-dose oral corticosteroids
C) Nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine
D) Surgical pericardial window
Answer: C) Nonsteroidal anti-inflammatory drugs (NSAIDs) and
colchicine
Explanation: In lupus-associated pericarditis without tamponade, initial
management involves anti-inflammatory therapy. NSAIDs are first-line,
and colchicine is often added to reduce recurrence. Pericardiocentesis is
, 4|Page
reserved for large effusions causing tamponade. Corticosteroids may be
used if refractory but are not first-line due to side effects.
Question 5
A 62-year-old male with a history of coronary artery disease and heart
failure with reduced ejection fraction (HFrEF) is being optimized on
guideline-directed medical therapy. Which of the following medications
has been shown to reduce mortality and hospitalizations in HFrEF by
inhibiting the renin-angiotensin-aldosterone system and also provides a
mortality benefit independent of blood pressure lowering?
A) Carvedilol
B) Enalapril
C) Spironolactone
D) Valsartan/sacubitril
Answer: D) Valsartan/sacubitril
Explanation: Valsartan/sacubitril is an ARNI (angiotensin receptor-
neprilysin inhibitor) that has been shown to reduce cardiovascular death
and heart failure hospitalizations in HFrEF. While ACE inhibitors
(enalapril) and beta-blockers (carvedilol) also reduce mortality, the ARNI
provides a mortality benefit superior to ACE inhibitors alone.
Spironolactone is an aldosterone antagonist beneficial in HFrEF but is
not the first-line RAAS inhibitor.
Question 6
A 58-year-old male with a history of smoking presents with a non-
healing ulcer on his left great toe. His ankle-brachial index (ABI) is 0.45.
NURS 753 EXAM / ACTUAL NURS 753 MIDTERM Exam 2026-
2027 BANK QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXAM QUESTIONS WILL COME FROM HERE
(100% Latest Already Graded A+
Question 1
A 68-year-old male with a history of hypertension and type 2 diabetes
mellitus presents to the emergency department with acute onset of
severe, tearing chest pain radiating to the back. His blood pressure is
185/110 mmHg in the right arm and 140/90 mmHg in the left arm.
Which of the following is the most appropriate initial diagnostic study?
A) Transthoracic echocardiogram
B) Computed tomography angiography of the chest
C) Standard 12-lead electrocardiogram
D) Serum troponin I level
Answer: B) Computed tomography angiography of the chest
Explanation: The presentation is classic for acute aortic dissection. CT
angiography is the preferred initial imaging modality due to its high
sensitivity and specificity, rapid availability, and ability to define the
extent of dissection. While echocardiography may be useful, it is
operator-dependent and less definitive in the acute setting. ECG and
troponin are useful to rule out myocardial infarction but do not
diagnose dissection.
,2|Page
Question 2
A 55-year-old female with a history of mitral valve prolapse is
undergoing a routine preoperative evaluation. On auscultation, you
note a mid-systolic click followed by a late systolic murmur at the apex.
Which of the following maneuvers would most likely increase the
intensity of the murmur?
A) Squatting
B) Handgrip exercise
C) Valsalva maneuver
D) Rapid standing from a squatting position
Answer: C) Valsalva maneuver
Explanation: In mitral valve prolapse, the murmur is due to mitral
regurgitation, which is augmented by maneuvers that decrease left
ventricular volume, such as the Valsalva maneuver or standing. These
maneuvers allow the mitral valve leaflets to prolapse more, increasing
regurgitation. Squatting and handgrip increase afterload and left
ventricular volume, which tend to decrease the murmur.
Question 3
A 72-year-old male with chronic obstructive pulmonary disease (COPD)
is admitted with an acute exacerbation. Arterial blood gas on room air
shows pH 7.28, PaCO2 65 mmHg, PaO2 55 mmHg, and HCO3- 28
mEq/L. Which of the following best describes his acid-base status?
A) Acute respiratory acidosis with metabolic compensation
B) Chronic respiratory acidosis with renal compensation
,3|Page
C) Acute respiratory acidosis without compensation
D) Mixed respiratory acidosis and metabolic alkalosis
Answer: A) Acute respiratory acidosis with metabolic compensation
Explanation: The pH is low, indicating acidemia. The PaCO2 is elevated,
consistent with respiratory acidosis. The HCO3- is elevated above 24,
suggesting metabolic compensation. However, the expected HCO3- for
chronic respiratory acidosis would be higher (approximately 1 mEq/L
increase per 10 mmHg increase in PaCO2). Here, the HCO3- is only 28,
indicating acute or partially compensated respiratory acidosis. In acute
settings, renal compensation takes 24-48 hours.
Question 4
A 45-year-old woman with systemic lupus erythematosus presents with
pleuritic chest pain and shortness of breath. A pericardial friction rub is
heard. An echocardiogram reveals a moderate pericardial effusion
without hemodynamic compromise. Which of the following is the most
appropriate initial management?
A) Pericardiocentesis
B) High-dose oral corticosteroids
C) Nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine
D) Surgical pericardial window
Answer: C) Nonsteroidal anti-inflammatory drugs (NSAIDs) and
colchicine
Explanation: In lupus-associated pericarditis without tamponade, initial
management involves anti-inflammatory therapy. NSAIDs are first-line,
and colchicine is often added to reduce recurrence. Pericardiocentesis is
, 4|Page
reserved for large effusions causing tamponade. Corticosteroids may be
used if refractory but are not first-line due to side effects.
Question 5
A 62-year-old male with a history of coronary artery disease and heart
failure with reduced ejection fraction (HFrEF) is being optimized on
guideline-directed medical therapy. Which of the following medications
has been shown to reduce mortality and hospitalizations in HFrEF by
inhibiting the renin-angiotensin-aldosterone system and also provides a
mortality benefit independent of blood pressure lowering?
A) Carvedilol
B) Enalapril
C) Spironolactone
D) Valsartan/sacubitril
Answer: D) Valsartan/sacubitril
Explanation: Valsartan/sacubitril is an ARNI (angiotensin receptor-
neprilysin inhibitor) that has been shown to reduce cardiovascular death
and heart failure hospitalizations in HFrEF. While ACE inhibitors
(enalapril) and beta-blockers (carvedilol) also reduce mortality, the ARNI
provides a mortality benefit superior to ACE inhibitors alone.
Spironolactone is an aldosterone antagonist beneficial in HFrEF but is
not the first-line RAAS inhibitor.
Question 6
A 58-year-old male with a history of smoking presents with a non-
healing ulcer on his left great toe. His ankle-brachial index (ABI) is 0.45.
