NURS 6531 ADVANCED PRACTICE
CARE OF ADULTS ACROSS THE
LIFESPAN EXAM (CORRECT Q & A)
SATISFACTION GUARANTEED
1. A 68-year-old male presents with new-onset atrial fibrillation. His medical history includes
hypertension and type 2 diabetes. Using the CHA2DS2-VASc score, what is the most
appropriate next step in management for stroke prevention?
A. Initiate daily aspirin 81 mg
B. Initiate oral anticoagulation with a DOAC or warfarin
C. Initiate dual antiplatelet therapy with aspirin and clopidogrel
D. Monitor rhythm with a Holter monitor before starting therapy
Answer: B
Conceptual Explanation: With a CHA2DS2-VASc score of 3 (Age=1, HTN=1, DM=1), the
patient is at high risk for stroke and requires oral anticoagulation according to current
guidelines.
2. A 54-year-old female presents with a 2-cm firm, non-tender, fixed thyroid nodule. TSH is
normal. Ultrasound shows microcalcifications and irregular borders. What is the next
diagnostic step?
A. Radioactive iodine uptake scan
,B. Fine-needle aspiration (FNA) biopsy
C. Repeat ultrasound in 6 months
D. Empiric treatment with levothyroxine
Answer: B
Conceptual Explanation: A firm, fixed nodule with suspicious ultrasound features and a
normal TSH warrants FNA to rule out malignancy, as hot nodules (detected by iodine scan)
are rarely malignant.
3. Which physical exam finding is most pathognomonic for a diagnosis of Acute Cholecystitis?
A. McBurney’s point tenderness
B. Rovsing’s sign
C. Murphy’s sign
D. Grey Turner’s sign
Answer: C
Conceptual Explanation: Murphy’s sign (arrest of inspiration on deep palpation of the
RUQ) is highly suggestive of acute cholecystitis.
4. A 45-year-old patient with asthma uses a SABA three times a week for symptoms and
wakes up twice a month due to wheezing. Their FEV1 is 85% predicted. According to GINA
guidelines, which treatment should be initiated?
A. SABA PRN only
, B. Daily low-dose ICS plus LABA
C. Daily medium-dose ICS
D. Low-dose ICS-formoterol PRN
Answer: D
Conceptual Explanation: Current GINA guidelines recommend PRN low-dose ICS-
formoterol as the preferred controller for Step 1 and 2 to reduce the risk of exacerbations
even in mild asthma.
5. A 72-year-old patient with COPD has a CAT score of 12 and has had two moderate
exacerbations in the last year requiring antibiotics. Which GOLD group do they fall into?
A. GOLD Group E
B. GOLD Group B
C. GOLD Group A
D. GOLD Group D
Answer: A
Conceptual Explanation: Under the updated GOLD 2023/2024 guidelines, patients with
two or more moderate exacerbations (or one hospitalization) are classified as Group E,
regardless of symptom score.
CARE OF ADULTS ACROSS THE
LIFESPAN EXAM (CORRECT Q & A)
SATISFACTION GUARANTEED
1. A 68-year-old male presents with new-onset atrial fibrillation. His medical history includes
hypertension and type 2 diabetes. Using the CHA2DS2-VASc score, what is the most
appropriate next step in management for stroke prevention?
A. Initiate daily aspirin 81 mg
B. Initiate oral anticoagulation with a DOAC or warfarin
C. Initiate dual antiplatelet therapy with aspirin and clopidogrel
D. Monitor rhythm with a Holter monitor before starting therapy
Answer: B
Conceptual Explanation: With a CHA2DS2-VASc score of 3 (Age=1, HTN=1, DM=1), the
patient is at high risk for stroke and requires oral anticoagulation according to current
guidelines.
2. A 54-year-old female presents with a 2-cm firm, non-tender, fixed thyroid nodule. TSH is
normal. Ultrasound shows microcalcifications and irregular borders. What is the next
diagnostic step?
A. Radioactive iodine uptake scan
,B. Fine-needle aspiration (FNA) biopsy
C. Repeat ultrasound in 6 months
D. Empiric treatment with levothyroxine
Answer: B
Conceptual Explanation: A firm, fixed nodule with suspicious ultrasound features and a
normal TSH warrants FNA to rule out malignancy, as hot nodules (detected by iodine scan)
are rarely malignant.
3. Which physical exam finding is most pathognomonic for a diagnosis of Acute Cholecystitis?
A. McBurney’s point tenderness
B. Rovsing’s sign
C. Murphy’s sign
D. Grey Turner’s sign
Answer: C
Conceptual Explanation: Murphy’s sign (arrest of inspiration on deep palpation of the
RUQ) is highly suggestive of acute cholecystitis.
4. A 45-year-old patient with asthma uses a SABA three times a week for symptoms and
wakes up twice a month due to wheezing. Their FEV1 is 85% predicted. According to GINA
guidelines, which treatment should be initiated?
A. SABA PRN only
, B. Daily low-dose ICS plus LABA
C. Daily medium-dose ICS
D. Low-dose ICS-formoterol PRN
Answer: D
Conceptual Explanation: Current GINA guidelines recommend PRN low-dose ICS-
formoterol as the preferred controller for Step 1 and 2 to reduce the risk of exacerbations
even in mild asthma.
5. A 72-year-old patient with COPD has a CAT score of 12 and has had two moderate
exacerbations in the last year requiring antibiotics. Which GOLD group do they fall into?
A. GOLD Group E
B. GOLD Group B
C. GOLD Group A
D. GOLD Group D
Answer: A
Conceptual Explanation: Under the updated GOLD 2023/2024 guidelines, patients with
two or more moderate exacerbations (or one hospitalization) are classified as Group E,
regardless of symptom score.
