NRNP 6531 ADVANCED PRACTICE
CARE OF ADULTS EXAM (VERIFIED
AND CORRECT Q & A) SATISFACTION
GUARANTEED 2026/2027
1. A 62-year-old male with a history of chronic kidney disease (CKD) Stage 3 and hypertension
presents for follow-up. His blood pressure is 152/94 mmHg. Which of the following is the
preferred first-line antihypertensive class for this patient?
A. Thiazide diuretics
B. ACE inhibitors
C. Calcium channel blockers
D. Beta-blockers
Answer: B
Conceptual Explanation: According to KDIGO and JNC 8 guidelines, ACE inhibitors or
ARBs are first-line for patients with CKD because they provide renoprotective effects by
reducing intraglomerular pressure.
2. When evaluating a patient with microcytic anemia, which of the following lab findings is
most consistent with Thalassemia?
A. High RDW and low serum iron
,B. Normal RDW and normal serum iron
C. High Ferritin and low TIBC
D. Low Ferritin and high TIBC
Answer: B
Conceptual Explanation: Thalassemia typically presents with a normal RDW and normal
iron studies, unlike iron deficiency anemia which shows high RDW and low serum iron.
3. A 45-year-old female presents with symptoms of hyperthyroidism. Her TSH is <0.01 mIU/L
and Free T4 is elevated. Radioactive iodine uptake (RAIU) shows a patchy, irregular uptake.
What is the most likely diagnosis?
A. Graves’ disease
B. Subacute thyroiditis
C. Toxic multinodular goiter
D. Hashimoto’s thyroiditis
Answer: C
Conceptual Explanation: Patchy, irregular uptake on RAIU is characteristic of toxic
multinodular goiter. Graves’ disease shows diffuse, symmetric uptake.
4. In the management of COPD, which criteria must be met to initiate long-term oxygen
therapy (LTOT) in a patient with stable disease?
A. SaO2 ≤ 92% during exercise only
, B. PaO2 ≤ 60 mmHg or SaO2 ≤ 90%
C. PaO2 ≤ 50 mmHg and FEV1 < 30%
D. PaO2 ≤ 55 mmHg or SaO2 ≤ 88%
Answer: D
Conceptual Explanation: LTOT is indicated for stable COPD patients with resting PaO2 ≤
55 mmHg or SaO2 ≤ 88% (or 56-59 mmHg if evidence of cor pulmonale or polycythemia).
5. A 70-year-old patient with HFrEF (EF 35%) is already taking Lisinopril and Metoprolol
Succinate. They remain symptomatic (NYHA Class II). Which medication should be added next
to improve mortality?
A. Furosemide
B. Digoxin
C. Amlodipine
D. Spironolactone
Answer: D
Conceptual Explanation: Aldosterone antagonists (like Spironolactone) are
recommended for patients with HFrEF and NYHA Class II-IV symptoms to reduce mortality.
6. A patient presents with a ‘curtain coming down’ over their vision in one eye. This is most
characteristic of:
A. Angle-closure glaucoma
CARE OF ADULTS EXAM (VERIFIED
AND CORRECT Q & A) SATISFACTION
GUARANTEED 2026/2027
1. A 62-year-old male with a history of chronic kidney disease (CKD) Stage 3 and hypertension
presents for follow-up. His blood pressure is 152/94 mmHg. Which of the following is the
preferred first-line antihypertensive class for this patient?
A. Thiazide diuretics
B. ACE inhibitors
C. Calcium channel blockers
D. Beta-blockers
Answer: B
Conceptual Explanation: According to KDIGO and JNC 8 guidelines, ACE inhibitors or
ARBs are first-line for patients with CKD because they provide renoprotective effects by
reducing intraglomerular pressure.
2. When evaluating a patient with microcytic anemia, which of the following lab findings is
most consistent with Thalassemia?
A. High RDW and low serum iron
,B. Normal RDW and normal serum iron
C. High Ferritin and low TIBC
D. Low Ferritin and high TIBC
Answer: B
Conceptual Explanation: Thalassemia typically presents with a normal RDW and normal
iron studies, unlike iron deficiency anemia which shows high RDW and low serum iron.
3. A 45-year-old female presents with symptoms of hyperthyroidism. Her TSH is <0.01 mIU/L
and Free T4 is elevated. Radioactive iodine uptake (RAIU) shows a patchy, irregular uptake.
What is the most likely diagnosis?
A. Graves’ disease
B. Subacute thyroiditis
C. Toxic multinodular goiter
D. Hashimoto’s thyroiditis
Answer: C
Conceptual Explanation: Patchy, irregular uptake on RAIU is characteristic of toxic
multinodular goiter. Graves’ disease shows diffuse, symmetric uptake.
4. In the management of COPD, which criteria must be met to initiate long-term oxygen
therapy (LTOT) in a patient with stable disease?
A. SaO2 ≤ 92% during exercise only
, B. PaO2 ≤ 60 mmHg or SaO2 ≤ 90%
C. PaO2 ≤ 50 mmHg and FEV1 < 30%
D. PaO2 ≤ 55 mmHg or SaO2 ≤ 88%
Answer: D
Conceptual Explanation: LTOT is indicated for stable COPD patients with resting PaO2 ≤
55 mmHg or SaO2 ≤ 88% (or 56-59 mmHg if evidence of cor pulmonale or polycythemia).
5. A 70-year-old patient with HFrEF (EF 35%) is already taking Lisinopril and Metoprolol
Succinate. They remain symptomatic (NYHA Class II). Which medication should be added next
to improve mortality?
A. Furosemide
B. Digoxin
C. Amlodipine
D. Spironolactone
Answer: D
Conceptual Explanation: Aldosterone antagonists (like Spironolactone) are
recommended for patients with HFrEF and NYHA Class II-IV symptoms to reduce mortality.
6. A patient presents with a ‘curtain coming down’ over their vision in one eye. This is most
characteristic of:
A. Angle-closure glaucoma
