NRNP 6531 ADVANCED PRACTICE
CARE OF ADULTS EXAM STUDY GUIDE
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A 65-year-old male presents with a rough, scaly, non-healing patch on his sun-exposed
forehead. What is the most likely precursor lesion to squamous cell carcinoma in this patient?
A. Seborrheic keratosis
B. Psoriatic plaque
C. Basal cell carcinoma
D. Actinic keratosis
Answer: D
Conceptual Explanation: Actinic keratosis (AK) is a precancerous skin lesion caused by
chronic UV exposure that can progress to squamous cell carcinoma (SCC).
2. During a physical exam, a 70-year-old patient exhibits a mid-systolic crescendo-
decrescendo murmur heard best at the right upper sternal border. Where does this murmur
typically radiate?
A. To the carotid arteries
B. To the left axilla
,C. To the back
D. To the apex
Answer: A
Conceptual Explanation: Aortic stenosis typically presents as a mid-systolic crescendo-
decrescendo murmur at the RUSB radiating to the carotids.
3. A patient with a history of hypertension and heart failure presents with a dry, hacking
cough. Which medication is the most likely cause?
A. Amlodipine
B. Lisinopril
C. Hydrochlorothiazide
D. Metoprolol
Answer: B
Conceptual Explanation: ACE inhibitors like Lisinopril are known to cause a dry cough
due to the accumulation of bradykinin in the lungs.
4. Which physical exam maneuver is specifically used to assess for acute cholecystitis?
A. Murphy’s sign
B. McBurney’s sign
C. Rovsing’s sign
, D. Psoas sign
Answer: A
Conceptual Explanation: Murphy’s sign involves inspiratory arrest upon deep palpation
of the right upper quadrant, indicating gallbladder inflammation.
5. A 50-year-old female presents with fatigue and weight gain. Lab results show a TSH of 12.5
mIU/L and a low Free T4. What is the most appropriate initial treatment?
A. Methimazole
B. Radioactive iodine
C. Propranolol
D. Levothyroxine
Answer: D
Conceptual Explanation: The labs indicate primary hypothyroidism, for which
Levothyroxine is the standard replacement therapy.
6. In the management of Type 2 Diabetes, which medication class is contraindicated in
patients with a history of medullary thyroid carcinoma?
A. GLP-1 receptor agonists
B. SGLT2 inhibitors
C. Sulfonylureas
D. Metformin
CARE OF ADULTS EXAM STUDY GUIDE
(VERIFIED AND CORRECT Q & A)
SATISFACTION GUARANTEED 2026/2027
1. A 65-year-old male presents with a rough, scaly, non-healing patch on his sun-exposed
forehead. What is the most likely precursor lesion to squamous cell carcinoma in this patient?
A. Seborrheic keratosis
B. Psoriatic plaque
C. Basal cell carcinoma
D. Actinic keratosis
Answer: D
Conceptual Explanation: Actinic keratosis (AK) is a precancerous skin lesion caused by
chronic UV exposure that can progress to squamous cell carcinoma (SCC).
2. During a physical exam, a 70-year-old patient exhibits a mid-systolic crescendo-
decrescendo murmur heard best at the right upper sternal border. Where does this murmur
typically radiate?
A. To the carotid arteries
B. To the left axilla
,C. To the back
D. To the apex
Answer: A
Conceptual Explanation: Aortic stenosis typically presents as a mid-systolic crescendo-
decrescendo murmur at the RUSB radiating to the carotids.
3. A patient with a history of hypertension and heart failure presents with a dry, hacking
cough. Which medication is the most likely cause?
A. Amlodipine
B. Lisinopril
C. Hydrochlorothiazide
D. Metoprolol
Answer: B
Conceptual Explanation: ACE inhibitors like Lisinopril are known to cause a dry cough
due to the accumulation of bradykinin in the lungs.
4. Which physical exam maneuver is specifically used to assess for acute cholecystitis?
A. Murphy’s sign
B. McBurney’s sign
C. Rovsing’s sign
, D. Psoas sign
Answer: A
Conceptual Explanation: Murphy’s sign involves inspiratory arrest upon deep palpation
of the right upper quadrant, indicating gallbladder inflammation.
5. A 50-year-old female presents with fatigue and weight gain. Lab results show a TSH of 12.5
mIU/L and a low Free T4. What is the most appropriate initial treatment?
A. Methimazole
B. Radioactive iodine
C. Propranolol
D. Levothyroxine
Answer: D
Conceptual Explanation: The labs indicate primary hypothyroidism, for which
Levothyroxine is the standard replacement therapy.
6. In the management of Type 2 Diabetes, which medication class is contraindicated in
patients with a history of medullary thyroid carcinoma?
A. GLP-1 receptor agonists
B. SGLT2 inhibitors
C. Sulfonylureas
D. Metformin
