NRNP 6531 ADVANCED PRACTICE
CARE OF ADULTS FINAL EXAM STUDY
GUIDE (VERIFIED AND CORRECT Q &
A) SATISFACTION GUARANTEED
2026/2027
1. A 62-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
and an ejection fraction of 30% presents for a follow-up. He is currently taking Lisinopril 20mg
daily and Carvedilol 25mg twice daily. According to current guidelines, what is the most
appropriate next step to improve survival?
A. Add Furosemide 40mg daily
B. Switch Lisinopril to Sacubitril/Valsartan
C. Add Amlodipine 5mg daily
D. Initiate Digoxin 0.125mg daily
Answer: B
Conceptual Explanation: For patients with symptomatic HFrEF who tolerate an ACE
inhibitor or ARB, switching to an Angiotensin Receptor-Neprilysin Inhibitor (ARNI) like
Sacubitril/Valsartan is recommended to further reduce morbidity and mortality.
2. Which of the following physical exam findings is most suggestive of Aortic Stenosis?
A. Holosystolic murmur at the apex radiating to the axilla
,B. Mid-systolic click followed by a late systolic murmur
C. Crescendo-decrescendo systolic murmur at the right upper sternal border
D. High-pitched decrescendo diastolic murmur at the left sternal border
Answer: C
Conceptual Explanation: Aortic Stenosis typically presents as a harsh crescendo-
decrescendo systolic murmur heard best at the right second intercostal space (right upper
sternal border) radiating to the carotids.
3. A 55-year-old female patient presents with a CHA2DS2-VASc score of 3 due to Age, Female
sex, and Hypertension. She has persistent Atrial Fibrillation. What is the recommended
management for stroke prevention?
A. Aspirin 81mg daily
B. Dual antiplatelet therapy with Aspirin and Clopidogrel
C. Rate control with a Beta-blocker only
D. Oral anticoagulation with a DOAC or Warfarin
Answer: D
Conceptual Explanation: In patients with atrial fibrillation and a CHA2DS2-VASc score of
2 or greater in men or 3 or greater in women, oral anticoagulation is recommended to
reduce the risk of thromboembolic events.
, 4. According to the JNC 8 and AHA/ACC 2017 guidelines, what is the blood pressure goal for a
68-year-old patient with Diabetes Mellitus?
A. < 140/90 mmHg
B. < 120/70 mmHg
C. < 150/90 mmHg
D. < 130/80 mmHg
Answer: D
Conceptual Explanation: The AHA/ACC guidelines recommend a blood pressure goal of <
130/80 mmHg for all adults with confirmed hypertension and known CVD or high risk,
including those with Diabetes.
5. A 45-year-old male presents with sudden onset of severe pain, redness, and swelling in the
first metatarsophalangeal joint. Arthrocentesis reveals negatively birefringent needle-shaped
crystals. What is the first-line treatment for this acute flare?
A. Allopurinol 100mg daily
B. Oral Colchicine or NSAIDs
C. Febuxostat 40mg daily
D. Intravenous Urate Oxidase
Answer: B
CARE OF ADULTS FINAL EXAM STUDY
GUIDE (VERIFIED AND CORRECT Q &
A) SATISFACTION GUARANTEED
2026/2027
1. A 62-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
and an ejection fraction of 30% presents for a follow-up. He is currently taking Lisinopril 20mg
daily and Carvedilol 25mg twice daily. According to current guidelines, what is the most
appropriate next step to improve survival?
A. Add Furosemide 40mg daily
B. Switch Lisinopril to Sacubitril/Valsartan
C. Add Amlodipine 5mg daily
D. Initiate Digoxin 0.125mg daily
Answer: B
Conceptual Explanation: For patients with symptomatic HFrEF who tolerate an ACE
inhibitor or ARB, switching to an Angiotensin Receptor-Neprilysin Inhibitor (ARNI) like
Sacubitril/Valsartan is recommended to further reduce morbidity and mortality.
2. Which of the following physical exam findings is most suggestive of Aortic Stenosis?
A. Holosystolic murmur at the apex radiating to the axilla
,B. Mid-systolic click followed by a late systolic murmur
C. Crescendo-decrescendo systolic murmur at the right upper sternal border
D. High-pitched decrescendo diastolic murmur at the left sternal border
Answer: C
Conceptual Explanation: Aortic Stenosis typically presents as a harsh crescendo-
decrescendo systolic murmur heard best at the right second intercostal space (right upper
sternal border) radiating to the carotids.
3. A 55-year-old female patient presents with a CHA2DS2-VASc score of 3 due to Age, Female
sex, and Hypertension. She has persistent Atrial Fibrillation. What is the recommended
management for stroke prevention?
A. Aspirin 81mg daily
B. Dual antiplatelet therapy with Aspirin and Clopidogrel
C. Rate control with a Beta-blocker only
D. Oral anticoagulation with a DOAC or Warfarin
Answer: D
Conceptual Explanation: In patients with atrial fibrillation and a CHA2DS2-VASc score of
2 or greater in men or 3 or greater in women, oral anticoagulation is recommended to
reduce the risk of thromboembolic events.
, 4. According to the JNC 8 and AHA/ACC 2017 guidelines, what is the blood pressure goal for a
68-year-old patient with Diabetes Mellitus?
A. < 140/90 mmHg
B. < 120/70 mmHg
C. < 150/90 mmHg
D. < 130/80 mmHg
Answer: D
Conceptual Explanation: The AHA/ACC guidelines recommend a blood pressure goal of <
130/80 mmHg for all adults with confirmed hypertension and known CVD or high risk,
including those with Diabetes.
5. A 45-year-old male presents with sudden onset of severe pain, redness, and swelling in the
first metatarsophalangeal joint. Arthrocentesis reveals negatively birefringent needle-shaped
crystals. What is the first-line treatment for this acute flare?
A. Allopurinol 100mg daily
B. Oral Colchicine or NSAIDs
C. Febuxostat 40mg daily
D. Intravenous Urate Oxidase
Answer: B
