NRNP 6531 Advanced Primary Care of Adults
Across the Lifespan Final Exam Questions
with Answers and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
the NRNP 6531 Final Examination. Topics include HEENT conditions, cardiovascular disorders,
respiratory diseases, dermatologic conditions, endocrine management, and professional
practice.
1. A patient reports painful oral lesions 3 days after feeling pain and tingling in the
mouth. The provider notes vesicles and ulcerative lesions on the buccal mucosa.
What is the most likely cause of these symptoms?
A. Bacterial infection
B. Candida albicans
C. Herpes simplex virus (HSV)
D. Human papilloma virus (HPV)
Correct Answer: C — Herpes simplex virus (HSV)
Rationale: HSV infections generally start with a prodrome of tingling, pain, and
burning followed by vesicular and ulcerative lesions. Bacterial infection presents
with inflammation of the gingiva, bleeding, and ulceration. Candida albicans
,appear as white, cottage cheese-like lesions. HPV manifests as white, verrucous
lesions individually or in clusters .
2. A patient diagnosed with gingival inflammation presents with several areas of
ulceration and a small amount of purulent discharge. What is required to
diagnose this condition?
A. Culture and sensitivity
B. Microscopic exam of oral scrapings
C. Physical examination
D. Tzancksmear
Correct Answer: C — Physical examination
Rationale: This patient has symptoms consistent with gingivitis, which may be
diagnosed by physical examination alone. Cultures are not necessary unless
systemic disease is present. A microscopic exam of oral scrapings may be
performed to diagnose candida infections. A Tzancksmear is performed to
confirm a diagnosis of herpes simplex .
,3. A patient reports painful oral lesions and the provider notes several white,
verrucous lesions in clusters throughout the mouth. What is the recommended
treatment for this patient?
A. Nystatin oral suspension
B. Oral acyclovir
C. Oral hygiene measures
D. Surgical excision
Correct Answer: D — Surgical excision
Rationale: White, verrucous lesions in clusters are diagnostic for human papilloma
virus (HPV) infection which is treated with surgical excision. Nystatin suspension is
given for candida infection. Oral acyclovir is used for herpes simplex virus (HSV)
infection .
4. Which physical examination finding suggests viral rather than bacterial
parotitis?
A. Clear discharge from Stensen's duct
B. Enlargement and pain of affected glands
C. Gradual reduction in saliva production
D. Unilateral edema of parotid glands
, Correct Answer: A — Clear discharge from Stensen's duct
Rationale: Viral parotitis generally produces clear discharge. Enlargement and
pain of affected glands may be nonspecific or associated with TB infection. A
gradual reduction in saliva is characteristic of HIV infection. Unilateral edema is
more often bacterial .
5. A patient diagnosed with acute suppurative parotitis has been taking
amoxicillin-clavulanate for 4 days without improvement. The provider will order
an antibiotic for Methicillin-resistant S. aureus. Which other measure may be
helpful?
A. Cool compresses
B. Discouraging chewing gum
C. Surgical drainage
D. Topical corticosteroids
Correct Answer: C — Surgical drainage
Rationale: If improvement does not occur after 3 to 4 days of antibiotics, surgical
drainage is appropriate. Warm compresses are recommended for comfort.
Chewing gum to stimulate saliva production is recommended. Steroids are
questionable .
Across the Lifespan Final Exam Questions
with Answers and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
the NRNP 6531 Final Examination. Topics include HEENT conditions, cardiovascular disorders,
respiratory diseases, dermatologic conditions, endocrine management, and professional
practice.
1. A patient reports painful oral lesions 3 days after feeling pain and tingling in the
mouth. The provider notes vesicles and ulcerative lesions on the buccal mucosa.
What is the most likely cause of these symptoms?
A. Bacterial infection
B. Candida albicans
C. Herpes simplex virus (HSV)
D. Human papilloma virus (HPV)
Correct Answer: C — Herpes simplex virus (HSV)
Rationale: HSV infections generally start with a prodrome of tingling, pain, and
burning followed by vesicular and ulcerative lesions. Bacterial infection presents
with inflammation of the gingiva, bleeding, and ulceration. Candida albicans
,appear as white, cottage cheese-like lesions. HPV manifests as white, verrucous
lesions individually or in clusters .
2. A patient diagnosed with gingival inflammation presents with several areas of
ulceration and a small amount of purulent discharge. What is required to
diagnose this condition?
A. Culture and sensitivity
B. Microscopic exam of oral scrapings
C. Physical examination
D. Tzancksmear
Correct Answer: C — Physical examination
Rationale: This patient has symptoms consistent with gingivitis, which may be
diagnosed by physical examination alone. Cultures are not necessary unless
systemic disease is present. A microscopic exam of oral scrapings may be
performed to diagnose candida infections. A Tzancksmear is performed to
confirm a diagnosis of herpes simplex .
,3. A patient reports painful oral lesions and the provider notes several white,
verrucous lesions in clusters throughout the mouth. What is the recommended
treatment for this patient?
A. Nystatin oral suspension
B. Oral acyclovir
C. Oral hygiene measures
D. Surgical excision
Correct Answer: D — Surgical excision
Rationale: White, verrucous lesions in clusters are diagnostic for human papilloma
virus (HPV) infection which is treated with surgical excision. Nystatin suspension is
given for candida infection. Oral acyclovir is used for herpes simplex virus (HSV)
infection .
4. Which physical examination finding suggests viral rather than bacterial
parotitis?
A. Clear discharge from Stensen's duct
B. Enlargement and pain of affected glands
C. Gradual reduction in saliva production
D. Unilateral edema of parotid glands
, Correct Answer: A — Clear discharge from Stensen's duct
Rationale: Viral parotitis generally produces clear discharge. Enlargement and
pain of affected glands may be nonspecific or associated with TB infection. A
gradual reduction in saliva is characteristic of HIV infection. Unilateral edema is
more often bacterial .
5. A patient diagnosed with acute suppurative parotitis has been taking
amoxicillin-clavulanate for 4 days without improvement. The provider will order
an antibiotic for Methicillin-resistant S. aureus. Which other measure may be
helpful?
A. Cool compresses
B. Discouraging chewing gum
C. Surgical drainage
D. Topical corticosteroids
Correct Answer: C — Surgical drainage
Rationale: If improvement does not occur after 3 to 4 days of antibiotics, surgical
drainage is appropriate. Warm compresses are recommended for comfort.
Chewing gum to stimulate saliva production is recommended. Steroids are
questionable .
