1|Page
MCPHS NUR 807 FINAL EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
Description
This comprehensive 200-item practice exam is designed for graduate-level students
enrolled in MCPHS NUR 807, focusing on advanced clinical decision-making,
pathophysiologic reasoning, pharmacologic management, evidence-based
interventions, and systems-level leadership. Questions assess complex scenarios
involving acute and chronic illness management, diagnostic reasoning, advanced
assessment, interdisciplinary collaboration, and high-level therapeutic planning.
Each question includes the correct answer and a detailed rationale in italics to
reinforce mastery of advanced practice nursing competencies.
1. A patient presents with sudden unilateral facial drooping. Which diagnostic
test is MOST urgent?
A. MRI of the brain
B. CT scan without contrast
C. Carotid ultrasound
D. EEG
ANSWER: B
CT without contrast is the fastest tool to rule out hemorrhagic stroke, essential
before thrombolytic therapy.
2. Which assessment finding is most concerning in acute decompensated heart
failure?
A. Bibasilar crackles
B. S3 heart sound
C. Hypotension and cold extremities
D. Mild pedal edema
ANSWER: C
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Hypoperfusion and hypotension indicate cardiogenic shock requiring immediate
intervention.
3. A patient on amiodarone develops fatigue, weight gain, and bradycardia.
What lab test is priority?
A. AST/ALT
B. TSH
C. BNP
D. Serum potassium
ANSWER: B
Amiodarone commonly induces hypothyroidism; TSH is the most sensitive
indicator.
4. The most reliable indicator of septic shock severity is:
A. WBC count
B. Serum lactate level
C. CRP elevation
D. Mild hypotension
ANSWER: B
Elevated lactate reflects tissue hypoperfusion and predicts mortality.
5. A 76-year-old with atrial fibrillation on warfarin has an INR of 8.2 without
bleeding. Best action?
A. Give vitamin K orally
B. Administer IV vitamin K
C. Hold warfarin only
D. Give FFP
ANSWER: A
Oral vitamin K is preferred for significantly elevated INR without bleeding.
,3|Page
6. Which EKG finding is consistent with hyperkalemia?
A. U waves
B. Prolonged PR interval
C. Tall peaked T waves
D. ST elevation
ANSWER: C
Tall, tented T waves are classic for early hyperkalemia.
7. A COPD patient is placed on high-flow oxygen. What complication is the
clinician most concerned about?
A. Pulmonary embolism
B. Oxygen toxicity
C. Hypoventilation leading to CO₂ retention
D. ARDS
ANSWER: C
High O₂ can suppress hypoxic respiratory drive in CO₂ retainers.
8. Which antihypertensive is preferred in a diabetic patient with
microalbuminuria?
A. Thiazide
B. ACE inhibitor
C. Beta-blocker
D. Calcium channel blocker
ANSWER: B
ACE inhibitors reduce intraglomerular pressure and protect renal function.
9. An elderly patient presents with delirium. First-line diagnostic step?
A. CT head
B. CBC
C. Urinalysis
D. ABG
, 4|Page
ANSWER: C
UTIs are the most common cause of delirium in older adults.
10. A patient on opioids has shallow breathing and pinpoint pupils. First
action?
A. Administer IV naloxone
B. Give oxygen
C. Call rapid response
D. Obtain ABG
ANSWER: A
Naloxone rapidly reverses opioid-induced respiratory depression.
11. Best test to confirm pulmonary embolism in a hemodynamically stable
patient?
A. V/Q scan
B. CTA chest
C. Chest X-ray
D. D-dimer
ANSWER: B
CT angiography is the gold standard for stable patients.
12. Which medication is contraindicated in asthma?
A. Montelukast
B. Albuterol
C. Propranolol
D. Prednisone
ANSWER: C
Nonselective beta-blockers can provoke bronchospasm.
MCPHS NUR 807 FINAL EXAM ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
Description
This comprehensive 200-item practice exam is designed for graduate-level students
enrolled in MCPHS NUR 807, focusing on advanced clinical decision-making,
pathophysiologic reasoning, pharmacologic management, evidence-based
interventions, and systems-level leadership. Questions assess complex scenarios
involving acute and chronic illness management, diagnostic reasoning, advanced
assessment, interdisciplinary collaboration, and high-level therapeutic planning.
Each question includes the correct answer and a detailed rationale in italics to
reinforce mastery of advanced practice nursing competencies.
1. A patient presents with sudden unilateral facial drooping. Which diagnostic
test is MOST urgent?
A. MRI of the brain
B. CT scan without contrast
C. Carotid ultrasound
D. EEG
ANSWER: B
CT without contrast is the fastest tool to rule out hemorrhagic stroke, essential
before thrombolytic therapy.
2. Which assessment finding is most concerning in acute decompensated heart
failure?
A. Bibasilar crackles
B. S3 heart sound
C. Hypotension and cold extremities
D. Mild pedal edema
ANSWER: C
,2|Page
Hypoperfusion and hypotension indicate cardiogenic shock requiring immediate
intervention.
3. A patient on amiodarone develops fatigue, weight gain, and bradycardia.
What lab test is priority?
A. AST/ALT
B. TSH
C. BNP
D. Serum potassium
ANSWER: B
Amiodarone commonly induces hypothyroidism; TSH is the most sensitive
indicator.
4. The most reliable indicator of septic shock severity is:
A. WBC count
B. Serum lactate level
C. CRP elevation
D. Mild hypotension
ANSWER: B
Elevated lactate reflects tissue hypoperfusion and predicts mortality.
5. A 76-year-old with atrial fibrillation on warfarin has an INR of 8.2 without
bleeding. Best action?
A. Give vitamin K orally
B. Administer IV vitamin K
C. Hold warfarin only
D. Give FFP
ANSWER: A
Oral vitamin K is preferred for significantly elevated INR without bleeding.
,3|Page
6. Which EKG finding is consistent with hyperkalemia?
A. U waves
B. Prolonged PR interval
C. Tall peaked T waves
D. ST elevation
ANSWER: C
Tall, tented T waves are classic for early hyperkalemia.
7. A COPD patient is placed on high-flow oxygen. What complication is the
clinician most concerned about?
A. Pulmonary embolism
B. Oxygen toxicity
C. Hypoventilation leading to CO₂ retention
D. ARDS
ANSWER: C
High O₂ can suppress hypoxic respiratory drive in CO₂ retainers.
8. Which antihypertensive is preferred in a diabetic patient with
microalbuminuria?
A. Thiazide
B. ACE inhibitor
C. Beta-blocker
D. Calcium channel blocker
ANSWER: B
ACE inhibitors reduce intraglomerular pressure and protect renal function.
9. An elderly patient presents with delirium. First-line diagnostic step?
A. CT head
B. CBC
C. Urinalysis
D. ABG
, 4|Page
ANSWER: C
UTIs are the most common cause of delirium in older adults.
10. A patient on opioids has shallow breathing and pinpoint pupils. First
action?
A. Administer IV naloxone
B. Give oxygen
C. Call rapid response
D. Obtain ABG
ANSWER: A
Naloxone rapidly reverses opioid-induced respiratory depression.
11. Best test to confirm pulmonary embolism in a hemodynamically stable
patient?
A. V/Q scan
B. CTA chest
C. Chest X-ray
D. D-dimer
ANSWER: B
CT angiography is the gold standard for stable patients.
12. Which medication is contraindicated in asthma?
A. Montelukast
B. Albuterol
C. Propranolol
D. Prednisone
ANSWER: C
Nonselective beta-blockers can provoke bronchospasm.
