NRNP 6531 Final Exam (2 Versions)(Total 200+ Q and Answers)(2024-2025):Walden university, Exams of Nursing

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NRNP 6531 Final Exam / NRNP6531 Final

Exam/ NRNP 6531 Week 11 Final Exam /

NRNP6531 Week 11 Final Exam(

Versions)(Each 100 Questions &

Answers):Walden university

NRNP 6531 Final Exam

(132 Exam Questions & Answers alphabetical)

A,B,C

1.) What is the most commonly abused substance? alcohol is the #1 abused substance in America.

An estimated 135.5 million people drink alcohol, but of those people, 86 million are

considered to be abusers,

2.) Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration and biopsy

3.) Risk factors for Addison’s disease include which of the following? Tuberculosis, Autoimmune

disease, AIDS (all of the above)

4.) Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be

achieved with: Ritalin and diet

5.) The correct treatment for ankle sprain during the first 48 hours after injury includes: a cold

compress to help reduce swelling (Rest, ice, compression, elevation)

6.) A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know

that the best initial approach is to: Having the client in view of staff for 90 minutes after each

meal Provide the client with a feeling of responsibility and control over her behavior

7.) A 32 year old male patient complains of urinary frequency and burning on urination for 3 days.

Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial

treatment should be: include nitrofurantoin monohydrate/macrocrystals, trimethoprim-

sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and sulfamethoxazole

8.) Dave, age 38, states that he thinks he has an ear infection because he just flew back from a

business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next

action? Prescribe nasal steroids and oral decongestants

9.) A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be

classified as: Overweight

10.)Which of the following is not a common early sign of benign prostatic hyperplasia (BPH )? Strong

urinary stream flow.

11.)Which of the following accounts for half of the bladder tumors among men and one third in

women? Cigarette smoke, both active and passive inhalation

12.)Which of the following set of symptoms should raise suspicion of a brain tumor? Holocranial

headaches present in the morning and accompanied by projectile vomiting without nausea

13.)Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome.

Your next step is to: try neutral position wrist splinting and order an oral NSAID

14.)Which drug category contains the drugs that are the first line Gold standard therapy for COPD?

Beta antagonist

15.)Other than smoking cessation, which of the following slows the progression of COPD in

smokers? oxygen

16.)Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?

Erythromycin

17.)Central obesity, “moon” face, and dorsocervical fat pad are associated with: Cushings syndrome

18.)What is the most common cause of Cushing’s syndrome? the long-term, high-dose use of

the cortisol-like glucocorticoids

D, E, F

29.)The intervention known to be most effective in the treatment of severe depression , with or

without psychosis, is: electroconvulsive therapy (ECT).

30.)A 72 year old female patient reports a 6 month history of gradually progressive swollen and

painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the

erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF)

are all minimally elevated. What is the most likely diagnosis? Osteoarthritis

31.)You are assessing a patient after a sports injury to his right knee. You elicit a positive

anterior/posterior drawer sign. This test indicates an injury to the: cruciate ligament

32.)A positive drawer sign supports a diagnosis of: Posterior cruciate ligament injury

33.)The initial clinical sign of Dupuytren’s contracture is: Painless nodule on palmer fascia

34.)A 26 year old female presents with elbow pain that is described as aching and burning. There is

point tenderness along the lateral aspect of the elbow and painful passive flexion and

extension. She reports she has been playing tennis almost daily for the past month. The most

likely diagnosis is: lateral epicondylitis (tennis elbow)

35.)Which is the most common cause of end-stage renal disease in the United States? Diabetes

36.)The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The

drug of choice for treatment of this patient is: Ceftriaxone 250 mg IM in a single dose plus.

Doxycycline 100 mg orally twice a day for 10 days

37.)A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She

requests information about contraception. The nurse practitioner should instruct her that while

taking phenytoin: the effective of an oral contraceptive may be reduced

38.)Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial

blood flow to his penis. The most common cause of this condition is: diabetes mellitus

39.)A 60 year old male patient with multiple health problems presents with a complaint of

erectile dysfunction (ED). Of the following, which medication is most likely to be causing the

problem? Hypertensive medication such as hydrochlorothiazides, and other DM2 medications

40.)A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the

following symptoms would lead you to look for another diagnosis? high fever (102 to 104

degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of

respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system

dysfunction resulting in high or low blood pressure, profuse perspiration, and excessive

sweating. called Malignant Hyperthermia” OR Neuroleptic malignant syndrome

41.)Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome,

which have many similarities. Which of the following is more characteristic of fibromyalgia?

Musculosckeletal pain

G, H, I

42.)A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following

medications may be used to treat generalized anxiety disorder? benzodiazepines include

Xanax, Librium, Valium, and Ativan

43.)Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to

reduce his lower esophageal sphincter pressure, which substances do you recommend that

he avoid? Food that is very hot or very cold. Fatty or fried foods. Peppermint or spearmint,

including flavoring Coffee, tea, and soft drinks that contain caffeine. Spicy, highly seasoned

foods. Fried food DT caffeine, chocolate and anticholinergics

44.)A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle

aches, and low grade fever. The headache is described as superficial tenderness rather than

deep pain. Giant cell arteritis is suspected. Appropriate treatment is: refer for temporal artery

biopsy and initiation of oral prednisone

45.)Which history is commonly found in a patient with glomerulonephritis? upper respiratory tract

infection or a skin infection that was caused by those bacteria

46.)The most reliable diagnostic indicator of gout is: Elevated serum uric acid levels

47.)After treating a patient for Helicobacter pylori infection , what test do you order to see if it has

been cured? A urea breath test

48.)A 28-year-old female presents to the office requesting testing for diagnosis of hereditary

thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her

risk factors. The nurse practitioner explains that: B and D (does not always require

anticoagulation therapy and genetic and risk management counseling are recommended

49.)A patient has HIV infection and is having a problem with massive diarrhea. You suspect the

cause is: Cryptosporidiosis

50.)A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a

possible cause of FUO in a patient with HIV? drug fever

51.)The diagnosis of human papilloma virus (HPV) infection in males is usually made by: The

diagnosis of HPV in men is made when external genital warts are seen. The diagnosis of genital

warts is made by examination of the lesions

52.)A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse

practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary

hyperparathyroidism is treated with parathyroidectomy

53.)A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals

hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the

patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness,

anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? Obtain a

thorough history and physical, and check serum cortisol and ACTH levels.

54.)What diabetic complications result from hyperglycemia? Retinopathy 2. Hypertension resistant

to treatment 3. Peripheral neuropathy

55.)Potential causes of hypocalcemia include which of the following? Hypoalbuminemia is the

most common cause of hypocalcemia. Causes include cirrhosis, nephrosis.

hypoparathyroidism, vitamin D deficiency, and renal disease.

56.)Which of the following patients most warrants screening for hypothyroidism? An elderly female

with recent onset of mental dysfunction

71.)Diagnostic radiological studies are indicated for low back pain : Pain lasting more than 1 month -

Objective radiculopathy - Cauda equina syndrome - Considering "red flag": systemic arthritis,

infection, malignancy, trauma, congenital/developmental abnormalities

72.)Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and

tell him which of the following? Begin lower back strengthening exercises depending on pain

tolerance.

M, N, O

73.) Major depression occurs most often in which of the following conditions? Stroke

74.)Which of the following is characteristic of a manic episode? Grandiosity or grandiose delusions

75.)Your patient has an elevated mean cell volume (MCV). What should you be considering in terms

of diagnosis? Anemia (pernicious or folic acid anemia) macrocytic Liver disease

76.)A middle-aged man presents to urgent care complaining of pain of the medial condyle of the

lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam,

the medial epicondyle is tender and pain is increased with flexion and pronation. Range of

motion is full The most likely cause of this patient’s pain is: epicondylitis

77.)Which of the following medications increase the risk for metabolic syndrome? Answer:

antihistamines and proton pump inhibitors, diuretics, beta-blockers

78.)Which of the following is a contraindication for metformin therapy? hypersensitity metabolic

acidiosis, dehydration, sepsis, hypoxemia, hepatic impairment, renal dysfunction

79.)The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: to

measure albumin in a spot urine sample, collected either as the first urine in the morning or at

random, for example, at the medical visit. This method is accurate,:Early morning

80.) Microalbuminuria is a measure of: Urinary excretion of 30-299mg/24 hours of albumin,

Expressing albumin and creatinine ratio (ACR) takes the variability into account and normalizes

the albumin in a spot specimen

81.)The obligatory criteria for diagnosis of muscular dystrophy (MD) are: Genetic testing to

evaluate missing or repeated mutations in the dystrophin gene. A lack of the dystrophin gene

can lead to a diagnosis of Duchenne or Becker MD. The test is important not only to confirm the

MD diagnosis in males but also to determine whether women with a family history of Duchenne

or Becker MD may be carriers

82.)Which of the following is the most common complication of the myelodysplastic syndromes?

Bleeding

83.)Who is at a higher risk for developing nephrolithiasis? Bill, who runs every day and takes

excessive amounts of vitamin C

84.)The most effective treatment of non-infectious bursitis includes: Conservative treatment

includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti-

inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections.

85.)Which of the following is the most common causative organism of nongonococcal urethritis?

Chlamydia trachomatis

86.)A 77-year-old female presents to the office complaining a sudden swelling on her right elbow.

She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling

over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse

practitioner suspects: Olecranon bursitis

87.)What intervention does the American College of Rheumatology recommend as first line

therapy for osteoarthritis? Acetaminophen should be used as first-line therapy for mild

osteoarthritis. Nonsteroidal anti-inflammatory drugs are superior to acetaminophen for

treating moderate to severe osteoarthritis

88.)Establishment of a definitive diagnosis of osteomyelitis requires: Bone biopsy leads to a

definitive diagnosis

89.)Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How

do you respond? "A high caffeine intake has a diuretic effect that may cause calcium to be

excreted more rapidly."

90.)Martin, age 24, presents with an erythematous ear canal, pain, and a recent history

of swimming. What do you suspect? Otitis externa/ swimmer’s ear

P, Q, R

91.)What is the first symptom seen in the majority of patients with Parkinson’s disease? Tremor at

rest

92.)Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd

trimester? Trimethoprim-sulfamethoxazole

93.) Phalen’s test , 90°wrist flexion for 60 seconds, reproduces symptoms of: carpal tunnel syndrome

94.)Which of the following characteristics are associated with prepatellar bursitis? Repetitive knee

trauma

95.)A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first

episode, 2 months ago. She reports considerable improvement in her symptoms and her

intention to discontinue the medication. What should be the nurse practitioner’s

recommendation? Answer: Recommend that the patient continue the antidepressant

medication for at least 4 more months

96.)Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems,

flashbacks, and depression. What is your initial diagnosis? Post-traumatic stress disorder

97.)The most commonly recommended method for prostate cancer screening in a 55 year old male

is: digital rectal exams

98.)Risk factors for prostate cancer include all of the following except: BPH

99.)A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal

exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the

most appropriate management strategy for you to follow at this time? Prescribe an alpha

adrenergic blocker.

100.) The organism most often associated with prostatitis is: Escherichia coli

101.) Prolonged PT suggests: Abnormality in extrinsic coagulation pathway, Deficiency of

FII, FV, FX, or fibrinogen abnormalities

102.) A 32 year old female patient presents with fever, chills, right flank pain, right

costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red

blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate

management is: Include 500 mg of oral ciprofloxacin (Cipro) twice per day for seven days; 1,

mg of

117.) Which of the following is a potential acquired cause of thrombophilia?

Antiphospholipid antibodies

118.) A 28-year-old female presents to the office requesting testing for diagnosis of

hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned

about her risk factors. The nurse practitioner explains that: B and D (does not always require

anticoagulation therapy and genetic and risk management counseling are recommended

119.) The most common symptoms of transient ischemic attack (TIA) include: Common

symptoms are sudden and transient, and include unilateral paresis, speech disturbance,

and monocular blindness. clinical symptoms typically lasting less than one hour, and

without evidence of infarction on imaging

121.) The most common presentation of thyroid cancer is: is an asymptomatic thyroid mass

or a nodule that can be felt in the neck.

122.) A 14 year old female cheerleader reports gradual and progressive dull anterior knee

pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at

the tibial tuberosity. X-ray is negative. What is the most likely diagnosis? prepatellar bursitis?

123.) Diagnostic evaluation for urinary calculi includes: Diagnosis is based on urinalysis

and radiologic imaging, usually noncontrast helical CT.

124.) A 21-year-old female presents to the office complaining of urinary frequency and

urinary burning. The nurse practitioner suspects a urinary tract infection when the

urinalysis reveals 10WBC/HPF.

V, W, X, Y, Z

125.) The diagnosis which must be considered in a patient who presents with a

severe headache of sudden onset, with neck stiffness and fever, is: viral meningitis

126.) A middle-aged female presents complaining of recent weight loss. The physical

exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this

patient’s problem includes: Answer: infection

127.) The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in

almost 100% of patients is: cafe au lait spots.

Misc

128.) What conditions must be met for you to bill “incident to” the physician, receiving

100% reimbursement from Medicare? The physician must be on-site and engaged in patient

care.

129.) A 30 year old female patient presents to the clinic with heat intolerance, tremors,

nervousness, and weight loss inconsistent with increased appetite. Which test would be most

likely to confirm the suspected diagnosis? TSH. We also assess free thyroid hormone (FT4) and

at times T

A Trauma

B Tight shoes

C Arthritis flare

- Question 2

1 out of 1 points

A Metabolic syndrome

B Unilateral

pheochromocytoma

C Cushing’s syndrome

D None of the above

- Question 3

1 out of 1 points

130.) A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation,

confusion, and impaired attention. This is accompanied by visual hallucinations and sleep

disturbance. What is the most likely cause of this behavior? Delirium

131.) Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did

not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it

remains at 144/98. What should your next action be? stage 2 hypertension (lifestyle change, and

medication

132.) How do you respond when Jessica, age 42, asks you what constitutes a good minimum

cardiovascular workout? 20 3x per week

NRNP 6531 Final Exam

Central obesity, “moon” face, and dorsocervical fat pad are associated with:

An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days

later, he returns to the office complaining of left great toe pain. On exam, the nurse

practitioner notes an edematous, erythematous tender left great toe. The likely precipitant

of this patient’s pain is:

The most effective treatment of non-infectious bursitis includes: Conservative treatment

- Question 9

1 out of 1 points

- Question 10

1 out of 1 points

- Question 11

1 out of 1 points

- Question 12

1 out of 1 points

reduce his lower esophageal sphincter pressure, which substances do you recommend that

he avoid?

Food that is very hot or very

cold Fatty or fried foods

Peppermint or spearmint, including flavoring

Coffee, tea, and soft drinks that contain

caffeine Spicy, highly seasoned foods

Fried food DT caffeine, chocolate and anticholinergics

Which drug category contains the drugs that are the first line Gold standard therapy for

COPD?

Beta antagonist

The most commonly recommended pharmacological treatment regimen for low back pain

(LBP) is:

Nsaid

Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?

Erythromycin

A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals

hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the

patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness,

anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take?

.A Obtain a thorough history and physical, and check serum cortisol

and ACTH levels.

B. Perform a diet history and check CBC and FBS.

- Question 16

1 out of 1 points

- Question 17

1 out of 1 points

- Question 19

1 out of 1 points

- Question 21

1 out of 1 points

C. Provide nutritional guidance and have the patient return in one month.

D. Consult home health for intravenous administration

You are assessing a patient after a sports injury to his right knee. You elicit a positive

anterior/posterior drawer sign. This test indicates an injury to the: he

A. lateral

meniscus B.

cruciate ligament

C. medial meniscus

D. collateral ligament.

A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral

angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood

cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management

is:

Include 500 mg of oral ciprofloxacin ( Cipro ) twice per day for seven days; 1,

mg of extended-release ciprofloxacin once per day for seven days; or 750 mg

of levofloxacin ( Levaquin ) once per day for five days.

A middle-aged man presents to urgent care complaining of pain of the medial condyle of the

lower humerus. The man works as a carpenter and describes a gradual onset of pain. On

exam, the medial epicondyle is tender and pain is increased with flexion and pronation.

Range of motion is full The most likely cause of this patient’s pain is: epicondylitis

A Lumbar disc

disease

B Spinal stenosis

C Traumatic

fracture

D Osteoporosis A Arthritis

B Ulnar neuritis

C Septic

arthritis

D Olecranon

bursitis

- Question 30

1 out of 1 points

- Question 31

1 out of 1 points

Which of the following is the most common cause of low back pain?

Which is the most common cause of end-stage renal disease in the United States?

Diabetes

A 77-year-old female presents to the office complaining a sudden swelling on her right

elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender

area of swelling over the extensor surface over the right elbow with evidence of trauma

or irritation. The nurse practitioner suspects:

1 out of 1 points

**- Question 38

Question 32**

1 out of 1 points

- Question 33

1 out of 1 points

- Question 35

1 out of 1 points

- Question 37

1 out of 1 points

A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in

the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is

triggered by touch or temperature extremes. Physical examination is normal.

Which of the following is the most likely diagnosis? A.

fibromyligia or neuro something

Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal

limits. Which of the following diagnoses do you explore further?

Arthritis, C

**- Question 34

• D**

1 out of 1 points

A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the

following symptoms would lead you to look for another diagnosis?

high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia),

increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic

nervous system dysfunction resulting in high or low blood pressure, profuse perspiration, and

excessive sweating. called Malignant Hyperthermia” OR Neuroleptic malignant

syndrome hallucinations.

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

carpal tunnel syndrome

The most common cause of elevated liver function tests is: alcohol

- Question 44

1 out of 1 points

- Question 46

1 out of 1 points

- Question 47

1 out of 1 points

and history of a palpable lump in his scrotum that “comes and goes”. On physical

examination, the nurse practitioner does not detect a scrotal mass. There is no

tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate.

What is the most likely diagnosis?

A. Testicular torsion

B. Epididymitis

C. Inguinal hernia

D. Varicocele

Dave, age 38, states that he thinks he has an ear infection because he just flew back from a

business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is

your next action?

A. Prescribe nasal steroids and oral decongestants

B. Prescribe antibiotic eardrops

C. Prescribe systemic eardrops

D. Refer David to an ear, nose, and throat specialist

A. Prescribe

The physiological explanation of syncope is:

Syncope is a transient loss of consciousness (TLOC) due to global cerebral

hypoperfusion characterized by rapid onset, short duration and spontaneous

complete recovery.

- Question 48

1 out of 1 points

- Question^49

1 out of 1 points

- Question 51

1 out of 1 points

A Weight gain

B Fracture risk

C Hypoglycem

ia

D Weight loss

A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy,

but denies pain. On examination, the nurse practitioner notes transillumination of the

scrotum. What is the most likely diagnosis? hydrocele

A 32 year old male patient complains of urinary frequency and burning on urination for 3 days.

Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial

treatment should be: nclude nitrofurantoin monohydrate/macrocrystals,

trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and

sulfamethoxazole

Diagnostic radiological studies are indicated for low back pain:

Diagnostic imaging is indicated for patients with low back pain only if they have severe

progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying

condition. In other patients, evidence indicates that routine imaging is not associated with

clinically meaningful benefits but can lead to harms.

An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for

this patient, the nurse practitioner is most concerned with which of the following side

effects?