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NRNP 6566 Final Exam Questions with
100% Correct Answers Latest Update 2025
(Graded A+)
Question 1
Which statement is correct about fluoroquinolones?
fluoroquinolones are effective treatment for urinary tract infections and
pyelonephritis
Fluoroquinolones are recommended treatment in uncomplicated skin
infections
fluoroquinolones are not associated with tendon rupture
fluoroquinolones are never indicated in the treatment of pediatric
infections
Question 2 A 42 year old year old women was admitted to the ICU with a severe asthmatic exacerbation. On rounds today, the patients T is 102.2. Her central IV line site is red, tender, and warm. Your remove the central line and order blood cultures along with IV cefepime. MRSA has been prevalent in this ICU. What additional medication should you order? po vancomycin IV gentamycin IV vancomycin IV pipercillin
Question 3
A 66-year-old male involved in a motor vehicle collision is admitted to the trauma
unit with multiplesbone fractions and left hemothorax with chest tube
placement. Current vital signs are BP 88/52 HR 120 T 98.4 RR 22. Past medical
history is positive for end stage renal disease requiring hemodialysis three times
a week. How should the NP manage his renal disease?
Hemodialysis Peritoneal dialysis
Question 7
A 13-year-old thin, female comes to your office with a 6-month history of
nondeliberate weight loss, polyuria and polydypsia. She has no other significant
illnesses. There are no abnormalities on physical examination except a random
venous blood sugar of 237.
Which of the following statements regarding this case is FALSE?
Type 1 diabetes is confirmed by this test
A glucose tolerance test is not necessary to confirm diagnosis
Obtain a fasting blood glucose
Insulin will probably be required
Question 8
A patient who is allergic to penicillins may also be allergic to
a
Erythromycin
b
Neomycin
c Tetracycline
d
Cefazolin
Question 9 Joe is a 46 year old man with normal renal function diagnosed with heparin induced thrombocytopenia (HIT). In addition to stopping all unfractionated heparin products, the next appropriate step in treating this patient would be the addition of? Low molecular weight heparin aspirin Agratroban Plavix Question 10
A 24-year-old male is a newly diagnosed type 1 diabetic. He weighs 62 kg and
you decide to start him on insulin therapy because his blood glucose is high
and he has ketonuria. His total daily dose of insulin to start with should be:
31 units
40 units
46 units
A 48-year-old female wt 70 kg, is in the ICU with acute pancreatitis. Her vital signs are as follows: BP 92/60 mm Hg; heart rate 116 bpm; She is intubated with current ventilator settings of VT 700 mL, assist control (AC) rate 12 bpm, FiO2 0.85, and positive end expiratory pressure (PEEP) 5.0 cm H 2 O. Her ABG reveals a pH of 7.31, PaCO2 of 53 mm Hg, and a PaO 2 of 62 mm Hg. Her chest radiograph shows diffuse, fluffy infiltrates. Based upon this assessment the ACNP would order a decrease of PEEP to
an increase of rate to 16 change to SIMV an increase of VT to 900 ml Question 12 A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? Take 5 units of regular insulin immediately after each meal Take 5 units of regular insulin for each 15 grams of carbohydrate consumed immediately after each meal. Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal Take 1 unit of regular insulin for each 5 grams of carbohydrate to be consumed 30 minutes before each meal. Question 13
All of the following statements about Type 2 diabetes mellitus are correct
EXCEPT:
Higher risk for development Question 18 A 22 year old female patient with type 1 diabetes presents with abdominal pain and T 100.1. Arterial blood gases reveal pH 7.2, pCO2 of 24, HCO3 12. What other finding would you expect on this patient? Decreased anion gap Decreased respirations
Decreased urine output
Which statement is correct about macrolide antibiotics?
first generation macrolides are not associated with GI side effects e.g., nausea
and vomiting
macrolide resistance is not a concern due to infrequent use of this category
prolonged QT intervals are an adverse effect associated with macrolides
use of macrolides during pregnancy is associated with elevated renal
function tests
Question 17 Cicely is a known diabetic with COPD who admitted to the hospital for pneumonia and acute COPD exacerbation. What treatment would the ACNP prescribe to manage her blood sugars? Continue her BID day dose of 70/30 insulin Every four hour BS readings with sliding scale insulin administration Administer Lantus at bed time and timed administration of regular insulin before meals Continue her 70/30 coverage but increase the dose by 10% to account for the stress of the illness Question 18 A 22 year old female patient with type 1 diabetes presents with abdominal pain and T 100.1. Arterial blood gases reveal pH 7.2, pCO2 of 24, HCO3 12. What other finding would you expect on this patient? Decreased anion gap Decreased respirations Decreased urine output Increased serum ketones
PHof 7. 43 ,PCO 2 of 36 ,
HCO 3 of 26
PHof 7. 41 ,PCO 2 of 49 ,
HCO 3 of 30 PHof 7. 33
,PCO 2 of 35 ,HCO 3 of 17
PHof 7. 25 ,PCO 2 of 56 ,
HCO 3 of 28
Question 20
The most common cause of low serum sodium and high serum osmolality is:
a
Hyperglycemia
b
Hypothyroidism
c Adrenal insufficiency
d
K+ sparing diuretic
Question 21 Which antibiotics would NOT be appropriate to empirically treat an E. Coli infection? Penicillin VK (Pen VK) Cephalexin (Keflex) Nitrofurantoin (Macrobid) Trimethoprim-Sulfamethoxazole (Bactri m DS) Question 22
The NP is managing a 66 year old female admitted to the ICU with a serum
potassium level of
8.9 mEg/L. Hemodialysis will be started as soon as the on-call staff can arrive.
What intervention should the NP order now?
Dextrose 50% , insulin and ,sodium bicarbonate
Sodium bicarbonate and ipratropium bromide
(Atrovent) Calcium gluconate and calcium
acetate (PhosLo)
Sodium polystyrene (Kayexalate) PO and Kayexalate enema
Question 23 The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a fasting blood sugar of 312 and HbA1C of 9. The APRN wants to start the patient on Lantus 0.2 unit/kg. What dose and instructions should the APRN provide? Give 2 units of Lantus subcutaneously prior to lunch every day Give 19 units of Lantus subcutaneously prior to
Question 27 The AGACNP is assessing a patient in the urgent care area. The patient is a 44 year old women in her third round of chemotherapy for breast cancer. She presents today with complains of generalize malaise and fever that has gradually increased over the past 12 hours, BP 110/62 P 96 T 102.6 RR 18 WBC 4.2 ANC 300 The best initial treatment by the AGACNP is:
Begin oral cephlosporin until causative organism is identified Monitor in the observation area for 12 hours to see if temperature is sustained before starting treatment Broad spectrum empiric antibiotic coverage Culture blood, sputum, and urine. Treat with tylenol until culture and sensitivity results are available Question 28 Mrs. J, age 62, is brought to the hospital by ambulance. She is severely dehydrated, does not respond to verbal stimuli, and withdraws from painful stimuli. BP is 90/60 with a heart rate of 130 bpm. Serum blood glucose level is 1000 mg/dl and there are no ketones in the initial urine analysis. HHS is suspected. Mrs. J's lab values would include which finding? Serum sodium of 120 mEq/l Serum osmolality of 380 mOsm/l Urine sodium of 50 mEq/l Bicarbonate of 15 mEq/l Question 29
The NP is caring for a patient with intra renal acute kidney injury (AKI). Which of
the following would cause this?
Acute glomerulonephritis
Ureter obstruction Acute pyelonephritis
Hypovolemia due to hemorrhage
uestion 30
What should be considered prior to prescribing a sulfonamide?
sulfonamide allergy is mild and uncommon
sulfonamides are effective against gram positive organisms only
sulfonamides are a good anti-infective choice during pregnancy and in
elderly
Question 31
Which of the following medications has the best gram negative bacteria
coverage?
Cefuroxime (Cefzil)
Amoxicillin (Amoxil)
Clarithromycin
(Biaxin) Moxifloxacin
(Avelox)
Question 32 A 66 year old patient is admitted to the ICU with hospital acquired pneumonia. She has consolidation in the right middle and lower lung lobe. Arterial blood gasses show a pO of 55%. Which mechanism likely accounts for this patients hypoxia? Decreased pO2 of inspired air Central hypoventilation Mismatch of ventilation and perfusion Decreased oxygen surface tension Question 33 The NP is managing the care of a patient admitted with hypokalemia. The patient's admission serum potassium was 3.0. The patient has been receiving potassium supplements for 4 days. Today's serum potassium is 3.1. What lab test should the NP order to assess this patient's failure to respond to treatment? Sodium Phosphor u s Calcium
Magnesiu m Question 34 A patient with COPD and asthma is intubated and becomes hypotensive. High levels of auto-peep are noted. What changes should be made in the ventilator settings to address the auto peep?
