NR601 WEEK 4: MIDTERM EXAM (may-2026)

A 78-year-old patient with mild cognitive impairment is being evaluated for a surgical procedure. The NP is concerned about the patient’s ability to understand the risks and benefits of the surgery. Which of the following is the most appropriate initial step in evaluating the patient’s medical decision-making capacity?

Proceed with assigning a legal guardian to make medical decisions
Document the patient as medically incompetent and involve a surrogate decision-maker for all future decisions
Refer the patient for formal neuropsychological testing to assess global cognitive function
✅ Assess whether the patient has received and comprehended all relevant information, accounting for any sensory or language barriers

The NP is evaluating whether a patient with ischemic heart disease should be started on a beta- adrenergic blocker. Which patient would a beta-adrenergic blocker be CONTRAINDICATED?

✅ A patient with severe bradycardia and a history of mental depression
A patient with hypertension and no history of lung disease
An insulin-dependent patient with mild bronchial obstruction
A patient with stable angina and controlled diabetes

The NP is diagnosing a patient with a respiratory viral infection. Which diagnostic test is considered the gold standard for identifying specific viral etiology?

Chest radiography
Rapid antigen-based diagnostic tests
Direct or indirect fluorescent antibody detection
✅ Virus isolation by inoculation of cell cultures

Which of the following patient presentations is MOST consistent with stable angina?

Sudden chest discomfort lasting over 30 minutes
Pain in the left shoulder occurring only after meals
Sharp chest pain that worsens with deep inspiration
✅ Chest pain relieved by rest and sublingual nitroglycerin

A 78-year-old man with a history of hypertension is found to have left ventricular hypertrophy on echocardiogram. Why is this finding clinically significant?