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NR601 WEEK 8: FINAL EXAM – (June 2026)
The NP is developing a management plan for a patient with asymptomatic vascular dementia as evidenced by small vessel cerebrovascular disease on imaging. Which intervention would be the MOST appropriate FIRST step in management?
Answers: A – D
A Screen for atrial fibrillation and consider prolonged cardiac monitoring
B Initiate antiplatelet therapy and statins for stroke prevention
✔️ C Follow primary stroke prevention guidelines for blood pressure, cholesterol and lifestyle management
D Prescribe anticoagulation therapy due to risk of silent embolic events
The NP is evaluating a patient who presents with sudden episodes of intense fear, palpitations, shortness of breath, and chest pain. The patient is concerned that they may have a heart condition. An electrocardiogram (ECG) and coronary angiogram reveal no abnormalities. Based on this finding, which choice is the MOST appropriate NEXT step in diagnosing the cause of the patient’s symptoms?
Answers: A – D
A Assess for a history of recurrent panic attacks and behavioral changes
B Prescribe benzodiazepines for immediate symptom relief
✔️ C Perform a thyroid function test to rule out thyrotoxicosis
D Evaluate the patient for a structural heart condition
A patient with chronic hyperuricemia presents with recurrent episodes of severe joint pain and inflammation. Based on the pathogenesis of gout, which of the following BEST explains the underlying cause of these symptoms?
Answers: A – D
✔️ A Loss of uricase enzyme results in urate accumulation and monosodium urate (MSU) crystal deposition
B Excess uric acid is rapidly cleared from the bloodstream, leading to crystal dissolution
C Gout occurs only in individuals with insulin resistance syndrome and cardiovascular disease
D Urate remains highly soluble in human physiology, preventing crystal formation
A 45-year-old patient is diagnosed with BPPV after a positive Dix-Hallpike maneuver. What is the MOST appropriate initial treatment in the clinic setting?
Answers: A – D
✔ A Perform the Epley repositioning maneuver
B Refer for MRI of the brain
C Recommend physical therapy for neck strengthening
D Prescribe corticosteroids and rest
Which of the following BEST describes a major limitation of using serum albumin as a nutritional marker in clinical practice?
Answers: A – D
A It is elevated in most malnourished patients and therefore lacks specificity
B It reflects only long-term nutritional intake and not current status
✔ C It is a negative acute-phase reactant and often suppressed by inflammation
D It varies too greatly with patient hydration to offer useful data
A 65-year-old patient with poorly controlled type 2 diabetes reports burning pain and tingling in both feet, which has gradually progressed over the past year. On examination, there is decreased vibration and pinprick sensation in a stocking distribution. Which of the following is the BEST initial step in management?
Answers: A – D
A Start a trial of a tricyclic antidepressant for symptom relief
✔ B Begin strict glycemic control and monitor for progression
C Refer for electromyography and nerve conduction studies
D Prescribe high-dose corticosteroids for suspected autoimmune neuropathy
A 65-year-old patient with poorly controlled type 2 diabetes reports burning pain and tingling in both feet, which has gradually progressed over the past year. On examination, there is decreased vibration and pinprick sensation in a stocking distribution. Which of the following is the BEST initial step in management?
Answers: A – D
A Start a trial of a tricyclic antidepressant for symptom relief
✔ B Begin strict glycemic control and monitor for progression
C Refer for electromyography and nerve conduction studies
D Prescribe high-dose corticosteroids for suspected autoimmune neuropathy
A 29-year-old woman presents to the clinic reporting episodes of sudden palpitations, shortness of breath, chest tightness, and fear of dying. These episodes occur without warning and typically last about 45 minutes. She now avoids crowded places and prefers to stay home, fearing the recurrence of symptoms. Her physical exam and routine labs are unremarkable. What is the BEST initial pharmacologic treatment for this patient?
Answers: A – D
✔ A Sertraline (Zoloft) 25 mg daily
B Propranolol (Inderal) 20 mg as needed
C Alprazolam (Xanax) 1 mg three times daily
D Amitriptyline (Elavil) 100 mg at bedtime
The NP has diagnosed a patient with type 2 diabetes mellitus after observing a fasting plasma glucose (FPG) of 210 mg/dL. The patient is asymptomatic with no history of cardiovascular or renal disease. According to current guidelines and the characteristics of available agents, which is the MOST appropriate initial treatment approach?
Answers: A – D
A Initiate insulin therapy due to FPG >200 mg/dL
B Begin treatment with a GLP-1 receptor agonist as monotherapy
✔ C Start lifestyle modification and prescribe metformin
D Start a sulfonylurea to achieve a faster glucose-lowering effect……………………………………purchase this entire exam at $75 only
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