NRNP 6645 MIDTERM EXAM QUESTIONS AND CORRECT
ANSWERS| ACCURATE REAL EXAM WITH FREQUENTLY
TESTED QUESTIONS AND RATIONALE|ALREADY A
GRADED|GUARANTEED PASS|LATEST UPDATE 2024/2025.
Hearing loss is a decreased ability or inability to hear. The loss may involve the external, middle,
or inner ear and can be unilateral or bilateral. Which of the following etiologies may result in
hearing loss? Select all that apply. - CORRECT ANSWER Sensorineural
Conductive
Dan is 70 years old and has been having frequent bouts of kidney stones. They are painful, and
he has had one procedure done for nephrolithiasis. Dan asks the nurse practitioner if there is
anything he can do to prevent these. He says his brother also has them, so he wonders if it is just
familial. How does the nurse practitioner respond? Select all that apply. - CORRECT ANSWER
Increase the amount of fluids you drink daily.
Avoid eating foods such as dairy, spinach, and nuts.
Some medications can contribute to stone formation.
Report signs of possible urinary tract infections to a physician for treatment.
Mr. Angulo is an 89-year-old patient who was recently an inpatient for pneumonia and was
bedridden for 1 week. He is now presenting dysuria, suprapubic tenderness accompanied by
fever, and increased confusion. Based on his recent history, which of the following conditions
may be developing? - CORRECT ANSWER Cystitis
Mr. Jones, a 70-year-old male, visits the urgent care and presents symptoms of unilateral eye
pain, visual blurring with halos around lights, red eye, and photophobia. He also reports nausea
and vomiting. Visual acuity shows a loss in the affected eye. He is immediately referred for a
complete ophthalmic examination. Which of the following conditions may Mr. Jones be
experiencing? - CORRECT ANSWER Acute glaucoma
Jane Smith is a 70-year-old Caucasian woman who comes to see her nurse practitioner for pain
in her abdomen. The nurse practitioner is aware that Mrs. Smith is obese and has diabetes.
Which of the following is a definitive diagnostic test for cholecystitis? - CORRECT ANSWER
Real-time ultrasonography of the gallbladder and biliary tree.
A patient is started on a low dose of a drug for safety but is never advanced to a therapeutic dose
while another drug is added. Which of the following does this describe? - CORRECT ANSWER
Clinical inertia.
Mrs. M. W. comes into the primary care office for her regular yearly checkup. The nurse
practitioner begins the assessment by asking if there are concerns Mrs. M. W. has that need to be
addressed. The patient says that she has been experiencing periodic episodes of abdominal
cramps and diarrhea that just comes and goes. The nurse practitioner continues the assessment
with which of the following? - CORRECT ANSWER Asking about the sequence of events and
events that triggered each episode
,Which of the following is the best statement regarding dyspnea - CORRECT ANSWER
Dyspnea is one of the most common reasons for visits to the emergency room for individuals
with advanced disease.
Mr. Adams is 90 years old. In the last few months he appears unable to comply with the health-
care plan developed by the nurse practitioner. The nurse practitioner considers which of the
following reasons for noncompliance when updating his home care plan? Select all that apply. -
CORRECT ANSWER Polypharmacy
Treatment burden
Attending multiple appointments
Affording complex drug regimens
Mary, 72 years old, goes to the pharmacy to pick up her prescriptions. The pharmacist asks if she
has had her immunizations. Mary replies, "I had all my childhood shots, so I do not need any
now." What should the nurse practitioner teach her about senior immunizations? Select all that
apply. - CORRECT ANSWER .
-Because the immune system may be weakened in older persons, immunizations are suggested.
-Persons over the age of 50 years should have a yearly influenza vaccine.
-The new Shingrix vaccine will help protect her from shingles.
Which of the following is a contraindication for exercise therapy and prevents patients from
joining an exercise program?
Select all that apply. - CORRECT ANSWER Uncontrolled hypertension
Unstable aortic aneurysm
Which of the following may be included in the healthy lifestyle counseling during the initial
Welcome to Medicare visit? Select all that apply. - CORRECT ANSWER Level of physical
activity assessment.
Physical therapy consultation.
Referral to a health coach.
A family member comes into the clinician's office with her older mother, the patient. In the
process of the examination, the nurse practitioner identifies the patient as "frail older adult." The
family member asks what that means. The nurse practitioner explains that this refers to: -
CORRECT ANSWER An older person already exhibiting signs of decline.
Mrs. Parsons is 75 years old and is anticipating renewing her driver's license. The nurse
practitioner conducts an eye examination and is concerned to find which of the following? Select
all that apply. - CORRECT ANSWER Visual acuity worse than 20/40.
Abnormality in the six cardinal fields of gaze.
A patient complains of dry, irritated, and itchy skin that has not been relieved with over-the-
counter medications. On examination, the patient is also found to present cholestasis and
jaundice. From which of the following conditions may the patient be suffering? - CORRECT
ANSWER Pruritus
,Which of the following terms refers to conditions that have multiple underlying factors and may
involve multiple organs? - CORRECT ANSWER Geriatric syndrome
The nurse practitioner knows that risk factors for coronary artery disease (CAD) include
atherosclerosis. The nurse practitioner includes teaching on these factors that can be remediated
to help prevent CAD: - CORRECT ANSWER Cholesterol levels and smoking.
Ms. Jameson, 72 years old, comes to the clinic with concerns about her breathing. She states that
she is having trouble with mucus collection and difficulty coughing it out. The nurse practitioner
suggests which of the following? Select all that apply. - CORRECT ANSWER -As you get
older, the tissue in your lungs is not as flexible to aid in exhaling.
-The body contains less water as you age, and the mucus begins to dry out.
Which of the following conditions is signaled by symptoms of swelling of the affected body
part, usually the limb, because of impaired flow of lymph fluid? - CORRECT ANSWER
Lymphedema
Abdominal Aortic Aneurysm (AAA) is mostly atherosclerotic in nature, but can also be caused
by trauma, infection, and inflammation. Which of the following is a true statement regarding the
tendency to develop AAA? Select all that apply. - CORRECT ANSWER -There is no dominant
ethnic group that develops AAA.
-There is a familial history associated with AAA development.
-AAA is the 13th leading cause of death in the United States.
The nurse practitioner is serving in a clinic dedicated to patients over age 65 years. The nurse
practitioner observes several common characteristics in the posture of elderly patients. Which of
the following is common? - CORRECT ANSWER Head tips backward.
Miss Benton is a 65-year-old female who complains of a painful big toe on the right foot. She
asks the nurse practitioner if this is normal for older people. The nurse practitioner explains that
this appears to be gout, and gives her what information? Select all that apply. - CORRECT
ANSWER Gout is an inflammatory condition of joints, tissues, and kidneys.
Gout is a problem with a protein called purine.
Long-term use of some medications can lead to gout.
A patient is being assessed for symptoms of headaches, changes in mental function, language
deficits, and visual problems. Diagnostic testing reveals that he does not have a brain tumor.
Which of the following may be the differential diagnosis for the patient's symptoms? Select all
that apply. - CORRECT ANSWER Stroke
Subdural hematoma
Meningitis
(credit also given for DM)
The nurse practitioner is conducting an admitting assessment of a 69-year-old man. He has
diminished ability to ambulate and has difficulty with activities of daily living (ADLs). In the
, interview, the nurse practitioner asks him if he drinks alcohol. He says, "Yes." The practitioner
follows up with a psycho-social evaluation because: - CORRECT ANSWER His condition
could be related to a long-term usage of alcohol or a new occurrence.
Ms. Smith, 70 years old, is being treated for geriatric depression. What choices does the nurse
practitioner have to order? Select all that apply. - CORRECT ANSWER Evaluate the present
medication regimen.
Treat any comorbidity.
Maintain basic daily needs.
Order a selective serotonin reuptake inhibitor (SSRI).
Order Abilify.
Mrs. K 95 years old, comes to the nurse practitioner with her daughter to discuss her medical
regime. She complains that she thinks some of the therapies are doing more harm than good.
Mrs. K wants to discontinue some of the medical orders. The nurse practitioner reviews her
medical plan and discusses a new model of care called minimally disruptive medicine (MDM).
She explains to the daughter and to Mrs. K that this model does which of the following? Select
all that apply. - CORRECT ANSWER .
-Recognizes the difference between patient-centered and disease-centered treatment.
-May suggest limitations on some traditional therapies for the frail patient with MCCs.
-Revises clinical practice guidelines to consider minimally disruptive medicine.
-Has clinicians use approaches that include patient values so that better decisions are made.
The nurse practitioner is asked to order medication for pain and disease control for a 60-year-old
patient who has suffered with RA for years. Which is the most common treatment? Select all that
apply. - CORRECT ANSWER Corticosteroids
NSAIDs
Analgesics
Biological disease-modifying antirheumatic drugs (DMARDs)
Tumor necrosis factor (TNF) receptor antagonists
Mark, 82 years old, is in a rehabilitation center for therapy post-knee replacement. The nurse
practitioner is visiting Mark and finds him confused, disoriented, and with speech difficulty. The
staff nurse says that his condition changed quickly over the last few hours. The nurse practitioner
orders which of the following? Select all that apply. - CORRECT ANSWER Pulse oximetry
Evaluation for infections
Assessment of change in medications
Brain scan
Conscious incompetency - CORRECT ANSWER A stage where a person is aware of their lack
of skill or knowledge.
Conscious competency - CORRECT ANSWER A stage where a person is aware of their skill or
knowledge and can perform it.
Unconscious competency - CORRECT ANSWER A stage where a person can perform a skill or
knowledge without conscious thought.
