NR 601 Week 4 Midterm Exam

Question 8 A patient with atrial fibrillation has a CHA₂DS₂-VASc score indicating elevated stroke risk. What is the priority management consideration? A. Daily aspirin alone for all patients B. Stroke prevention with appropriate anticoagulation, if indicated C. Immediate pacemaker placement D. Antibiotic therapy Answer: B Question 9 A 65-year-old smoker presents with chronic cough and progressive dyspnea. Which diagnosis is most likely? A. COPD B. Migraine C. Appendicitis D. Peptic ulcer disease Answer: A Question 10 Which test confirms persistent airflow obstruction in COPD? A. Chest X-ray B. Spirometry after bronchodilator administration C. CBC D. Pulse oximetry alone Answer: B Question 11 C. GERD D. Sinus headache Answer: A Question 15 What is the most important first step in evaluating dizziness in an older adult? A. Prescribe meclizine immediately B. Obtain a focused history and perform a targeted physical examination C. Start antibiotics D. Order MRI for every patient Answer: B Question 16 Which medication class is associated with an increased risk of hyperkalemia? A. ACE inhibitors B. Antacids C. Acetaminophen D. Antihistamines Answer: A Question 17 A patient taking warfarin develops black, tarry stools. What is the most appropriate action? A. Reassure the patient B. Advise immediate medical evaluation for possible gastrointestinal bleeding C. Recommend an over-the-counter antacid D. Continue the medication without assessment Answer: B C. Mini-Cog D. Snellen visual acuity test Answer: B Question 22 A patient with diabetes presents for preventive care. Which recommendation is most appropriate? A. Annual comprehensive foot examination B. Foot examination only if symptoms occur C. Avoid exercise D. Annual chest CT regardless of smoking history Answer: A Question 23 Which medication is included in the AGS Beers Criteria as potentially inappropriate for many older adults because of its anticholinergic effects? A. Diphenhydramine B. Acetaminophen C. Amoxicillin D. Calcium carbonate Answer: A Question 24 A patient with asthma experiences symptoms twice per week but not daily. How should asthma control be assessed? A. By symptom frequency, nighttime awakenings, activity limitation, rescue inhaler use, and lung function B. Chest X-ray alone C. CBC only D. Sputum culture only Question 28 Which symptom most strongly suggests uncontrolled hypothyroidism? A. Heat intolerance and tremor B. Weight gain, constipation, and fatigue C. Persistent diarrhea and palpitations D. Excessive sweating Answer: B Question 29 A 70-year-old woman with osteoporosis asks about fracture prevention. Which recommendation has the strongest evidence? A. High-dose vitamin C alone B. Weight-bearing exercise with adequate calcium and vitamin D intake C. Bed rest D. Protein restriction Answer: B Question 30 A patient with atrial fibrillation reports sudden onset of unilateral weakness and slurred speech. What is the priority action? A. Schedule an office visit next week B. Activate emergency stroke evaluation immediately C. Recommend acetaminophen D. Encourage hydration only Answer: B Question 31 Which finding is most consistent with acute bacterial sinusitis rather than a viral upper respiratory infection? Question 35 Which laboratory test is most appropriate to monitor long-term glycemic control? A. Hemoglobin A1c B. Random sodium C. ALT only D. Troponin