NR601 Week 8: Final Exam (june-2026)

NR601 Week 8: Final Exam [June-2026]

A 72-year-old man presents to the clinic with a history of NSAID use for chronic osteoarthritis and now reports vague epigastric discomfort. He denies heartburn or regurgitation but mentions some nausea and decreased appetite. The NP suspects peptic ulcer disease. Which of the following BEST explains a contributing factor to his condition?

Answers: A – D

1. Stimulation of mucus production by COX-2 inhibition
2. ✅ Inhibition of COX-1, which impairs mucosal integrity
3. Increased bicarbonate secretion due to NSAID use
4. Enhanced gastric blood flow from prostaglandin inhibition

The NP is assessing a patient with suspected rheumatoid arthritis (RA) and finds that the patient is positive for anti-cyclic citrullinated peptide (anti-CCP antibodies) but negative for rheumatoid factor (RF). Based on this result, what is the MOST appropriate interpretation?

Answers: A – D

1. RA is unlikely, and another autoimmune disease should be considered
2. ✅ RA remains a strong possibility, as anti-CCP antibodies are highly specific for the disease
3. RA can be ruled out because RF is necessary for diagnosis
4. RA is diagnosed only when both RF and anti-CCP antibodies are positive

Which of the following BEST defines an uncomplicated urinary tract infection (UTI)?

Answers: A – D

1. An infection involving the kidneys, with systemic symptoms such as fever and flank pain
2. ✅ An infection confined to the bladder, or acute cystitis
3. A catheter-associated infection with positive urine culture but no symptoms
4. A recurrent bladder infection in a postmenopausal woman with diabetes

A 68-year-old male with no significant symptoms presents for a routine check-up. His digital rectal examination (DRE) is normal, but his baseline serum PSA level is 2.5 ng/mL. He is in good health with a life expectancy of over 15 years. Based on current guidelines and best practices, what is the MOST appropriate next step in managing this patient?

Answers: A – D

1. Reassure the patient and repeat PSA testing in 5 years
2. ✅ Engage in shared decision-making about PSA-based screening and monitoring
3. Recommend prostate biopsy due to elevated PSA
4. Prescribe an alpha-reductase inhibitor and reassess PSA in 6 weeks

The NP is evaluating a patient with frequent migraine attacks who prefers to avoid daily medications. The patient has no history of cardiovascular disease. Which of the following is the BEST option for acute treatment?

Answers: A – D

1. Propranolol (Inderal)
2. ✅ Sumatriptan (Imitrex)
3. Naproxen (Naprosyn)
4. Amitriptyline (Elavil)

A 58-year-old woman with a 10-year history of rheumatoid arthritis presents for routine follow-up. She has morning stiffness lasting over an hour and reports increasing shortness of breath on exertion. She is a former smoker and has no history of cardiac disease. Physical examination reveals fine bibasilar crackles, and pulmonary function testing shows a restrictive pattern with reduced diffusing capacity for carbon monoxide (DLCO). Which of the following is the MOST likely pulmonary complication of her underlying disease?

Answers: A – D

1. Chronic obstructive pulmonary disease (COPD)
2. Pulmonary embolism
3. Bronchial asthma
4. ✅ Usual interstitial pneumonia (UIP)

Which of the following is a risk factor for developing urinary tract infections in aging patients?

Answers: A – D

1. Daily physical activity
2. High fluid intake
3. ✅ Urinary retention
4. Increased estrogen levels

A 54-year-old postmenopausal woman with an intact uterus asks about estrogen therapy for fracture prevention. What additional medication is MOST important to include if you prescribe estrogen?

Answers: A – D

1. Alendronate (Fosamax)
2. Raloxifene (Evista)
3. Calcitonin-salmon (Miacalcin)
4. ✅ Progesterone (Prometrium)……………………………………purchase this 100% accurate exam at $99 only