NRNP 6540 FINAL NEWEST 2024 – 2025 EXAM
COMPLETE 200 ACTUAL EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
The nurse practitioner is making patient rounds in a long-term care facility and is visiting
Mr. Smith, 95 years old, who has a large amount of fungus growing from his toenails.
The staff nurse asks what can be done to help alleviate this nail fungus. What does the
nurse practitioner advise? Select all that apply.
1. Wash and completely dry the feet and toes daily.
2. Keep the patient's feet cool and dry.
3. Use aluminum acetate solution (Burow's solution).
4. Have the patient wear occlusive footwear.
5. Use clotrimazole (ointment, cream, or lotion). - Answer: 1, 2, 3
Feedback
1. The key to prevention of recurrence is to keep the area dry. Use a hairdryer to
thoroughly dry the area after bathing.
2. The key to prevention of all types is to keep the skin cool and dry.
3. The use of aluminum acetate solution (Burow's) and the application of antifungal or
absorbent powder have all been shown to prevent recurrence.
4. Avoiding occlusive footwear, wearing absorbent materials, and practicing good
hygiene offer the best primary prevention.
5. Newer agents are more likely to cure tinea pedis than the older generation of
antifungals, including clotrimazole, which is fungistatic, whereas terbinafine is fungicidal.
pg. 1
,In the assessment for peripheral vascular disorders, the clinician should begin with
which of the following after the general history and physical examination?
1. Auscultation of the carotid arteries bilaterally.
2. Palpation of the carotid arteries bilaterally.
3. Inspection of the carotid arteries bilaterally.
4. Order diagnostic testing. - Answer: 1
Feedback
1. The clinician should begin with auscultation of the carotid arteries bilaterally because
cardiac murmurs will usually radiate into the carotid arteries.
2. After auscultation of the carotid and subclavian arteries, the clinician should proceed
to palpation of the brachial, radial, and ulnar arteries.
3. After auscultation and palpation, careful inspection should be performed of the distal
fingers and the nail beds.
4. Diagnostic testing is usually ordered when areas of concern are found.
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?
1. Abdominal aortic aneurysm (AAA)
2. Venous ulcers
3. Peripheral vascular disease (PVD)
4. Lymphedema - Correct Answer: 4
Feedback
1. AAA presents the signal symptoms of persistent or intermittent pain in the middle or
lower abdomen, radiating to the lower back.
2. Venous leg ulcers present signal symptoms of swelling that subside with elevation of
lower extremities, eczematous skin changes, dull ache in lower extremities, and
presence of varicosities.
3. PVD is a disease that alters blood flow to or from the extremities and vital organs
other than the heart. It presents signal symptoms of pain, intermittent claudication of the
feet, and tissue loss in affected leg/arm.
pg. 2
,4. Lymphedema presents the signal symptoms of swelling of the affected body part,
usually the limb, because of impaired flow of lymph fluid.
In the initial screening for a diagnosis of AAA, which of the following is the best
screening test?
1. CT scan
2. Complete blood count (CBC)
3. Ultrasound in the abdominal area
4. Angiography - Correct Answer : 3
Feedback
1.CT screening is indicated when surgery is planned.
2. CBC may be a secondary screening when surgery is planned.
3. Ultrasound in the abdominal area is the best initial screening test for AAA.
4. Angiography screening is indicated when surgery is planned.
Lucy is 65 years old and has been coping with irritable bowel syndrome-diarrhea (IBS-
D) for over 10 years. She has tried various treatments with minimal effectiveness. She
asks the nurse practitioner if there is anything else that might be helpful to control this
diarrhea. The nurse practitioner suggests which of the following? Select any that apply.
1. Antispasmodics
2. Caffeinated beverages
3. Antidiarrheal medications
4. Eluxadoline,75 mcg, twice daily with food
5. Rifaximin - Correct Answer: 4, 5
Feedback
1. Antispasmodics are not recommended for treatment of IBS-D in older adults because
of the anticholinergic side effects of these medications.
2. Foods that may exacerbate IBS-D should be avoided (e.g., caffeinated beverages).
pg. 3
, 3. Antidiarrheal medications are not beneficial in treating global IBS-D symptoms.
4. A newer agent recently approved for the treatment of IBS-D is a combination mu-
opioid receptor agonist and delta-opioid receptor antagonist called eluxadoline in doses
of 100 mcg and 75 mcg to be given twice a day with food. This has been shown
effective in improving both diarrhea and abdominal pain symptoms associated with IBS-
D.
5. Early studies point to the use of rifaximin, an antibiotic, for consideration of the
treatment of IBS without constipation and can be considered for use with patients who
have not had success with other treatments.
Thom is 60 years old and has been treated for nonalcoholic fatty liver disease (NAFLD)
for over 10 years. He still suffers from fatigue, abdominal pain, and an enlarged liver.
The nurse practitioner discusses which of the following home-care plans to assist him in
adjusting to his disease? Select all that apply.
1. Monitor weight and stay within optimal weight limits.
2. Avoid anti-lipid medications, such as atorvastatin.
3. Obtain a hepatitis A and B vaccine, if not immune.
4. May drink alcohol socially, but not daily.
5. If obese, set a goal for rapid weight loss. - Correct Answer: 1, 3
Feedback
1. Overweight or obese patients with NAFLD should consider a weight-loss program. It
has been shown that weight loss and exercise reduce liver enzyme levels and steatosis.
2. Treatment for hyperlipidemia (atorvastatin, gemfibrozil) has been shown to improve
liver enzymes and liver steatosis.
3. The hepatitis A and B vaccine should be given to patients without serological
evidence of immunity.
4. Patients with NAFLD should avoid alcohol consumption.
5. Weight loss should not exceed 1 to 2 pounds a week. Patients should avoid rapid
weight loss.
pg. 4
