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NURS 6531 FINAL EXAM WEEK 11 SPRING QTR 2025
WITH ALL 200 QUESTIONS AND CORRECT DETAILED
ANSWERS ALREADY GRADED A+ |WALDEN
UNIVERSITY/ NURS 6531 PRACTICE CARE OF ADULTS
LATEST FINAL EXAM (BRAND NEW!!)
A pregnant woman at 30 weeks gestation presents with proteinuria. What will the provider do next?
- Evaluate her blood pressure and discuss with OB/GYN
- Monitor serum glucose for gestational diabetes
- Perform a 24-hour urine collection
- Reassure her that this normal at this stage of pregnancy - Correct Answer - ANS: A
Proteinuria after 24 weeks gestation is usually a sign of preeclampsia, so her blood pressure should be evaluated and discussed with the OB/GYN. Serum glucose evaluation for gestational diabetes is performed as part of routine screening but is not related to the finding of proteinuria. A 24-hour urine collection is not indicated.
An older male patient reports gross hematuria but denies flank pain and fever. What will the provider do to manage this patient?
- Monitor blood pressure closely
- Obtain a urine culture
- Perform a 24-hour urine collection
- Refer for cystoscopy and imaging - Correct Answer - Gross hematuria in older men
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denotes a significant risk of malignant disease, so cystoscopy and imaging are indicated. Proteinuria is concerning for hypertension. The patient does not have flank pain or fever, so the likelihood of infection is lower. A 24-hour urine collection is not indicated.
pg. 2 A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection. After treatment for the urinary tract infection (UTI), what testing is indicated for this patient?
- 24-hour urine collection to evaluate for glomerulonephritis
- Bladder scan
- Repeat urinalysis
d. Voiding cystourethrogram - Correct Answer - ANS: C
After treatment has been completed, repeated urinalysis is necessary to ensure that the hematuria has resolved. Failure to follow hematuria to resolution may result in failure to diagnose a serious condition.
Which is a prerenal cause of acute kidney injury (AKI)?
- Hemorrhagic shock
- Hydronephrosis
- Hypertension
d. Renal calculi - Correct Answer - ANS: A
Hemorrhagic shock interferes with perfusion of the kidney, which is a prerenal cause of AKI. Hydronephrosis and renal calculi are postrenal causes leading to obstruction to renal pelvis, ureters, bladder, or urethra. Hypertension is an intrinsic cause.
A primary care provider sees a new patient who reports having a diagnosis of chronic kidney disease for several years. The patient is taking one medication for hypertension which has been prescribed since the diagnosis was made. The provider orders laboratory tests to evaluate the status of this patient. Which laboratory finding indicates a need to refer the patient to a nephrologist?
- Albumin/creatinine ratio (ACR) of 325 mg/g
- Blood pressure of 145/85 mm Hg
- Glomerular filtration rate (eGFR) of 35
d. Urine red blood cell (RBC) count of 15/hpf - Correct Answer - ANS: A
An albumin/creatinine ratio greater than 300 mg/g warrants referral. A specialist is necessary for persistent hypertension refractory to treatment with four or more agents, a GFR of less than 30, and urine RBC greater than 20/hpf. 2 / 4
pg. 3 Which tests should be monitored regularly to monitor for complications of chronic renal disease (CRD)? (Select all that apply.)
- Liver enzymes
- Parathyroid hormone levels
- Serum glucose
- Serum lipids
e. Vitamin D levels - Correct Answer - ANS: B, D, E
CKD can cause hyperparathyroidism, hyperlipidemia, and alterations in vitamin D, calcium, and phosphorus metabolism, so these should be monitored. Liver function and serum glucose are not affected by CKD.
Which is true about hypoactive sexual desire in older men?
- Hypoactive sexual desire in older men is related to sexual aversion.
- Hypoactive sexual desire is a conscious choice to avoid sexual relations.
- Men with hypoactive sexual desire may have normal excitement and orgasm.
- The most common type of sexual dysfunction is hypoactive sexual desire. - Correct
Answer - ANS: C
Men with hypoactive sexual desire have diminished response in the desire phase of the sexual response cycle but may still experience normal excitement and orgasm. Sexual aversion and hypoactive desire are not related. Many people with normal sexual desires choose not to have sexual relations; hypoactive desire is a physiological condition. Only 16% of men have hypoactive desire.
A 50-year-old man reports having erectile dysfunction (ED). What is an important response by the provider when developing a plan of care for this patient?
- Considering testosterone hormone replacement therapy
- Evaluating the patient for cardiovascular disease
- Prescribing an oral phosphodiesterase type 5 inhibitor
- Referring the patient for psychotherapy and counseling - Correct Answer - ANS: B
Men under age 60 years with ED are at higher risk for cardiovascular disease, so this patient should be evaluated for this condition. Until the underlying cause is found, 3 / 4
pg. 4 prescribing medications or hormones is not indicated. Psychotherapy and counseling are used when psychogenic ED is present.
The provider prescribes the oral phosphodiesterase type 5 inhibitor sildenafil to treat erectile dysfunction (ED) in a 65-year-old male patient. What will be included when teaching this patient about taking this medication? (Select all that apply.)
- The medication is best taken on an empty stomach.
- The medication should be taken with a fatty food or meal.
- The medication's effects may last for 24 to 36 hours.
- This medication has a rapid onset and short duration of action.
e. This medication may be taken once daily. - Correct Answer - ANS: A, D
Sildenafil has a rapid onset and short duration of action and should be taken on an empty stomach. Fatty foods may delay or interfere with absorption. This medication is given when sexual activity is desired and not once daily.
A young adult male reports a dull pain in the right scrotum and the provider notes a bluish color showing through the skin on the affected side. Palpation reveals a bag of worms on the proximal spermatic cord. What is an important next step in managing this patient?
- Anti-infective therapy with ceftriaxone or doxycycline
- Consideration of underlying causes of this finding
- Reassurance that this is benign and may resolve spontaneously
- Referral to an emergency department for surgical consultation - Correct Answer -
ANS: B
This patient has symptoms of varicocele. Because varicocele is rare on the right side, the provider should look for underlying causes of these findings. Anti infective therapy is indicated for epididymitis. Varicocele requires surgical intervention or ablation to resolve. Testicular torsion is an emergency.
An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention?
- Doppler ultrasound to assess testicular blood flow
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