1|Page
UTA CP2 FNP FINAL ACTUAL EXAM
PREP 2026 |ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |RATED A+ | NEW AND
REVISED
1. A 45-year-old female presents with fatigue, weight gain, and cold
intolerance. On exam, she has dry skin and bradycardia. Which
laboratory test is most appropriate to confirm the suspected
diagnosis?
A. Serum calcium
B. TSH and free T4
C. Serum cortisol
D. Complete blood count
Rationale: Fatigue, weight gain, cold intolerance, and
bradycardia suggest hypothyroidism. TSH and free T4 are first-
line tests to confirm thyroid function.
2. A 7-year-old presents with a barking cough, stridor, and low-grade
fever. The nurse practitioner suspects croup. Which intervention is
first-line?
A. Broad-spectrum antibiotics
B. Dexamethasone oral or intramuscular
C. Nebulized albuterol
D. Oxygen only
Rationale: Croup is primarily viral; corticosteroids reduce airway
inflammation. Antibiotics are not indicated unless bacterial
infection is confirmed.
,2|Page
3. A patient with type 2 diabetes reports new-onset numbness and
tingling in the feet. Which is the most appropriate initial
assessment?
A. HbA1c only
B. Monofilament testing and foot exam
C. MRI of lumbar spine
D. Serum creatinine
Rationale: Peripheral neuropathy screening is recommended
annually using monofilament testing. MRI is unnecessary unless
neurological deficits suggest spinal pathology.
4. A 60-year-old male with hypertension presents for routine follow-
up. BP is 150/95 mmHg. He reports adherence to lifestyle
modifications but no medications. According to current guidelines,
what is the next step?
A. Observe and recheck in 12 months
B. Begin lifestyle modifications only
C. Start antihypertensive therapy
D. Prescribe diuretics only if edema develops
Rationale: According to ACC/AHA 2017 guidelines, stage 2
hypertension (≥140/90 mmHg) requires initiation of
pharmacologic therapy in addition to lifestyle interventions.
5. A 32-year-old female presents with sudden-onset right lower
quadrant pain, nausea, and vomiting. Physical exam shows
rebound tenderness. What is the most appropriate next step?
A. Pelvic ultrasound only
B. Surgical consult for suspected appendicitis
C. Prescribe analgesics and observe
D. Order stool studies
Rationale: Acute appendicitis is a surgical emergency; imaging
may assist, but immediate surgical consultation is standard of
care.
6. Which of the following vaccines is recommended for all adults
aged 65 years and older, regardless of previous vaccination
history?
A. Hepatitis B
,3|Page
B. Varicella
C. Shingles (Shingrix)
D. HPV
Rationale: CDC recommends the recombinant shingles vaccine
for all adults ≥50, regardless of previous shingles history.
7. A 28-year-old male presents with dysuria, urethral discharge, and a
history of unprotected sex. Which is the most appropriate empiric
treatment before lab results return?
A. Ciprofloxacin alone
B. Metronidazole
C. Ceftriaxone IM plus doxycycline
D. Amoxicillin
Rationale: Empiric treatment covers gonorrhea and chlamydia
per CDC guidelines: ceftriaxone for gonorrhea and doxycycline
for chlamydia.
8. A patient presents with acute asthma exacerbation. Which
assessment finding indicates severe obstruction?
A. Mild wheezing only
B. Peak expiratory flow <50% predicted
C. Respiratory rate 18
D. Pulse oximetry 98% on room air
Rationale: Severe asthma is indicated by significantly reduced
peak expiratory flow (<50%), accessory muscle use, and
hypoxemia.
9. A 25-year-old woman presents with fever, right costovertebral
angle tenderness, and dysuria. Which test best confirms acute
pyelonephritis?
A. Urine culture and urinalysis
B. Urinalysis with pyuria, bacteriuria, and urine culture
C. Renal ultrasound only
D. CBC only
Rationale: Urinalysis and urine culture confirm infection;
imaging is reserved for complicated cases.
10. Which antihypertensive class is considered first-line therapy
for a patient with diabetes and albuminuria?
, 4|Page
A. Beta-blocker
B. Calcium channel blocker
C. Diuretic
D. ACE inhibitor or ARB
Rationale: ACE inhibitors or ARBs are preferred due to renal-
protective effects in diabetic nephropathy.
11. A 35-year-old presents with palpitations and anxiety. Lab
work reveals elevated free T4 and suppressed TSH. What is the
most likely diagnosis?
A. Hypothyroidism
B. Hashimoto thyroiditis
C. Hyperthyroidism
D. Thyroid cancer
Rationale: Low TSH and high T4 indicate primary
hyperthyroidism; symptoms of palpitations and anxiety are
consistent.
12. A 72-year-old female with a history of COPD presents with
sudden shortness of breath and pleuritic chest pain. Vital signs: HR
110, BP 100/60, RR 28, SpO2 88% on room air. What is the most
likely diagnosis?
A. Pneumonia
B. Asthma exacerbation
C. Pulmonary embolism
D. Pneumothorax
Rationale: Acute SOB, pleuritic pain, hypotension, and
hypoxemia in this patient suggest PE; risk factors include age
and immobility.
13. A patient presents with chronic low back pain. Red-flag
symptoms include all EXCEPT:
A. Unexplained weight loss
B. Mild intermittent pain for 3 months
C. History of cancer
D. Neurologic deficits
Rationale: Chronic, mild pain without systemic symptoms is not
a red flag; other options suggest serious underlying pathology.
UTA CP2 FNP FINAL ACTUAL EXAM
PREP 2026 |ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES |RATED A+ | NEW AND
REVISED
1. A 45-year-old female presents with fatigue, weight gain, and cold
intolerance. On exam, she has dry skin and bradycardia. Which
laboratory test is most appropriate to confirm the suspected
diagnosis?
A. Serum calcium
B. TSH and free T4
C. Serum cortisol
D. Complete blood count
Rationale: Fatigue, weight gain, cold intolerance, and
bradycardia suggest hypothyroidism. TSH and free T4 are first-
line tests to confirm thyroid function.
2. A 7-year-old presents with a barking cough, stridor, and low-grade
fever. The nurse practitioner suspects croup. Which intervention is
first-line?
A. Broad-spectrum antibiotics
B. Dexamethasone oral or intramuscular
C. Nebulized albuterol
D. Oxygen only
Rationale: Croup is primarily viral; corticosteroids reduce airway
inflammation. Antibiotics are not indicated unless bacterial
infection is confirmed.
,2|Page
3. A patient with type 2 diabetes reports new-onset numbness and
tingling in the feet. Which is the most appropriate initial
assessment?
A. HbA1c only
B. Monofilament testing and foot exam
C. MRI of lumbar spine
D. Serum creatinine
Rationale: Peripheral neuropathy screening is recommended
annually using monofilament testing. MRI is unnecessary unless
neurological deficits suggest spinal pathology.
4. A 60-year-old male with hypertension presents for routine follow-
up. BP is 150/95 mmHg. He reports adherence to lifestyle
modifications but no medications. According to current guidelines,
what is the next step?
A. Observe and recheck in 12 months
B. Begin lifestyle modifications only
C. Start antihypertensive therapy
D. Prescribe diuretics only if edema develops
Rationale: According to ACC/AHA 2017 guidelines, stage 2
hypertension (≥140/90 mmHg) requires initiation of
pharmacologic therapy in addition to lifestyle interventions.
5. A 32-year-old female presents with sudden-onset right lower
quadrant pain, nausea, and vomiting. Physical exam shows
rebound tenderness. What is the most appropriate next step?
A. Pelvic ultrasound only
B. Surgical consult for suspected appendicitis
C. Prescribe analgesics and observe
D. Order stool studies
Rationale: Acute appendicitis is a surgical emergency; imaging
may assist, but immediate surgical consultation is standard of
care.
6. Which of the following vaccines is recommended for all adults
aged 65 years and older, regardless of previous vaccination
history?
A. Hepatitis B
,3|Page
B. Varicella
C. Shingles (Shingrix)
D. HPV
Rationale: CDC recommends the recombinant shingles vaccine
for all adults ≥50, regardless of previous shingles history.
7. A 28-year-old male presents with dysuria, urethral discharge, and a
history of unprotected sex. Which is the most appropriate empiric
treatment before lab results return?
A. Ciprofloxacin alone
B. Metronidazole
C. Ceftriaxone IM plus doxycycline
D. Amoxicillin
Rationale: Empiric treatment covers gonorrhea and chlamydia
per CDC guidelines: ceftriaxone for gonorrhea and doxycycline
for chlamydia.
8. A patient presents with acute asthma exacerbation. Which
assessment finding indicates severe obstruction?
A. Mild wheezing only
B. Peak expiratory flow <50% predicted
C. Respiratory rate 18
D. Pulse oximetry 98% on room air
Rationale: Severe asthma is indicated by significantly reduced
peak expiratory flow (<50%), accessory muscle use, and
hypoxemia.
9. A 25-year-old woman presents with fever, right costovertebral
angle tenderness, and dysuria. Which test best confirms acute
pyelonephritis?
A. Urine culture and urinalysis
B. Urinalysis with pyuria, bacteriuria, and urine culture
C. Renal ultrasound only
D. CBC only
Rationale: Urinalysis and urine culture confirm infection;
imaging is reserved for complicated cases.
10. Which antihypertensive class is considered first-line therapy
for a patient with diabetes and albuminuria?
, 4|Page
A. Beta-blocker
B. Calcium channel blocker
C. Diuretic
D. ACE inhibitor or ARB
Rationale: ACE inhibitors or ARBs are preferred due to renal-
protective effects in diabetic nephropathy.
11. A 35-year-old presents with palpitations and anxiety. Lab
work reveals elevated free T4 and suppressed TSH. What is the
most likely diagnosis?
A. Hypothyroidism
B. Hashimoto thyroiditis
C. Hyperthyroidism
D. Thyroid cancer
Rationale: Low TSH and high T4 indicate primary
hyperthyroidism; symptoms of palpitations and anxiety are
consistent.
12. A 72-year-old female with a history of COPD presents with
sudden shortness of breath and pleuritic chest pain. Vital signs: HR
110, BP 100/60, RR 28, SpO2 88% on room air. What is the most
likely diagnosis?
A. Pneumonia
B. Asthma exacerbation
C. Pulmonary embolism
D. Pneumothorax
Rationale: Acute SOB, pleuritic pain, hypotension, and
hypoxemia in this patient suggest PE; risk factors include age
and immobility.
13. A patient presents with chronic low back pain. Red-flag
symptoms include all EXCEPT:
A. Unexplained weight loss
B. Mild intermittent pain for 3 months
C. History of cancer
D. Neurologic deficits
Rationale: Chronic, mild pain without systemic symptoms is not
a red flag; other options suggest serious underlying pathology.
