NURS 5433 FAMILY NURSE PRACTITIONER FINAL
EXAM ACTUAL QUESTIONS AND ANSWERS - LATEST
AND COMPLETE UPDATE WITH VERIFIED SOLUTIONS
– ASSURED PASS WITH INSTANT DOWNLOAD PDF.
1. A 45-year-old patient with type 2 diabetes presents for routine follow-up.
Which initial management change best reflects current evidence-based FNP
practice when A1C remains above goal despite metformin therapy?
A. Add basal insulin immediately
B. Discontinue metformin and start sulfonylurea
C. Add a GLP-1 receptor agonist
D. Delay medication changes for lifestyle counseling only
*Rationale: GLP-1 receptor agonists improve glycemic control, promote
weight loss, and reduce cardiovascular risk while continuing metformin.
2. A 6-year-old presents with fever, sore throat, and tender anterior cervical
nodes. Which finding most strongly supports group A streptococcal
pharyngitis?
A. Cough and rhinorrhea
B. Tonsillar exudates
C. Hoarseness
D. Conjunctivitis
*Rationale: Tonsillar exudates with fever and tender nodes support
streptococcal infection rather than viral causes.
3. An adult patient requests opioid medication for chronic low back pain
without red-flag symptoms. What is the most appropriate FNP response?
A. Prescribe opioids short-term
B. Order MRI before any treatment
, C. Initiate nonpharmacologic therapy and non-opioid analgesics
D. Refer immediately for surgery
*Rationale: Guidelines prioritize nonpharmacologic and non-opioid
approaches for chronic noncancer pain.
4. A pregnant patient at 10 weeks’ gestation asks about folic acid
supplementation. The recommended daily dose for low-risk pregnancy is:
A. 0.1 mg
B. 0.4–0.8 mg
C. 2 mg
D. 4 mg
*Rationale: Standard supplementation of 0.4–0.8 mg reduces neural tube
defect risk.
5. A 72-year-old with hypertension and diabetes should generally have a BP
target of:
A. <150/90 mmHg
B. <130/80 mmHg
C. <140/95 mmHg
D. <120/70 mmHg
*Rationale: Current guidelines favor <130/80 mmHg for most adults with
diabetes.
6. A patient presents with sudden unilateral leg swelling and pain. What is the
most appropriate initial diagnostic test?
A. CT angiography
B. Compression ultrasonography
C. D-dimer only
D. MRI of the leg
, *Rationale: Compression ultrasound is first-line for suspected deep vein
thrombosis.
7. Which vaccine is contraindicated in pregnancy?
A. Inactivated influenza
B. Tdap
C. Live attenuated influenza (nasal)
D. Hepatitis B
*Rationale: Live vaccines are contraindicated during pregnancy.
8. An adolescent with asthma reports using a rescue inhaler daily. Best next
step?
A. Reassure and continue regimen
B. Initiate daily inhaled corticosteroid
C. Switch to oral bronchodilator
D. Discontinue rescue inhaler
*Rationale: Daily symptoms indicate uncontrolled asthma requiring
controller therapy.
9. A patient with hyperlipidemia and established ASCVD should receive which
therapy?
A. Moderate-intensity statin
B. High-intensity statin
C. Lifestyle changes only
D. Fibrate monotherapy
*Rationale: Secondary prevention requires high-intensity statin therapy.
10.Which screening is recommended for all adults aged 50–75?
A. PSA annually
B. Colorectal cancer screening
C. Lung CT regardless of smoking history
, D. Bone density in all men
*Rationale: Routine colorectal cancer screening is recommended in this age
group.
11.A child presents with acute otitis media and severe symptoms. First-line
treatment is:
A. Observation only
B. Amoxicillin
C. Azithromycin
D. Ciprofloxacin drops
*Rationale: Amoxicillin is first-line unless contraindicated.
12.Which lab finding best confirms iron-deficiency anemia?
A. Elevated ferritin
B. Normal TIBC
C. Low ferritin
D. High MCV
*Rationale: Low ferritin reflects depleted iron stores.
13.An adult with BMI 33 kg/m² asks about weight loss. Best initial
management?
A. Bariatric surgery referral
B. Lifestyle modification with diet and exercise counseling
C. Appetite suppressants only
D. Very-low-calorie diet unsupervised
*Rationale: Lifestyle modification is first-line therapy.
14.A patient with suspected appendicitis should receive which imaging as first
choice (nonpregnant adult)?
A. Ultrasound
B. CT abdomen with contrast
EXAM ACTUAL QUESTIONS AND ANSWERS - LATEST
AND COMPLETE UPDATE WITH VERIFIED SOLUTIONS
– ASSURED PASS WITH INSTANT DOWNLOAD PDF.
1. A 45-year-old patient with type 2 diabetes presents for routine follow-up.
Which initial management change best reflects current evidence-based FNP
practice when A1C remains above goal despite metformin therapy?
A. Add basal insulin immediately
B. Discontinue metformin and start sulfonylurea
C. Add a GLP-1 receptor agonist
D. Delay medication changes for lifestyle counseling only
*Rationale: GLP-1 receptor agonists improve glycemic control, promote
weight loss, and reduce cardiovascular risk while continuing metformin.
2. A 6-year-old presents with fever, sore throat, and tender anterior cervical
nodes. Which finding most strongly supports group A streptococcal
pharyngitis?
A. Cough and rhinorrhea
B. Tonsillar exudates
C. Hoarseness
D. Conjunctivitis
*Rationale: Tonsillar exudates with fever and tender nodes support
streptococcal infection rather than viral causes.
3. An adult patient requests opioid medication for chronic low back pain
without red-flag symptoms. What is the most appropriate FNP response?
A. Prescribe opioids short-term
B. Order MRI before any treatment
, C. Initiate nonpharmacologic therapy and non-opioid analgesics
D. Refer immediately for surgery
*Rationale: Guidelines prioritize nonpharmacologic and non-opioid
approaches for chronic noncancer pain.
4. A pregnant patient at 10 weeks’ gestation asks about folic acid
supplementation. The recommended daily dose for low-risk pregnancy is:
A. 0.1 mg
B. 0.4–0.8 mg
C. 2 mg
D. 4 mg
*Rationale: Standard supplementation of 0.4–0.8 mg reduces neural tube
defect risk.
5. A 72-year-old with hypertension and diabetes should generally have a BP
target of:
A. <150/90 mmHg
B. <130/80 mmHg
C. <140/95 mmHg
D. <120/70 mmHg
*Rationale: Current guidelines favor <130/80 mmHg for most adults with
diabetes.
6. A patient presents with sudden unilateral leg swelling and pain. What is the
most appropriate initial diagnostic test?
A. CT angiography
B. Compression ultrasonography
C. D-dimer only
D. MRI of the leg
, *Rationale: Compression ultrasound is first-line for suspected deep vein
thrombosis.
7. Which vaccine is contraindicated in pregnancy?
A. Inactivated influenza
B. Tdap
C. Live attenuated influenza (nasal)
D. Hepatitis B
*Rationale: Live vaccines are contraindicated during pregnancy.
8. An adolescent with asthma reports using a rescue inhaler daily. Best next
step?
A. Reassure and continue regimen
B. Initiate daily inhaled corticosteroid
C. Switch to oral bronchodilator
D. Discontinue rescue inhaler
*Rationale: Daily symptoms indicate uncontrolled asthma requiring
controller therapy.
9. A patient with hyperlipidemia and established ASCVD should receive which
therapy?
A. Moderate-intensity statin
B. High-intensity statin
C. Lifestyle changes only
D. Fibrate monotherapy
*Rationale: Secondary prevention requires high-intensity statin therapy.
10.Which screening is recommended for all adults aged 50–75?
A. PSA annually
B. Colorectal cancer screening
C. Lung CT regardless of smoking history
, D. Bone density in all men
*Rationale: Routine colorectal cancer screening is recommended in this age
group.
11.A child presents with acute otitis media and severe symptoms. First-line
treatment is:
A. Observation only
B. Amoxicillin
C. Azithromycin
D. Ciprofloxacin drops
*Rationale: Amoxicillin is first-line unless contraindicated.
12.Which lab finding best confirms iron-deficiency anemia?
A. Elevated ferritin
B. Normal TIBC
C. Low ferritin
D. High MCV
*Rationale: Low ferritin reflects depleted iron stores.
13.An adult with BMI 33 kg/m² asks about weight loss. Best initial
management?
A. Bariatric surgery referral
B. Lifestyle modification with diet and exercise counseling
C. Appetite suppressants only
D. Very-low-calorie diet unsupervised
*Rationale: Lifestyle modification is first-line therapy.
14.A patient with suspected appendicitis should receive which imaging as first
choice (nonpregnant adult)?
A. Ultrasound
B. CT abdomen with contrast
