NEW FNP REVIEW QUESTIONS 2025/2026 REVISED
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
Which class of medication id frequently used to improve long-
term outcomes in patients with systolic dysfunction?
a. Loop diuretics
b. Calcium channel blockers
c. ACE inhibitors
d. Thiazide diuretics - correct answer✔✔c. ACE inhibitors
Rationale:
ACE inhibitors are commonly used in patients with systolic
dysfunction because they reduce morbidity and mortality, i.e.
these medications alter prognosis. They also improve
symptoms of fatigue, shortness of breath, and exercise
intolerance. Loop and thiazide diuretics improve symptoms,
but do not alter long-term prognosis with heart failure. Beta
blockers should be used in conjunction with ACE inhibitors and
diuretics, but not as solo agents. Beta blockers can potentially
,worsen heart failure, so their use in patients with heart failure
should be monitored carefully.
Which hypertensive patient is most likely to have adverse
blood pressure effects from excessive sodium consumption?
a. 21-year-old Asian American male
b. 35-year-old menstruating female
c. 55-year-old post menopausal female
d. 70-year-old African American male - correct answer✔✔d.
70-year-old African American male
Rationale:
Two groups of patients typically experience adverse blood
pressure effects from consumption of sodium greater than
2,000 mg daily. Those patients considered to be most sodium
sensitive are elderly patients and African American patients.
A patient with poorly controlled hypertension and history of
myocardial infarction 6-years-ago presents today with mild
shortness of breath. He takes quinapril, ASA, metoprolol, and
a statin daily. What symptom in NOT indicative of a heart
failure exacerbation? a. fatigue
,b. headache
c. orthopnea
d. cough - correct answer✔✔b. headache
Rationale:
Fatigue is a common symptom in cardiac patients that can
represent a worsening of many cardiac diseases such as
coronary artery disease, heart failure, and valvular dysfunction.
Orthopnea and cough, especially nocturnal, are classic
symptoms of heart failure.
A patient with newly diagnosed heart failure has started
fosinapril in the last few days. She has developed a cough.
What clinical finding can help distinguish the etiology of the
cough as heart failure? a. It is dry and non-productive.
b. It is wet and worse with recumbence.
c. It is purulent and tachycardia accompanies it.
d. Shortness of breath always results after coughing. - correct
answer✔✔b. It is wet and worse with recumbence.
Rationale:
, The cough associated with fosinapril (an ACE inhibitor), is dry,
non-productive and may be described as annoying. Its severity
does not change with position or time of day. A cough
associated with heart failure is wet, worse when lying down,
and is usually described by patients as "worse at night". A
cough that is purulent and when tachycardia accompanies it is
often associated with fever and probably reflects an infectious
process like pneumonia.
A patient with shortness of breath has suspected heart failure.
What diagnostic test would best help determine this?
a. Echocardiogram
b. B type natriuretic peptide (BNP)
c. EKG
d. Chest x-ray - correct answer✔✔b. B type natriuretic peptide
(BNP)
Rationale:
BNP is a hormone involved in regulation of blood pressure and
fluid volume. When the BNP level is 80 pg/mL or greater, the
sensitivity and specificity is 98% and 92%, favoring a diagnosis
of heart failure. Alternatively, BNP level less than 80 pg/mL
strongly suggest that heart failure is not present (some U.S.
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
Which class of medication id frequently used to improve long-
term outcomes in patients with systolic dysfunction?
a. Loop diuretics
b. Calcium channel blockers
c. ACE inhibitors
d. Thiazide diuretics - correct answer✔✔c. ACE inhibitors
Rationale:
ACE inhibitors are commonly used in patients with systolic
dysfunction because they reduce morbidity and mortality, i.e.
these medications alter prognosis. They also improve
symptoms of fatigue, shortness of breath, and exercise
intolerance. Loop and thiazide diuretics improve symptoms,
but do not alter long-term prognosis with heart failure. Beta
blockers should be used in conjunction with ACE inhibitors and
diuretics, but not as solo agents. Beta blockers can potentially
,worsen heart failure, so their use in patients with heart failure
should be monitored carefully.
Which hypertensive patient is most likely to have adverse
blood pressure effects from excessive sodium consumption?
a. 21-year-old Asian American male
b. 35-year-old menstruating female
c. 55-year-old post menopausal female
d. 70-year-old African American male - correct answer✔✔d.
70-year-old African American male
Rationale:
Two groups of patients typically experience adverse blood
pressure effects from consumption of sodium greater than
2,000 mg daily. Those patients considered to be most sodium
sensitive are elderly patients and African American patients.
A patient with poorly controlled hypertension and history of
myocardial infarction 6-years-ago presents today with mild
shortness of breath. He takes quinapril, ASA, metoprolol, and
a statin daily. What symptom in NOT indicative of a heart
failure exacerbation? a. fatigue
,b. headache
c. orthopnea
d. cough - correct answer✔✔b. headache
Rationale:
Fatigue is a common symptom in cardiac patients that can
represent a worsening of many cardiac diseases such as
coronary artery disease, heart failure, and valvular dysfunction.
Orthopnea and cough, especially nocturnal, are classic
symptoms of heart failure.
A patient with newly diagnosed heart failure has started
fosinapril in the last few days. She has developed a cough.
What clinical finding can help distinguish the etiology of the
cough as heart failure? a. It is dry and non-productive.
b. It is wet and worse with recumbence.
c. It is purulent and tachycardia accompanies it.
d. Shortness of breath always results after coughing. - correct
answer✔✔b. It is wet and worse with recumbence.
Rationale:
, The cough associated with fosinapril (an ACE inhibitor), is dry,
non-productive and may be described as annoying. Its severity
does not change with position or time of day. A cough
associated with heart failure is wet, worse when lying down,
and is usually described by patients as "worse at night". A
cough that is purulent and when tachycardia accompanies it is
often associated with fever and probably reflects an infectious
process like pneumonia.
A patient with shortness of breath has suspected heart failure.
What diagnostic test would best help determine this?
a. Echocardiogram
b. B type natriuretic peptide (BNP)
c. EKG
d. Chest x-ray - correct answer✔✔b. B type natriuretic peptide
(BNP)
Rationale:
BNP is a hormone involved in regulation of blood pressure and
fluid volume. When the BNP level is 80 pg/mL or greater, the
sensitivity and specificity is 98% and 92%, favoring a diagnosis
of heart failure. Alternatively, BNP level less than 80 pg/mL
strongly suggest that heart failure is not present (some U.S.
