FNP NUR 509 – FAMILY NURSE PRACTITIONER
ADULTS TEST 3 QUESTIONS AND 100%
VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
Question 1
A 52-year-old male presents with persistent fatigue, polyuria, and polydipsia. His
fasting glucose is 142 mg/dL. Which is the most appropriate initial management
step?
A. Start insulin therapy immediately
B. Begin metformin and lifestyle modifications
C. Order an oral glucose tolerance test
D. Recheck fasting glucose in 6 months
Answer: B. Begin metformin and lifestyle modifications
Rationale: The patient meets criteria for type 2 diabetes (fasting glucose ≥126
mg/dL). First-line management includes metformin and lifestyle modifications
unless there are contraindications. Immediate insulin is reserved for severe
hyperglycemia or symptomatic patients.
,Question 2
A 65-year-old female with a history of hypertension presents for a routine visit.
Her BP is 142/88 mmHg. She reports adherence to her current ACE inhibitor.
Which is the most appropriate next step?
A. Add a thiazide diuretic
B. Increase dietary sodium
C. Switch to a beta-blocker
D. Continue current management without changes
Answer: A. Add a thiazide diuretic
Rationale: Blood pressure is above goal (typically <130/80 for most adults with
hypertension). Adding a thiazide diuretic is guideline-recommended if
monotherapy is insufficient. Continuing the same therapy would not achieve target
BP.
Question 3
A 28-year-old male presents with acute onset of dyspnea, fever, and productive
cough. Physical exam reveals crackles in the right lower lobe. Which pathogen is
most likely?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Influenza A virus
D. Staphylococcus aureus
Answer: A. Streptococcus pneumoniae
Rationale: Community-acquired pneumonia in adults often results from
Streptococcus pneumoniae, especially when presenting acutely with lobar
consolidation and productive cough. Mycoplasma typically causes milder, atypical
pneumonia.
,Question 4
A 45-year-old female reports joint pain and morning stiffness lasting 1 hour in her
hands and wrists. Labs show positive rheumatoid factor and elevated ESR. What is
the most likely diagnosis?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Lupus erythematosus
D. Gout
Answer: B. Rheumatoid arthritis
Rationale: Symmetric joint pain with prolonged morning stiffness, positive
rheumatoid factor, and elevated ESR indicate rheumatoid arthritis. Osteoarthritis
typically presents with shorter stiffness and more localized joint involvement.
Question 5
Which of the following lipid levels indicates the need for statin therapy in a 50-
year-old patient without cardiovascular disease but with diabetes?
A. LDL 110 mg/dL
B. LDL 70 mg/dL
C. HDL 60 mg/dL
D. Triglycerides 150 mg/dL
Answer: A. LDL 110 mg/dL
Rationale: For adults aged 40–75 with diabetes, moderate-intensity statin therapy
is recommended if LDL ≥70 mg/dL, even in the absence of established
cardiovascular disease.
, Question 6
A 35-year-old male presents with a non-healing ulcer on his foot. He has a history
of type 2 diabetes. On examination, there is erythema, mild purulent drainage, and
no systemic signs. Which is the most appropriate management?
A. Immediate hospital admission and IV antibiotics
B. Oral antibiotics targeting gram-positive organisms and wound care
C. Topical antifungal therapy
D. Observation only
Answer: B. Oral antibiotics targeting gram-positive organisms and wound care
Rationale: Mild diabetic foot infections without systemic involvement can be
managed with oral antibiotics targeting gram-positive organisms (e.g., cephalexin)
and proper wound care. Hospitalization is reserved for severe infections or
systemic signs.
Question 7
A 60-year-old female smoker presents with chronic cough and occasional
hemoptysis. Chest X-ray reveals a solitary pulmonary nodule. Which is the most
appropriate next step?
A. Reassure the patient and repeat X-ray in 6 months
B. Immediate surgical excision
C. Obtain a CT scan and consider biopsy
D. Start empiric antibiotics
Answer: C. Obtain a CT scan and consider biopsy
Rationale: Solitary pulmonary nodules in older smokers require further evaluation
with CT scan and potentially biopsy to rule out malignancy. Observation alone is
insufficient in high-risk patients.
ADULTS TEST 3 QUESTIONS AND 100%
VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
Question 1
A 52-year-old male presents with persistent fatigue, polyuria, and polydipsia. His
fasting glucose is 142 mg/dL. Which is the most appropriate initial management
step?
A. Start insulin therapy immediately
B. Begin metformin and lifestyle modifications
C. Order an oral glucose tolerance test
D. Recheck fasting glucose in 6 months
Answer: B. Begin metformin and lifestyle modifications
Rationale: The patient meets criteria for type 2 diabetes (fasting glucose ≥126
mg/dL). First-line management includes metformin and lifestyle modifications
unless there are contraindications. Immediate insulin is reserved for severe
hyperglycemia or symptomatic patients.
,Question 2
A 65-year-old female with a history of hypertension presents for a routine visit.
Her BP is 142/88 mmHg. She reports adherence to her current ACE inhibitor.
Which is the most appropriate next step?
A. Add a thiazide diuretic
B. Increase dietary sodium
C. Switch to a beta-blocker
D. Continue current management without changes
Answer: A. Add a thiazide diuretic
Rationale: Blood pressure is above goal (typically <130/80 for most adults with
hypertension). Adding a thiazide diuretic is guideline-recommended if
monotherapy is insufficient. Continuing the same therapy would not achieve target
BP.
Question 3
A 28-year-old male presents with acute onset of dyspnea, fever, and productive
cough. Physical exam reveals crackles in the right lower lobe. Which pathogen is
most likely?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Influenza A virus
D. Staphylococcus aureus
Answer: A. Streptococcus pneumoniae
Rationale: Community-acquired pneumonia in adults often results from
Streptococcus pneumoniae, especially when presenting acutely with lobar
consolidation and productive cough. Mycoplasma typically causes milder, atypical
pneumonia.
,Question 4
A 45-year-old female reports joint pain and morning stiffness lasting 1 hour in her
hands and wrists. Labs show positive rheumatoid factor and elevated ESR. What is
the most likely diagnosis?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Lupus erythematosus
D. Gout
Answer: B. Rheumatoid arthritis
Rationale: Symmetric joint pain with prolonged morning stiffness, positive
rheumatoid factor, and elevated ESR indicate rheumatoid arthritis. Osteoarthritis
typically presents with shorter stiffness and more localized joint involvement.
Question 5
Which of the following lipid levels indicates the need for statin therapy in a 50-
year-old patient without cardiovascular disease but with diabetes?
A. LDL 110 mg/dL
B. LDL 70 mg/dL
C. HDL 60 mg/dL
D. Triglycerides 150 mg/dL
Answer: A. LDL 110 mg/dL
Rationale: For adults aged 40–75 with diabetes, moderate-intensity statin therapy
is recommended if LDL ≥70 mg/dL, even in the absence of established
cardiovascular disease.
, Question 6
A 35-year-old male presents with a non-healing ulcer on his foot. He has a history
of type 2 diabetes. On examination, there is erythema, mild purulent drainage, and
no systemic signs. Which is the most appropriate management?
A. Immediate hospital admission and IV antibiotics
B. Oral antibiotics targeting gram-positive organisms and wound care
C. Topical antifungal therapy
D. Observation only
Answer: B. Oral antibiotics targeting gram-positive organisms and wound care
Rationale: Mild diabetic foot infections without systemic involvement can be
managed with oral antibiotics targeting gram-positive organisms (e.g., cephalexin)
and proper wound care. Hospitalization is reserved for severe infections or
systemic signs.
Question 7
A 60-year-old female smoker presents with chronic cough and occasional
hemoptysis. Chest X-ray reveals a solitary pulmonary nodule. Which is the most
appropriate next step?
A. Reassure the patient and repeat X-ray in 6 months
B. Immediate surgical excision
C. Obtain a CT scan and consider biopsy
D. Start empiric antibiotics
Answer: C. Obtain a CT scan and consider biopsy
Rationale: Solitary pulmonary nodules in older smokers require further evaluation
with CT scan and potentially biopsy to rule out malignancy. Observation alone is
insufficient in high-risk patients.
