Page 1 of 91
NURS 5433 University Of Texas - Arlington -NURS 5433 FNP II
Final ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
EXAM COVERAGE: FNP II – Advanced Clinical Management
1. Cardiovascular – HTN, HF, CAD, dyslipidemia, arrhythmias
2. Pulmonary – COPD, asthma, pneumonia, PE
3. Endocrine – DM, thyroid disorders, adrenal insufficiency
4. Neurology – Stroke, headache, seizures, neuropathy
5. GI/Hepatic – GERD, PUD, hepatitis, IBD
6. Renal/GU – CKD, UTI, BPH, incontinence
7. Women’s Health – Contraception, menopause, abnormal bleeding
8. Men’s Health – Testosterone deficiency, prostate disorders
9. Pediatrics – Common infections, asthma, developmental screening
10. Geriatrics – Polypharmacy, falls, dementia, frailty
11. Dermatology – Rash identification, skin cancer
12. Musculoskeletal – Arthritis, back pain, sports injuries
13. Mental Health – Depression, anxiety, bipolar, substance use
14. Infectious Disease – CAP, UTI, cellulitis, sepsis
15. Heme/Onc – Anemia, coagulopathy, cancer screening
16. Evidence-Based Practice – Guidelines, shared decision-making
QUESTIONS 1–200
Cardiovascular (1–20)
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1. A 58-year-old male with hypertension is on lisinopril 20 mg daily. His BP is 148/92 mmHg.
Which is the best next step?
a) Add HCTZ 12.5 mg
b) Switch to amlodipine 10 mg
c) Increase lisinopril to 40 mg
d) Add carvedilol
Answer: a) Add HCTZ 12.5 mg
Rationale: First-line add-on for HTN not controlled on an ACE inhibitor is a thiazide diuretic or
CCB. HCTZ is appropriate and synergistic.
2. Which finding in heart failure with reduced ejection fraction (HFrEF) requires immediate
referral?
a) JVD and peripheral edema
b) S3 gallop
c) Orthopnea relieved by two pillows
d) Systolic BP 82 mmHg with altered mental status
Answer: d) Systolic BP 82 mmHg with altered mental status
Rationale: Cardiogenic shock (low BP + end-organ hypoperfusion) is an emergency requiring
hospitalization and possible inotropes.
3. A 72-year-old with HFrEF (EF 35%) is on carvedilol, lisinopril, and furosemide. Which lab
requires immediate action?
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a) Potassium 4.2 mEq/L
b) Creatinine 1.3 mg/dL (baseline 1.1)
c) BNP 450 pg/mL (down from 600)
d) Potassium 5.9 mEq/L
Answer: d) Potassium 5.9 mEq/L
*Rationale: Severe hyperkalemia (>5.5) on ACEi/ARB + diuretic risks arrhythmia. Hold ACEi/ARB
and consider kayexalate or urgent dialysis.*
4. First-line pharmacotherapy for stable angina in a patient with known CAD is:
a) Aspirin 81 mg daily
b) Nitroglycerin sublingual PRN
c) Metoprolol succinate
d) Atorvastatin 80 mg
Answer: c) Metoprolol succinate
Rationale: Beta-blockers reduce myocardial oxygen demand and are first-line for chronic stable
angina. Aspirin and statin are secondary prevention.
5. A 45-year-old female presents with palpitations. ECG shows irregularly irregular rhythm with
no P waves. Rate is 140 bpm. Next step?
a) Metoprolol IV
b) Amiodarone IV
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c) Immediate cardioversion
d) Rate control with diltiazem and anticoagulation assessment
Answer: d) Rate control with diltiazem and anticoagulation assessment
Rationale: Atrial fibrillation with RVR. Stable patient → rate control (CCB or beta-blocker). Need
CHA₂DS₂-VASc score for anticoagulation.
6. Which LDL level is the goal for a patient with diabetes and established ASCVD?
a) <100 mg/dL
b) <70 mg/dL
c) <130 mg/dL
d) <55 mg/dL
Answer: d) <55 mg/dL
*Rationale: 2023 ACC/AHA guidelines recommend very high-risk patients (ASCVD + DM) aim for
LDL <55 mg/dL or ≥50% reduction.*
7. A patient reports chest pain that is sharp, worse with inspiration, and relieved by leaning
forward. Likely diagnosis?
a) Unstable angina
b) Pericarditis
c) Aortic dissection
d) PE
NURS 5433 University Of Texas - Arlington -NURS 5433 FNP II
Final ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
EXAM COVERAGE: FNP II – Advanced Clinical Management
1. Cardiovascular – HTN, HF, CAD, dyslipidemia, arrhythmias
2. Pulmonary – COPD, asthma, pneumonia, PE
3. Endocrine – DM, thyroid disorders, adrenal insufficiency
4. Neurology – Stroke, headache, seizures, neuropathy
5. GI/Hepatic – GERD, PUD, hepatitis, IBD
6. Renal/GU – CKD, UTI, BPH, incontinence
7. Women’s Health – Contraception, menopause, abnormal bleeding
8. Men’s Health – Testosterone deficiency, prostate disorders
9. Pediatrics – Common infections, asthma, developmental screening
10. Geriatrics – Polypharmacy, falls, dementia, frailty
11. Dermatology – Rash identification, skin cancer
12. Musculoskeletal – Arthritis, back pain, sports injuries
13. Mental Health – Depression, anxiety, bipolar, substance use
14. Infectious Disease – CAP, UTI, cellulitis, sepsis
15. Heme/Onc – Anemia, coagulopathy, cancer screening
16. Evidence-Based Practice – Guidelines, shared decision-making
QUESTIONS 1–200
Cardiovascular (1–20)
, Page 2 of 91
1. A 58-year-old male with hypertension is on lisinopril 20 mg daily. His BP is 148/92 mmHg.
Which is the best next step?
a) Add HCTZ 12.5 mg
b) Switch to amlodipine 10 mg
c) Increase lisinopril to 40 mg
d) Add carvedilol
Answer: a) Add HCTZ 12.5 mg
Rationale: First-line add-on for HTN not controlled on an ACE inhibitor is a thiazide diuretic or
CCB. HCTZ is appropriate and synergistic.
2. Which finding in heart failure with reduced ejection fraction (HFrEF) requires immediate
referral?
a) JVD and peripheral edema
b) S3 gallop
c) Orthopnea relieved by two pillows
d) Systolic BP 82 mmHg with altered mental status
Answer: d) Systolic BP 82 mmHg with altered mental status
Rationale: Cardiogenic shock (low BP + end-organ hypoperfusion) is an emergency requiring
hospitalization and possible inotropes.
3. A 72-year-old with HFrEF (EF 35%) is on carvedilol, lisinopril, and furosemide. Which lab
requires immediate action?
, Page 3 of 91
a) Potassium 4.2 mEq/L
b) Creatinine 1.3 mg/dL (baseline 1.1)
c) BNP 450 pg/mL (down from 600)
d) Potassium 5.9 mEq/L
Answer: d) Potassium 5.9 mEq/L
*Rationale: Severe hyperkalemia (>5.5) on ACEi/ARB + diuretic risks arrhythmia. Hold ACEi/ARB
and consider kayexalate or urgent dialysis.*
4. First-line pharmacotherapy for stable angina in a patient with known CAD is:
a) Aspirin 81 mg daily
b) Nitroglycerin sublingual PRN
c) Metoprolol succinate
d) Atorvastatin 80 mg
Answer: c) Metoprolol succinate
Rationale: Beta-blockers reduce myocardial oxygen demand and are first-line for chronic stable
angina. Aspirin and statin are secondary prevention.
5. A 45-year-old female presents with palpitations. ECG shows irregularly irregular rhythm with
no P waves. Rate is 140 bpm. Next step?
a) Metoprolol IV
b) Amiodarone IV
, Page 4 of 91
c) Immediate cardioversion
d) Rate control with diltiazem and anticoagulation assessment
Answer: d) Rate control with diltiazem and anticoagulation assessment
Rationale: Atrial fibrillation with RVR. Stable patient → rate control (CCB or beta-blocker). Need
CHA₂DS₂-VASc score for anticoagulation.
6. Which LDL level is the goal for a patient with diabetes and established ASCVD?
a) <100 mg/dL
b) <70 mg/dL
c) <130 mg/dL
d) <55 mg/dL
Answer: d) <55 mg/dL
*Rationale: 2023 ACC/AHA guidelines recommend very high-risk patients (ASCVD + DM) aim for
LDL <55 mg/dL or ≥50% reduction.*
7. A patient reports chest pain that is sharp, worse with inspiration, and relieved by leaning
forward. Likely diagnosis?
a) Unstable angina
b) Pericarditis
c) Aortic dissection
d) PE
