NURS 5432 FNP I Final Exam – 300 Questions
University of Texas at Arlington | 2026 | Modules
7–10 | FNP Foundation
Module 7: Chronic Disease Management (Questions 1–80)
1. A 55-year-old with hypertension and DM has BP 148/90. First-line medication?
A. HCTZ
B. Lisinopril
C. Amlodipine
D. Metoprolol
Rationale: ACEi/ARB preferred in diabetes for renal protection.
2. A patient with DM and CKD (eGFR 45) has A1c 8.0%. Which medication is preferred?
A. Metformin alone
B. Empagliflozin
C. Glipizide
D. Pioglitazone
Rationale: SGLT2i reduces CKD progression and CV events.
3. LDL goal for a patient with diabetes and ASCVD?
A. <100 mg/dL
B. <70 mg/dL
C. <55 mg/dL
D. <130 mg/dL
*Rationale: Very high-risk patients (DM + ASCVD) LDL <55 mg/dL.*
4. A 65-year-old with HFrEF (EF 35%) on metoprolol, lisinopril, furosemide. Add for
mortality benefit?
A. Digoxin
B. Spironolactone
C. Hydralazine
,D. Amiodarone
Rationale: MRA reduces mortality in HFrEF.
5. A patient with COPD, FEV1 50%, frequent exacerbations. GOLD group E. Initial
therapy?
A. LABA alone
B. LAMA alone
C. LAMA + LABA
D. ICS alone
*Rationale: Group E: LAMA + LABA; add ICS if eosinophils ≥300.*
6. A 70-year-old with osteoporosis, T-score -2.8 at femoral neck. First-line therapy?
A. Calcium + vitamin D
B. Alendronate
C. Raloxifene
D. Teriparatide
Rationale: Bisphosphonates first-line for osteoporosis.
7. A patient with CKD stage 4 (eGFR 25) and hyperkalemia (K 5.8). Which medication
should be held?
A. Furosemide
B. Spironolactone
C. Atorvastatin
D. Levothyroxine
Rationale: MRAs increase potassium; hold if K >5.5.
8. A 60-year-old with osteoarthritis and moderate knee pain. First-line treatment?
A. Acetaminophen
B. Topical NSAID
C. Oral NSAID
D. Tramadol
Rationale: Topical NSAID first-line; oral if inadequate.
9. A patient with gout and CKD stage 3 starts allopurinol. Starting dose?
A. 300 mg daily
B. 50–100 mg daily
C. 100 mg BID
,D. 600 mg daily
Rationale: Start low in CKD (50–100 mg) and titrate.
10. A 65-year-old with BPH, AUA symptom score 18. First-line medical therapy?
A. Finasteride
B. Tamsulosin
C. Dutasteride
D. Surgery
Rationale: Alpha-blockers provide rapid symptom relief.
11. A patient with HFpEF and hypertension. First-line medication?
A. Beta-blocker
B. Spironolactone
C. Digoxin
D. Hydralazine
Rationale: MRAs and SGLT2i improve outcomes in HFpEF.
12. A 50-year-old with type 2 DM, A1c 7.5%, BMI 35, no ASCVD. Add to metformin?
A. Glipizide
B. Semaglutide
C. Insulin glargine
D. Pioglitazone
*Rationale: GLP-1 agonists preferred for weight loss and CV benefit.*
13. A patient with COPD on triple therapy (ICS/LABA/LAMA) has eosinophils 450. Benefit
of ICS?
A. No benefit
B. Reduces exacerbations
C. Worsens outcomes
D. Only for asthma
Rationale: Eosinophils ≥300 predict ICS response.
14. A 75-year-old with Alzheimer's disease, MMSE 18, no behavioral issues. Start?
A. Memantine
B. Donepezil
C. Vitamin E
, D. Antipsychotic
Rationale: Cholinesterase inhibitors for mild-moderate AD.
15. A patient with CKD and anemia, Hb 9.5, ferritin 800, TSAT 20%. Next step?
A. Oral iron
B. ESA (erythropoiesis-stimulating agent)
C. Transfusion
D. B12
Rationale: Functional iron deficiency; ESA indicated if Hb <10.
16. A 60-year-old with Parkinson's disease, tremor, bradykinesia. First-line?
A. Levodopa/carbidopa
B. Levodopa/carbidopa
C. Pramipexole
D. Amantadine
Rationale: Levodopa most effective; dopamine agonists for younger.
17. A patient with type 2 DM and ASCVD on metformin. Add for CV benefit?
A. Glipizide
B. Empagliflozin or liraglutide
C. Insulin
D. Pioglitazone
*Rationale: SGLT2i and GLP-1 agonists reduce MACE.*
18. A 55-year-old with chronic low back pain, no red flags. First-line?
A. Opioids
B. Non-pharmacologic (exercise, PT) + acetaminophen/NSAID
C. Gabapentin
D. Muscle relaxant
Rationale: Non-pharmacologic first; opioids last resort.
19. A patient with HFrEF on optimal therapy has EF 30% and LBBB 150 ms. Device
indicated?
A. ICD alone
B. CRT-D
C. Pacemaker
University of Texas at Arlington | 2026 | Modules
7–10 | FNP Foundation
Module 7: Chronic Disease Management (Questions 1–80)
1. A 55-year-old with hypertension and DM has BP 148/90. First-line medication?
A. HCTZ
B. Lisinopril
C. Amlodipine
D. Metoprolol
Rationale: ACEi/ARB preferred in diabetes for renal protection.
2. A patient with DM and CKD (eGFR 45) has A1c 8.0%. Which medication is preferred?
A. Metformin alone
B. Empagliflozin
C. Glipizide
D. Pioglitazone
Rationale: SGLT2i reduces CKD progression and CV events.
3. LDL goal for a patient with diabetes and ASCVD?
A. <100 mg/dL
B. <70 mg/dL
C. <55 mg/dL
D. <130 mg/dL
*Rationale: Very high-risk patients (DM + ASCVD) LDL <55 mg/dL.*
4. A 65-year-old with HFrEF (EF 35%) on metoprolol, lisinopril, furosemide. Add for
mortality benefit?
A. Digoxin
B. Spironolactone
C. Hydralazine
,D. Amiodarone
Rationale: MRA reduces mortality in HFrEF.
5. A patient with COPD, FEV1 50%, frequent exacerbations. GOLD group E. Initial
therapy?
A. LABA alone
B. LAMA alone
C. LAMA + LABA
D. ICS alone
*Rationale: Group E: LAMA + LABA; add ICS if eosinophils ≥300.*
6. A 70-year-old with osteoporosis, T-score -2.8 at femoral neck. First-line therapy?
A. Calcium + vitamin D
B. Alendronate
C. Raloxifene
D. Teriparatide
Rationale: Bisphosphonates first-line for osteoporosis.
7. A patient with CKD stage 4 (eGFR 25) and hyperkalemia (K 5.8). Which medication
should be held?
A. Furosemide
B. Spironolactone
C. Atorvastatin
D. Levothyroxine
Rationale: MRAs increase potassium; hold if K >5.5.
8. A 60-year-old with osteoarthritis and moderate knee pain. First-line treatment?
A. Acetaminophen
B. Topical NSAID
C. Oral NSAID
D. Tramadol
Rationale: Topical NSAID first-line; oral if inadequate.
9. A patient with gout and CKD stage 3 starts allopurinol. Starting dose?
A. 300 mg daily
B. 50–100 mg daily
C. 100 mg BID
,D. 600 mg daily
Rationale: Start low in CKD (50–100 mg) and titrate.
10. A 65-year-old with BPH, AUA symptom score 18. First-line medical therapy?
A. Finasteride
B. Tamsulosin
C. Dutasteride
D. Surgery
Rationale: Alpha-blockers provide rapid symptom relief.
11. A patient with HFpEF and hypertension. First-line medication?
A. Beta-blocker
B. Spironolactone
C. Digoxin
D. Hydralazine
Rationale: MRAs and SGLT2i improve outcomes in HFpEF.
12. A 50-year-old with type 2 DM, A1c 7.5%, BMI 35, no ASCVD. Add to metformin?
A. Glipizide
B. Semaglutide
C. Insulin glargine
D. Pioglitazone
*Rationale: GLP-1 agonists preferred for weight loss and CV benefit.*
13. A patient with COPD on triple therapy (ICS/LABA/LAMA) has eosinophils 450. Benefit
of ICS?
A. No benefit
B. Reduces exacerbations
C. Worsens outcomes
D. Only for asthma
Rationale: Eosinophils ≥300 predict ICS response.
14. A 75-year-old with Alzheimer's disease, MMSE 18, no behavioral issues. Start?
A. Memantine
B. Donepezil
C. Vitamin E
, D. Antipsychotic
Rationale: Cholinesterase inhibitors for mild-moderate AD.
15. A patient with CKD and anemia, Hb 9.5, ferritin 800, TSAT 20%. Next step?
A. Oral iron
B. ESA (erythropoiesis-stimulating agent)
C. Transfusion
D. B12
Rationale: Functional iron deficiency; ESA indicated if Hb <10.
16. A 60-year-old with Parkinson's disease, tremor, bradykinesia. First-line?
A. Levodopa/carbidopa
B. Levodopa/carbidopa
C. Pramipexole
D. Amantadine
Rationale: Levodopa most effective; dopamine agonists for younger.
17. A patient with type 2 DM and ASCVD on metformin. Add for CV benefit?
A. Glipizide
B. Empagliflozin or liraglutide
C. Insulin
D. Pioglitazone
*Rationale: SGLT2i and GLP-1 agonists reduce MACE.*
18. A 55-year-old with chronic low back pain, no red flags. First-line?
A. Opioids
B. Non-pharmacologic (exercise, PT) + acetaminophen/NSAID
C. Gabapentin
D. Muscle relaxant
Rationale: Non-pharmacologic first; opioids last resort.
19. A patient with HFrEF on optimal therapy has EF 30% and LBBB 150 ms. Device
indicated?
A. ICD alone
B. CRT-D
C. Pacemaker
