NURS 5434 FNP III Final Exam – 300 Questions
University of Texas at Arlington | 2026 | FNP
Certification Prep
Cardiology (Questions 1–35)
First-line medication for chronic stable angina with prior MI and LVEF
40%?
A. Aspirin
B. Metoprolol succinate
C. Amlodipine
D. Isosorbide mononitrate
Rationale: Beta-blockers reduce mortality post-MI with reduced EF.
Most specific finding for aortic dissection?
A. Tearing chest pain
B. BP differential between arms
C. Widened mediastinum on CXR
D. Pericardial rub
Rationale: BP differential >20 mmHg suggests dissection involving
subclavian artery.
First-line BP target for most hypertensive diabetics?
A. <150/90
B. <130/80
C. <140/90
D. <120/80
*Rationale: ACC/AHA 2017: <130/80 for diabetics.*
Best initial test for suspected heart failure with dyspnea?
A. CXR
B. BNP or NT-proBNP
C. Echocardiogram
D. ECG
Rationale: BNP rules out HF if normal; echo confirms.
,Medication that reduces mortality in HFrEF (EF ≤40%)?
A. Furosemide
B. Sacubitril/valsartan
C. Digoxin
D. Hydralazine
Rationale: ARNI superior to ACEi in PARADIGM-HF.
Which statin is moderate-intensity?
A. Rosuvastatin 40 mg
B. Atorvastatin 10 mg
C. Simvastatin 80 mg
D. Pravastatin 80 mg
*Rationale: Atorvastatin 10–20 mg = moderate intensity (LDL reduction
30–50%).*
A fib with CHA₂DS₂-VASc score of 2 in a 68-year-old diabetic. Best
therapy?
A. Aspirin 325 mg
B. Apixaban
C. Clopidogrel
D. No anticoagulation
Rationale: Score ≥1 (men) or ≥2 (women) needs DOAC or warfarin.
Most common cause of acute pericarditis?
A. Uremia
B. Idiopathic (likely viral)
C. Post-MI
D. TB
Rationale: Viral/idiopathic most common; presents with pleuritic chest
pain, pericardial rub.
ECG finding in acute pericarditis?
A. ST elevation in single lead
B. Diffuse ST elevation with PR depression
C. Pathologic Q waves
D. T wave inversion only
*Rationale: Diffuse ST elevation and PR depression = stage 1 pericarditis.*
,Initial drug for acute decompensated HF with volume overload?
A. Metoprolol
B. IV furosemide
C. Spironolactone
D. Digoxin
Rationale: Loop diuretics first for congestion.
Best test for suspected DVT?
A. D-dimer
B. Compression ultrasound
C. Venography
D. INR
Rationale: Ultrasound is noninvasive gold standard.
Wells score for PE: moderate probability. Next step?
A. CT pulmonary angiogram
B. D-dimer
C. V/Q scan
D. Treat empirically
Rationale: D-dimer rules out if negative; if positive, CTPA.
Most common valvular abnormality in elderly?
A. Mitral regurgitation
B. Aortic stenosis
C. Mitral stenosis
D. Tricuspid regurgitation
Rationale: Calcific AS most common in >70 years.
Classic triad of aortic stenosis?
A. Syncope, dyspnea, fever
B. Angina, syncope, dyspnea
C. Palpitations, cough, edema
D. Hemoptysis, hoarseness, dysphagia
Rationale: Classic AS triad.
Best initial therapy for hypertensive urgency (BP 200/110, asymptomatic)?
A. IV nitroprusside
B. Oral clonidine or captopril
, C. IV labetalol
D. Sublingual nifedipine
Rationale: Gradual oral reduction; avoid rapid drop.
Which BP medication is contraindicated in pregnancy?
A. Labetalol
B. Nifedipine
C. Lisinopril
D. Methyldopa
Rationale: ACEi causes fetal renal agenesis, oligohydramnios.
LDL goal in very high-risk ASCVD?
A. <100 mg/dL
B. <70 mg/dL
C. <55 mg/dL
D. <130 mg/dL
*Rationale: 2018 ACC/AHA: <55 mg/dL for very high risk.*
A patient on amiodarone develops cough, dyspnea, and CXR interstitial
infiltrates. Most likely?
A. Heart failure
B. Pulmonary toxicity
C. Pneumonia
D. PE
Rationale: Amiodarone pulmonary toxicity common after high dose/long
duration.
First-line rate control in stable A fib with HFrEF?
A. Diltiazem
B. Digoxin
C. Metoprolol
D. Amiodarone
Rationale: Digoxin safe in HFrEF; beta-blockers also used but may worsen
acute decompensation.
Which ECG finding suggests prior MI?
A. ST elevation
B. Pathologic Q waves
University of Texas at Arlington | 2026 | FNP
Certification Prep
Cardiology (Questions 1–35)
First-line medication for chronic stable angina with prior MI and LVEF
40%?
A. Aspirin
B. Metoprolol succinate
C. Amlodipine
D. Isosorbide mononitrate
Rationale: Beta-blockers reduce mortality post-MI with reduced EF.
Most specific finding for aortic dissection?
A. Tearing chest pain
B. BP differential between arms
C. Widened mediastinum on CXR
D. Pericardial rub
Rationale: BP differential >20 mmHg suggests dissection involving
subclavian artery.
First-line BP target for most hypertensive diabetics?
A. <150/90
B. <130/80
C. <140/90
D. <120/80
*Rationale: ACC/AHA 2017: <130/80 for diabetics.*
Best initial test for suspected heart failure with dyspnea?
A. CXR
B. BNP or NT-proBNP
C. Echocardiogram
D. ECG
Rationale: BNP rules out HF if normal; echo confirms.
,Medication that reduces mortality in HFrEF (EF ≤40%)?
A. Furosemide
B. Sacubitril/valsartan
C. Digoxin
D. Hydralazine
Rationale: ARNI superior to ACEi in PARADIGM-HF.
Which statin is moderate-intensity?
A. Rosuvastatin 40 mg
B. Atorvastatin 10 mg
C. Simvastatin 80 mg
D. Pravastatin 80 mg
*Rationale: Atorvastatin 10–20 mg = moderate intensity (LDL reduction
30–50%).*
A fib with CHA₂DS₂-VASc score of 2 in a 68-year-old diabetic. Best
therapy?
A. Aspirin 325 mg
B. Apixaban
C. Clopidogrel
D. No anticoagulation
Rationale: Score ≥1 (men) or ≥2 (women) needs DOAC or warfarin.
Most common cause of acute pericarditis?
A. Uremia
B. Idiopathic (likely viral)
C. Post-MI
D. TB
Rationale: Viral/idiopathic most common; presents with pleuritic chest
pain, pericardial rub.
ECG finding in acute pericarditis?
A. ST elevation in single lead
B. Diffuse ST elevation with PR depression
C. Pathologic Q waves
D. T wave inversion only
*Rationale: Diffuse ST elevation and PR depression = stage 1 pericarditis.*
,Initial drug for acute decompensated HF with volume overload?
A. Metoprolol
B. IV furosemide
C. Spironolactone
D. Digoxin
Rationale: Loop diuretics first for congestion.
Best test for suspected DVT?
A. D-dimer
B. Compression ultrasound
C. Venography
D. INR
Rationale: Ultrasound is noninvasive gold standard.
Wells score for PE: moderate probability. Next step?
A. CT pulmonary angiogram
B. D-dimer
C. V/Q scan
D. Treat empirically
Rationale: D-dimer rules out if negative; if positive, CTPA.
Most common valvular abnormality in elderly?
A. Mitral regurgitation
B. Aortic stenosis
C. Mitral stenosis
D. Tricuspid regurgitation
Rationale: Calcific AS most common in >70 years.
Classic triad of aortic stenosis?
A. Syncope, dyspnea, fever
B. Angina, syncope, dyspnea
C. Palpitations, cough, edema
D. Hemoptysis, hoarseness, dysphagia
Rationale: Classic AS triad.
Best initial therapy for hypertensive urgency (BP 200/110, asymptomatic)?
A. IV nitroprusside
B. Oral clonidine or captopril
, C. IV labetalol
D. Sublingual nifedipine
Rationale: Gradual oral reduction; avoid rapid drop.
Which BP medication is contraindicated in pregnancy?
A. Labetalol
B. Nifedipine
C. Lisinopril
D. Methyldopa
Rationale: ACEi causes fetal renal agenesis, oligohydramnios.
LDL goal in very high-risk ASCVD?
A. <100 mg/dL
B. <70 mg/dL
C. <55 mg/dL
D. <130 mg/dL
*Rationale: 2018 ACC/AHA: <55 mg/dL for very high risk.*
A patient on amiodarone develops cough, dyspnea, and CXR interstitial
infiltrates. Most likely?
A. Heart failure
B. Pulmonary toxicity
C. Pneumonia
D. PE
Rationale: Amiodarone pulmonary toxicity common after high dose/long
duration.
First-line rate control in stable A fib with HFrEF?
A. Diltiazem
B. Digoxin
C. Metoprolol
D. Amiodarone
Rationale: Digoxin safe in HFrEF; beta-blockers also used but may worsen
acute decompensation.
Which ECG finding suggests prior MI?
A. ST elevation
B. Pathologic Q waves
