CMN 568 FAMILY NURSE PRACTITIONER FINAL EXAM,
2026/2027 – 75-QUESTION NGN-ALIGNED PRACTICE EXAM
WITH VERIFIED ANSWERS AND RATIONALES.
**Question 1**
A 58-year-old male with a history of hypertension presents with substernal chest pressure that occurs with
exertion and resolves with rest. The pain is relieved within 5 minutes of taking sublingual nitroglycerin.
Which diagnosis is most likely?
A) Unstable angina
B) Stable angina
C) Non-ST elevation myocardial infarction (NSTEMI)
D) Pericarditis
Answer: B) Stable angina
Rationale: Stable angina is characterized by chest pain or pressure that is reproducible with exertion or
stress, relieved by rest or nitroglycerin, and has a predictable pattern. Unstable angina (A) occurs at rest
or with minimal exertion and is increasing in frequency or severity. NSTEMI (C) would present with
prolonged pain and elevated cardiac biomarkers. Pericarditis (D) typically presents with sharp pleuritic
chest pain relieved by sitting forward.
,---
**Question 2**
A 72-year-old female with heart failure with reduced ejection fraction (HFrEF) is prescribed lisinopril,
furosemide, and carvedilol. Which finding would indicate a need to adjust or hold the carvedilol?
A) Heart rate 72 bpm
B) Blood pressure 110/70 mmHg
C) Heart rate 52 bpm with dizziness upon standing
D) Respiratory rate 18 breaths per minute
Answer: C) Heart rate 52 bpm with dizziness upon standing
Rationale: Carvedilol is a beta-blocker that can cause bradycardia and hypotension. Symptomatic
bradycardia (heart rate <60 bpm with dizziness, fatigue, or syncope) warrants dose reduction or holding
the medication. The other options are within acceptable ranges for a patient with HFrEF on guideline-
directed medical therapy.
---
**Question 3**
, A 65-year-old male with a 40-pack-year smoking history presents with a new onset of pain in the right calf
when walking that resolves within 2-3 minutes of rest. On exam, the right foot is cool to touch with
diminished dorsalis pedis and posterior tibial pulses. The most appropriate initial diagnostic test is:
A) Ankle-brachial index (ABI)
B) Venous Doppler ultrasound
C) CT angiography of the lower extremities
D) Complete blood count and coagulation studies
Answer: A) Ankle-brachial index (ABI)
Rationale: This patient has classic symptoms of peripheral arterial disease (PAD) – intermittent
claudication relieved by rest. The ankle-brachial index is a noninvasive, inexpensive, and reliable initial
test to diagnose PAD. ABI <0.90 is diagnostic. Venous Doppler (B) is for deep vein thrombosis. CT
angiography (C) is more invasive and not first-line. Lab studies (D) are not diagnostic for PAD.
---
**Question 4**
A 55-year-old female with hypertension is started on hydrochlorothiazide. Which electrolyte abnormality is
the FNP most likely to monitor for?
A) Hyperkalemia
2026/2027 – 75-QUESTION NGN-ALIGNED PRACTICE EXAM
WITH VERIFIED ANSWERS AND RATIONALES.
**Question 1**
A 58-year-old male with a history of hypertension presents with substernal chest pressure that occurs with
exertion and resolves with rest. The pain is relieved within 5 minutes of taking sublingual nitroglycerin.
Which diagnosis is most likely?
A) Unstable angina
B) Stable angina
C) Non-ST elevation myocardial infarction (NSTEMI)
D) Pericarditis
Answer: B) Stable angina
Rationale: Stable angina is characterized by chest pain or pressure that is reproducible with exertion or
stress, relieved by rest or nitroglycerin, and has a predictable pattern. Unstable angina (A) occurs at rest
or with minimal exertion and is increasing in frequency or severity. NSTEMI (C) would present with
prolonged pain and elevated cardiac biomarkers. Pericarditis (D) typically presents with sharp pleuritic
chest pain relieved by sitting forward.
,---
**Question 2**
A 72-year-old female with heart failure with reduced ejection fraction (HFrEF) is prescribed lisinopril,
furosemide, and carvedilol. Which finding would indicate a need to adjust or hold the carvedilol?
A) Heart rate 72 bpm
B) Blood pressure 110/70 mmHg
C) Heart rate 52 bpm with dizziness upon standing
D) Respiratory rate 18 breaths per minute
Answer: C) Heart rate 52 bpm with dizziness upon standing
Rationale: Carvedilol is a beta-blocker that can cause bradycardia and hypotension. Symptomatic
bradycardia (heart rate <60 bpm with dizziness, fatigue, or syncope) warrants dose reduction or holding
the medication. The other options are within acceptable ranges for a patient with HFrEF on guideline-
directed medical therapy.
---
**Question 3**
, A 65-year-old male with a 40-pack-year smoking history presents with a new onset of pain in the right calf
when walking that resolves within 2-3 minutes of rest. On exam, the right foot is cool to touch with
diminished dorsalis pedis and posterior tibial pulses. The most appropriate initial diagnostic test is:
A) Ankle-brachial index (ABI)
B) Venous Doppler ultrasound
C) CT angiography of the lower extremities
D) Complete blood count and coagulation studies
Answer: A) Ankle-brachial index (ABI)
Rationale: This patient has classic symptoms of peripheral arterial disease (PAD) – intermittent
claudication relieved by rest. The ankle-brachial index is a noninvasive, inexpensive, and reliable initial
test to diagnose PAD. ABI <0.90 is diagnostic. Venous Doppler (B) is for deep vein thrombosis. CT
angiography (C) is more invasive and not first-line. Lab studies (D) are not diagnostic for PAD.
---
**Question 4**
A 55-year-old female with hypertension is started on hydrochlorothiazide. Which electrolyte abnormality is
the FNP most likely to monitor for?
A) Hyperkalemia
