NURS 5433 FNP II FINAL EXAM REVIEW 2026 FAMILY NURSING AND
PRACTICE QUESTIONS ACCURATE EXAM COMPLETE ACTUAL
QUESTIONS WITH WELL ELABORATED ANSWERS WITH DETAILED
RATIONALES (VERIFIED ANSWERS) LATEST UPDATED VERSION 2026
EDITION |GUARANTEED SUCCESS A+ (BRAND NEW!) |UTA
1. A 45-year-old patient with hypertension and type 2 diabetes presents with a
blood pressure of 148/90 mm Hg. Current medications include metformin 1000 mg
BID and Lisinopril 10 mg daily. What is the most appropriate next step?
A. Add hydrochlorothiazide 12.5 mg daily.
B. Increase Lisinopril to 20 mg daily.
C. Add amlodipine 5 mg daily.
D. Continue current regimen and recheck in 3 months.
CORRECT ANSWER: B – Increase Lisinopril to 20 mg daily.
Rationale: In diabetic hypertension, ACE inhibitors are first-line. Target BP
<130/80. Current dose is suboptimal; up-titrating Lisinopril before adding another
agent is guideline-recommended.
2. A 72-year-old female with osteoporosis and chronic kidney disease stage 3b has
a 25-hydroxyvitamin D level of 18 ng/mL (normal ≥30). Which supplement
regimen is safest?
A. Ergocalciferol 50,000 IU once weekly for 8 weeks.
B. Cholecalciferol 600 IU daily.
C. Calcitriol 0.25 mcg daily.
D. No supplementation needed.
CORRECT ANSWER: A – Ergocalciferol 50,000 IU once weekly for 8 weeks.
,Rationale: Severe deficiency requires high-dose repletion. Cholecalciferol 600 IU
is inadequate. Calcitriol risks hypercalcemia in CKD without monitoring.
Ergocalciferol is standard repletion.
3. A 28-year-old G2P1 at 34 weeks’ gestation reports sudden onset of right upper
quadrant pain, nausea, and a headache. BP is 165/100 mm Hg; urinalysis shows 2+
protein. Labs: platelets 98,000/mm³, AST 120 U/L, ALT 140 U/L. What is the
priority intervention?
A. Labetalol 20 mg IV push.
B. Magnesium sulfate 4 g IV load.
C. Immediate delivery.
D. Outpatient monitoring with BP log.
CORRECT ANSWER: C – Immediate delivery.
Rationale: Findings consistent with HELLP syndrome (thrombocytopenia, elevated
LFTs) at 34 weeks. Delivery is definitive treatment regardless of gestational age
given maternal risk.
4. Which finding in a 4-month-old infant requires immediate referral to a pediatric
ophthalmologist?
A. Intermittent isotropic when tired.
B. Red reflex absent in left eye.
C. Transient nystagmus with head movement.
D. Epiphora with mild conjunctival injection.
CORRECT ANSWER: B – Red reflex absent in left eye.
Rationale: Absent red reflex suggests cataract, retinoblastoma, or other intraocular
pathology – requires urgent ophthalmology evaluation. Intermittent isotropic can
be normal until 4-6 months.
,5. A 55-year-old male presents with lower urinary tract symptoms (hesitancy, weak
stream, nocturnal x3). DRE reveals smooth, symmetrically enlarged prostate. PSA
is 2.5 ng/milk What is the most appropriate initial management?
A. Tamsulosin 0.4 mg daily.
B. Trans rectal ultrasound-guided biopsy.
C. Finasteride 5 mg daily.
D. Watchful waiting with symptom score.
CORRECT ANSWER: A – Tamsulosin 0.4 mg daily.
Rationale: Symptomatic BPH with normal DRE and age-appropriate PSA. Alpha-
blockers improve flow and symptoms. Finasteride is for larger prostates (>40 mL)
with longer onset.
6. A 32-year-old female on combined oral contraceptive (COC) for 6 months
develops gradual onset of shortness of breath and pleuritic chest pain. She has no
leg swelling. Vital signs: HR 110, BP 110/70, RR 22, O2 sat 94% RA. What is the
next step?
A. D-dimer blood test.
B. Chest X-ray.
C. CT pulmonary angiography.
D. Discontinue COC and re-evaluate in 1 week.
CORRECT ANSWER: C – CT pulmonary angiography.
Rationale: High clinical suspicion for pulmonary embolism (COC use + symptoms
+ tachycardia). CT angiography is definitive. D-dimer is less specific and delays
diagnosis.
, 7. A 60-year-old with heart failure (LVEF 35%) and chronic kidney disease (eGFI
40 mL/min) presents with 3+ pitting edema to the knees, JVP 12 cm, and crackles
bilaterally. Current furosemide 80 mg BID. What is the best next step?
A. Add metolazone 2.5 mg daily.
B. Double furosemide to 160 mg BID.
C. Switch to horsehide 100 mg daily.
D. Add spironolactone 25 mg daily.
CORRECT ANSWER: A – Add metolazone 2.5 mg daily.
Rationale: Diuretic resistance in CKD/ Here – metolazone synergistically blocks
distal tubule, enhancing loop diuretic effect. Increased furosemide alone often
insufficient.
8. A 25-year-old male presents with 3 days of sore throat, fever, and fatigue.
Exam: pharyngeal erythema, patchy exudates, anterior cervical lymphadenopathy.
No cough. What is the most appropriate diagnostic test?
A. Rapid antigen detection test (RADT) for Group a Strep.
B. Monopod test.
C. Throat culture.
D. CBC with differential.
CORRECT ANSWER: A – Rapid antigen detection test for Group a Strep.
Rationale: Centro criteria 3-4 – high likelihood strep pharyngitis. RADT provides
immediate result; throat culture if RADT negative but high suspicion.
9. A 68-year-old female reports 6 months of progressive difficulty walking, urinary
urgency, and memory lapses. Exam: wide-based gait, impaired recall of 3 words at
5 minutes, bilateral up going planters. What is the most likely diagnosis?
PRACTICE QUESTIONS ACCURATE EXAM COMPLETE ACTUAL
QUESTIONS WITH WELL ELABORATED ANSWERS WITH DETAILED
RATIONALES (VERIFIED ANSWERS) LATEST UPDATED VERSION 2026
EDITION |GUARANTEED SUCCESS A+ (BRAND NEW!) |UTA
1. A 45-year-old patient with hypertension and type 2 diabetes presents with a
blood pressure of 148/90 mm Hg. Current medications include metformin 1000 mg
BID and Lisinopril 10 mg daily. What is the most appropriate next step?
A. Add hydrochlorothiazide 12.5 mg daily.
B. Increase Lisinopril to 20 mg daily.
C. Add amlodipine 5 mg daily.
D. Continue current regimen and recheck in 3 months.
CORRECT ANSWER: B – Increase Lisinopril to 20 mg daily.
Rationale: In diabetic hypertension, ACE inhibitors are first-line. Target BP
<130/80. Current dose is suboptimal; up-titrating Lisinopril before adding another
agent is guideline-recommended.
2. A 72-year-old female with osteoporosis and chronic kidney disease stage 3b has
a 25-hydroxyvitamin D level of 18 ng/mL (normal ≥30). Which supplement
regimen is safest?
A. Ergocalciferol 50,000 IU once weekly for 8 weeks.
B. Cholecalciferol 600 IU daily.
C. Calcitriol 0.25 mcg daily.
D. No supplementation needed.
CORRECT ANSWER: A – Ergocalciferol 50,000 IU once weekly for 8 weeks.
,Rationale: Severe deficiency requires high-dose repletion. Cholecalciferol 600 IU
is inadequate. Calcitriol risks hypercalcemia in CKD without monitoring.
Ergocalciferol is standard repletion.
3. A 28-year-old G2P1 at 34 weeks’ gestation reports sudden onset of right upper
quadrant pain, nausea, and a headache. BP is 165/100 mm Hg; urinalysis shows 2+
protein. Labs: platelets 98,000/mm³, AST 120 U/L, ALT 140 U/L. What is the
priority intervention?
A. Labetalol 20 mg IV push.
B. Magnesium sulfate 4 g IV load.
C. Immediate delivery.
D. Outpatient monitoring with BP log.
CORRECT ANSWER: C – Immediate delivery.
Rationale: Findings consistent with HELLP syndrome (thrombocytopenia, elevated
LFTs) at 34 weeks. Delivery is definitive treatment regardless of gestational age
given maternal risk.
4. Which finding in a 4-month-old infant requires immediate referral to a pediatric
ophthalmologist?
A. Intermittent isotropic when tired.
B. Red reflex absent in left eye.
C. Transient nystagmus with head movement.
D. Epiphora with mild conjunctival injection.
CORRECT ANSWER: B – Red reflex absent in left eye.
Rationale: Absent red reflex suggests cataract, retinoblastoma, or other intraocular
pathology – requires urgent ophthalmology evaluation. Intermittent isotropic can
be normal until 4-6 months.
,5. A 55-year-old male presents with lower urinary tract symptoms (hesitancy, weak
stream, nocturnal x3). DRE reveals smooth, symmetrically enlarged prostate. PSA
is 2.5 ng/milk What is the most appropriate initial management?
A. Tamsulosin 0.4 mg daily.
B. Trans rectal ultrasound-guided biopsy.
C. Finasteride 5 mg daily.
D. Watchful waiting with symptom score.
CORRECT ANSWER: A – Tamsulosin 0.4 mg daily.
Rationale: Symptomatic BPH with normal DRE and age-appropriate PSA. Alpha-
blockers improve flow and symptoms. Finasteride is for larger prostates (>40 mL)
with longer onset.
6. A 32-year-old female on combined oral contraceptive (COC) for 6 months
develops gradual onset of shortness of breath and pleuritic chest pain. She has no
leg swelling. Vital signs: HR 110, BP 110/70, RR 22, O2 sat 94% RA. What is the
next step?
A. D-dimer blood test.
B. Chest X-ray.
C. CT pulmonary angiography.
D. Discontinue COC and re-evaluate in 1 week.
CORRECT ANSWER: C – CT pulmonary angiography.
Rationale: High clinical suspicion for pulmonary embolism (COC use + symptoms
+ tachycardia). CT angiography is definitive. D-dimer is less specific and delays
diagnosis.
, 7. A 60-year-old with heart failure (LVEF 35%) and chronic kidney disease (eGFI
40 mL/min) presents with 3+ pitting edema to the knees, JVP 12 cm, and crackles
bilaterally. Current furosemide 80 mg BID. What is the best next step?
A. Add metolazone 2.5 mg daily.
B. Double furosemide to 160 mg BID.
C. Switch to horsehide 100 mg daily.
D. Add spironolactone 25 mg daily.
CORRECT ANSWER: A – Add metolazone 2.5 mg daily.
Rationale: Diuretic resistance in CKD/ Here – metolazone synergistically blocks
distal tubule, enhancing loop diuretic effect. Increased furosemide alone often
insufficient.
8. A 25-year-old male presents with 3 days of sore throat, fever, and fatigue.
Exam: pharyngeal erythema, patchy exudates, anterior cervical lymphadenopathy.
No cough. What is the most appropriate diagnostic test?
A. Rapid antigen detection test (RADT) for Group a Strep.
B. Monopod test.
C. Throat culture.
D. CBC with differential.
CORRECT ANSWER: A – Rapid antigen detection test for Group a Strep.
Rationale: Centro criteria 3-4 – high likelihood strep pharyngitis. RADT provides
immediate result; throat culture if RADT negative but high suspicion.
9. A 68-year-old female reports 6 months of progressive difficulty walking, urinary
urgency, and memory lapses. Exam: wide-based gait, impaired recall of 3 words at
5 minutes, bilateral up going planters. What is the most likely diagnosis?
