NURS 5433 FNP II Final Exam
Review Family Nursing ACTUAL
EXAM 2026/2027 | UTA NURS 5433
FNP II Final | Verified Q&A | Pass
Guaranteed - A+ Graded
Section A: Multiple Choice (Questions 1–55)
Q1: A 6-month-old infant presents for a well-child visit. Current weight is 7.5 kg (birth weight 3.2 kg).
The parent reports the infant is sitting with support, rolling over both ways, and reaching for objects.
Based on the assessment findings, which statement is correct?
A. The infant is underweight for age
B. The infant's weight gain and developmental milestones are appropriate for age. [CORRECT]
C. The infant should be referred for developmental delay
D. The infant needs nutritional supplementation
Correct Answer: B
Rationale: By 6 months, infants typically double their birth weight (3.2 kg × 2 = 6.4 kg; 7.5 kg exceeds
this benchmark appropriately). Developmental milestones at 6 months include sitting with support,
rolling over in both directions, and purposeful reaching—all demonstrated here. These findings align
with AAP/CDC well-child guidelines and indicate normal growth and development.
Q2: A 58-year-old male presents with blood pressure of 148/92 mmHg on two separate office visits, one
month apart. He has no known comorbidities and is not taking any antihypertensives. His 10-year ASCVD
risk is calculated at 6%. According to current ACC/AHA hypertension guidelines, what is the initial
management step for this patient?
A. Start two antihypertensive medications immediately
B. Initiate lifestyle modifications and reassess BP in 3–6 months. [CORRECT]
,C. Start low-dose hydrochlorothiazide monotherapy
D. Order renal artery ultrasound before any treatment
Correct Answer: B
Rationale: Stage 1 hypertension (130–139/80–89 mmHg) with low 10-year ASCVD risk (<10%) is
managed initially with lifestyle modifications including the DASH diet, sodium reduction, regular aerobic
exercise, weight management, and limited alcohol intake. Pharmacotherapy is initiated if BP remains
elevated after 3–6 months of lifestyle intervention, following the 2017 ACC/AHA Hypertension Guideline
framework.
Q3: A 78-year-old female is brought to the clinic by family with new onset confusion over 48 hours.
Family reports she was cognitively baseline last week. Urinalysis is positive for nitrites and leukocyte
esterase. She has no history of dementia. What is the most likely cause of this patient's confusion?
A. Delirium secondary to urinary tract infection. [CORRECT]
B. New onset Alzheimer's disease
C. Normal aging cognitive decline
D. Depression with pseudodementia
Correct Answer: A
Rationale: Acute onset of confusion over hours to days with a clear precipitant (urinary tract infection)
in an older adult without baseline cognitive impairment is characteristic of delirium. Delirium is a
medical emergency distinct from dementia, which has an insidious, progressive course over months to
years. Identification and treatment of the underlying cause—in this case, antibiotic therapy for UTI—is
the priority management.
Q4: A 4-year-old child is brought to the clinic with ear pain and fever of 101.2°F (38.4°C) for 2 days.
Otoscopic examination reveals a bulging, erythematous tympanic membrane with decreased mobility on
pneumatic otoscopy. The child is otherwise healthy with no drug allergies. According to AAP guidelines,
what is the most appropriate initial management?
A. Immediate antibiotic therapy with amoxicillin 80–90 mg/kg/day. [CORRECT]
B. Watchful waiting with pain management only
C. Azithromycin as first-line therapy
D. Referral to otolaryngology for tympanostomy tubes
Correct Answer: A
Rationale: This child meets criteria for acute otitis media requiring antibiotic therapy: moderate to
severe ear pain, fever ≥102.2°F (39°C), and otoscopic findings of bulging TM with impaired mobility.
First-line therapy is high-dose amoxicillin (80–90 mg/kg/day divided BID) for 10 days in children under 6
,years. Watchful waiting is reserved for mild symptoms in children 6 months to 2 years with uncertain
diagnosis.
Q5: A 45-year-old female presents for her annual well-woman visit. She is up to date on cervical cancer
screening. Her last Pap smear 3 years ago was normal. She is in a monogamous relationship and has no
new sexual partners. According to USPSTF guidelines, when is her next cervical cancer screening due?
A. Now—annual Pap smear
B. In 3 years with cytology alone or in 5 years with co-testing. [CORRECT]
C. In 10 years with colonoscopy
D. Cervical cancer screening is no longer needed after age 40
Correct Answer: B
Rationale: USPSTF recommends cervical cancer screening every 3 years with cytology alone or every 5
years with high-risk HPV testing alone or co-testing (cytology + HPV) for women aged 30–65. This patient
had a normal Pap 3 years ago and is low-risk, so either 3-year cytology or 5-year co-testing intervals are
appropriate. Annual screening is no longer recommended for average-risk women.
Q6: A 62-year-old male with a 40 pack-year smoking history presents for a routine visit. He currently
smokes one pack per day and has tried to quit unsuccessfully twice. According to USPSTF guidelines,
what is the recommended lung cancer screening?
A. Annual low-dose CT scan. [CORRECT]
B. Annual chest x-ray
C. Sputum cytology every 6 months
D. No screening is recommended for smokers
Correct Answer: A
Rationale: USPSTF recommends annual lung cancer screening with low-dose computed tomography
(LDCT) for adults aged 50–80 with a 20 pack-year smoking history who currently smoke or have quit
within the past 15 years. This patient's 40 pack-year history and current smoking status meet criteria.
Screening should be discontinued once the patient has not smoked for 15 years or develops a health
problem that substantially limits life expectancy.
Q7: A 35-year-old female presents with fatigue, weight gain of 12 lbs over 3 months, cold intolerance,
constipation, and dry skin. Laboratory results show TSH 12.5 mIU/L (normal 0.4–4.0) and free T4 0.6
ng/dL (normal 0.8–1.8). What is the most appropriate initial management?
, A. Start levothyroxine 1.6 mcg/kg/day. [CORRECT]
B. Order thyroid ultrasound before starting medication
C. Start liothyronine (T3) replacement
D. Reassure the patient and recheck TSH in 6 months
Correct Answer: A
Rationale: This patient has overt primary hypothyroidism (elevated TSH, low free T4) with classic
symptoms. Levothyroxine monotherapy is the standard of care, dosed at approximately 1.6 mcg/kg/day
for full replacement in otherwise healthy adults. Younger patients without cardiac disease can be
started at full replacement doses, while elderly patients or those with coronary artery disease require
lower starting doses (25–50 mcg/day) with gradual titration.
Q8: A 52-year-old male with type 2 diabetes presents for follow-up. His current medications are
metformin 1,000 mg BID and glipizide 10 mg daily. His most recent A1c is 8.2%. According to ADA
guidelines, what is the next appropriate step in management?
A. Increase glipizide to 20 mg daily
B. Add a GLP-1 receptor agonist or SGLT2 inhibitor. [CORRECT]
C. Discontinue metformin and start insulin
D. Add pioglitazone as third-line therapy
Correct Answer: B
Rationale: The ADA recommends adding a GLP-1 receptor agonist or SGLT2 inhibitor as second-line
therapy when A1c remains above target (typically <7% for most adults) despite metformin monotherapy
or dual therapy. These agents offer cardiovascular and renal benefits beyond glycemic control.
Sulfonylureas such as glipizide carry hypoglycemia and weight gain risks, making them less preferred as
intensification options.
Q9: A 68-year-old female with osteoporosis (T-score -2.8 at the lumbar spine) is prescribed alendronate
70 mg weekly. Which instruction should the nurse practitioner include in patient teaching?
A. "Take the medication with breakfast and a full glass of water."
B. "Take the medication first thing in the morning on an empty stomach with a full glass of water, and
remain upright for 30 minutes." [CORRECT]
C. "Take the medication at bedtime with a snack."
D. "You can lie down immediately after taking this medication."
Correct Answer: B
Rationale: Oral bisphosphonates such as alendronate require administration first thing in the morning
with a full glass of plain water on an empty stomach to optimize absorption. The patient must remain
upright (sitting or standing) for at least 30 minutes to prevent esophageal irritation and ulceration. Food,
Review Family Nursing ACTUAL
EXAM 2026/2027 | UTA NURS 5433
FNP II Final | Verified Q&A | Pass
Guaranteed - A+ Graded
Section A: Multiple Choice (Questions 1–55)
Q1: A 6-month-old infant presents for a well-child visit. Current weight is 7.5 kg (birth weight 3.2 kg).
The parent reports the infant is sitting with support, rolling over both ways, and reaching for objects.
Based on the assessment findings, which statement is correct?
A. The infant is underweight for age
B. The infant's weight gain and developmental milestones are appropriate for age. [CORRECT]
C. The infant should be referred for developmental delay
D. The infant needs nutritional supplementation
Correct Answer: B
Rationale: By 6 months, infants typically double their birth weight (3.2 kg × 2 = 6.4 kg; 7.5 kg exceeds
this benchmark appropriately). Developmental milestones at 6 months include sitting with support,
rolling over in both directions, and purposeful reaching—all demonstrated here. These findings align
with AAP/CDC well-child guidelines and indicate normal growth and development.
Q2: A 58-year-old male presents with blood pressure of 148/92 mmHg on two separate office visits, one
month apart. He has no known comorbidities and is not taking any antihypertensives. His 10-year ASCVD
risk is calculated at 6%. According to current ACC/AHA hypertension guidelines, what is the initial
management step for this patient?
A. Start two antihypertensive medications immediately
B. Initiate lifestyle modifications and reassess BP in 3–6 months. [CORRECT]
,C. Start low-dose hydrochlorothiazide monotherapy
D. Order renal artery ultrasound before any treatment
Correct Answer: B
Rationale: Stage 1 hypertension (130–139/80–89 mmHg) with low 10-year ASCVD risk (<10%) is
managed initially with lifestyle modifications including the DASH diet, sodium reduction, regular aerobic
exercise, weight management, and limited alcohol intake. Pharmacotherapy is initiated if BP remains
elevated after 3–6 months of lifestyle intervention, following the 2017 ACC/AHA Hypertension Guideline
framework.
Q3: A 78-year-old female is brought to the clinic by family with new onset confusion over 48 hours.
Family reports she was cognitively baseline last week. Urinalysis is positive for nitrites and leukocyte
esterase. She has no history of dementia. What is the most likely cause of this patient's confusion?
A. Delirium secondary to urinary tract infection. [CORRECT]
B. New onset Alzheimer's disease
C. Normal aging cognitive decline
D. Depression with pseudodementia
Correct Answer: A
Rationale: Acute onset of confusion over hours to days with a clear precipitant (urinary tract infection)
in an older adult without baseline cognitive impairment is characteristic of delirium. Delirium is a
medical emergency distinct from dementia, which has an insidious, progressive course over months to
years. Identification and treatment of the underlying cause—in this case, antibiotic therapy for UTI—is
the priority management.
Q4: A 4-year-old child is brought to the clinic with ear pain and fever of 101.2°F (38.4°C) for 2 days.
Otoscopic examination reveals a bulging, erythematous tympanic membrane with decreased mobility on
pneumatic otoscopy. The child is otherwise healthy with no drug allergies. According to AAP guidelines,
what is the most appropriate initial management?
A. Immediate antibiotic therapy with amoxicillin 80–90 mg/kg/day. [CORRECT]
B. Watchful waiting with pain management only
C. Azithromycin as first-line therapy
D. Referral to otolaryngology for tympanostomy tubes
Correct Answer: A
Rationale: This child meets criteria for acute otitis media requiring antibiotic therapy: moderate to
severe ear pain, fever ≥102.2°F (39°C), and otoscopic findings of bulging TM with impaired mobility.
First-line therapy is high-dose amoxicillin (80–90 mg/kg/day divided BID) for 10 days in children under 6
,years. Watchful waiting is reserved for mild symptoms in children 6 months to 2 years with uncertain
diagnosis.
Q5: A 45-year-old female presents for her annual well-woman visit. She is up to date on cervical cancer
screening. Her last Pap smear 3 years ago was normal. She is in a monogamous relationship and has no
new sexual partners. According to USPSTF guidelines, when is her next cervical cancer screening due?
A. Now—annual Pap smear
B. In 3 years with cytology alone or in 5 years with co-testing. [CORRECT]
C. In 10 years with colonoscopy
D. Cervical cancer screening is no longer needed after age 40
Correct Answer: B
Rationale: USPSTF recommends cervical cancer screening every 3 years with cytology alone or every 5
years with high-risk HPV testing alone or co-testing (cytology + HPV) for women aged 30–65. This patient
had a normal Pap 3 years ago and is low-risk, so either 3-year cytology or 5-year co-testing intervals are
appropriate. Annual screening is no longer recommended for average-risk women.
Q6: A 62-year-old male with a 40 pack-year smoking history presents for a routine visit. He currently
smokes one pack per day and has tried to quit unsuccessfully twice. According to USPSTF guidelines,
what is the recommended lung cancer screening?
A. Annual low-dose CT scan. [CORRECT]
B. Annual chest x-ray
C. Sputum cytology every 6 months
D. No screening is recommended for smokers
Correct Answer: A
Rationale: USPSTF recommends annual lung cancer screening with low-dose computed tomography
(LDCT) for adults aged 50–80 with a 20 pack-year smoking history who currently smoke or have quit
within the past 15 years. This patient's 40 pack-year history and current smoking status meet criteria.
Screening should be discontinued once the patient has not smoked for 15 years or develops a health
problem that substantially limits life expectancy.
Q7: A 35-year-old female presents with fatigue, weight gain of 12 lbs over 3 months, cold intolerance,
constipation, and dry skin. Laboratory results show TSH 12.5 mIU/L (normal 0.4–4.0) and free T4 0.6
ng/dL (normal 0.8–1.8). What is the most appropriate initial management?
, A. Start levothyroxine 1.6 mcg/kg/day. [CORRECT]
B. Order thyroid ultrasound before starting medication
C. Start liothyronine (T3) replacement
D. Reassure the patient and recheck TSH in 6 months
Correct Answer: A
Rationale: This patient has overt primary hypothyroidism (elevated TSH, low free T4) with classic
symptoms. Levothyroxine monotherapy is the standard of care, dosed at approximately 1.6 mcg/kg/day
for full replacement in otherwise healthy adults. Younger patients without cardiac disease can be
started at full replacement doses, while elderly patients or those with coronary artery disease require
lower starting doses (25–50 mcg/day) with gradual titration.
Q8: A 52-year-old male with type 2 diabetes presents for follow-up. His current medications are
metformin 1,000 mg BID and glipizide 10 mg daily. His most recent A1c is 8.2%. According to ADA
guidelines, what is the next appropriate step in management?
A. Increase glipizide to 20 mg daily
B. Add a GLP-1 receptor agonist or SGLT2 inhibitor. [CORRECT]
C. Discontinue metformin and start insulin
D. Add pioglitazone as third-line therapy
Correct Answer: B
Rationale: The ADA recommends adding a GLP-1 receptor agonist or SGLT2 inhibitor as second-line
therapy when A1c remains above target (typically <7% for most adults) despite metformin monotherapy
or dual therapy. These agents offer cardiovascular and renal benefits beyond glycemic control.
Sulfonylureas such as glipizide carry hypoglycemia and weight gain risks, making them less preferred as
intensification options.
Q9: A 68-year-old female with osteoporosis (T-score -2.8 at the lumbar spine) is prescribed alendronate
70 mg weekly. Which instruction should the nurse practitioner include in patient teaching?
A. "Take the medication with breakfast and a full glass of water."
B. "Take the medication first thing in the morning on an empty stomach with a full glass of water, and
remain upright for 30 minutes." [CORRECT]
C. "Take the medication at bedtime with a snack."
D. "You can lie down immediately after taking this medication."
Correct Answer: B
Rationale: Oral bisphosphonates such as alendronate require administration first thing in the morning
with a full glass of plain water on an empty stomach to optimize absorption. The patient must remain
upright (sitting or standing) for at least 30 minutes to prevent esophageal irritation and ulceration. Food,
