NURS 5433 FNP II FINAL EXAM REVIEW
Actual Exam 2026/2027 Complete
Questions and Answers | 100% Verified
Detailed Rationales - Pass Guaranteed - A+
Graded
TABLE OF CONTENTS
Section 1 | Primary Care of Families Across the Lifespan | Q1 – Q10
Section 2 | Management of Acute Conditions in Family Practice | Q11 – Q20
Section 3 | Management of Chronic Conditions in Family Practice | Q21 – Q30
Section 4 | Health Promotion, Prevention, and Screening Guidelines | Q31 – Q40
Section 5 | Complex Cases, Pharmacology, and Evidence-Based Practice | Q41 – Q50
══════════════════════════════════════
SECTION 1: PRIMARY CARE OF FAMILIES ACROSS THE LIFESPAN Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 6-week-old infant is brought to the family practice clinic by his mother, who reports
that he has been fussy and pulling at his right ear for two days. On examination, the
tympanic membrane is bulging, erythematous, and immobile on pneumatic otoscopy.
The infant has a temperature of 38.6°C and has been feeding poorly. What is the most
appropriate initial management?
A. Reassurance and observation for 48 hours
B. Amoxicillin 45 mg/kg/day divided twice daily for 10 days ✓ CORRECT
C. Azithromycin 10 mg/kg on day 1, then 5 mg/kg days 2–5
D. Amoxicillin-clavulanate 90 mg/kg/day divided twice daily
,Correct Answer: B
Rationale: First-line treatment for acute otitis media in infants under 6 months is
amoxicillin at standard dosing, as this age group has a higher risk of bacteremia and
complications, making observation inappropriate. The most tempting wrong answer is
A because watchful waiting is reserved for children over 6 months with mild symptoms,
and infants under 6 months require definitive antibiotic therapy. Accurate diagnosis and
treatment of AOM in infants prevents complications like mastoiditis and hearing loss,
which can impair language development.
Question 2 of 50
A 14-year-old female presents to the clinic for a sports physical. She reports that her
last menstrual period was 8 weeks ago, and a urine pregnancy test is positive. She is
tearful and states she does not want her parents to know. According to most state laws
and ethical guidelines, what is the FNP's priority action?
A. Notify the parents immediately because she is a minor
B. Assess for safety, provide counseling, and discuss confidential care options ✓
CORRECT
C. Refuse care until she brings a parent to the appointment
D. Report the pregnancy to child protective services
Correct Answer: B
Rationale: Most states allow minors to consent to pregnancy-related care confidentially,
and the FNP's priority is to assess for coercion, intimate partner violence, and safety
while providing non-judgmental counseling and discussing all options within the bounds
of state law. The most tempting wrong answer is A because while parental involvement
is ideal, mandatory disclosure is not standard in most jurisdictions, and premature
notification may prevent the adolescent from seeking necessary care. Adolescent
pregnancy care requires balancing confidentiality with safety, and establishing trust
ensures ongoing engagement with prenatal or pregnancy termination services.
,Question 3 of 50
A 68-year-old man with type 2 diabetes presents for his annual wellness visit. His
HbA1c is 7.2%, blood pressure is 138/84 mmHg, and LDL is 112 mg/dL. He takes
metformin 1000 mg twice daily. According to ADA guidelines, what is the most
appropriate next step in management?
A. Add a sulfonylurea to improve glycemic control
B. Initiate a statin for cardiovascular risk reduction ✓ CORRECT
C. Intensify blood pressure medication to achieve <130/80
D. Increase metformin to 2000 mg three times daily
Correct Answer: B
Rationale: ADA guidelines recommend statin therapy for all patients with diabetes aged
40–75 regardless of baseline LDL, as diabetes is considered a cardiovascular risk
equivalent, making cardiovascular risk reduction a priority even with acceptable
glycemic control. The most tempting wrong answer is A because while glycemic control
is important, his HbA1c of 7.2% is near target, and cardiovascular protection takes
precedence in this age group. Cardiovascular disease remains the leading cause of
mortality in diabetes, and statin initiation at appropriate ages has been shown to reduce
major adverse cardiovascular events significantly.
Question 4 of 50
A 3-year-old boy is seen in the clinic for a well-child visit. His mother reports that he
speaks in three-word sentences, runs without falling, and can build a tower of six
blocks. The nurse practitioner notes that he cannot pedal a tricycle and does not use a
spoon well. Which developmental milestone is most concerning?
A. Speaking in three-word sentences
B. Running without falling
C. Inability to pedal a tricycle ✓ CORRECT
D. Building a tower of six blocks
, Correct Answer: C
Rationale: Pedaling a tricycle is typically achieved by age 3, and inability to do so may
indicate gross motor delay requiring further evaluation, while three-word sentences,
running, and block building are all appropriate for this age. The most tempting wrong
answer is A because parents often worry about language development, but three-word
sentences at age 3 are actually within normal limits and not concerning. Early
identification of motor delays allows for referral to physical therapy and evaluation for
underlying neuromuscular conditions, improving long-term functional outcomes.
Question 5 of 50
A 42-year-old woman presents with a 2-week history of fatigue, constipation, and cold
intolerance. Her TSH is 8.5 mIU/L and free T4 is 1.0 ng/dL. She has no known thyroid
disease. What is the most likely diagnosis?
A. Primary hyperthyroidism
B. Subclinical hypothyroidism ✓ CORRECT
C. Central hypothyroidism
D. Hashimoto's thyroiditis
Correct Answer: B
Rationale: An elevated TSH with a normal free T4 defines subclinical hypothyroidism,
which is the most likely diagnosis in this patient with mild symptoms, distinguishing it
from overt hypothyroidism where free T4 would be low. The most tempting wrong
answer is D because while Hashimoto's thyroiditis is the most common cause of
hypothyroidism, it typically presents with overt hypothyroidism and elevated thyroid
antibodies, and the laboratory pattern here is specifically subclinical. Subclinical
hypothyroidism management depends on TSH level and symptoms, with treatment
generally recommended when TSH exceeds 10 mIU/L or in pregnancy.
Question 6 of 50
Actual Exam 2026/2027 Complete
Questions and Answers | 100% Verified
Detailed Rationales - Pass Guaranteed - A+
Graded
TABLE OF CONTENTS
Section 1 | Primary Care of Families Across the Lifespan | Q1 – Q10
Section 2 | Management of Acute Conditions in Family Practice | Q11 – Q20
Section 3 | Management of Chronic Conditions in Family Practice | Q21 – Q30
Section 4 | Health Promotion, Prevention, and Screening Guidelines | Q31 – Q40
Section 5 | Complex Cases, Pharmacology, and Evidence-Based Practice | Q41 – Q50
══════════════════════════════════════
SECTION 1: PRIMARY CARE OF FAMILIES ACROSS THE LIFESPAN Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 6-week-old infant is brought to the family practice clinic by his mother, who reports
that he has been fussy and pulling at his right ear for two days. On examination, the
tympanic membrane is bulging, erythematous, and immobile on pneumatic otoscopy.
The infant has a temperature of 38.6°C and has been feeding poorly. What is the most
appropriate initial management?
A. Reassurance and observation for 48 hours
B. Amoxicillin 45 mg/kg/day divided twice daily for 10 days ✓ CORRECT
C. Azithromycin 10 mg/kg on day 1, then 5 mg/kg days 2–5
D. Amoxicillin-clavulanate 90 mg/kg/day divided twice daily
,Correct Answer: B
Rationale: First-line treatment for acute otitis media in infants under 6 months is
amoxicillin at standard dosing, as this age group has a higher risk of bacteremia and
complications, making observation inappropriate. The most tempting wrong answer is
A because watchful waiting is reserved for children over 6 months with mild symptoms,
and infants under 6 months require definitive antibiotic therapy. Accurate diagnosis and
treatment of AOM in infants prevents complications like mastoiditis and hearing loss,
which can impair language development.
Question 2 of 50
A 14-year-old female presents to the clinic for a sports physical. She reports that her
last menstrual period was 8 weeks ago, and a urine pregnancy test is positive. She is
tearful and states she does not want her parents to know. According to most state laws
and ethical guidelines, what is the FNP's priority action?
A. Notify the parents immediately because she is a minor
B. Assess for safety, provide counseling, and discuss confidential care options ✓
CORRECT
C. Refuse care until she brings a parent to the appointment
D. Report the pregnancy to child protective services
Correct Answer: B
Rationale: Most states allow minors to consent to pregnancy-related care confidentially,
and the FNP's priority is to assess for coercion, intimate partner violence, and safety
while providing non-judgmental counseling and discussing all options within the bounds
of state law. The most tempting wrong answer is A because while parental involvement
is ideal, mandatory disclosure is not standard in most jurisdictions, and premature
notification may prevent the adolescent from seeking necessary care. Adolescent
pregnancy care requires balancing confidentiality with safety, and establishing trust
ensures ongoing engagement with prenatal or pregnancy termination services.
,Question 3 of 50
A 68-year-old man with type 2 diabetes presents for his annual wellness visit. His
HbA1c is 7.2%, blood pressure is 138/84 mmHg, and LDL is 112 mg/dL. He takes
metformin 1000 mg twice daily. According to ADA guidelines, what is the most
appropriate next step in management?
A. Add a sulfonylurea to improve glycemic control
B. Initiate a statin for cardiovascular risk reduction ✓ CORRECT
C. Intensify blood pressure medication to achieve <130/80
D. Increase metformin to 2000 mg three times daily
Correct Answer: B
Rationale: ADA guidelines recommend statin therapy for all patients with diabetes aged
40–75 regardless of baseline LDL, as diabetes is considered a cardiovascular risk
equivalent, making cardiovascular risk reduction a priority even with acceptable
glycemic control. The most tempting wrong answer is A because while glycemic control
is important, his HbA1c of 7.2% is near target, and cardiovascular protection takes
precedence in this age group. Cardiovascular disease remains the leading cause of
mortality in diabetes, and statin initiation at appropriate ages has been shown to reduce
major adverse cardiovascular events significantly.
Question 4 of 50
A 3-year-old boy is seen in the clinic for a well-child visit. His mother reports that he
speaks in three-word sentences, runs without falling, and can build a tower of six
blocks. The nurse practitioner notes that he cannot pedal a tricycle and does not use a
spoon well. Which developmental milestone is most concerning?
A. Speaking in three-word sentences
B. Running without falling
C. Inability to pedal a tricycle ✓ CORRECT
D. Building a tower of six blocks
, Correct Answer: C
Rationale: Pedaling a tricycle is typically achieved by age 3, and inability to do so may
indicate gross motor delay requiring further evaluation, while three-word sentences,
running, and block building are all appropriate for this age. The most tempting wrong
answer is A because parents often worry about language development, but three-word
sentences at age 3 are actually within normal limits and not concerning. Early
identification of motor delays allows for referral to physical therapy and evaluation for
underlying neuromuscular conditions, improving long-term functional outcomes.
Question 5 of 50
A 42-year-old woman presents with a 2-week history of fatigue, constipation, and cold
intolerance. Her TSH is 8.5 mIU/L and free T4 is 1.0 ng/dL. She has no known thyroid
disease. What is the most likely diagnosis?
A. Primary hyperthyroidism
B. Subclinical hypothyroidism ✓ CORRECT
C. Central hypothyroidism
D. Hashimoto's thyroiditis
Correct Answer: B
Rationale: An elevated TSH with a normal free T4 defines subclinical hypothyroidism,
which is the most likely diagnosis in this patient with mild symptoms, distinguishing it
from overt hypothyroidism where free T4 would be low. The most tempting wrong
answer is D because while Hashimoto's thyroiditis is the most common cause of
hypothyroidism, it typically presents with overt hypothyroidism and elevated thyroid
antibodies, and the laboratory pattern here is specifically subclinical. Subclinical
hypothyroidism management depends on TSH level and symptoms, with treatment
generally recommended when TSH exceeds 10 mIU/L or in pregnancy.
Question 6 of 50
