NURS 5433 FNP II Final Exam – University of Texas at Arlington:
Direct Content Multiple-Choice Practice Questions 1 multiple-
choice practice questions with correct answers in bold and
detailed italic explanations.
This NURS 5433 FNP II Final Exam document contains multiple-choice practice questions with correct
answers in bold and detailed italic explanations. Content covers advanced pharmacology including
antibiotics (penicillins, cephalosporins, macrolides, fluoroquinolones, tetracyclines, aminoglycosides,
sulfonamides, metronidazole, vancomycin), infectious diseases (Kawasaki disease, mononucleosis, Lyme
disease, RMSF, measles, pertussis, roseola, fifth disease, STIs, CAP, pyelonephritis, PCP), cardiology
(STEMI, hypertension, heart failure, atrial fibrillation, statins), respiratory (asthma, COPD, pulmonary
embolism, croup, epiglottitis), endocrinology (type 2 diabetes, DKA, HHS, hypothyroidism, hyperthyroidism,
SGLT2 inhibitors, GLP-1 agonists), neurology (stroke, subarachnoid hemorrhage, migraine, cluster
headache, vertigo, Guillain-Barré, myasthenia gravis, seizures), women's health (BV, candidiasis,
trichomoniasis, LARC, menorrhagia, cervical cancer screening, threatened abortion, ectopic pregnancy,
folic acid), pediatrics (AOM, OME, meningitis, Kawasaki disease, croup, strep throat, vitamin D,
intussusception), geriatrics (Beers Criteria, antipsychotics in dementia, falls, alpha-blockers, relaxed HbA1c
goals), and mental health (MDD, panic disorder, GAD, OCD, schizophrenia). Designed for Family Nurse
Practitioner students preparing for the NURS 5433 final exam or FNP certification.
SECTION 1: ADVANCED PHARMACOLOGY (ANTIBIOTICS)
1. Which of the following is the mechanism of action of penicillins?
A) Inhibition of bacterial protein synthesis (50S ribosome)
B) Inhibition of bacterial DNA synthesis
C) Inhibition of bacterial cell wall synthesis
D) Inhibition of folic acid synthesis
Answer: C
,Penicillins are beta-lactam antibiotics that inhibit bacterial cell wall synthesis by binding to
penicillin-binding proteins (PBPs).
2. A patient with a penicillin allergy (anaphylactic reaction) requires an antibiotic for
strep throat. Which of the following is most appropriate?
A) Amoxicillin
B) Cephalexin
C) Clindamycin
D) Ampicillin
Answer: C
Clindamycin or a macrolide (azithromycin) is appropriate for penicillin-allergic patients with
strep throat. Cephalosporins should be avoided in patients with anaphylactic penicillin
allergy due to cross-reactivity.
3. Which generation of cephalosporin provides the best coverage against gram-
negative bacteria including Pseudomonas?
A) First generation
B) Second generation
C) Third generation
D) Fourth generation
Answer: D
Fourth-generation cephalosporins (e.g., cefepime) have enhanced gram-negative coverage
including Pseudomonas. Third-generation (e.g., ceftriaxone) has good gram-negative
coverage but less Pseudomonas activity.
4. A patient is prescribed azithromycin for community-acquired pneumonia. What is
the mechanism of action of macrolides?
A) Inhibition of cell wall synthesis
B) Inhibition of protein synthesis (50S ribosome)
C) Inhibition of DNA synthesis
D) Inhibition of folic acid synthesis
Answer: B
Macrolides bind to the 50S ribosomal subunit, inhibiting bacterial protein synthesis. They
are bacteriostatic.
5. Which antibiotic class carries a Black Box Warning for tendon rupture, particularly
the Achilles tendon?
A) Penicillins
B) Cephalosporins
C) Macrolides
D) Fluoroquinolones
,Answer: D
Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) have a Black Box Warning for
tendonitis and tendon rupture, especially in patients over 60, those on corticosteroids, and
organ transplant recipients.
6. A patient is prescribed doxycycline for Lyme disease. Which of the following is a
key patient education point?
A) Take with dairy products to reduce GI upset
B) Avoid sun exposure due to photosensitivity
C) May cause brown-gray tooth discoloration in adults
D) No food interactions
Answer: B
Doxycycline causes significant photosensitivity; patients should use sunscreen and avoid
prolonged sun exposure. Dairy products reduce absorption and should be avoided within 2
hours of dosing.
7. Which antibiotic class requires therapeutic drug monitoring due to risk of
ototoxicity and nephrotoxicity?
A) Penicillins
B) Cephalosporins
C) Aminoglycosides
D) Tetracyclines
Answer: C
Aminoglycosides (gentamicin, tobramycin) have a narrow therapeutic index and require
monitoring of peak and trough levels to prevent ototoxicity and nephrotoxicity.
8. Trimethoprim-sulfamethoxazole (Bactrim) is most commonly used for which
condition?
A) Strep throat
B) Uncomplicated urinary tract infection (UTI)
C) Community-acquired pneumonia
D) Cellulitis
Answer: B
Bactrim is first-line for uncomplicated UTIs in many regions. It is also used for MRSA skin
infections and Pneumocystis jirovecii pneumonia.
9. A patient with a sulfa allergy should avoid which antibiotic?
A) Ciprofloxacin
B) Doxycycline
C) Trimethoprim-sulfamethoxazole (Bactrim)
D) Azithromycin
, Answer: C
Bactrim contains a sulfonamide moiety and is contraindicated in patients with true sulfa
allergies.
10. Which of the following is the appropriate treatment for uncomplicated cystitis in a
non-pregnant woman?
A) Ciprofloxacin 500 mg BID for 7 days
B) Nitrofurantoin 100 mg BID for 5 days
C) Doxycycline 100 mg BID for 10 days
D) Amoxicillin 500 mg TID for 7 days
Answer: B
*Nitrofurantoin 100 mg BID for 5 days is first-line for uncomplicated cystitis per IDSA
guidelines. Fluoroquinolones are reserved for more complicated infections due to resistance
and side effects.*
SECTION 2: INFECTIOUS DISEASES
11. A 4-year-old patient presents with a 6-day history of high fever, bilateral
conjunctival injection without exudate, a "strawberry tongue," and the NP notes
peeling at the fingertips. What is the most appropriate next step?
Answer: Refer to Cardiology for IVIG and Aspirin therapy
These are diagnostic criteria for Kawasaki Disease. Treatment with IVIG and high-dose
aspirin is required to prevent coronary artery aneurysms.
12. A patient diagnosed with Infectious Mononucleosis also tests positive for Group
A Streptococcus. Which antibiotic should be AVOIDED to prevent a characteristic
non-allergic rash?
Answer: Amoxicillin (and other penicillins)
Patients with acute EBV (Mono) frequently develop a maculopapular rash if treated with
amoxicillin or ampicillin. Use cephalexin or clindamycin instead if strep coverage is needed.
13. A 24-year-old patient presents with a target-like "bulls-eye" rash (erythema
migrans). Which organism and treatment are most likely?
Direct Content Multiple-Choice Practice Questions 1 multiple-
choice practice questions with correct answers in bold and
detailed italic explanations.
This NURS 5433 FNP II Final Exam document contains multiple-choice practice questions with correct
answers in bold and detailed italic explanations. Content covers advanced pharmacology including
antibiotics (penicillins, cephalosporins, macrolides, fluoroquinolones, tetracyclines, aminoglycosides,
sulfonamides, metronidazole, vancomycin), infectious diseases (Kawasaki disease, mononucleosis, Lyme
disease, RMSF, measles, pertussis, roseola, fifth disease, STIs, CAP, pyelonephritis, PCP), cardiology
(STEMI, hypertension, heart failure, atrial fibrillation, statins), respiratory (asthma, COPD, pulmonary
embolism, croup, epiglottitis), endocrinology (type 2 diabetes, DKA, HHS, hypothyroidism, hyperthyroidism,
SGLT2 inhibitors, GLP-1 agonists), neurology (stroke, subarachnoid hemorrhage, migraine, cluster
headache, vertigo, Guillain-Barré, myasthenia gravis, seizures), women's health (BV, candidiasis,
trichomoniasis, LARC, menorrhagia, cervical cancer screening, threatened abortion, ectopic pregnancy,
folic acid), pediatrics (AOM, OME, meningitis, Kawasaki disease, croup, strep throat, vitamin D,
intussusception), geriatrics (Beers Criteria, antipsychotics in dementia, falls, alpha-blockers, relaxed HbA1c
goals), and mental health (MDD, panic disorder, GAD, OCD, schizophrenia). Designed for Family Nurse
Practitioner students preparing for the NURS 5433 final exam or FNP certification.
SECTION 1: ADVANCED PHARMACOLOGY (ANTIBIOTICS)
1. Which of the following is the mechanism of action of penicillins?
A) Inhibition of bacterial protein synthesis (50S ribosome)
B) Inhibition of bacterial DNA synthesis
C) Inhibition of bacterial cell wall synthesis
D) Inhibition of folic acid synthesis
Answer: C
,Penicillins are beta-lactam antibiotics that inhibit bacterial cell wall synthesis by binding to
penicillin-binding proteins (PBPs).
2. A patient with a penicillin allergy (anaphylactic reaction) requires an antibiotic for
strep throat. Which of the following is most appropriate?
A) Amoxicillin
B) Cephalexin
C) Clindamycin
D) Ampicillin
Answer: C
Clindamycin or a macrolide (azithromycin) is appropriate for penicillin-allergic patients with
strep throat. Cephalosporins should be avoided in patients with anaphylactic penicillin
allergy due to cross-reactivity.
3. Which generation of cephalosporin provides the best coverage against gram-
negative bacteria including Pseudomonas?
A) First generation
B) Second generation
C) Third generation
D) Fourth generation
Answer: D
Fourth-generation cephalosporins (e.g., cefepime) have enhanced gram-negative coverage
including Pseudomonas. Third-generation (e.g., ceftriaxone) has good gram-negative
coverage but less Pseudomonas activity.
4. A patient is prescribed azithromycin for community-acquired pneumonia. What is
the mechanism of action of macrolides?
A) Inhibition of cell wall synthesis
B) Inhibition of protein synthesis (50S ribosome)
C) Inhibition of DNA synthesis
D) Inhibition of folic acid synthesis
Answer: B
Macrolides bind to the 50S ribosomal subunit, inhibiting bacterial protein synthesis. They
are bacteriostatic.
5. Which antibiotic class carries a Black Box Warning for tendon rupture, particularly
the Achilles tendon?
A) Penicillins
B) Cephalosporins
C) Macrolides
D) Fluoroquinolones
,Answer: D
Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin) have a Black Box Warning for
tendonitis and tendon rupture, especially in patients over 60, those on corticosteroids, and
organ transplant recipients.
6. A patient is prescribed doxycycline for Lyme disease. Which of the following is a
key patient education point?
A) Take with dairy products to reduce GI upset
B) Avoid sun exposure due to photosensitivity
C) May cause brown-gray tooth discoloration in adults
D) No food interactions
Answer: B
Doxycycline causes significant photosensitivity; patients should use sunscreen and avoid
prolonged sun exposure. Dairy products reduce absorption and should be avoided within 2
hours of dosing.
7. Which antibiotic class requires therapeutic drug monitoring due to risk of
ototoxicity and nephrotoxicity?
A) Penicillins
B) Cephalosporins
C) Aminoglycosides
D) Tetracyclines
Answer: C
Aminoglycosides (gentamicin, tobramycin) have a narrow therapeutic index and require
monitoring of peak and trough levels to prevent ototoxicity and nephrotoxicity.
8. Trimethoprim-sulfamethoxazole (Bactrim) is most commonly used for which
condition?
A) Strep throat
B) Uncomplicated urinary tract infection (UTI)
C) Community-acquired pneumonia
D) Cellulitis
Answer: B
Bactrim is first-line for uncomplicated UTIs in many regions. It is also used for MRSA skin
infections and Pneumocystis jirovecii pneumonia.
9. A patient with a sulfa allergy should avoid which antibiotic?
A) Ciprofloxacin
B) Doxycycline
C) Trimethoprim-sulfamethoxazole (Bactrim)
D) Azithromycin
, Answer: C
Bactrim contains a sulfonamide moiety and is contraindicated in patients with true sulfa
allergies.
10. Which of the following is the appropriate treatment for uncomplicated cystitis in a
non-pregnant woman?
A) Ciprofloxacin 500 mg BID for 7 days
B) Nitrofurantoin 100 mg BID for 5 days
C) Doxycycline 100 mg BID for 10 days
D) Amoxicillin 500 mg TID for 7 days
Answer: B
*Nitrofurantoin 100 mg BID for 5 days is first-line for uncomplicated cystitis per IDSA
guidelines. Fluoroquinolones are reserved for more complicated infections due to resistance
and side effects.*
SECTION 2: INFECTIOUS DISEASES
11. A 4-year-old patient presents with a 6-day history of high fever, bilateral
conjunctival injection without exudate, a "strawberry tongue," and the NP notes
peeling at the fingertips. What is the most appropriate next step?
Answer: Refer to Cardiology for IVIG and Aspirin therapy
These are diagnostic criteria for Kawasaki Disease. Treatment with IVIG and high-dose
aspirin is required to prevent coronary artery aneurysms.
12. A patient diagnosed with Infectious Mononucleosis also tests positive for Group
A Streptococcus. Which antibiotic should be AVOIDED to prevent a characteristic
non-allergic rash?
Answer: Amoxicillin (and other penicillins)
Patients with acute EBV (Mono) frequently develop a maculopapular rash if treated with
amoxicillin or ampicillin. Use cephalexin or clindamycin instead if strep coverage is needed.
13. A 24-year-old patient presents with a target-like "bulls-eye" rash (erythema
migrans). Which organism and treatment are most likely?
