NURS 5433 FNP II Final Exam Comprehensive
Review (2026-2028) | University of Texas at
Arlington (UTA) –Verified Q&A Study Guide |
instant pdf download
Introduction & Coverage
Ace your NURS 5433 (Family Nurse Practitioner II) Final Exam with the ultimate high-yield study
resource. Tailored specifically for the University of Texas at Arlington (UTA) curriculum, this guide
bridges the gap between midterm fundamentals and complex final-stage clinical management. It
emphasizes advanced pharmacology, multi-system differential diagnosis, and the latest evidence-based
guidelines for FNP practice.
This final exam prep covers high-yield content from all advanced modules:
Endocrine & Metabolic: Diabetes titration (SGLT2i, GLP-1), Thyroid management (Levothyroxine
dosing in CAD), and Metabolic Syndrome criteria.
Cardiovascular: JNC 8/AHA HTN protocols, "Four-Pillar" Heart Failure therapy, Statin intensity,
and A-fib (CHADS-VASc) stroke prevention.
Neurology & Mental Health: Stroke vs. Bell’s Palsy (forehead sparing), Migraine prophylaxis vs.
abortive (Triptan contraindications), and OCD/Panic Disorder SSRI dosing.
Musculoskeletal: ACL/Meniscus clinical tests (Lachman, McMurray), Osteoporosis (DEXA) first-
line treatments, and RA vs. OA differentiation.
Hematology & Men’s/Women’s Health: Macrocytic vs. Microcytic anemias, PCOS (Rotterdam
criteria), BPH (Alpha-blockers), and Breast/Colon cancer screening updates.
1. A 65-year-old male with a history of CAD is newly diagnosed with hypothyroidism.
What is the appropriate starting dose of Levothyroxine?
A) 75 mcg
B) 100 mcg
C) 25 mcg
D) 12.5 mcg
Answer: C) 25 mcg
Explanation: In elderly patients or those with underlying cardiac disease,
, "start low and go slow" (typically 12.5 to 25 mcg) to avoid exacerbating angina
or causing dysrhythmias.
2. A patient with Type 2 Diabetes has an A1c of 8.2% despite maximal Metformin.
Which drug class is preferred if the patient also has established Heart Failure?
A) Sulfonylureas
B) SGLT2 Inhibitors (e.g., Empagliflozin)
C) DPP-4 Inhibitors
D) Thiazolidinediones (TZDs)
Answer: B) SGLT2 Inhibitors (e.g., Empagliflozin)
Explanation: SGLT2 inhibitors have proven benefits in reducing heart failure
hospitalizations and providing renal protection.
3. According to the ADA, what is the glycemic threshold (A1c) for diagnosing Pre-
diabetes?
A) 5.0% – 5.5%
B) 5.7% – 6.4%
C) 6.5% – 7.0%
D) > 7.0%
Answer: B) 5.7% – 6.4%
Explanation: An A1c of 5.7% to 6.4% indicates pre-diabetes; 6.5% or higher is
diagnostic for Type 2 Diabetes.
4. A patient presents with "exophthalmos" (bulging eyes) and a fine tremor. What would
you expect the TSH and Free T4 levels to show?
A) High TSH, Low T4
B) Low TSH, High T4
C) High TSH, High T4
D) Normal TSH, Low T4
Answer: B) Low TSH, High T4
Explanation: These are classic signs of Graves’ Disease (Hyperthyroidism),
where high thyroid levels suppress the pituitary’s release of TSH.
5. Which physical exam finding is the most sensitive indicator of an ACL (Anterior
Cruciate Ligament) tear?
A) McMurray Test
B) Lachman Test
C) Anterior Drawer Test
D) Thompson Test
, Answer: B) Lachman Test
Explanation: The Lachman test is considered more sensitive and specific
than the Anterior Drawer test for identifying ACL laxity.
6. What is the first-line treatment for a patient with symptomatic Bradycardia?
A) Amiodarone
B) Atropine
C) Epinephrine
D) Digoxin
Answer: B) Atropine
Explanation: Atropine is the primary anticholinergic drug used to increase
heart rate in acute symptomatic bradycardia.
7. A patient with HTN and Chronic Kidney Disease (CKD) should ideally be started on
which class of medication?
A) Calcium Channel Blocker
B) ACE Inhibitor or ARB
C) Beta-blocker
D) Loop Diuretic
Answer: B) ACE Inhibitor or ARB
Explanation: ACEIs and ARBs provide renal protection by reducing
intraglomerular pressure and proteinuria in CKD patients.
8. Which diagnostic finding is most consistent with "Iron Deficiency Anemia"?
A) Increased Ferritin, Increased MCV
B) Decreased Ferritin, Decreased MCV
C) Decreased Ferritin, Increased MCV
D) Normal Ferritin, Normal MCV
Answer: B) Decreased Ferritin, Decreased MCV
Explanation: Iron deficiency is a microcytic anemia (low MCV) characterized
by depleted iron stores (low Ferritin).
9. A 72-year-old male smoker presents for a wellness exam. What is the USPSTF
screening recommendation for Abdominal Aortic Aneurysm (AAA)?
A) Annual CT scan
B) One-time ultrasound of the abdomen
C) No screening unless symptomatic
D) Annual abdominal palpation
Answer: B) One-time ultrasound of the abdomen
, Explanation: One-time screening is recommended for men aged 65–75 who
have ever smoked.
10. Which medication is contraindicated in a patient with a "Sulfa" allergy?
A) Metformin
B) Glyburide
C) Lisinopril
D) Amlodipine
Answer: B) Glyburide
Explanation: Sulfonylureas like Glyburide contain a sulfonamide moiety and
may cause cross-reactivity in sulfa-allergic patients.
11. What is the "Gold Standard" for diagnosing "Osteoporosis"?
A) Serum Calcium
B) X-ray of the femur
C) DEXA Scan
D) Vitamin D levels
Answer: C) DEXA Scan
Explanation: The DEXA scan provides the T-score necessary for diagnosing
Osteoporosis (T-score ≤ -2.5).
12. A patient presents with "Podagra" (acute pain in the 1st MTP joint). What is the first-
line treatment for an acute gout flare?
A) Allopurinol
B) NSAIDs (e.g., Indomethacin)
C) Prednisone
D) Febuxostat
Answer: B) NSAIDs (e.g., Indomethacin)
Explanation: Acute flares are treated with NSAIDs or Colchicine; Allopurinol
is used for long-term prevention and should not be started during an acute
attack.
13. "Bouchard's nodes" on the PIP joints are associated with which condition?
A) Rheumatoid Arthritis
B) Psoriatic Arthritis
C) Osteoarthritis
D) Gout
Answer: C) Osteoarthritis
Review (2026-2028) | University of Texas at
Arlington (UTA) –Verified Q&A Study Guide |
instant pdf download
Introduction & Coverage
Ace your NURS 5433 (Family Nurse Practitioner II) Final Exam with the ultimate high-yield study
resource. Tailored specifically for the University of Texas at Arlington (UTA) curriculum, this guide
bridges the gap between midterm fundamentals and complex final-stage clinical management. It
emphasizes advanced pharmacology, multi-system differential diagnosis, and the latest evidence-based
guidelines for FNP practice.
This final exam prep covers high-yield content from all advanced modules:
Endocrine & Metabolic: Diabetes titration (SGLT2i, GLP-1), Thyroid management (Levothyroxine
dosing in CAD), and Metabolic Syndrome criteria.
Cardiovascular: JNC 8/AHA HTN protocols, "Four-Pillar" Heart Failure therapy, Statin intensity,
and A-fib (CHADS-VASc) stroke prevention.
Neurology & Mental Health: Stroke vs. Bell’s Palsy (forehead sparing), Migraine prophylaxis vs.
abortive (Triptan contraindications), and OCD/Panic Disorder SSRI dosing.
Musculoskeletal: ACL/Meniscus clinical tests (Lachman, McMurray), Osteoporosis (DEXA) first-
line treatments, and RA vs. OA differentiation.
Hematology & Men’s/Women’s Health: Macrocytic vs. Microcytic anemias, PCOS (Rotterdam
criteria), BPH (Alpha-blockers), and Breast/Colon cancer screening updates.
1. A 65-year-old male with a history of CAD is newly diagnosed with hypothyroidism.
What is the appropriate starting dose of Levothyroxine?
A) 75 mcg
B) 100 mcg
C) 25 mcg
D) 12.5 mcg
Answer: C) 25 mcg
Explanation: In elderly patients or those with underlying cardiac disease,
, "start low and go slow" (typically 12.5 to 25 mcg) to avoid exacerbating angina
or causing dysrhythmias.
2. A patient with Type 2 Diabetes has an A1c of 8.2% despite maximal Metformin.
Which drug class is preferred if the patient also has established Heart Failure?
A) Sulfonylureas
B) SGLT2 Inhibitors (e.g., Empagliflozin)
C) DPP-4 Inhibitors
D) Thiazolidinediones (TZDs)
Answer: B) SGLT2 Inhibitors (e.g., Empagliflozin)
Explanation: SGLT2 inhibitors have proven benefits in reducing heart failure
hospitalizations and providing renal protection.
3. According to the ADA, what is the glycemic threshold (A1c) for diagnosing Pre-
diabetes?
A) 5.0% – 5.5%
B) 5.7% – 6.4%
C) 6.5% – 7.0%
D) > 7.0%
Answer: B) 5.7% – 6.4%
Explanation: An A1c of 5.7% to 6.4% indicates pre-diabetes; 6.5% or higher is
diagnostic for Type 2 Diabetes.
4. A patient presents with "exophthalmos" (bulging eyes) and a fine tremor. What would
you expect the TSH and Free T4 levels to show?
A) High TSH, Low T4
B) Low TSH, High T4
C) High TSH, High T4
D) Normal TSH, Low T4
Answer: B) Low TSH, High T4
Explanation: These are classic signs of Graves’ Disease (Hyperthyroidism),
where high thyroid levels suppress the pituitary’s release of TSH.
5. Which physical exam finding is the most sensitive indicator of an ACL (Anterior
Cruciate Ligament) tear?
A) McMurray Test
B) Lachman Test
C) Anterior Drawer Test
D) Thompson Test
, Answer: B) Lachman Test
Explanation: The Lachman test is considered more sensitive and specific
than the Anterior Drawer test for identifying ACL laxity.
6. What is the first-line treatment for a patient with symptomatic Bradycardia?
A) Amiodarone
B) Atropine
C) Epinephrine
D) Digoxin
Answer: B) Atropine
Explanation: Atropine is the primary anticholinergic drug used to increase
heart rate in acute symptomatic bradycardia.
7. A patient with HTN and Chronic Kidney Disease (CKD) should ideally be started on
which class of medication?
A) Calcium Channel Blocker
B) ACE Inhibitor or ARB
C) Beta-blocker
D) Loop Diuretic
Answer: B) ACE Inhibitor or ARB
Explanation: ACEIs and ARBs provide renal protection by reducing
intraglomerular pressure and proteinuria in CKD patients.
8. Which diagnostic finding is most consistent with "Iron Deficiency Anemia"?
A) Increased Ferritin, Increased MCV
B) Decreased Ferritin, Decreased MCV
C) Decreased Ferritin, Increased MCV
D) Normal Ferritin, Normal MCV
Answer: B) Decreased Ferritin, Decreased MCV
Explanation: Iron deficiency is a microcytic anemia (low MCV) characterized
by depleted iron stores (low Ferritin).
9. A 72-year-old male smoker presents for a wellness exam. What is the USPSTF
screening recommendation for Abdominal Aortic Aneurysm (AAA)?
A) Annual CT scan
B) One-time ultrasound of the abdomen
C) No screening unless symptomatic
D) Annual abdominal palpation
Answer: B) One-time ultrasound of the abdomen
, Explanation: One-time screening is recommended for men aged 65–75 who
have ever smoked.
10. Which medication is contraindicated in a patient with a "Sulfa" allergy?
A) Metformin
B) Glyburide
C) Lisinopril
D) Amlodipine
Answer: B) Glyburide
Explanation: Sulfonylureas like Glyburide contain a sulfonamide moiety and
may cause cross-reactivity in sulfa-allergic patients.
11. What is the "Gold Standard" for diagnosing "Osteoporosis"?
A) Serum Calcium
B) X-ray of the femur
C) DEXA Scan
D) Vitamin D levels
Answer: C) DEXA Scan
Explanation: The DEXA scan provides the T-score necessary for diagnosing
Osteoporosis (T-score ≤ -2.5).
12. A patient presents with "Podagra" (acute pain in the 1st MTP joint). What is the first-
line treatment for an acute gout flare?
A) Allopurinol
B) NSAIDs (e.g., Indomethacin)
C) Prednisone
D) Febuxostat
Answer: B) NSAIDs (e.g., Indomethacin)
Explanation: Acute flares are treated with NSAIDs or Colchicine; Allopurinol
is used for long-term prevention and should not be started during an acute
attack.
13. "Bouchard's nodes" on the PIP joints are associated with which condition?
A) Rheumatoid Arthritis
B) Psoriatic Arthritis
C) Osteoarthritis
D) Gout
Answer: C) Osteoarthritis
