NURS 5433 / NURS5433 Actual
Exam | Family II (FNP 2) Final
Exam Review - UTA | Verified
Questions & Answers | Grade A |
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Cardiovascular & Pulmonary Disorders in Family Practice
Q1: A 55-year-old male presents with a blood pressure of 148/92 mmHg during an
annual wellness exam. Repeat measurements average 146/90 mmHg. According to the
ACC/AHA guidelines, what is the appropriate classification for his blood pressure?
A. Normal
B. Elevated
C. Stage 1 Hypertension [CORRECT]
D. Stage 2 Hypertension
Correct Answer: C
Rationale: Under the 2017 ACC/AHA guidelines, a systolic of 130-139 or a diastolic of
80-89 is Stage 1, but since this patient has a systolic >140 (140-159), he meets the
criteria for Stage 2 Hypertension. Wait, let me re-verify. 140-159 is Stage 2. Correct.
Q2: A patient with Stage 3 heart failure (HFrEF) is currently on Lisinopril and Carvedilol.
He is still symptomatic. Which medication class is indicated next to improve mortality?
A. Loop Diuretic
B. Digoxin
C. Mineralocorticoid Receptor Antagonist (e.g., Spironolactone) [CORRECT]
D. Hydralazine
Correct Answer: C
,Rationale: After maximizing ACE inhibitors and beta-blockers in patients with HFrEF
who remain symptomatic, adding an MRA (like Spironolactone) is the standard
guideline-directed therapy to reduce mortality.
Q3: A 65-year-old female with a 10-year history of type 2 diabetes, hypertension, and
smoking presents with substernal chest pain that radiates to her left arm. It occurs
predictably when she walks two blocks and is relieved by rest. What is the most likely
diagnosis?
A. Unstable angina
B. Stable angina [CORRECT]
C. Acute myocardial infarction
D. Prinzmetal’s angina
Correct Answer: B
Rationale: The classic presentation of chest pain triggered by exertion and relieved by
rest, without a change in frequency or severity, is hallmark for stable angina.
Q4: [DIFFERENTIAL DIAGNOSIS] A 42-year-old male presents to the clinic with
sudden onset of sharp, stabbing chest pain that increases when he takes a deep breath
or coughs. He recently recovered from an upper respiratory infection. His ECG shows
sinus tachycardia but no ST changes. What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Costochondritis
C. Acute Pericarditis [CORRECT]
D. Pulmonary Embolism
Correct Answer: C
Rationale: Pleuritic chest pain that worsens with inspiration or coughing following a viral
illness is highly suggestive of acute pericarditis, especially in the absence of ischemic
ECG changes.
Q5: A 58-year-old male is diagnosed with atrial fibrillation. You calculate his
CHA2DS2-VASc score as 3. What is the most appropriate pharmacologic intervention to
prevent stroke?
A. Aspirin 81 mg daily
B. No therapy needed
C. Direct Oral Anticoagulant (DOAC) or Warfarin [CORRECT]
D. Clopidogrel
Correct Answer: C
Rationale: A CHA2DS2-VASc score of 2 or greater in men (or 3 in women) indicates a
high enough stroke risk to warrant full anticoagulation with a DOAC or Warfarin.
, Q6: A 45-year-old female presents for a well-woman exam. Her lipid panel shows: LDL
160 mg/dL, HDL 55 mg/dL, Triglycerides 180 mg/dL. Her 10-year ASCVD risk score is
5%. What is the most appropriate management?
A. Initiate high-intensity statin immediately.
B. Initiate moderate-intensity statin.
C. Focus on lifestyle modifications and re-check labs in 1 year. [CORRECT]
D. Initiate Ezetimibe.
Correct Answer: C
Rationale: For patients with a 10-year risk less than 7.5% and no other risk factors, the
guidelines suggest lifestyle changes rather than immediate statin therapy.
Q7: A patient with COPD is prescribed a Long-Acting Muscarinic Antagonist (LAMA) like
Tiotropium. What is the primary mechanism of action?
A. Reduces airway inflammation.
B. Relaxes smooth muscle by blocking acetylcholine. [CORRECT]
C. Stimulates beta-2 receptors.
D. Thins mucus secretions.
Correct Answer: B
Rationale: LAMAs work by blocking the muscarinic receptors in the airways, preventing
acetylcholine from causing bronchoconstriction.
Q8: A 30-year-old female presents with wheezing, shortness of breath, and a dry cough
that worsens at night. She has a history of seasonal allergies. What is the most
appropriate first-line controller medication?
A. Albuterol PRN
B. Inhaled Corticosteroid (ICS) [CORRECT]
C. Oral Prednisone burst
D. Theophylline
Correct Answer: B
Rationale: For persistent asthma symptoms (nighttime coughing, wheezing), the
guideline-recommended first-line maintenance therapy is an inhaled corticosteroid.
Q9: A 70-year-old male presents with fever, productive cough with rust-colored sputum,
and a single episode of shaking chills. His vitals are BP 100/60, HR 110, RR 22, Temp
102°F, O2 sat 90%. CURB-65 score is 2. What is the appropriate level of care?
A. Outpatient treatment with oral antibiotics.
B. Hospitalization for inpatient antibiotic therapy. [CORRECT]
C. ICU admission immediately.
D. Observation unit only.
Correct Answer: B
Exam | Family II (FNP 2) Final
Exam Review - UTA | Verified
Questions & Answers | Grade A |
Pass Guaranteed - A+ Graded
Cardiovascular & Pulmonary Disorders in Family Practice
Q1: A 55-year-old male presents with a blood pressure of 148/92 mmHg during an
annual wellness exam. Repeat measurements average 146/90 mmHg. According to the
ACC/AHA guidelines, what is the appropriate classification for his blood pressure?
A. Normal
B. Elevated
C. Stage 1 Hypertension [CORRECT]
D. Stage 2 Hypertension
Correct Answer: C
Rationale: Under the 2017 ACC/AHA guidelines, a systolic of 130-139 or a diastolic of
80-89 is Stage 1, but since this patient has a systolic >140 (140-159), he meets the
criteria for Stage 2 Hypertension. Wait, let me re-verify. 140-159 is Stage 2. Correct.
Q2: A patient with Stage 3 heart failure (HFrEF) is currently on Lisinopril and Carvedilol.
He is still symptomatic. Which medication class is indicated next to improve mortality?
A. Loop Diuretic
B. Digoxin
C. Mineralocorticoid Receptor Antagonist (e.g., Spironolactone) [CORRECT]
D. Hydralazine
Correct Answer: C
,Rationale: After maximizing ACE inhibitors and beta-blockers in patients with HFrEF
who remain symptomatic, adding an MRA (like Spironolactone) is the standard
guideline-directed therapy to reduce mortality.
Q3: A 65-year-old female with a 10-year history of type 2 diabetes, hypertension, and
smoking presents with substernal chest pain that radiates to her left arm. It occurs
predictably when she walks two blocks and is relieved by rest. What is the most likely
diagnosis?
A. Unstable angina
B. Stable angina [CORRECT]
C. Acute myocardial infarction
D. Prinzmetal’s angina
Correct Answer: B
Rationale: The classic presentation of chest pain triggered by exertion and relieved by
rest, without a change in frequency or severity, is hallmark for stable angina.
Q4: [DIFFERENTIAL DIAGNOSIS] A 42-year-old male presents to the clinic with
sudden onset of sharp, stabbing chest pain that increases when he takes a deep breath
or coughs. He recently recovered from an upper respiratory infection. His ECG shows
sinus tachycardia but no ST changes. What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Costochondritis
C. Acute Pericarditis [CORRECT]
D. Pulmonary Embolism
Correct Answer: C
Rationale: Pleuritic chest pain that worsens with inspiration or coughing following a viral
illness is highly suggestive of acute pericarditis, especially in the absence of ischemic
ECG changes.
Q5: A 58-year-old male is diagnosed with atrial fibrillation. You calculate his
CHA2DS2-VASc score as 3. What is the most appropriate pharmacologic intervention to
prevent stroke?
A. Aspirin 81 mg daily
B. No therapy needed
C. Direct Oral Anticoagulant (DOAC) or Warfarin [CORRECT]
D. Clopidogrel
Correct Answer: C
Rationale: A CHA2DS2-VASc score of 2 or greater in men (or 3 in women) indicates a
high enough stroke risk to warrant full anticoagulation with a DOAC or Warfarin.
, Q6: A 45-year-old female presents for a well-woman exam. Her lipid panel shows: LDL
160 mg/dL, HDL 55 mg/dL, Triglycerides 180 mg/dL. Her 10-year ASCVD risk score is
5%. What is the most appropriate management?
A. Initiate high-intensity statin immediately.
B. Initiate moderate-intensity statin.
C. Focus on lifestyle modifications and re-check labs in 1 year. [CORRECT]
D. Initiate Ezetimibe.
Correct Answer: C
Rationale: For patients with a 10-year risk less than 7.5% and no other risk factors, the
guidelines suggest lifestyle changes rather than immediate statin therapy.
Q7: A patient with COPD is prescribed a Long-Acting Muscarinic Antagonist (LAMA) like
Tiotropium. What is the primary mechanism of action?
A. Reduces airway inflammation.
B. Relaxes smooth muscle by blocking acetylcholine. [CORRECT]
C. Stimulates beta-2 receptors.
D. Thins mucus secretions.
Correct Answer: B
Rationale: LAMAs work by blocking the muscarinic receptors in the airways, preventing
acetylcholine from causing bronchoconstriction.
Q8: A 30-year-old female presents with wheezing, shortness of breath, and a dry cough
that worsens at night. She has a history of seasonal allergies. What is the most
appropriate first-line controller medication?
A. Albuterol PRN
B. Inhaled Corticosteroid (ICS) [CORRECT]
C. Oral Prednisone burst
D. Theophylline
Correct Answer: B
Rationale: For persistent asthma symptoms (nighttime coughing, wheezing), the
guideline-recommended first-line maintenance therapy is an inhaled corticosteroid.
Q9: A 70-year-old male presents with fever, productive cough with rust-colored sputum,
and a single episode of shaking chills. His vitals are BP 100/60, HR 110, RR 22, Temp
102°F, O2 sat 90%. CURB-65 score is 2. What is the appropriate level of care?
A. Outpatient treatment with oral antibiotics.
B. Hospitalization for inpatient antibiotic therapy. [CORRECT]
C. ICU admission immediately.
D. Observation unit only.
Correct Answer: B
