Page 1 of 199
FNP 652 MIDTERM EXAM 2026/2027
SUMMER FALL ACTUAL EXAM GCU
COMPLETE ACCURATE EXAM REAL
QUESTIONS AND CORRECT VERIFIED
ANSWERS (DETAILED ANSWERS) NEWEST
UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ (BRAND NEW!)
FULL REVISED FNP 652 APPROVED
MIDTERM EX
1. A 58-year-old male with hypertension and DM type 2
presents with substernal chest pressure radiating to the jaw,
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occurring at rest for 20 minutes. ECG shows ST depression in
V3-V6. Troponin is elevated. What is the most appropriate
initial management?
A. Aspirin 324 mg and discharge with follow-up
B. Nitroglycerin sublingual and stress test in 3 days
C. Immediate aspirin, clopidogrel, heparin, and cardiology
consultation for possible PCI
D. Morphine, oxygen, and echocardiogram only
Correct Answer: C
Rationale: This is NSTEMI (unstable angina at rest + troponin
elevation). Immediate antiplatelet/antithrombotic therapy and
invasive strategy (PCI) within 24 hours is standard. Option A
misses acute treatment; option B delays care; option D lacks
antiplatelet therapy.
2. A 72-year-old woman with chronic heart failure (HFrEF, EF
30%) reports worsening dyspnea, fatigue, and 4-lb weight
gain in 2 days. She takes lisinopril, metoprolol succinate, and
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furosemide. BP 110/70, HR 88, lungs crackles bilateral. Next
best step?
A. Double furosemide dose
B. Add digoxin
C. Increase lisinopril
D. IV furosemide in observation unit
Correct Answer: D
Rationale: Acute decompensated HF with fluid overload
requires IV loop diuretics for rapid response. Doubling oral
dose may be insufficient. Digoxin is not first-line acute.
Lisinopril increase would not relieve congestion.
3. A 45-year-old with no past medical history has a BP of
148/92 on three separate occasions. No symptoms. Labs: Cr
0.9, K 4.1. What is the initial treatment per JNC 8?
A. Hydrochlorothiazide
B. Lifestyle modification only for 6 months
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C. Amlodipine 5 mg daily
D. Losartan 50 mg daily
Correct Answer: C
Rationale: JNC 8 recommends starting monotherapy (thiazide,
CCB, ACEi/ARB) for stage 1 hypertension with no compelling
indications. Amlodipine is appropriate. Lifestyle alone not
sufficient for persistent stage 1 HTN.
4. A 65-year-old with history of paroxysmal atrial fibrillation
is on apixaban. He presents with acute onset left leg pain,
pallor, and pulselessness. What is the most likely diagnosis?
A. Deep vein thrombosis
B. Arterial embolism
C. Venous stasis ulcer
D. Cellulitis
Correct Answer: B
Rationale: Apixaban reduces stroke risk but does not
eliminate emboli. Sudden painful, pulseless limb in AF patient is
FNP 652 MIDTERM EXAM 2026/2027
SUMMER FALL ACTUAL EXAM GCU
COMPLETE ACCURATE EXAM REAL
QUESTIONS AND CORRECT VERIFIED
ANSWERS (DETAILED ANSWERS) NEWEST
UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ (BRAND NEW!)
FULL REVISED FNP 652 APPROVED
MIDTERM EX
1. A 58-year-old male with hypertension and DM type 2
presents with substernal chest pressure radiating to the jaw,
,Page 2 of 199
occurring at rest for 20 minutes. ECG shows ST depression in
V3-V6. Troponin is elevated. What is the most appropriate
initial management?
A. Aspirin 324 mg and discharge with follow-up
B. Nitroglycerin sublingual and stress test in 3 days
C. Immediate aspirin, clopidogrel, heparin, and cardiology
consultation for possible PCI
D. Morphine, oxygen, and echocardiogram only
Correct Answer: C
Rationale: This is NSTEMI (unstable angina at rest + troponin
elevation). Immediate antiplatelet/antithrombotic therapy and
invasive strategy (PCI) within 24 hours is standard. Option A
misses acute treatment; option B delays care; option D lacks
antiplatelet therapy.
2. A 72-year-old woman with chronic heart failure (HFrEF, EF
30%) reports worsening dyspnea, fatigue, and 4-lb weight
gain in 2 days. She takes lisinopril, metoprolol succinate, and
,Page 3 of 199
furosemide. BP 110/70, HR 88, lungs crackles bilateral. Next
best step?
A. Double furosemide dose
B. Add digoxin
C. Increase lisinopril
D. IV furosemide in observation unit
Correct Answer: D
Rationale: Acute decompensated HF with fluid overload
requires IV loop diuretics for rapid response. Doubling oral
dose may be insufficient. Digoxin is not first-line acute.
Lisinopril increase would not relieve congestion.
3. A 45-year-old with no past medical history has a BP of
148/92 on three separate occasions. No symptoms. Labs: Cr
0.9, K 4.1. What is the initial treatment per JNC 8?
A. Hydrochlorothiazide
B. Lifestyle modification only for 6 months
, Page 4 of 199
C. Amlodipine 5 mg daily
D. Losartan 50 mg daily
Correct Answer: C
Rationale: JNC 8 recommends starting monotherapy (thiazide,
CCB, ACEi/ARB) for stage 1 hypertension with no compelling
indications. Amlodipine is appropriate. Lifestyle alone not
sufficient for persistent stage 1 HTN.
4. A 65-year-old with history of paroxysmal atrial fibrillation
is on apixaban. He presents with acute onset left leg pain,
pallor, and pulselessness. What is the most likely diagnosis?
A. Deep vein thrombosis
B. Arterial embolism
C. Venous stasis ulcer
D. Cellulitis
Correct Answer: B
Rationale: Apixaban reduces stroke risk but does not
eliminate emboli. Sudden painful, pulseless limb in AF patient is
