FNP Board review FINAL EXAM PREP 2025/2026 ACCURATE QUESTIONS WITH VERIFIED CORRECT ANSWERS || 100% GUARANTEED PASSLATEST VERSION

FNP Board review FINAL EXAM PREP 2025/2026 ACCURATE QUESTIONS WITH VERIFIED CORRECT ANSWERS || 100% GUARANTEED PASSLATEST VERSION 1. A child must consume ____ oz. of fortified milk each day to receive the recommended 400 IU daily of vitamin D. A) 8 B) 16 C) 32 D) 48 - ANSWER C) 32 oz 2. For adults under the age of 70 years old, what is the recommended daily intake of vitamin D? A) 200 IU B) 400 IU C) 600 IU D) 1000 IU - ANSWER C) 600 IU 3. The daily amount of vitamin D3 recommended for pregnant/lactating women is A) 400 IU B) 600 IU C) 1000 IU D) 1200 IU - ANSWER B) 600 IU 4. You see a 46-year old female diagnosed with vitamin D deficiency and a 25(OH)D level of 18 ng/ml. Treatment should be initiated with which of the following vitamin D regimens? A) 400 IU twice a day B) 1000 IU daily C) 10,000 IU twice a week D) 50,000 IU weekly - ANSWER D) 50,000 IU weekly (for at least 8 weeks) Vitamin D3 is the preferred form of the micronutrient to treat vitamin D deficiency. A dose of 50,000 IU of vitamin D3 by mouth once per week for at least 8 weeks is advised. 5. Mr. Johnson is a 38-year old chef. He comes to the clinic for his initial visit. His vitals today are BP 150/95, P 78, RR 16, T 98.6, BMI 31. He takes Lisinopril 20mg/HCTZ 25 mg daily, Advair 250/50 BID and albuterol PRN for asthma. What is his BP goal (according to JNC 8 guidelines)? ____________ What could be done to help Mr. Johnson reach his BP goal? A) Add 5 mg amlodipine daily B) Add 50 mg losartan daily C) Add metoprolol 25 mg daily D) Continue on current medication regimen - ANSWER His BP goal is 140/90 6. Add 5 mg amlodipine daily Mr. Johnson was started on amlodipine 5 mg for BP control 4 weeks ago in addition to his daily Lisinopril 20mg/HCTZ 25 mg daily. He also takes Advair 250/50 BID and albuterol PRN for asthma. 4 weeks after starting amlodipine, his average BP is 145/88 (goal 140/90). He has no complaints. What is your next step? A) Increase amlodipine to 10 mg daily B) Add 25 mg HCTZ daily C) Add metoprolol 25 mg daily D) Continue on current medication regimen - ANSWER A) Increase amlodipine to 10 mg daily 7. A patient with newly diagnosed heart failure has started fosinapril in the last few days. She has developed a cough. What clinical finding can help distinguish the etiology of the cough as heart failure? a. It is dry and non-productive. b. It is wet and worse with recumbence. c. It is purulent and tachycardia accompanies it. d. Shortness of breath always results after coughing. - ANSWER b. It is wet and worse with recumbence. Rationale: The cough associated with fosinapril (an ACE inhibitor), is dry, non productive and may be described as annoying. Its severity does not change with position or time of day. A cough associated with heart failure is wet, worse when lying down, and is usually described by patients as "worse at night". A cough that is purulent and when tachycardia accompanies it is often associated with fever and probably reflects an infectious process like pneumonia. 8. A patient with shortness of breath has suspected heart failure. What diagnostic test would best help determine this? a. Echocardiogram b. B type natriuretic peptide (BNP) c. EKG d. Chest x-ray - ANSWER b. B type natriuretic peptide (BNP) Rationale: BNP is a hormone involved in regulation of blood pressure and fluid volume. When the BNP level is 80 pg/mL or greater, the sensitivity and specificity is 98% and 92%, favoring a diagnosis of heart failure. Alternatively, BNP level less than 80 pg/mL strongly suggest that heart failure is not present (some U.S. institutions use 100 pg/mL). Other conditions may cause elevated BNP levels: thoracic and abdominal surgery, renal failure, and subarachnoid hemorrhage. Consequently, careful assessment of the patient is prudent. Echocardiograms mechanically evaluate the heart and establish an ejection fraction. If 35-40%, then CHF can usually be diagnosed. Ejection fractions do not always correlate with patient symptoms. EKG evaluates the electrical activity of the heart. Chest x-ray can indicate heart failure, but a BNP is a more sensitive measure. 9. Which class of medication id frequently used to improve long-term outcomes in patients with systolic dysfunction? a. Loop diuretics b. Calcium channel blockers c. ACE inhibitors d. Thiazide diuretics - ANSWER c. ACE inhibitors Rationale: ACE inhibitors are commonly used in patients with systolic dysfunction because they reduce morbidity and mortality, i.e. these medications alter prognosis. They also improve symptoms of fatigue, shortness of breath, and exercise intolerance. Loop and thiazide diuretics improve symptoms, but do not alter long-term prognosis with heart failure. Beta blockers should be used in conjunction with ACE inhibitors and diuretics, but not as solo agents. Beta blockers can potentially worsen heart failure, so their use in patients with heart failure should be monitored carefully. 10. Ramipril has been initiated at a low dose in a patient with heart failure. What is most important to monitor in about one week? a. Heart rate b. Blood pressure c. EKG d. Potassium level - ANSWER d. Potassium level Rationale: ACE inhibitors work in the kidney in the renin angiotensin aldosterone system and can impair renal excretion of potassium in patients with normal kidney function. In patients with impaired renal blood flow and/or function, the risk of hyperkalemia is increased. Common practice is to monitor potassium, BUN, and Cr at about one week after initiation of an ACE inhibitor and with each increase in dosage. 11. Which medication listed below could potentially exacerbate heart failure in a susceptible individual? a. Metoprolol b. Furosemide c. Metformin d. Acetaminophen - ANSWER a. Metoprolol Rationale: Metoprolol is a cardioselective beta blocker that decreases heart rate. A patient with heart failure wil compensate for heart failure by increasing heart rate to maintain cardiac output (CO). Metoprolol impairs the patient's ability to increase heart rate when needed to maintain cardiac output (CO=stroke volume x heart rate). Consequently, the use of beta blockers in patients with heart failure should be monitored carefully. Furosemide may actually improve shortness of breath in a patient with heart failure. Metformin and acetaminophen have no direct effect on cardiac output on a patient with heart failure. 12. A 75-year-old patient with longstanding hypertension takes a combination ACE inhibitor/thiazide diuretic and amlodipine daily. Today his diastolic blood pressure and heart rate are elevated. He has developed dyspnea on exertion and peripheral edema over the past several days. These symptoms demonstrate: a. primary renal dysfunction b. development of heart failure c. failure of HCTZ d. dietary indiscretions - ANSWER b. development of heart failure Rationale: The symptoms of increased heart rate in the presence of dyspnea on exertion and peripheral edema are symptoms of heart failure. Longstanding hypertension is a major risk factor for development of heart failure. Dietary indiscretion, like sodium/fluid excess may produce peripheral edema, but should not produce dyspnea and peripheral edema in the absence of heart failure. 13. A medication which may produce exercise intolerance in a patient with hypertension is a. hydrochlorothiazide b. amlodipine c. metoprolol d. fosinopril - ANSWER c. metoprolol Rationale: Metoprolol is a cardioselective beta blocker. It will produce bradycardia that is responsible for exercise intolerance. As a patient exercises, concomitant increase in heart rate allows for an increase in cardiac output. If the heart rate is not able to increase because of beta blocker influence, neither can the cardiac output. The patient will necessarily slow down his physical activity. Choices a and d have no direct effect on heart rate. Amlodipine is a calcium channel blocker that does not decrease heart rate. 14. A 40-year-old African American patient has a B/P readings of 175/100 and 170/102. What is the reasonable plan of care for this patient today? a. Start low dose thiazide diuretic b. Start an ACE inhibitor twice daily c. Initiate low dose HCTZ and candesartan d. Initiate amlodipine, beta blocker, or ACE inhibitor - ANSWER c. Initiate low dose HCTZ and candesartan Rationale: This patient has Stage 2 hypertension based on JNC VII's classification of hypertension. Stage 2 hypertension should be treated initially with two medications and lifestyle modifications. Based on this, choice c is the best response. A single medication is unlikely to decrease his blood pressure to a normal range. 15. A patient with hypertension describes a previous allergy to a sulfa antibiotic as "sloughing of skin" and hospitalization. Which medication is contraindicated in this patient? a. Ramipril b. Metoprolol c. Hydrochlorothiazide d. Verapamil - ANSWER c. Hydrochlorothiazide Rationale: This patient's allergy to "sulfa" sounds like Stevens-Johnson Syndrome, a potentially life-threatening allergic reaction. Hydrochlorothiazide has a sulfonamide ring in its chemical structure, generally referred to as "sulfa". This sulfonamide ring can initiate an allergic reaction in patients with sulfa allergy. Since the patient's allergic reaction to sulfa was so serious, other sulfonamide medications should be completely avoided until consultation with an allergist. The other medications can be used without concern in the presence of a patient with sulfa allergy because there is no sulfonamide component. 16. Which item below represents the best choice of anti-hypertensive agents for the indicated patient? a. Beta blocker for a 38-year-old diabetic patient b. ACE inhibitor for a patient on a K⁺ sparing diuretic c. Beta blocker for a 46-year-old patient with migraines d. Diuretic for a patient with a history of gout - ANSWER c. Beta blocker for a 46-year-old patient with migraines Rationale: Beta blockers may be used is prophylactic agents in patients with migraine headaches, thus, serving to treat hypertension and as prophylaxis for migraine headaches in this patient. Beta blockers may mask the signs and symptoms of hypoglycemia in patients with diabetes. They should be used with caution, but use when indicated. ACE inhibitors decrease potassium loss and should not be routinely used in patients who are on potassium sparing diuretics because hypercalcemia may result. Diuretics can produce hyperuricemic states due to fluid loss. Therefore, they should be avoided in patients with gout.