NURS 5433 Family II Midterm Exam – 100 Original Practice
Questions with Answers in Bold Italic & Detailed Italicized
Rationales Covering Acute and Chronic Management Across
the Lifespan – UTA FNP Curriculum Aligned – Graded A Study
Guide for Spring 2026
Family II topics typically include:
o Acute and chronic management of pediatric and adult conditions
o Respiratory disorders (asthma, COPD, pneumonia)
o Cardiovascular conditions (hypertension, heart failure, CAD)
o Endocrine disorders (diabetes mellitus types 1 & 2, thyroid disease)
o Gastrointestinal conditions (GERD, IBS, peptic ulcer disease)
o Genitourinary and renal conditions
o Musculoskeletal disorders
o Neurological conditions (headache, seizures, stroke)
o Dermatologic conditions
o Infectious diseases
o Health promotion and screening across the lifespan
o Pharmacology for Family Nurse Practitioners
o Differential diagnosis and clinical decision-making
Exam – 100 Original Practice Questions (FNP Curriculum)
INTRO:
*This original practice exam is designed for students preparing for the NURS 5433
Family II midterm at UTA or similar FNP programs. Topics include acute and chronic
management of respiratory, cardiovascular, endocrine, gastrointestinal, genitourinary,
,musculoskeletal, neurological, dermatologic, and infectious conditions across the
lifespan. Answers are provided in bold italic * with italicized rationales.
1. A 45-year-old patient with type 2 diabetes has a hemoglobin A1c of 8.5% on
metformin 1000 mg twice daily. What is the most appropriate next step?
A) Add glipizide
B) Add insulin glargine
C) Add sitagliptin
D) Increase metformin to 2000 mg twice daily
Answer: A
*Metformin is at near-max dose (max 2550 mg/day). A1c >7.5% on metformin
monotherapy typically requires add-on therapy. Sulfonylureas (glipizide) are first-line
add-on unless contraindications exist.*
2. A 68-year-old male with COPD presents with increased shortness of breath,
purulent sputum, and fever. He is using his rescue inhaler every 2 hours. What is
the most appropriate initial management?
A) Oral azithromycin and prednisone
B) Increase tiotropium to twice daily
C) Chest x-ray and hospital admission
D) Levofloxacin and prednisone as outpatient
Answer: A
Acute exacerbation of COPD with purulent sputum and increased rescue use requires
antibiotics (azithromycin or doxycycline) and systemic corticosteroids (prednisone 40mg x5
days). Hospitalize if severe.
3. A 32-year-old pregnant patient at 28 weeks gestation has blood pressure of
155/95 mmHg and 2+ protein on dipstick. She denies headache or visual changes.
,What is the most appropriate next step?
A) Start labetalol and discharge home
B) Admit for fetal monitoring and blood pressure management
C) Start methyldopa and follow up in 1 week
D) Deliver immediately
Answer: B
*Gestational hypertension with proteinuria = preeclampsia. At 28 weeks, admission for
maternal/fetal monitoring and antihypertensive therapy (labetalol or nifedipine) is
standard.*
4. A 55-year-old patient presents with acute onset of severe right lower quadrant
abdominal pain, nausea, and fever. White blood cell count is 18,000. What is the
most appropriate next step?
A) Outpatient oral antibiotics
B) CT abdomen and surgery consultation
C) Abdominal x-ray
D) Colonoscopy
Answer: B
Symptoms suggest acute appendicitis. CT abdomen is imaging of choice. Surgery
consultation is urgent. Do not delay with oral antibiotics or outpatient management.
5. A 72-year-old with heart failure (EF 35%) presents with worsening dyspnea, 3+
pitting edema to knees, and jugular venous distension. Vital signs: BP 110/70, HR
95, RR 24. What is the most appropriate initial intervention?
A) Increase metoprolol dose
B) IV furosemide and hospital admission
C) Oral bumetanide and discharge
D) Start digoxin
Answer: B
Acute decompensated heart failure with volume overload requires IV loop diuretics and
, admission. Oral diuretics are insufficient. Do not increase beta-blocker during acute
decompensation.
6. A 28-year-old female presents with dysuria, frequency, and suprapubic pain.
Urinalysis shows nitrites and leukocyte esterase. She has no known drug allergies.
What is first-line antibiotic?
A) Ciprofloxacin
B) Nitrofurantoin
C) Trimethoprim-sulfamethoxazole
D) Amoxicillin
Answer: B
*Nitrofurantoin 100 mg BID x5 days is first-line for uncomplicated cystitis in women.
Fluoroquinolones (ciprofloxacin) are reserved for complicated UTI or pyelonephritis due
to resistance and side effects.*
7. A 60-year-old male with hypertension presents with new onset of chest pressure
with exertion that resolves with rest. ECG is normal. What is the most appropriate
next step?
A) Aspirin 81 mg daily and stress test
B) Nitroglycerin as needed and follow up in 1 month
C) Chest x-ray and discharge
D) Troponin and admit for rule out MI
Answer: A
Stable angina (exertional chest pain relieved by rest) requires aspirin and outpatient stress
testing. No indication for admission unless unstable or high-risk features.
8. A 4-year-old child presents with cough, fever 102°F, and tachypnea. Lung exam
reveals crackles in the right lower lobe. Oxygen saturation is 92%. What is the
most appropriate treatment?
A) Amoxicillin and outpatient management
B) Azithromycin and discharge
Questions with Answers in Bold Italic & Detailed Italicized
Rationales Covering Acute and Chronic Management Across
the Lifespan – UTA FNP Curriculum Aligned – Graded A Study
Guide for Spring 2026
Family II topics typically include:
o Acute and chronic management of pediatric and adult conditions
o Respiratory disorders (asthma, COPD, pneumonia)
o Cardiovascular conditions (hypertension, heart failure, CAD)
o Endocrine disorders (diabetes mellitus types 1 & 2, thyroid disease)
o Gastrointestinal conditions (GERD, IBS, peptic ulcer disease)
o Genitourinary and renal conditions
o Musculoskeletal disorders
o Neurological conditions (headache, seizures, stroke)
o Dermatologic conditions
o Infectious diseases
o Health promotion and screening across the lifespan
o Pharmacology for Family Nurse Practitioners
o Differential diagnosis and clinical decision-making
Exam – 100 Original Practice Questions (FNP Curriculum)
INTRO:
*This original practice exam is designed for students preparing for the NURS 5433
Family II midterm at UTA or similar FNP programs. Topics include acute and chronic
management of respiratory, cardiovascular, endocrine, gastrointestinal, genitourinary,
,musculoskeletal, neurological, dermatologic, and infectious conditions across the
lifespan. Answers are provided in bold italic * with italicized rationales.
1. A 45-year-old patient with type 2 diabetes has a hemoglobin A1c of 8.5% on
metformin 1000 mg twice daily. What is the most appropriate next step?
A) Add glipizide
B) Add insulin glargine
C) Add sitagliptin
D) Increase metformin to 2000 mg twice daily
Answer: A
*Metformin is at near-max dose (max 2550 mg/day). A1c >7.5% on metformin
monotherapy typically requires add-on therapy. Sulfonylureas (glipizide) are first-line
add-on unless contraindications exist.*
2. A 68-year-old male with COPD presents with increased shortness of breath,
purulent sputum, and fever. He is using his rescue inhaler every 2 hours. What is
the most appropriate initial management?
A) Oral azithromycin and prednisone
B) Increase tiotropium to twice daily
C) Chest x-ray and hospital admission
D) Levofloxacin and prednisone as outpatient
Answer: A
Acute exacerbation of COPD with purulent sputum and increased rescue use requires
antibiotics (azithromycin or doxycycline) and systemic corticosteroids (prednisone 40mg x5
days). Hospitalize if severe.
3. A 32-year-old pregnant patient at 28 weeks gestation has blood pressure of
155/95 mmHg and 2+ protein on dipstick. She denies headache or visual changes.
,What is the most appropriate next step?
A) Start labetalol and discharge home
B) Admit for fetal monitoring and blood pressure management
C) Start methyldopa and follow up in 1 week
D) Deliver immediately
Answer: B
*Gestational hypertension with proteinuria = preeclampsia. At 28 weeks, admission for
maternal/fetal monitoring and antihypertensive therapy (labetalol or nifedipine) is
standard.*
4. A 55-year-old patient presents with acute onset of severe right lower quadrant
abdominal pain, nausea, and fever. White blood cell count is 18,000. What is the
most appropriate next step?
A) Outpatient oral antibiotics
B) CT abdomen and surgery consultation
C) Abdominal x-ray
D) Colonoscopy
Answer: B
Symptoms suggest acute appendicitis. CT abdomen is imaging of choice. Surgery
consultation is urgent. Do not delay with oral antibiotics or outpatient management.
5. A 72-year-old with heart failure (EF 35%) presents with worsening dyspnea, 3+
pitting edema to knees, and jugular venous distension. Vital signs: BP 110/70, HR
95, RR 24. What is the most appropriate initial intervention?
A) Increase metoprolol dose
B) IV furosemide and hospital admission
C) Oral bumetanide and discharge
D) Start digoxin
Answer: B
Acute decompensated heart failure with volume overload requires IV loop diuretics and
, admission. Oral diuretics are insufficient. Do not increase beta-blocker during acute
decompensation.
6. A 28-year-old female presents with dysuria, frequency, and suprapubic pain.
Urinalysis shows nitrites and leukocyte esterase. She has no known drug allergies.
What is first-line antibiotic?
A) Ciprofloxacin
B) Nitrofurantoin
C) Trimethoprim-sulfamethoxazole
D) Amoxicillin
Answer: B
*Nitrofurantoin 100 mg BID x5 days is first-line for uncomplicated cystitis in women.
Fluoroquinolones (ciprofloxacin) are reserved for complicated UTI or pyelonephritis due
to resistance and side effects.*
7. A 60-year-old male with hypertension presents with new onset of chest pressure
with exertion that resolves with rest. ECG is normal. What is the most appropriate
next step?
A) Aspirin 81 mg daily and stress test
B) Nitroglycerin as needed and follow up in 1 month
C) Chest x-ray and discharge
D) Troponin and admit for rule out MI
Answer: A
Stable angina (exertional chest pain relieved by rest) requires aspirin and outpatient stress
testing. No indication for admission unless unstable or high-risk features.
8. A 4-year-old child presents with cough, fever 102°F, and tachypnea. Lung exam
reveals crackles in the right lower lobe. Oxygen saturation is 92%. What is the
most appropriate treatment?
A) Amoxicillin and outpatient management
B) Azithromycin and discharge
