NR667 Week 4 Actual Exam Style V1 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 45-year-old male presents with a blood pressure of 145/92 mmHg on two separate visits.
According to the ACC/AHA guidelines, what is the most appropriate initial management step?
A. Initiate lifestyle modifications only and recheck in 6 months.
B. Start a thiazide-type diuretic and lifestyle modifications.
C. Order an echocardiogram before starting medication.
D. Begin dual therapy with an ACE inhibitor and a Beta-blocker.
Answer: B
Rationale: This patient meets the criteria for Stage 2 hypertension. According to current
guidelines, pharmacotherapy should be initiated alongside lifestyle changes for individuals
with Stage 2 hypertension. A thiazide diuretic, ACE inhibitor, or CCB are appropriate first-
line choices.
2. Which of the following is considered a primary prevention strategy for a 65-year-old
female?
A. Referring the patient for physical therapy after a hip fracture.
B. Performing a DEXA scan to screen for osteoporosis.
C. Starting low-dose aspirin after a transient ischemic attack.
,D. Administering the Shingrix vaccine.
Answer: D
Rationale: Primary prevention aims to prevent the onset of disease before it occurs.
Immunizations like the Shingrix vaccine are classic examples of primary prevention
interventions. Screening and post-event treatments fall into secondary and tertiary
prevention categories respectively.
3. A patient with a history of heart failure with reduced ejection fraction (HFrEF) presents for
a follow-up. Which medication class is contraindicated as a first-line treatment for
hypertension in this patient?
A. ACE Inhibitors
B. Beta-blockers
C. Non-dihydropyridine Calcium Channel Blockers
D. Aldosterone Antagonists
Answer: C
Rationale: Non-dihydropyridine calcium channel blockers like verapamil and diltiazem
should be avoided in patients with HFrEF. These medications have negative inotropic
effects that can worsen heart failure symptoms. ACE inhibitors and beta-blockers are
actually standard of care for these patients.
, 4. An 18-month-old child is brought to the clinic for a well-child visit. Which developmental
milestone is expected for this age?
A. Speaking in four-word sentences.
B. Walking up stairs with alternating feet.
C. Using a spoon and drinking from a cup.
D. Naming at least four colors.
Answer: C
Rationale: At 18 months, children are typically able to use a spoon and drink from a cup,
though they may still be messy. They should also be able to walk alone and say several
single words. More complex language and motor skills like alternating feet on stairs occur
later in toddlerhood.
5. What is the gold standard diagnostic test for confirming a diagnosis of obstructive sleep
apnea (OSA)?
A. Overnight pulse oximetry
B. Epworth Sleepiness Scale
C. Neck circumference measurement
D. Polysomnography
Answer: D
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 45-year-old male presents with a blood pressure of 145/92 mmHg on two separate visits.
According to the ACC/AHA guidelines, what is the most appropriate initial management step?
A. Initiate lifestyle modifications only and recheck in 6 months.
B. Start a thiazide-type diuretic and lifestyle modifications.
C. Order an echocardiogram before starting medication.
D. Begin dual therapy with an ACE inhibitor and a Beta-blocker.
Answer: B
Rationale: This patient meets the criteria for Stage 2 hypertension. According to current
guidelines, pharmacotherapy should be initiated alongside lifestyle changes for individuals
with Stage 2 hypertension. A thiazide diuretic, ACE inhibitor, or CCB are appropriate first-
line choices.
2. Which of the following is considered a primary prevention strategy for a 65-year-old
female?
A. Referring the patient for physical therapy after a hip fracture.
B. Performing a DEXA scan to screen for osteoporosis.
C. Starting low-dose aspirin after a transient ischemic attack.
,D. Administering the Shingrix vaccine.
Answer: D
Rationale: Primary prevention aims to prevent the onset of disease before it occurs.
Immunizations like the Shingrix vaccine are classic examples of primary prevention
interventions. Screening and post-event treatments fall into secondary and tertiary
prevention categories respectively.
3. A patient with a history of heart failure with reduced ejection fraction (HFrEF) presents for
a follow-up. Which medication class is contraindicated as a first-line treatment for
hypertension in this patient?
A. ACE Inhibitors
B. Beta-blockers
C. Non-dihydropyridine Calcium Channel Blockers
D. Aldosterone Antagonists
Answer: C
Rationale: Non-dihydropyridine calcium channel blockers like verapamil and diltiazem
should be avoided in patients with HFrEF. These medications have negative inotropic
effects that can worsen heart failure symptoms. ACE inhibitors and beta-blockers are
actually standard of care for these patients.
, 4. An 18-month-old child is brought to the clinic for a well-child visit. Which developmental
milestone is expected for this age?
A. Speaking in four-word sentences.
B. Walking up stairs with alternating feet.
C. Using a spoon and drinking from a cup.
D. Naming at least four colors.
Answer: C
Rationale: At 18 months, children are typically able to use a spoon and drink from a cup,
though they may still be messy. They should also be able to walk alone and say several
single words. More complex language and motor skills like alternating feet on stairs occur
later in toddlerhood.
5. What is the gold standard diagnostic test for confirming a diagnosis of obstructive sleep
apnea (OSA)?
A. Overnight pulse oximetry
B. Epworth Sleepiness Scale
C. Neck circumference measurement
D. Polysomnography
Answer: D
