NURS 5433 FNP 2 – QUESTIONS AND ANSWERS |
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1. A 55-year-old patient with type 2 diabetes is started on metformin. Which
mechanism of action best describes how metformin lowers blood glucose?
A. Increases insulin secretion from pancreatic beta cells
B. Decreases hepatic gluconeogenesis and improves insulin sensitivity
C. Blocks glucose absorption in the intestines completely
D. Stimulates glucagon release from the pancreas
Rationale: Metformin primarily reduces hepatic glucose production and
increases peripheral insulin sensitivity. It does not stimulate insulin or glucagon
secretion and does not completely block intestinal glucose absorption.
2. A patient on lisinopril reports a persistent dry cough. What is the most
appropriate clinical action?
A. Continue medication and reassure the patient
B. Switch to a beta-blocker immediately
C. Discontinue and consider switching to an ARB
D. Reduce the lisinopril dose by half
Rationale: ACE inhibitors like lisinopril can cause a dry cough due to bradykinin
accumulation. Switching to an ARB is appropriate as it avoids this side effect.
3. Which condition is a contraindication for prescribing combined oral
contraceptives?
A. Migraine without aura
B. History of deep vein thrombosis
C. Mild acne
D. Irregular menstruation
,Rationale: Estrogen-containing contraceptives increase thromboembolic risk and
are contraindicated in patients with prior DVT.
4. A patient presents with wheezing and shortness of breath. Which
medication provides rapid relief?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Tiotropium
Rationale: Albuterol is a short-acting beta-agonist providing immediate
bronchodilation for acute asthma symptoms.
5. Which lab finding is most concerning in a patient taking spironolactone?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Rationale: Spironolactone is potassium-sparing and can lead to dangerous
elevations in potassium levels.
6. A patient with hypertension is started on hydrochlorothiazide. What is the
primary expected effect?
A. Increased sodium retention
B. Decreased urine output
C. Reduced blood volume and blood pressure
D. Increased heart rate
Rationale: Thiazide diuretics reduce sodium and water reabsorption, decreasing
blood volume and lowering blood pressure.
7. Which symptom is most indicative of hypoglycemia?
A. Fruity breath odor
B. Polyuria
,C. Diaphoresis and tremors
D. Dry skin
Rationale: Hypoglycemia triggers sympathetic activation causing sweating,
tremors, and anxiety.
8. A patient taking warfarin has an INR of 6.0. What is the priority action?
A. Increase warfarin dose
B. Hold warfarin and assess for bleeding
C. Give vitamin K prophylactically without assessment
D. Continue current dose
Rationale: An INR of 6 indicates high bleeding risk; warfarin should be held and
patient evaluated.
9. Which antibiotic is most appropriate for uncomplicated urinary tract
infection?
A. Amoxicillin-clavulanate
B. Nitrofurantoin
C. Vancomycin
D. Ceftriaxone IV
Rationale: Nitrofurantoin is first-line for uncomplicated cystitis due to targeted
urinary tract activity.
10. A patient is diagnosed with hyperthyroidism. Which medication reduces
thyroid hormone production?
A. Levothyroxine
B. Methimazole
C. Prednisone
D. Propranolol only
Rationale: Methimazole inhibits thyroid hormone synthesis by blocking iodine
incorporation.
11. Which adverse effect is associated with long-term corticosteroid use?
A. Weight loss
, B. Osteoporosis
C. Hypoglycemia
D. Bradycardia
Rationale: Chronic corticosteroid use decreases bone density, increasing fracture
risk.
12. A patient presents with chest pain radiating to the left arm. What is the
priority intervention?
A. Administer oral ibuprofen
B. Obtain ECG and administer oxygen if needed
C. Schedule outpatient stress test
D. Give antacid therapy
Rationale: Suspected acute coronary syndrome requires immediate ECG and
stabilization.
13. Which medication is contraindicated in pregnancy?
A. Penicillin
B. Acetaminophen
C. Isotretinoin
D. Folic acid
Rationale: Isotretinoin is highly teratogenic and contraindicated in pregnancy.
14. What is the mechanism of beta-blockers in hypertension?
A. Vasoconstriction of arteries
B. Blocking calcium channels
C. Reducing heart rate and cardiac output
D. Increasing renin release
Rationale: Beta-blockers decrease sympathetic stimulation, reducing heart rate
and cardiac output.
15. A patient with asthma should avoid which medication?
A. Albuterol
B. Propranolol
VERIFIED AND WELL DETAILED ANSWERS
PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE | EXAM PREP | STUDY
GUIDE | PRACTICE TEST| DOWNLOAD INSTANT
1. A 55-year-old patient with type 2 diabetes is started on metformin. Which
mechanism of action best describes how metformin lowers blood glucose?
A. Increases insulin secretion from pancreatic beta cells
B. Decreases hepatic gluconeogenesis and improves insulin sensitivity
C. Blocks glucose absorption in the intestines completely
D. Stimulates glucagon release from the pancreas
Rationale: Metformin primarily reduces hepatic glucose production and
increases peripheral insulin sensitivity. It does not stimulate insulin or glucagon
secretion and does not completely block intestinal glucose absorption.
2. A patient on lisinopril reports a persistent dry cough. What is the most
appropriate clinical action?
A. Continue medication and reassure the patient
B. Switch to a beta-blocker immediately
C. Discontinue and consider switching to an ARB
D. Reduce the lisinopril dose by half
Rationale: ACE inhibitors like lisinopril can cause a dry cough due to bradykinin
accumulation. Switching to an ARB is appropriate as it avoids this side effect.
3. Which condition is a contraindication for prescribing combined oral
contraceptives?
A. Migraine without aura
B. History of deep vein thrombosis
C. Mild acne
D. Irregular menstruation
,Rationale: Estrogen-containing contraceptives increase thromboembolic risk and
are contraindicated in patients with prior DVT.
4. A patient presents with wheezing and shortness of breath. Which
medication provides rapid relief?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Tiotropium
Rationale: Albuterol is a short-acting beta-agonist providing immediate
bronchodilation for acute asthma symptoms.
5. Which lab finding is most concerning in a patient taking spironolactone?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Rationale: Spironolactone is potassium-sparing and can lead to dangerous
elevations in potassium levels.
6. A patient with hypertension is started on hydrochlorothiazide. What is the
primary expected effect?
A. Increased sodium retention
B. Decreased urine output
C. Reduced blood volume and blood pressure
D. Increased heart rate
Rationale: Thiazide diuretics reduce sodium and water reabsorption, decreasing
blood volume and lowering blood pressure.
7. Which symptom is most indicative of hypoglycemia?
A. Fruity breath odor
B. Polyuria
,C. Diaphoresis and tremors
D. Dry skin
Rationale: Hypoglycemia triggers sympathetic activation causing sweating,
tremors, and anxiety.
8. A patient taking warfarin has an INR of 6.0. What is the priority action?
A. Increase warfarin dose
B. Hold warfarin and assess for bleeding
C. Give vitamin K prophylactically without assessment
D. Continue current dose
Rationale: An INR of 6 indicates high bleeding risk; warfarin should be held and
patient evaluated.
9. Which antibiotic is most appropriate for uncomplicated urinary tract
infection?
A. Amoxicillin-clavulanate
B. Nitrofurantoin
C. Vancomycin
D. Ceftriaxone IV
Rationale: Nitrofurantoin is first-line for uncomplicated cystitis due to targeted
urinary tract activity.
10. A patient is diagnosed with hyperthyroidism. Which medication reduces
thyroid hormone production?
A. Levothyroxine
B. Methimazole
C. Prednisone
D. Propranolol only
Rationale: Methimazole inhibits thyroid hormone synthesis by blocking iodine
incorporation.
11. Which adverse effect is associated with long-term corticosteroid use?
A. Weight loss
, B. Osteoporosis
C. Hypoglycemia
D. Bradycardia
Rationale: Chronic corticosteroid use decreases bone density, increasing fracture
risk.
12. A patient presents with chest pain radiating to the left arm. What is the
priority intervention?
A. Administer oral ibuprofen
B. Obtain ECG and administer oxygen if needed
C. Schedule outpatient stress test
D. Give antacid therapy
Rationale: Suspected acute coronary syndrome requires immediate ECG and
stabilization.
13. Which medication is contraindicated in pregnancy?
A. Penicillin
B. Acetaminophen
C. Isotretinoin
D. Folic acid
Rationale: Isotretinoin is highly teratogenic and contraindicated in pregnancy.
14. What is the mechanism of beta-blockers in hypertension?
A. Vasoconstriction of arteries
B. Blocking calcium channels
C. Reducing heart rate and cardiac output
D. Increasing renin release
Rationale: Beta-blockers decrease sympathetic stimulation, reducing heart rate
and cardiac output.
15. A patient with asthma should avoid which medication?
A. Albuterol
B. Propranolol
