1
CMN 568 FINAL EXAM – FAMILY NURSE PRACTITIONER (FNP)
COMPREHENSIVE ASSESSMENT – 2026/2027] ACTUAL QUESTIONS
AND CORRECT ANSWERS (LATEST 2026/2027 UPDATE) | COMPLETE
Q&A WITH VERIFIED ANSWERS AND DETAILED RATIONALES |
OBJECTIVE ASSESSMENT PREP | A+ GRADED
Core Domains
Health Promotion and Disease Prevention
Cardiovascular and Respiratory Disorders
Endocrine, Metabolic, and Hematologic Disorders
Gastrointestinal and Renal Conditions
Musculoskeletal and Neurologic Disorders
Infectious Diseases and Dermatology
Psychosocial, Behavioral, and Women’s Health
Pediatric and Adolescent Primary Care
Geriatric and Palliative Care
Pharmacotherapeutics and Safe Prescribing
Ethical, Legal, and Professional Issues
Introduction
This CMN 568 Final Exam assesses the Family Nurse Practitioner student’s
competency across the lifespan in primary care. The 100 multiple-choice
questions integrate evidence-based screening, differential diagnosis,
pharmacologic management, and ethical decision-making. Aligned with
current national guidelines and the 2026/2027 curriculum, each item
includes a verified rationale to strengthen clinical reasoning. Mastery
of this content ensures readiness for the certification examination and
for safe, comprehensive, patient-centered practice as a nurse
practitioner.
SECTION ONE: QUESTIONS 1–100
pg. 1
,2
1. A 55-year-old woman with hypertension and diabetes presents for a
routine visit. Her blood pressure is 134/84 mmHg. According to the 2017
ACC/AHA guideline, this blood pressure is classified as:
A. Normal
B. Elevated
C. Stage 1 hypertension
D. Stage 2 hypertension
C. Stage 1 hypertension
RATIONALE: Stage 1 hypertension is defined as systolic 130–139 mmHg or
diastolic 80–89 mmHg. This patient’s reading of 134/84 meets that threshold.
Normal is <120/<80; elevated is 120–129/<80; stage 2 is ≥140/≥90.
2. A 62-year-old man with a 40-pack-year smoking history asks about lung
cancer screening. The USPSTF recommends annual low-dose CT for adults
aged 50–80 who have at least a ____ pack-year history and currently smoke
or quit within the past 15 years.
A. 10
B. 20
C. 30
D. 40
B. 20
RATIONALE: USPSTF guidelines specify a 20-pack-year smoking history for
lung cancer screening eligibility, along with current smoking or cessation within
15 years, and age 50–80.
3. A 48-year-old woman presents with fatigue, weight gain, and cold
intolerance. Lab results: TSH 12 mIU/L (elevated), free T4 low. What is the
first-line treatment?
A. Methimazole
B. Levothyroxine
C. Radioactive iodine
D. Sertraline
pg. 2
,3
B. Levothyroxine
RATIONALE: Elevated TSH with low free T4 indicates primary hypothyroidism.
Levothyroxine is the standard replacement. Methimazole and radioactive iodine
are for hyperthyroidism; sertraline is an antidepressant.
4. A 72-year-old man with BPH has persistent moderate symptoms despite
tamsulosin. He has an enlarged prostate (55 g). Which additional
medication class should be considered?
A. Anticholinergic
B. 5-alpha-reductase inhibitor (e.g., finasteride)
C. PDE5 inhibitor
D. Alpha-2 agonist
B. 5-alpha-reductase inhibitor (e.g., finasteride)
RATIONALE: For men with larger prostates and persistent symptoms on alpha
blocker, adding a 5-alpha-reductase inhibitor reduces prostate size and improves
symptoms over months. Anticholinergics are for overactive bladder; PDE5
inhibitors can help but are not first-line additive therapy.
5. A 56-year-old postmenopausal woman has a DEXA scan showing a T-score
of –2.8 at the femoral neck. She has no history of fractures. The diagnosis
is:
A. Osteopenia
B. Osteoporosis
C. Severe osteoporosis
D. Normal bone density
B. Osteoporosis
RATIONALE: Osteoporosis is defined by a T-score ≤ –2.5. Osteopenia is –1.0 to
–2.5. Severe osteoporosis includes a fragility fracture. This patient meets
osteoporosis criteria.
6. A 35-year-old woman presents with acute onset of right lower quadrant
pain, fever, and cervical motion tenderness. Which diagnosis is most likely?
pg. 3
, 4
A. Appendicitis
B. Ectopic pregnancy
C. Pelvic inflammatory disease (PID)
D. Ovarian torsion
C. Pelvic inflammatory disease (PID)
RATIONALE: Cervical motion tenderness, adnexal tenderness, and fever are
part of the CDC diagnostic criteria for PID. Appendicitis lacks cervical motion
tenderness. Ectopic pregnancy must be ruled out but PID is classic.
7. A 68-year-old man with atrial fibrillation has a CHA₂DS₂-VASc score of 3
(hypertension, age ≥65, diabetes). What is recommended for stroke
prevention?
A. Aspirin 81 mg daily
B. Clopidogrel 75 mg daily
C. Warfarin or a direct oral anticoagulant (DOAC)
D. No antithrombotic therapy
C. Warfarin or a direct oral anticoagulant (DOAC)
RATIONALE: For nonvalvular AF with CHA₂DS₂-VASc ≥2 in men, oral
anticoagulation is recommended. Aspirin alone is no longer recommended for
stroke prevention in AF.
8. A 45-year-old woman with asthma reports using albuterol 3 times per week
for wheezing and awakens at night once a month. According to GINA
guidelines, what is the next step?
A. Continue current treatment
B. Add a low-dose inhaled corticosteroid (ICS)
C. Start a long-acting beta-agonist (LABA) monotherapy
D. Refer for allergy testing
B. Add a low-dose inhaled corticosteroid (ICS)
RATIONALE: The patient has partially controlled asthma. The recommended
step-up is to initiate a low-dose ICS. LABA monotherapy is not recommended
without ICS.
pg. 4
CMN 568 FINAL EXAM – FAMILY NURSE PRACTITIONER (FNP)
COMPREHENSIVE ASSESSMENT – 2026/2027] ACTUAL QUESTIONS
AND CORRECT ANSWERS (LATEST 2026/2027 UPDATE) | COMPLETE
Q&A WITH VERIFIED ANSWERS AND DETAILED RATIONALES |
OBJECTIVE ASSESSMENT PREP | A+ GRADED
Core Domains
Health Promotion and Disease Prevention
Cardiovascular and Respiratory Disorders
Endocrine, Metabolic, and Hematologic Disorders
Gastrointestinal and Renal Conditions
Musculoskeletal and Neurologic Disorders
Infectious Diseases and Dermatology
Psychosocial, Behavioral, and Women’s Health
Pediatric and Adolescent Primary Care
Geriatric and Palliative Care
Pharmacotherapeutics and Safe Prescribing
Ethical, Legal, and Professional Issues
Introduction
This CMN 568 Final Exam assesses the Family Nurse Practitioner student’s
competency across the lifespan in primary care. The 100 multiple-choice
questions integrate evidence-based screening, differential diagnosis,
pharmacologic management, and ethical decision-making. Aligned with
current national guidelines and the 2026/2027 curriculum, each item
includes a verified rationale to strengthen clinical reasoning. Mastery
of this content ensures readiness for the certification examination and
for safe, comprehensive, patient-centered practice as a nurse
practitioner.
SECTION ONE: QUESTIONS 1–100
pg. 1
,2
1. A 55-year-old woman with hypertension and diabetes presents for a
routine visit. Her blood pressure is 134/84 mmHg. According to the 2017
ACC/AHA guideline, this blood pressure is classified as:
A. Normal
B. Elevated
C. Stage 1 hypertension
D. Stage 2 hypertension
C. Stage 1 hypertension
RATIONALE: Stage 1 hypertension is defined as systolic 130–139 mmHg or
diastolic 80–89 mmHg. This patient’s reading of 134/84 meets that threshold.
Normal is <120/<80; elevated is 120–129/<80; stage 2 is ≥140/≥90.
2. A 62-year-old man with a 40-pack-year smoking history asks about lung
cancer screening. The USPSTF recommends annual low-dose CT for adults
aged 50–80 who have at least a ____ pack-year history and currently smoke
or quit within the past 15 years.
A. 10
B. 20
C. 30
D. 40
B. 20
RATIONALE: USPSTF guidelines specify a 20-pack-year smoking history for
lung cancer screening eligibility, along with current smoking or cessation within
15 years, and age 50–80.
3. A 48-year-old woman presents with fatigue, weight gain, and cold
intolerance. Lab results: TSH 12 mIU/L (elevated), free T4 low. What is the
first-line treatment?
A. Methimazole
B. Levothyroxine
C. Radioactive iodine
D. Sertraline
pg. 2
,3
B. Levothyroxine
RATIONALE: Elevated TSH with low free T4 indicates primary hypothyroidism.
Levothyroxine is the standard replacement. Methimazole and radioactive iodine
are for hyperthyroidism; sertraline is an antidepressant.
4. A 72-year-old man with BPH has persistent moderate symptoms despite
tamsulosin. He has an enlarged prostate (55 g). Which additional
medication class should be considered?
A. Anticholinergic
B. 5-alpha-reductase inhibitor (e.g., finasteride)
C. PDE5 inhibitor
D. Alpha-2 agonist
B. 5-alpha-reductase inhibitor (e.g., finasteride)
RATIONALE: For men with larger prostates and persistent symptoms on alpha
blocker, adding a 5-alpha-reductase inhibitor reduces prostate size and improves
symptoms over months. Anticholinergics are for overactive bladder; PDE5
inhibitors can help but are not first-line additive therapy.
5. A 56-year-old postmenopausal woman has a DEXA scan showing a T-score
of –2.8 at the femoral neck. She has no history of fractures. The diagnosis
is:
A. Osteopenia
B. Osteoporosis
C. Severe osteoporosis
D. Normal bone density
B. Osteoporosis
RATIONALE: Osteoporosis is defined by a T-score ≤ –2.5. Osteopenia is –1.0 to
–2.5. Severe osteoporosis includes a fragility fracture. This patient meets
osteoporosis criteria.
6. A 35-year-old woman presents with acute onset of right lower quadrant
pain, fever, and cervical motion tenderness. Which diagnosis is most likely?
pg. 3
, 4
A. Appendicitis
B. Ectopic pregnancy
C. Pelvic inflammatory disease (PID)
D. Ovarian torsion
C. Pelvic inflammatory disease (PID)
RATIONALE: Cervical motion tenderness, adnexal tenderness, and fever are
part of the CDC diagnostic criteria for PID. Appendicitis lacks cervical motion
tenderness. Ectopic pregnancy must be ruled out but PID is classic.
7. A 68-year-old man with atrial fibrillation has a CHA₂DS₂-VASc score of 3
(hypertension, age ≥65, diabetes). What is recommended for stroke
prevention?
A. Aspirin 81 mg daily
B. Clopidogrel 75 mg daily
C. Warfarin or a direct oral anticoagulant (DOAC)
D. No antithrombotic therapy
C. Warfarin or a direct oral anticoagulant (DOAC)
RATIONALE: For nonvalvular AF with CHA₂DS₂-VASc ≥2 in men, oral
anticoagulation is recommended. Aspirin alone is no longer recommended for
stroke prevention in AF.
8. A 45-year-old woman with asthma reports using albuterol 3 times per week
for wheezing and awakens at night once a month. According to GINA
guidelines, what is the next step?
A. Continue current treatment
B. Add a low-dose inhaled corticosteroid (ICS)
C. Start a long-acting beta-agonist (LABA) monotherapy
D. Refer for allergy testing
B. Add a low-dose inhaled corticosteroid (ICS)
RATIONALE: The patient has partially controlled asthma. The recommended
step-up is to initiate a low-dose ICS. LABA monotherapy is not recommended
without ICS.
pg. 4
