NSG 554 EXAM 3 (WILKES) NEWEST 2026 ACTUAL
EXAM TEST BANK| NSG554 FNP EXAM 3 REVIEW
WITH COMPLETE 100 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
Cardiology (Hypertension, Heart Failure, CAD) – Questions 1–15
1. A 58-year-old Black male with hypertension has a BP of 148/92 mmHg. Which
antihypertensive is recommended as first-line therapy per JNC-8/ACC guidelines
for this patient?
• A) Lisinopril
• B) Metoprolol
• C) Amlodipine
• D) Hydrochlorothiazide
Answer: C (Thiazide diuretics or CCBs are preferred first-line in Black patients
without CKD. ACE inhibitors are less effective as monotherapy in this population.)
2. A patient with HFrEF (EF 30%) is on carvedilol, lisinopril, and furosemide. He
develops a dry hacking cough. What is the most appropriate next step?
• A) Stop lisinopril and start losartan
• B) Stop carvedilol
• C) Increase furosemide
• D) Add codeine for the cough
Answer: A (ACE inhibitors cause bradykinin-mediated cough. Switch to an ARB
like losartan.)
3. Which beta-blocker has proven mortality benefit specifically in heart failure
with reduced ejection fraction (HFrEF)?
• A) Atenolol
, • B) Metoprolol succinate
• C) Propranolol
• D) Esmolol
Answer: B (Carvedilol, bisoprolol, and metoprolol succinate (extended release)
are the 3 proven for HFrEF. Metoprolol tartrate is not.)
4. A patient presents with crushing substernal chest pain radiating to the jaw. ECG
shows ST-elevations in V1-V4. Which intervention is time-critical?
• A) Aspirin 324 mg chewed
• B) Sublingual NTG
• C) Percutaneous coronary intervention (PCI) within 90 minutes
• D) IV heparin
Answer: C (PCI within 90 minutes is the gold standard for STEMI. Aspirin is given
immediately but PCI is the definitive answer for "time-critical" intervention.)
5. What is the target LDL goal for a patient with established atherosclerotic
cardiovascular disease (ASCVD) per the 2018 AHA/ACC guidelines?
• A) < 100 mg/dL
• B) < 70 mg/dL
• C) < 130 mg/dL
• D) < 55 mg/dL
Answer: B (< 70 mg/dL is the goal for secondary prevention. Very high-risk
patients may aim for < 55 mg/dL, but <70 is the standard goal.)
6. A patient on atorvastatin 80 mg reports severe bilateral thigh pain and dark
urine. Labs show CK > 10,000 U/L. What should you do?
• A) Decrease atorvastatin to 40 mg
• B) Continue atorvastatin and add CoQ10
• C) Hold atorvastatin and monitor renal function
, • D) Switch to rosuvastatin 40 mg
Answer: C (This is rhabdomyolysis. Hold the statin immediately and monitor for
acute kidney injury.)
7. Which diuretic is most effective for managing hypertension in a patient with
chronic kidney disease (CKD) stage 4?
• A) Hydrochlorothiazide
• B) Chlorthalidone
• C) Furosemide
• D) Spironolactone
Answer: C (Loop diuretics are required when GFR is < 30 mL/min because
thiazides lose efficacy.)
8. A 72-year-old with HFpEF presents with exertional dyspnea and pedal edema.
Which medication class has been shown to improve outcomes in HFpEF?
• A) ACE inhibitors
• B) Beta-blockers
• C) SGLT-2 inhibitors (e.g., Empagliflozin)
• D) Digoxin
Answer: C (SGLT-2 inhibitors are the first class to show significant reduction in
HF hospitalization in HFpEF.)
9. What ECG finding is diagnostic of a previous inferior wall MI?
• A) Q waves in leads II, III, aVF
• B) ST elevation in V1-V4
• C) Q waves in leads I, aVL, V5-V6
• D) Tall R waves in V1
Answer: A (II, III, aVF represent the inferior wall. Q waves indicate necrosis.)
EXAM TEST BANK| NSG554 FNP EXAM 3 REVIEW
WITH COMPLETE 100 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
Cardiology (Hypertension, Heart Failure, CAD) – Questions 1–15
1. A 58-year-old Black male with hypertension has a BP of 148/92 mmHg. Which
antihypertensive is recommended as first-line therapy per JNC-8/ACC guidelines
for this patient?
• A) Lisinopril
• B) Metoprolol
• C) Amlodipine
• D) Hydrochlorothiazide
Answer: C (Thiazide diuretics or CCBs are preferred first-line in Black patients
without CKD. ACE inhibitors are less effective as monotherapy in this population.)
2. A patient with HFrEF (EF 30%) is on carvedilol, lisinopril, and furosemide. He
develops a dry hacking cough. What is the most appropriate next step?
• A) Stop lisinopril and start losartan
• B) Stop carvedilol
• C) Increase furosemide
• D) Add codeine for the cough
Answer: A (ACE inhibitors cause bradykinin-mediated cough. Switch to an ARB
like losartan.)
3. Which beta-blocker has proven mortality benefit specifically in heart failure
with reduced ejection fraction (HFrEF)?
• A) Atenolol
, • B) Metoprolol succinate
• C) Propranolol
• D) Esmolol
Answer: B (Carvedilol, bisoprolol, and metoprolol succinate (extended release)
are the 3 proven for HFrEF. Metoprolol tartrate is not.)
4. A patient presents with crushing substernal chest pain radiating to the jaw. ECG
shows ST-elevations in V1-V4. Which intervention is time-critical?
• A) Aspirin 324 mg chewed
• B) Sublingual NTG
• C) Percutaneous coronary intervention (PCI) within 90 minutes
• D) IV heparin
Answer: C (PCI within 90 minutes is the gold standard for STEMI. Aspirin is given
immediately but PCI is the definitive answer for "time-critical" intervention.)
5. What is the target LDL goal for a patient with established atherosclerotic
cardiovascular disease (ASCVD) per the 2018 AHA/ACC guidelines?
• A) < 100 mg/dL
• B) < 70 mg/dL
• C) < 130 mg/dL
• D) < 55 mg/dL
Answer: B (< 70 mg/dL is the goal for secondary prevention. Very high-risk
patients may aim for < 55 mg/dL, but <70 is the standard goal.)
6. A patient on atorvastatin 80 mg reports severe bilateral thigh pain and dark
urine. Labs show CK > 10,000 U/L. What should you do?
• A) Decrease atorvastatin to 40 mg
• B) Continue atorvastatin and add CoQ10
• C) Hold atorvastatin and monitor renal function
, • D) Switch to rosuvastatin 40 mg
Answer: C (This is rhabdomyolysis. Hold the statin immediately and monitor for
acute kidney injury.)
7. Which diuretic is most effective for managing hypertension in a patient with
chronic kidney disease (CKD) stage 4?
• A) Hydrochlorothiazide
• B) Chlorthalidone
• C) Furosemide
• D) Spironolactone
Answer: C (Loop diuretics are required when GFR is < 30 mL/min because
thiazides lose efficacy.)
8. A 72-year-old with HFpEF presents with exertional dyspnea and pedal edema.
Which medication class has been shown to improve outcomes in HFpEF?
• A) ACE inhibitors
• B) Beta-blockers
• C) SGLT-2 inhibitors (e.g., Empagliflozin)
• D) Digoxin
Answer: C (SGLT-2 inhibitors are the first class to show significant reduction in
HF hospitalization in HFpEF.)
9. What ECG finding is diagnostic of a previous inferior wall MI?
• A) Q waves in leads II, III, aVF
• B) ST elevation in V1-V4
• C) Q waves in leads I, aVL, V5-V6
• D) Tall R waves in V1
Answer: A (II, III, aVF represent the inferior wall. Q waves indicate necrosis.)
