NR 603 CEA FINAL EXAM PREP TEST BANK
REAL EXAM QUESTIONS & VERIFIED ANSWERS
GRADED A+ [UPDATED 2025-2026]
This comprehensive test bank offers verified,
correct answers and detailed clinical rationales
designed to help you master the NR 603
Comprehensive Exit Assessment. It covers critical
primary care topics including advanced clinical
diagnostics, pharmacology guidelines, and chronic
disease management for family nurse practitioners.
Perfect for University FNP students, this high-yield
study bank ensures you achieve an A+ grade on
your final exit exam.
Question 1
A 58-year-old male with a history of Type 2
Diabetes and Chronic Kidney Disease (CKD) Stage 4
presents for a follow-up. His eGFR is 25
mL/min/1.73m². Which of the following antidiabetic
medications must be discontinued in this patient
due to renal impairment?
A) Pioglitazone
B) Metformin
,C) Liraglutide
D) Sitagliptin
Rationale: Metformin is strictly contraindicated in
patients with an eGFR below 30 mL/min/1.73m² due
to the significantly increased risk of developing
accumulation-induced lactic acidosis. Pioglitazone
is safe in renal impairment but contraindicated in
heart failure. Liraglutide and Sitagliptin do not
require absolute discontinuation, though Sitagliptin
requires a dose reduction.
Question 2
A 32-year-old female at 28 weeks gestation
presents with a blood pressure of 152/96 mmHg and
2+ proteinuria on a dipstick. Which of the following
antihypertensive agents is preferred as a first-line
option for managing hypertension in this pregnant
patient?
A) Lisinopril
B) Losartan
C) Hydrochlorothiazide
D) Labetalol
Rationale: Labetalol is a combined alpha and beta-
blocker that serves as a first-line, safe
antihypertensive during pregnancy. ACE inhibitors
,(Lisinopril) and ARBs (Losartan) are strictly
contraindicated due to severe fetotoxic risks,
including fetal renal failure and skull abnormalities.
Thiazide diuretics are avoided due to the risk of
maternal volume depletion and decreased placental
perfusion.
Question 3
A 45-year-old female presents with fatigue, heat
intolerance, weight loss, and palpitations.
Laboratory findings reveal a TSH of 0.01 mIU/L and
an elevated Free T4 of 3.4 ng/dL. Which diagnosis is
most consistent with these findings?
A) Subclinical hyperthyroidism
B) Central hypothyroidism
C) Primary hyperthyroidism
D) Hashimoto's thyroiditis
Rationale: Primary hyperthyroidism presents with a
suppressed TSH and an elevated Free T4 level,
indicating overproduction of hormone by the thyroid
gland itself. Subclinical hyperthyroidism would
show a low TSH but a normal Free T4. Central
hypothyroidism features low or normal TSH with a
low Free T4, while Hashimoto's typically causes
primary hypothyroidism (elevated TSH, low T4).
, Question 4
A 28-year-old female presents with severe fatigue
and pica. Labs reveal: Hgb 9.0 g/dL, MCV 70 fL,
elevated TIBC, and a serum ferritin level of 6 ng/mL.
What is the most likely diagnosis?
A) Anemia of chronic disease
B) Thalassemia minor
C) Iron deficiency anemia
D) Sideroblastic anemia
Rationale: Iron deficiency anemia is characterized
by a microcytic (low MCV), hypochromic
presentation accompanied by low ferritin (depleted
iron stores) and elevated TIBC (reflecting the body's
open capacity to bind iron). Anemia of chronic
disease usually features normal or elevated ferritin
and a low TIBC. Thalassemia minor presents with a
low MCV but normal to elevated ferritin levels.
Question 5
A 24-year-old male with mild asthma uses a short-
acting beta-agonist (SABA) PRN. He reports waking
up at night with coughing fits 3 times a month and
using his SABA 4 times a week. According to
NHLBI/GINA guidelines, what is the best next step?
REAL EXAM QUESTIONS & VERIFIED ANSWERS
GRADED A+ [UPDATED 2025-2026]
This comprehensive test bank offers verified,
correct answers and detailed clinical rationales
designed to help you master the NR 603
Comprehensive Exit Assessment. It covers critical
primary care topics including advanced clinical
diagnostics, pharmacology guidelines, and chronic
disease management for family nurse practitioners.
Perfect for University FNP students, this high-yield
study bank ensures you achieve an A+ grade on
your final exit exam.
Question 1
A 58-year-old male with a history of Type 2
Diabetes and Chronic Kidney Disease (CKD) Stage 4
presents for a follow-up. His eGFR is 25
mL/min/1.73m². Which of the following antidiabetic
medications must be discontinued in this patient
due to renal impairment?
A) Pioglitazone
B) Metformin
,C) Liraglutide
D) Sitagliptin
Rationale: Metformin is strictly contraindicated in
patients with an eGFR below 30 mL/min/1.73m² due
to the significantly increased risk of developing
accumulation-induced lactic acidosis. Pioglitazone
is safe in renal impairment but contraindicated in
heart failure. Liraglutide and Sitagliptin do not
require absolute discontinuation, though Sitagliptin
requires a dose reduction.
Question 2
A 32-year-old female at 28 weeks gestation
presents with a blood pressure of 152/96 mmHg and
2+ proteinuria on a dipstick. Which of the following
antihypertensive agents is preferred as a first-line
option for managing hypertension in this pregnant
patient?
A) Lisinopril
B) Losartan
C) Hydrochlorothiazide
D) Labetalol
Rationale: Labetalol is a combined alpha and beta-
blocker that serves as a first-line, safe
antihypertensive during pregnancy. ACE inhibitors
,(Lisinopril) and ARBs (Losartan) are strictly
contraindicated due to severe fetotoxic risks,
including fetal renal failure and skull abnormalities.
Thiazide diuretics are avoided due to the risk of
maternal volume depletion and decreased placental
perfusion.
Question 3
A 45-year-old female presents with fatigue, heat
intolerance, weight loss, and palpitations.
Laboratory findings reveal a TSH of 0.01 mIU/L and
an elevated Free T4 of 3.4 ng/dL. Which diagnosis is
most consistent with these findings?
A) Subclinical hyperthyroidism
B) Central hypothyroidism
C) Primary hyperthyroidism
D) Hashimoto's thyroiditis
Rationale: Primary hyperthyroidism presents with a
suppressed TSH and an elevated Free T4 level,
indicating overproduction of hormone by the thyroid
gland itself. Subclinical hyperthyroidism would
show a low TSH but a normal Free T4. Central
hypothyroidism features low or normal TSH with a
low Free T4, while Hashimoto's typically causes
primary hypothyroidism (elevated TSH, low T4).
, Question 4
A 28-year-old female presents with severe fatigue
and pica. Labs reveal: Hgb 9.0 g/dL, MCV 70 fL,
elevated TIBC, and a serum ferritin level of 6 ng/mL.
What is the most likely diagnosis?
A) Anemia of chronic disease
B) Thalassemia minor
C) Iron deficiency anemia
D) Sideroblastic anemia
Rationale: Iron deficiency anemia is characterized
by a microcytic (low MCV), hypochromic
presentation accompanied by low ferritin (depleted
iron stores) and elevated TIBC (reflecting the body's
open capacity to bind iron). Anemia of chronic
disease usually features normal or elevated ferritin
and a low TIBC. Thalassemia minor presents with a
low MCV but normal to elevated ferritin levels.
Question 5
A 24-year-old male with mild asthma uses a short-
acting beta-agonist (SABA) PRN. He reports waking
up at night with coughing fits 3 times a month and
using his SABA 4 times a week. According to
NHLBI/GINA guidelines, what is the best next step?
