NR 667 WEEK 8 ACTUAL EXAM STYLE
V1 | NR 667 FNP CAPSTONE
PRACTICUM AND INTENSIVE CEA |
CHAMBERLAIN
Core Domains
• Clinical Reasoning and Differential Diagnosis
• Cardiovascular Disorders and Hypertension Management
• Respiratory and Pulmonary Conditions
• Endocrine and Metabolic Disorders
• Neurological and Cognitive Disorders
• Dermatological Conditions and Skin Lesions
• Renal and Genitourinary Disorders
• Musculoskeletal and Autoimmune Conditions
• Infectious Diseases and Immunizations
• Pharmacology and Medication Management
Introduction
This comprehensive exit examination is designed to assess the advanced
clinical knowledge, diagnostic reasoning, and evidence-based practice skills
required for the Family Nurse Practitioner (FNP) Capstone Practicum and
Intensive course at Chamberlain University. The exam serves as the final
competency assessment to prepare students for FNP board certification
examinations, covering advanced health assessment, differential diagnosis,
treatment planning, pharmacologic management, and primary care across
the lifespan. Through a combination of multiple-choice questions and clinical
vignettes, candidates are expected to demonstrate proficiency in managing
acute and chronic conditions, applying clinical guidelines, and making sound
,clinical decisions in complex patient scenarios. Emphasis is placed on
integrating evidence-based practice, patient safety, cultural competence,
and interprofessional collaboration in the delivery of primary care.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with heart failure and reduced ejection fraction (HFrEF) has an
ejection fraction of less than what percentage?
A. 50%
B. 45%
C. 40%
D. 35%
C. 40%
RATIONALE: Heart failure with reduced ejection fraction (HFrEF) is
defined as an ejection fraction <40%. These patients require guideline-
directed medical therapy including beta-blockers, ACE inhibitors/ARBs, and
diuretics.
Question 2
A 25-year-old athlete presents with shoulder pain and difficulty with
overhead activities. Physical examination suggests shoulder impingement
syndrome. What is the most appropriate initial treatment?
A. Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical activity
modification
B. Corticosteroid injection
C. Surgical intervention
D. Physical therapy focusing on rotator cuff strengthening
A. Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical activity
modification
, RATIONALE: Initial management of impingement syndrome includes
NSAIDs, activity modification, and ice. Physical therapy may be added if no
improvement. Corticosteroid injection is second-line. Surgery is reserved for
refractory cases.
Question 3
A patient with type 2 diabetes and CKD should avoid which medication due
to the risk of lactic acidosis?
A. Metformin
B. Insulin
C. GLP-1 receptor agonist
D. SGLT-2 inhibitor
A. Metformin
RATIONALE: Metformin is contraindicated in patients with significant
renal impairment (eGFR <30 mL/min/1.73m²) due to the risk of lactic
acidosis.
Question 4
What is the mechanism of action of Entresto (sacubitril/valsartan)?
A. Beta-blocker with alpha-1 blocking activity
B. Neprilysin inhibitor combined with an ARB
C. Direct renin inhibitor
D. Aldosterone antagonist
B. Neprilysin inhibitor combined with an ARB
RATIONALE: Entresto is a neprilysin inhibitor combined with an ARB that
increases natriuretic peptides while blocking angiotensin II. It improves
outcomes in HFrEF but can cause hyperkalemia and increased creatinine.
Question 5
, A 72-year-old male with stable angina undergoes a stress test. Which
symptom requires immediate cardiology referral?
A. Mild fatigue
B. Dizziness with activity
C. Occasional palpitations
D. Mild shortness of breath
B. Dizziness with activity
RATIONALE: Dizziness with activity in a patient with angina or aortic
stenosis may precede syncope and indicates hemodynamic compromise,
warranting urgent cardiology referral.
Question 6
A 28-year-old male patient with HIV would be considered well managed
when they have which of the following in addition to having undetectable or
very low viral copies?
A. CD4 count of 200
B. CD4 count of 350
C. CD4 count of 500
D. CD4 count of 800
C. CD4 count of 500
RATIONALE: A CD4 count of 500 cells/mm³ or higher indicates a well-
functioning immune system in a patient with HIV. A CD4 count below 200
indicates AIDS.
Question 7
A patient presents with a new onset rapid heart rate that is irregularly
irregular, heart rate 100, BP 120/74, SpO2 99%. This has been ongoing
intermittently for a week and continuously for the past four days. What is
the first priority intervention?
A. Immediate cardioversion
B. Maintain rate control and anticoagulation prior to rhythm conversion
V1 | NR 667 FNP CAPSTONE
PRACTICUM AND INTENSIVE CEA |
CHAMBERLAIN
Core Domains
• Clinical Reasoning and Differential Diagnosis
• Cardiovascular Disorders and Hypertension Management
• Respiratory and Pulmonary Conditions
• Endocrine and Metabolic Disorders
• Neurological and Cognitive Disorders
• Dermatological Conditions and Skin Lesions
• Renal and Genitourinary Disorders
• Musculoskeletal and Autoimmune Conditions
• Infectious Diseases and Immunizations
• Pharmacology and Medication Management
Introduction
This comprehensive exit examination is designed to assess the advanced
clinical knowledge, diagnostic reasoning, and evidence-based practice skills
required for the Family Nurse Practitioner (FNP) Capstone Practicum and
Intensive course at Chamberlain University. The exam serves as the final
competency assessment to prepare students for FNP board certification
examinations, covering advanced health assessment, differential diagnosis,
treatment planning, pharmacologic management, and primary care across
the lifespan. Through a combination of multiple-choice questions and clinical
vignettes, candidates are expected to demonstrate proficiency in managing
acute and chronic conditions, applying clinical guidelines, and making sound
,clinical decisions in complex patient scenarios. Emphasis is placed on
integrating evidence-based practice, patient safety, cultural competence,
and interprofessional collaboration in the delivery of primary care.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with heart failure and reduced ejection fraction (HFrEF) has an
ejection fraction of less than what percentage?
A. 50%
B. 45%
C. 40%
D. 35%
C. 40%
RATIONALE: Heart failure with reduced ejection fraction (HFrEF) is
defined as an ejection fraction <40%. These patients require guideline-
directed medical therapy including beta-blockers, ACE inhibitors/ARBs, and
diuretics.
Question 2
A 25-year-old athlete presents with shoulder pain and difficulty with
overhead activities. Physical examination suggests shoulder impingement
syndrome. What is the most appropriate initial treatment?
A. Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical activity
modification
B. Corticosteroid injection
C. Surgical intervention
D. Physical therapy focusing on rotator cuff strengthening
A. Nonsteroidal anti-inflammatory drugs (NSAIDs) and physical activity
modification
, RATIONALE: Initial management of impingement syndrome includes
NSAIDs, activity modification, and ice. Physical therapy may be added if no
improvement. Corticosteroid injection is second-line. Surgery is reserved for
refractory cases.
Question 3
A patient with type 2 diabetes and CKD should avoid which medication due
to the risk of lactic acidosis?
A. Metformin
B. Insulin
C. GLP-1 receptor agonist
D. SGLT-2 inhibitor
A. Metformin
RATIONALE: Metformin is contraindicated in patients with significant
renal impairment (eGFR <30 mL/min/1.73m²) due to the risk of lactic
acidosis.
Question 4
What is the mechanism of action of Entresto (sacubitril/valsartan)?
A. Beta-blocker with alpha-1 blocking activity
B. Neprilysin inhibitor combined with an ARB
C. Direct renin inhibitor
D. Aldosterone antagonist
B. Neprilysin inhibitor combined with an ARB
RATIONALE: Entresto is a neprilysin inhibitor combined with an ARB that
increases natriuretic peptides while blocking angiotensin II. It improves
outcomes in HFrEF but can cause hyperkalemia and increased creatinine.
Question 5
, A 72-year-old male with stable angina undergoes a stress test. Which
symptom requires immediate cardiology referral?
A. Mild fatigue
B. Dizziness with activity
C. Occasional palpitations
D. Mild shortness of breath
B. Dizziness with activity
RATIONALE: Dizziness with activity in a patient with angina or aortic
stenosis may precede syncope and indicates hemodynamic compromise,
warranting urgent cardiology referral.
Question 6
A 28-year-old male patient with HIV would be considered well managed
when they have which of the following in addition to having undetectable or
very low viral copies?
A. CD4 count of 200
B. CD4 count of 350
C. CD4 count of 500
D. CD4 count of 800
C. CD4 count of 500
RATIONALE: A CD4 count of 500 cells/mm³ or higher indicates a well-
functioning immune system in a patient with HIV. A CD4 count below 200
indicates AIDS.
Question 7
A patient presents with a new onset rapid heart rate that is irregularly
irregular, heart rate 100, BP 120/74, SpO2 99%. This has been ongoing
intermittently for a week and continuously for the past four days. What is
the first priority intervention?
A. Immediate cardioversion
B. Maintain rate control and anticoagulation prior to rhythm conversion
