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NURS 5433 FNP II FINAL EXAM – 2026 FAMILY NURSE
PRACTITIONER COMPLETE (200) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURS
Prepare for the NURS 5433 FNP I Midterm – Family Nurse Practitioner with this
comprehensive study resource designed to reinforce essential family nurse
practitioner concepts, advanced health assessment, differential diagnosis,
primary care management, pharmacology, evidence-based treatment planning,
health promotion, and disease prevention. This document helps you review key
topics, assess your understanding, and identify areas that may require additional
study before the midterm exam. Use it to strengthen your advanced practice
nursing knowledge and build confidence through focused, organized preparation.
An excellent companion for successful NURS 5433 FNP I Midterm preparation.
MULTIPLE CHOICE.
Question 1
A 55-year-old male with a 30-pack-year smoking history presents with a 2-month
history of progressive dyspnea on exertion and a dry cough. Pulmonary function tests
show a reduced FEV1/FVC ratio (0.65) with increased total lung capacity. What is the
most likely diagnosis?
A. Restrictive lung disease
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pulmonary fibrosis
Correct Answer: B
Rationale: Reduced FEV1/FVC ratio (<0.70) with increased total lung capacity indicates
air trapping, classic for COPD. Asthma typically shows reversibility; restrictive diseases
have reduced total lung capacity.
Question 2
A 45-year-old woman presents with a 3-month history of progressive proximal muscle
weakness, difficulty rising from a chair, and a heliotrope rash on her eyelids. She also has
Gottron's papules on her knuckles. What is the most appropriate initial diagnostic test?
A. Serum creatine kinase (CK)
, Page 2 of 86
B. Antinuclear antibody (ANA)
C. MRI of affected muscles
D. Electromyography (EMG)
Correct Answer: A
Rationale: Heliotrope rash + Gottron's papules + proximal weakness = dermatomyositis.
CK is a sensitive initial test for muscle inflammation. EMG and muscle biopsy confirm.
Question 3
A 68-year-old male with type 2 diabetes and hypertension presents with a 1-day history
of acute, painless vision loss in the right eye described as a "curtain" coming down.
What is the most appropriate next step?
A. Urgent ophthalmology referral
B. CT head without contrast
C. Aspirin 325 mg daily
D. Reassurance and follow-up in 1 week
Correct Answer: A
Rationale: Painless monocular vision loss with curtain-like description is central retinal
artery occlusion until proven otherwise. Time is vision; urgent ophthalmology evaluation
is critical.
Question 4
A 32-year-old G2P1 at 34 weeks gestation presents with a blood pressure of 165/105
mmHg and 3+ proteinuria. She reports a severe frontal headache and visual blurring.
What is the most appropriate immediate management?
A. Outpatient labetalol and bed rest
, Page 3 of 86
B. Magnesium sulfate and delivery planning
C. Immediate cesarean section
D. Methyldopa and home monitoring
Correct Answer: B
Rationale: Severe preeclampsia (BP ≥160/110, symptoms) at 34 weeks requires
magnesium sulfate for seizure prophylaxis and delivery after maternal stabilization.
Question 5
A 50-year-old male with a history of alcohol use disorder presents with confusion,
ataxia, and nystagmus. He is given IV thiamine. What is the next most important step?
A. MRI brain
B. IV glucose
C. Lumbar puncture
D. CT head
Correct Answer: B
Rationale: Wernicke's encephalopathy is treated with thiamine first. Glucose without
thiamine can precipitate or worsen encephalopathy. After thiamine, glucose if
hypoglycemic.
Question 6
A 40-year-old woman presents with a 2-month history of episodic flushing, diarrhea,
and wheezing. Physical exam reveals telangiectasias on her face. What is the most
appropriate initial diagnostic test?
A. 24-hour urine 5-HIAA
B. Serum chromogranin A
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C. Colonoscopy
D. CT abdomen
Correct Answer: A
Rationale: Carcinoid syndrome (flushing, diarrhea, wheezing, telangiectasias) – 24-hour
urine 5-HIAA is the most specific initial test.
Question 7
A 72-year-old male with BPH presents with acute urinary retention. A Foley catheter is
placed and 1200 mL of urine is drained. One hour later, he becomes hypotensive (90/60)
and tachycardic. What is the most likely cause?
A. Hemorrhage
B. Post-obstructive diuresis
C. Myocardial infarction
D. Sepsis
Correct Answer: B
Rationale: Post-obstructive diuresis after relief of chronic retention can cause
hypotension from salt and water loss. Monitor urine output and administer IV fluids as
needed.
Question 8
A 28-year-old man presents with acute testicular pain, nausea, and vomiting. On exam,
the left testis is high-riding, horizontal, and tender. Cremasteric reflex is absent. What is
the most appropriate next step?
A. Scrotal ultrasound with Doppler
B. Immediate surgical exploration
NURS 5433 FNP II FINAL EXAM – 2026 FAMILY NURSE
PRACTITIONER COMPLETE (200) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURS
Prepare for the NURS 5433 FNP I Midterm – Family Nurse Practitioner with this
comprehensive study resource designed to reinforce essential family nurse
practitioner concepts, advanced health assessment, differential diagnosis,
primary care management, pharmacology, evidence-based treatment planning,
health promotion, and disease prevention. This document helps you review key
topics, assess your understanding, and identify areas that may require additional
study before the midterm exam. Use it to strengthen your advanced practice
nursing knowledge and build confidence through focused, organized preparation.
An excellent companion for successful NURS 5433 FNP I Midterm preparation.
MULTIPLE CHOICE.
Question 1
A 55-year-old male with a 30-pack-year smoking history presents with a 2-month
history of progressive dyspnea on exertion and a dry cough. Pulmonary function tests
show a reduced FEV1/FVC ratio (0.65) with increased total lung capacity. What is the
most likely diagnosis?
A. Restrictive lung disease
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pulmonary fibrosis
Correct Answer: B
Rationale: Reduced FEV1/FVC ratio (<0.70) with increased total lung capacity indicates
air trapping, classic for COPD. Asthma typically shows reversibility; restrictive diseases
have reduced total lung capacity.
Question 2
A 45-year-old woman presents with a 3-month history of progressive proximal muscle
weakness, difficulty rising from a chair, and a heliotrope rash on her eyelids. She also has
Gottron's papules on her knuckles. What is the most appropriate initial diagnostic test?
A. Serum creatine kinase (CK)
, Page 2 of 86
B. Antinuclear antibody (ANA)
C. MRI of affected muscles
D. Electromyography (EMG)
Correct Answer: A
Rationale: Heliotrope rash + Gottron's papules + proximal weakness = dermatomyositis.
CK is a sensitive initial test for muscle inflammation. EMG and muscle biopsy confirm.
Question 3
A 68-year-old male with type 2 diabetes and hypertension presents with a 1-day history
of acute, painless vision loss in the right eye described as a "curtain" coming down.
What is the most appropriate next step?
A. Urgent ophthalmology referral
B. CT head without contrast
C. Aspirin 325 mg daily
D. Reassurance and follow-up in 1 week
Correct Answer: A
Rationale: Painless monocular vision loss with curtain-like description is central retinal
artery occlusion until proven otherwise. Time is vision; urgent ophthalmology evaluation
is critical.
Question 4
A 32-year-old G2P1 at 34 weeks gestation presents with a blood pressure of 165/105
mmHg and 3+ proteinuria. She reports a severe frontal headache and visual blurring.
What is the most appropriate immediate management?
A. Outpatient labetalol and bed rest
, Page 3 of 86
B. Magnesium sulfate and delivery planning
C. Immediate cesarean section
D. Methyldopa and home monitoring
Correct Answer: B
Rationale: Severe preeclampsia (BP ≥160/110, symptoms) at 34 weeks requires
magnesium sulfate for seizure prophylaxis and delivery after maternal stabilization.
Question 5
A 50-year-old male with a history of alcohol use disorder presents with confusion,
ataxia, and nystagmus. He is given IV thiamine. What is the next most important step?
A. MRI brain
B. IV glucose
C. Lumbar puncture
D. CT head
Correct Answer: B
Rationale: Wernicke's encephalopathy is treated with thiamine first. Glucose without
thiamine can precipitate or worsen encephalopathy. After thiamine, glucose if
hypoglycemic.
Question 6
A 40-year-old woman presents with a 2-month history of episodic flushing, diarrhea,
and wheezing. Physical exam reveals telangiectasias on her face. What is the most
appropriate initial diagnostic test?
A. 24-hour urine 5-HIAA
B. Serum chromogranin A
, Page 4 of 86
C. Colonoscopy
D. CT abdomen
Correct Answer: A
Rationale: Carcinoid syndrome (flushing, diarrhea, wheezing, telangiectasias) – 24-hour
urine 5-HIAA is the most specific initial test.
Question 7
A 72-year-old male with BPH presents with acute urinary retention. A Foley catheter is
placed and 1200 mL of urine is drained. One hour later, he becomes hypotensive (90/60)
and tachycardic. What is the most likely cause?
A. Hemorrhage
B. Post-obstructive diuresis
C. Myocardial infarction
D. Sepsis
Correct Answer: B
Rationale: Post-obstructive diuresis after relief of chronic retention can cause
hypotension from salt and water loss. Monitor urine output and administer IV fluids as
needed.
Question 8
A 28-year-old man presents with acute testicular pain, nausea, and vomiting. On exam,
the left testis is high-riding, horizontal, and tender. Cremasteric reflex is absent. What is
the most appropriate next step?
A. Scrotal ultrasound with Doppler
B. Immediate surgical exploration
