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NURS 5432 FNP I MIDTERM EXAM – 2026 UNIVERSITY OF
TEXAS AT ARLINGTON MODULES 1–6 FNP FOUNDATION
COMPLETE (300) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NURS
Prepare for the NURS 5432 FNP I midterm Exam with this comprehensive study
resource designed to reinforce essential family nurse practitioner concepts,
comprehensive health assessment, differential diagnosis, evidence-based
treatment planning, pharmacologic management, health promotion, disease
prevention, and primary care clinical decision-making. This document helps you
review key topics, assess your understanding, and identify areas that may require
additional study before the final exam. Use it to strengthen your advanced practice
nursing knowledge and build confidence through focused, organized preparation. An
excellent companion for successful NURS 5432 FNP I Final Exam preparation.
MULTIPLE CHOICE.
Module 1: Advanced Health Assessment & Clinical
Reasoning (Questions 1–60)
1. A 45-year-old presents with chest pain. Which historical feature most suggests
cardiac origin?
A. Sharp, localized pain worsened by palpation
B. Substernal pressure radiating to left arm, provoked by exertion
C. Pleuritic pain relieved by leaning forward
D. Burning epigastric pain after meals
Rationale: Cardiac pain is substernal, radiating, exertional.
2. Which question best screens for depression in a busy primary care visit?
A. "Are you sad?"
B. "Over the past 2 weeks, have you felt down, depressed, or hopeless?"
C. "Do you have suicidal thoughts?"
D. "How is your sleep?"
*Rationale: PHQ-2 is validated; first question screens for depression.*
3. A 60-year-old reports "dizziness." Which description most suggests vertigo?
A. Lightheadedness when standing
B. Sensation of spinning or movement
C. Feeling of impending faint
D. Floating sensation
Rationale: Vertigo = illusion of movement; distinguish from presyncope/disequilibrium.
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4. A 30-year-old with headache describes throbbing, unilateral pain with nausea,
photophobia, and preceding visual aura. Most likely diagnosis?
A. Tension headache
B. Migraine with aura
C. Cluster headache
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D. Subarachnoid hemorrhage
Rationale: Migraine: unilateral, throbbing, aura, associated symptoms.
5. Which finding on abdominal exam suggests peritonitis?
A. Hyperactive bowel sounds
B. Involuntary guarding and rebound tenderness
C. Dullness to percussion
D. Visible peristalsis
Rationale: Peritonitis = guarding, rigidity, rebound.
6. A 55-year-old with knee pain. Which maneuver tests for medial meniscus tear?
A. Lachman test
B. McMurray test
C. Anterior drawer
D. Patellar grind
Rationale: McMurray = meniscus; Lachman = ACL.
7. A 70-year-old with hearing loss. Weber test lateralizes to right ear; Rinne shows AC >
BC bilaterally. Interpretation?
A. Right sensorineural loss
B. Left sensorineural loss
C. Right conductive loss
D. Normal
Rationale: Weber lateralizes to affected ear in conductive loss, away in sensorineural. AC >
BC normal. Lateralizes to right = right conductive or left sensorineural. AC > BC normal =
left sensorineural.
8. A patient has a blood pressure of 150/95 in right arm, 130/80 in left arm. This
suggests?
A. Normal variant
B. Subclavian artery stenosis or aortic dissection
C. Coarctation of aorta
D. Technical error
Rationale: >15 mmHg difference suggests arterial obstruction.
9. Which murmur is best heard at the left lower sternal border with the patient leaning
forward?
A. Mitral stenosis
B. Aortic regurgitation
C. Pulmonic stenosis
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D. Tricuspid regurgitation
Rationale: AR best heard at LLSB with patient leaning forward, end-expiration.
10. A 25-year-old with palpitations. ECG shows narrow QRS tachycardia, regular, rate
180. Patient is stable. Most likely rhythm?
A. Atrial fibrillation
B. SVT (AV nodal reentry)
C. Ventricular tachycardia
D. Atrial flutter
Rationale: Regular narrow complex tachycardia = SVT until proven otherwise.
11. Which finding on fundoscopic exam is most concerning for hypertensive
emergency?
A. Arteriovenous nicking
B. Papilledema
C. Copper wiring
D. Microaneurysms
Rationale: Papilledema = optic disc swelling = hypertensive emergency.
12. A 40-year-old with acute low back pain after lifting. No red flags. Best initial
management?
A. MRI spine
B. NSAIDs, heat, activity as tolerated
C. Bed rest for 3 days
D. Opioid analgesics
Rationale: Acute mechanical back pain: conservative care; imaging not indicated without
red flags.
13. Which finding on musculoskeletal exam suggests a rotator cuff tear?
A. Positive Phalen test
B. Positive drop arm test
C. Positive Finkelstein test
D. Positive Tinel sign at elbow
Rationale: Drop arm test = inability to maintain abduction = rotator cuff tear.
14. A 65-year-old with chronic cough. Which finding on lung exam suggests COPD?
A. Bronchial breath sounds
B. Prolonged expiratory phase with wheezes
C. Crackles at bases
D. Egophony
Rationale: COPD: prolonged expiration, wheezing, hyperinflation.
NURS 5432 FNP I MIDTERM EXAM – 2026 UNIVERSITY OF
TEXAS AT ARLINGTON MODULES 1–6 FNP FOUNDATION
COMPLETE (300) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NURS
Prepare for the NURS 5432 FNP I midterm Exam with this comprehensive study
resource designed to reinforce essential family nurse practitioner concepts,
comprehensive health assessment, differential diagnosis, evidence-based
treatment planning, pharmacologic management, health promotion, disease
prevention, and primary care clinical decision-making. This document helps you
review key topics, assess your understanding, and identify areas that may require
additional study before the final exam. Use it to strengthen your advanced practice
nursing knowledge and build confidence through focused, organized preparation. An
excellent companion for successful NURS 5432 FNP I Final Exam preparation.
MULTIPLE CHOICE.
Module 1: Advanced Health Assessment & Clinical
Reasoning (Questions 1–60)
1. A 45-year-old presents with chest pain. Which historical feature most suggests
cardiac origin?
A. Sharp, localized pain worsened by palpation
B. Substernal pressure radiating to left arm, provoked by exertion
C. Pleuritic pain relieved by leaning forward
D. Burning epigastric pain after meals
Rationale: Cardiac pain is substernal, radiating, exertional.
2. Which question best screens for depression in a busy primary care visit?
A. "Are you sad?"
B. "Over the past 2 weeks, have you felt down, depressed, or hopeless?"
C. "Do you have suicidal thoughts?"
D. "How is your sleep?"
*Rationale: PHQ-2 is validated; first question screens for depression.*
3. A 60-year-old reports "dizziness." Which description most suggests vertigo?
A. Lightheadedness when standing
B. Sensation of spinning or movement
C. Feeling of impending faint
D. Floating sensation
Rationale: Vertigo = illusion of movement; distinguish from presyncope/disequilibrium.
, Page 2 of 56
4. A 30-year-old with headache describes throbbing, unilateral pain with nausea,
photophobia, and preceding visual aura. Most likely diagnosis?
A. Tension headache
B. Migraine with aura
C. Cluster headache
, Page 3 of 56
D. Subarachnoid hemorrhage
Rationale: Migraine: unilateral, throbbing, aura, associated symptoms.
5. Which finding on abdominal exam suggests peritonitis?
A. Hyperactive bowel sounds
B. Involuntary guarding and rebound tenderness
C. Dullness to percussion
D. Visible peristalsis
Rationale: Peritonitis = guarding, rigidity, rebound.
6. A 55-year-old with knee pain. Which maneuver tests for medial meniscus tear?
A. Lachman test
B. McMurray test
C. Anterior drawer
D. Patellar grind
Rationale: McMurray = meniscus; Lachman = ACL.
7. A 70-year-old with hearing loss. Weber test lateralizes to right ear; Rinne shows AC >
BC bilaterally. Interpretation?
A. Right sensorineural loss
B. Left sensorineural loss
C. Right conductive loss
D. Normal
Rationale: Weber lateralizes to affected ear in conductive loss, away in sensorineural. AC >
BC normal. Lateralizes to right = right conductive or left sensorineural. AC > BC normal =
left sensorineural.
8. A patient has a blood pressure of 150/95 in right arm, 130/80 in left arm. This
suggests?
A. Normal variant
B. Subclavian artery stenosis or aortic dissection
C. Coarctation of aorta
D. Technical error
Rationale: >15 mmHg difference suggests arterial obstruction.
9. Which murmur is best heard at the left lower sternal border with the patient leaning
forward?
A. Mitral stenosis
B. Aortic regurgitation
C. Pulmonic stenosis
, Page 4 of 56
D. Tricuspid regurgitation
Rationale: AR best heard at LLSB with patient leaning forward, end-expiration.
10. A 25-year-old with palpitations. ECG shows narrow QRS tachycardia, regular, rate
180. Patient is stable. Most likely rhythm?
A. Atrial fibrillation
B. SVT (AV nodal reentry)
C. Ventricular tachycardia
D. Atrial flutter
Rationale: Regular narrow complex tachycardia = SVT until proven otherwise.
11. Which finding on fundoscopic exam is most concerning for hypertensive
emergency?
A. Arteriovenous nicking
B. Papilledema
C. Copper wiring
D. Microaneurysms
Rationale: Papilledema = optic disc swelling = hypertensive emergency.
12. A 40-year-old with acute low back pain after lifting. No red flags. Best initial
management?
A. MRI spine
B. NSAIDs, heat, activity as tolerated
C. Bed rest for 3 days
D. Opioid analgesics
Rationale: Acute mechanical back pain: conservative care; imaging not indicated without
red flags.
13. Which finding on musculoskeletal exam suggests a rotator cuff tear?
A. Positive Phalen test
B. Positive drop arm test
C. Positive Finkelstein test
D. Positive Tinel sign at elbow
Rationale: Drop arm test = inability to maintain abduction = rotator cuff tear.
14. A 65-year-old with chronic cough. Which finding on lung exam suggests COPD?
A. Bronchial breath sounds
B. Prolonged expiratory phase with wheezes
C. Crackles at bases
D. Egophony
Rationale: COPD: prolonged expiration, wheezing, hyperinflation.
