NR 667 WEEK 8 MASTER EXAM REVIEW 2026/2027 | FNP CAPSTONE
PRACTICUM & INTENSIVE CEA | EXAM STYLE V1 | COMPLETE EXAM
PREPARATION | MOST TESTED FNP CONCEPTS | PRACTICE Q&A |
DETAILED RATIONALES
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 NR 667 WEEK 8 ACTUAL EXAM STYLE V1 — FNP CAPSTONE PRACTICUM AND INTENSIVE CEA
Page 1
,Q1 A 62-year-old male with a history of hypertension and type 2 diabetes presents...
A 62-year-old male with a history of hypertension and type 2 diabetes presents with substernal
chest pressure that occurs with exertion and is relieved by rest. He describes the pain as "heavy"
and radiating to his left jaw. What is the most likely diagnosis?
A) Gastroesophageal reflux disease
B) Musculoskeletal chest pain
C) Stable angina pectoris CORRECT
D) Pericarditis
Rationale
Stable angina is characterized by substernal chest pressure or discomfort that is provoked by exertion or
emotional stress and relieved by rest or nitroglycerin. The radiation to the jaw is a classic feature. GERD
typically causes burning pain after meals; pericarditis pain is pleuritic and improves with leaning forward.
---
Q2 A 55-year-old female presents with acute onset of severe, tearing chest pain...
A 55-year-old female presents with acute onset of severe, tearing chest pain radiating to the back.
Her blood pressure is 160/90 mmHg in the right arm and 110/70 mmHg in the left arm. What is the
most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection CORRECT
C) Pulmonary embolism
D) Pericarditis
Rationale
Aortic dissection presents with severe, tearing chest pain radiating to the back, often with a pulse deficit
or blood pressure discrepancy between arms. This is a life-threatening emergency requiring immediate
imaging and surgical consultation. A blood pressure difference of >20 mmHg between arms is a key
clinical clue. ---
Page 2
,Q3 A 68-year-old patient with heart failure with reduced ejection fraction...
A 68-year-old patient with heart failure with reduced ejection fraction (HFrEF) is being managed
with a beta-blocker, ACE inhibitor, and loop diuretic. Which medication should be added to
reduce mortality in HFrEF?
A) Digoxin
B) Sacubitril/valsartan (Entresto) CORRECT
C) Amlodipine
D) Spironolactone
Rationale
Sacubitril/valsartan is a first-line therapy for HFrEF that has been shown to reduce cardiovascular
mortality and heart failure hospitalizations compared to ACE inhibitors alone. It should replace an ACE
inhibitor in patients with NYHA class II-IV HFrEF. ---
Q4 A 72-year-old patient with a history of atrial fibrillation is on warfarin for...
A 72-year-old patient with a history of atrial fibrillation is on warfarin for stroke prevention. Her
INR is 4.8. She has no signs of bleeding. What is the most appropriate management?
A) Administer vitamin K 10 mg IV
B) Hold warfarin and monitor INR CORRECT
C) Increase the warfarin dose
D) Administer fresh frozen plasma
Rationale
For an INR between 4.0 and 5.0 without bleeding, the recommended approach is to hold the warfarin
and monitor the INR. Vitamin K is indicated for INR >5.0 without bleeding or for any INR with bleeding.
Fresh frozen plasma is reserved for life-threatening bleeding. ---
Q5 A 45-year-old patient with hypertension has a blood pressure of 150/95 mmHg....
A 45-year-old patient with hypertension has a blood pressure of 150/95 mmHg. Laboratory
studies show microalbuminuria. Which antihypertensive class is preferred for this patient?
A) Thiazide diuretic
B) Calcium channel blocker
Page 3
, C) ACE inhibitor or ARB CORRECT
D) Beta-blocker
Rationale
ACE inhibitors and ARBs are preferred in patients with hypertension and microalbuminuria because they
slow the progression of diabetic nephropathy and reduce proteinuria. They are renoprotective. ---
Q6 A 60-year-old patient with hyperlipidemia is started on atorvastatin
A 60-year-old patient with hyperlipidemia is started on atorvastatin. What laboratory test should
be monitored at baseline and periodically?
A) Complete blood count
B) Serum creatinine
C) Liver function tests (LFTs) CORRECT
D) Thyroid function tests
Rationale
Statins can cause hepatotoxicity, and liver function tests should be monitored at baseline and periodically
during treatment. The patient should also be monitored for muscle pain or weakness (myalgia) and
elevated creatine kinase. ---
Q7 A 55-year-old patient with heart failure presents with worsening dyspnea,...
A 55-year-old patient with heart failure presents with worsening dyspnea, orthopnea, and
peripheral edema. On examination, you note crackles in the lung bases, elevated JVP, and an S3
gallop. What is the most appropriate initial intervention?
A) Increase the beta-blocker dose
B) Administer IV diuretics CORRECT
C) Start an ACE inhibitor
D) Obtain an echocardiogram
Rationale
Acute decompensated heart failure with volume overload requires immediate diuresis. IV loop diuretics
(e.g., furosemide) are the first-line treatment to reduce preload and relieve pulmonary congestion. ---
Page 4
PRACTICUM & INTENSIVE CEA | EXAM STYLE V1 | COMPLETE EXAM
PREPARATION | MOST TESTED FNP CONCEPTS | PRACTICE Q&A |
DETAILED RATIONALES
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 NR 667 WEEK 8 ACTUAL EXAM STYLE V1 — FNP CAPSTONE PRACTICUM AND INTENSIVE CEA
Page 1
,Q1 A 62-year-old male with a history of hypertension and type 2 diabetes presents...
A 62-year-old male with a history of hypertension and type 2 diabetes presents with substernal
chest pressure that occurs with exertion and is relieved by rest. He describes the pain as "heavy"
and radiating to his left jaw. What is the most likely diagnosis?
A) Gastroesophageal reflux disease
B) Musculoskeletal chest pain
C) Stable angina pectoris CORRECT
D) Pericarditis
Rationale
Stable angina is characterized by substernal chest pressure or discomfort that is provoked by exertion or
emotional stress and relieved by rest or nitroglycerin. The radiation to the jaw is a classic feature. GERD
typically causes burning pain after meals; pericarditis pain is pleuritic and improves with leaning forward.
---
Q2 A 55-year-old female presents with acute onset of severe, tearing chest pain...
A 55-year-old female presents with acute onset of severe, tearing chest pain radiating to the back.
Her blood pressure is 160/90 mmHg in the right arm and 110/70 mmHg in the left arm. What is the
most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection CORRECT
C) Pulmonary embolism
D) Pericarditis
Rationale
Aortic dissection presents with severe, tearing chest pain radiating to the back, often with a pulse deficit
or blood pressure discrepancy between arms. This is a life-threatening emergency requiring immediate
imaging and surgical consultation. A blood pressure difference of >20 mmHg between arms is a key
clinical clue. ---
Page 2
,Q3 A 68-year-old patient with heart failure with reduced ejection fraction...
A 68-year-old patient with heart failure with reduced ejection fraction (HFrEF) is being managed
with a beta-blocker, ACE inhibitor, and loop diuretic. Which medication should be added to
reduce mortality in HFrEF?
A) Digoxin
B) Sacubitril/valsartan (Entresto) CORRECT
C) Amlodipine
D) Spironolactone
Rationale
Sacubitril/valsartan is a first-line therapy for HFrEF that has been shown to reduce cardiovascular
mortality and heart failure hospitalizations compared to ACE inhibitors alone. It should replace an ACE
inhibitor in patients with NYHA class II-IV HFrEF. ---
Q4 A 72-year-old patient with a history of atrial fibrillation is on warfarin for...
A 72-year-old patient with a history of atrial fibrillation is on warfarin for stroke prevention. Her
INR is 4.8. She has no signs of bleeding. What is the most appropriate management?
A) Administer vitamin K 10 mg IV
B) Hold warfarin and monitor INR CORRECT
C) Increase the warfarin dose
D) Administer fresh frozen plasma
Rationale
For an INR between 4.0 and 5.0 without bleeding, the recommended approach is to hold the warfarin
and monitor the INR. Vitamin K is indicated for INR >5.0 without bleeding or for any INR with bleeding.
Fresh frozen plasma is reserved for life-threatening bleeding. ---
Q5 A 45-year-old patient with hypertension has a blood pressure of 150/95 mmHg....
A 45-year-old patient with hypertension has a blood pressure of 150/95 mmHg. Laboratory
studies show microalbuminuria. Which antihypertensive class is preferred for this patient?
A) Thiazide diuretic
B) Calcium channel blocker
Page 3
, C) ACE inhibitor or ARB CORRECT
D) Beta-blocker
Rationale
ACE inhibitors and ARBs are preferred in patients with hypertension and microalbuminuria because they
slow the progression of diabetic nephropathy and reduce proteinuria. They are renoprotective. ---
Q6 A 60-year-old patient with hyperlipidemia is started on atorvastatin
A 60-year-old patient with hyperlipidemia is started on atorvastatin. What laboratory test should
be monitored at baseline and periodically?
A) Complete blood count
B) Serum creatinine
C) Liver function tests (LFTs) CORRECT
D) Thyroid function tests
Rationale
Statins can cause hepatotoxicity, and liver function tests should be monitored at baseline and periodically
during treatment. The patient should also be monitored for muscle pain or weakness (myalgia) and
elevated creatine kinase. ---
Q7 A 55-year-old patient with heart failure presents with worsening dyspnea,...
A 55-year-old patient with heart failure presents with worsening dyspnea, orthopnea, and
peripheral edema. On examination, you note crackles in the lung bases, elevated JVP, and an S3
gallop. What is the most appropriate initial intervention?
A) Increase the beta-blocker dose
B) Administer IV diuretics CORRECT
C) Start an ACE inhibitor
D) Obtain an echocardiogram
Rationale
Acute decompensated heart failure with volume overload requires immediate diuresis. IV loop diuretics
(e.g., furosemide) are the first-line treatment to reduce preload and relieve pulmonary congestion. ---
Page 4
