NR 667 CEA Advanced FNP Capstone Practice Exam |
(Chamberlain University FNP Capstone Practicum)
Practice Test with Actual Exam Questions, Verified
Correct Answers and Detailed Rationales | Latest
Update 2026/2027(Brand New!!) | Already Graded A+
Question 1
Your patient has been noticing cracking and peeling on their hands and having some
vesicular rash component. Which of the following is not likely the diagnosis?
A. Dyshidrotic eczema
B. Psoriasis
C. Pompholyx
D. Palmoplantar eczema
Answer: B
Rationale: Dyshidrotic eczema, pompholyx, and palmoplantar eczema all present with
vesicular lesions, cracking, and peeling on the hands and feet. Psoriasis typically presents
with well-demarcated, erythematous plaques with silvery scale, not vesicular rash.
Therefore, psoriasis is least likely.
Question 2
You are admitting an otherwise healthy 67-year-old female patient with a leading diagnosis
of hypotension. She has a history of palmar dyshidrotic eczema who has been taking
mometasone ointment for over a month. She reports stopping this medication a few days
prior to admission. With this information, what is the likely diagnosis of her admission?
A. Dehydration
B. Suppression of the adrenal glands causing Cushing syndrome
C. Acute heart failure
D. Suppression of the HPA axis causing an Addisonian crisis
Answer: D
Rationale: Prolonged use of topical corticosteroids (mometasone) can suppress the
hypothalamic-pituitary-adrenal (HPA) axis. Abrupt discontinuation can precipitate an
Addisonian crisis with hypotension. This is a classic presentation of adrenal insufficiency
secondary to exogenous steroid use.
1
,Question 3
5-year-old boy is brought to the clinic with a rash that started on his face and spread to the
trunk. The rash is described as "slapped cheek" appearance. What is the most likely
diagnosis?
A. Roseola
B. Measles
C. Rubella
D. Fifth disease
Answer: D
Rationale: Fifth disease (erythema infectiosum) is caused by parvovirus B19 and presents
with a "slapped cheek" rash on the face that spreads to the trunk and limbs in a lacy pattern.
Roseola presents with high fever followed by a rose-colored rash. Measles presents with
Koplik spots and a descending rash. Rubella presents with a fine pink rash starting on the
face.
Question 4
A patient who has active herpes zoster is at risk of shedding which contagious virus?
A. Varicella zoster
B. Herpes simplex virus-2
C. Herpes simplex virus-1
D. Shingles
Answer: A
Rationale: Herpes zoster (shingles) is caused by reactivation of varicella-zoster virus
(VZV). Active lesions can shed VZV, which can cause chickenpox in susceptible
individuals. Shingles is the clinical manifestation, not the virus itself.
Question 5
Patients presenting to the emergency department with hematuria and RBC casts in their
urine should be considered for which diagnosis?
A. Acute tubular necrosis
B. Pyelonephritis
C. Glomerulonephritis
D. Nephrotic syndrome
Answer: C
Rationale: RBC casts are highly specific for glomerulonephritis. They indicate bleeding
within the glomerulus. Acute tubular necrosis causes muddy brown casts. Pyelonephritis
causes WBC casts. Nephrotic syndrome causes fatty casts and proteinuria.
2
,Question 6
Your patient has evidence of Kerley B lines. Which of the following diagnoses might this
suggest?
A. Congestive heart failure
B. Sarcoidosis
C. COVID-19 pneumonia
D. Porphyrea
Answer: A
Rationale: Kerley B lines are horizontal lines seen on chest X-ray at the lung bases,
representing thickened interlobular septa due to interstitial edema. They are a classic sign of
congestive heart failure. Sarcoidosis, COVID-19 pneumonia, and porphyria do not typically
cause Kerley B lines.
Question 7
A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary
hormones can cause immediate hemodynamic instability and has a risk of death. Which is
the most critical hormone deficiency to rule out?
A. Prolactin
B. TSH
C. ACTH
D. FSH/LH
Answer: C
Rationale: ACTH deficiency causes adrenal insufficiency (Addisonian crisis) with
hypotension, hemodynamic instability, and risk of death. Prolactin, TSH, and FSH/LH
deficiencies do not cause immediate life-threatening hemodynamic instability.
Question 8
A patient is having increased thirst and urination. You have ruled out diabetes mellitus.
After a complete history and physical you suspect diabetes insipidus. Your initial lab tests
should include?
A. Plasma sodium, 24-hour urine osmolality and volume
B. Recording Intake and output
C. Plasma sodium and renal US
D. Renal US and 24-hour urine for volume
Answer: A
Rationale: Diabetes insipidus is evaluated with plasma sodium (often elevated), 24-hour
urine osmolality (low), and volume (high). A water deprivation test may follow. Renal
ultrasound is not the initial test.
3
, Question 9
29-year-old male presents with severe abdominal pain, he has a history of alcohol abuse,
and recurrent pancreatitis. Patient's Lipase is elevated, and he has nausea and vomiting as
well. Abdominal CT shows inflammatory changes around the pancreas. What is the most
important intervention to consider in the acute phase?
A. Admit to the hospital for fluid resuscitation to avoid hypovolemic state, and reduce risk
of developing further complications
B. Amitriptyline (Elavil) 25 mg oral once daily
Answer: A
Rationale: Acute pancreatitis management prioritizes aggressive fluid resuscitation to
prevent hypovolemia, shock, and organ failure. Pain control and bowel rest are also
important. Amitriptyline is for chronic pain, not acute management.
Question 10
Your 24-year-old male patient has been admitted post-motor vehicle collision at a high rate
of speed. A CT head is performed revealing a pyramidal fracture involving the lateral walls
of the maxillary sinuses and inferior orbital rim. Which classification of fracture is this?
A. Le Fort II
B. Le Fort III
C. Le Fort I
D. Le Fort IV
Answer: A
Rationale: Le Fort II fracture involves the pyramidal fracture through the maxilla,
including the lateral walls of the maxillary sinuses and inferior orbital rim. Le Fort I is a
horizontal fracture above the teeth. Le Fort III is craniofacial separation. Le Fort IV is not a
standard classification.
Question 11
Adult patient with left lower quadrant abdominal pain dx with diverticulitis. No allergies.
Following is tx of choice:
A. Keflex
B. Prednisone
C. Medrol
D. Bactrim
Answer: A
Rationale: Keflex (cephalexin) is a first-generation cephalosporin used for uncomplicated
4
(Chamberlain University FNP Capstone Practicum)
Practice Test with Actual Exam Questions, Verified
Correct Answers and Detailed Rationales | Latest
Update 2026/2027(Brand New!!) | Already Graded A+
Question 1
Your patient has been noticing cracking and peeling on their hands and having some
vesicular rash component. Which of the following is not likely the diagnosis?
A. Dyshidrotic eczema
B. Psoriasis
C. Pompholyx
D. Palmoplantar eczema
Answer: B
Rationale: Dyshidrotic eczema, pompholyx, and palmoplantar eczema all present with
vesicular lesions, cracking, and peeling on the hands and feet. Psoriasis typically presents
with well-demarcated, erythematous plaques with silvery scale, not vesicular rash.
Therefore, psoriasis is least likely.
Question 2
You are admitting an otherwise healthy 67-year-old female patient with a leading diagnosis
of hypotension. She has a history of palmar dyshidrotic eczema who has been taking
mometasone ointment for over a month. She reports stopping this medication a few days
prior to admission. With this information, what is the likely diagnosis of her admission?
A. Dehydration
B. Suppression of the adrenal glands causing Cushing syndrome
C. Acute heart failure
D. Suppression of the HPA axis causing an Addisonian crisis
Answer: D
Rationale: Prolonged use of topical corticosteroids (mometasone) can suppress the
hypothalamic-pituitary-adrenal (HPA) axis. Abrupt discontinuation can precipitate an
Addisonian crisis with hypotension. This is a classic presentation of adrenal insufficiency
secondary to exogenous steroid use.
1
,Question 3
5-year-old boy is brought to the clinic with a rash that started on his face and spread to the
trunk. The rash is described as "slapped cheek" appearance. What is the most likely
diagnosis?
A. Roseola
B. Measles
C. Rubella
D. Fifth disease
Answer: D
Rationale: Fifth disease (erythema infectiosum) is caused by parvovirus B19 and presents
with a "slapped cheek" rash on the face that spreads to the trunk and limbs in a lacy pattern.
Roseola presents with high fever followed by a rose-colored rash. Measles presents with
Koplik spots and a descending rash. Rubella presents with a fine pink rash starting on the
face.
Question 4
A patient who has active herpes zoster is at risk of shedding which contagious virus?
A. Varicella zoster
B. Herpes simplex virus-2
C. Herpes simplex virus-1
D. Shingles
Answer: A
Rationale: Herpes zoster (shingles) is caused by reactivation of varicella-zoster virus
(VZV). Active lesions can shed VZV, which can cause chickenpox in susceptible
individuals. Shingles is the clinical manifestation, not the virus itself.
Question 5
Patients presenting to the emergency department with hematuria and RBC casts in their
urine should be considered for which diagnosis?
A. Acute tubular necrosis
B. Pyelonephritis
C. Glomerulonephritis
D. Nephrotic syndrome
Answer: C
Rationale: RBC casts are highly specific for glomerulonephritis. They indicate bleeding
within the glomerulus. Acute tubular necrosis causes muddy brown casts. Pyelonephritis
causes WBC casts. Nephrotic syndrome causes fatty casts and proteinuria.
2
,Question 6
Your patient has evidence of Kerley B lines. Which of the following diagnoses might this
suggest?
A. Congestive heart failure
B. Sarcoidosis
C. COVID-19 pneumonia
D. Porphyrea
Answer: A
Rationale: Kerley B lines are horizontal lines seen on chest X-ray at the lung bases,
representing thickened interlobular septa due to interstitial edema. They are a classic sign of
congestive heart failure. Sarcoidosis, COVID-19 pneumonia, and porphyria do not typically
cause Kerley B lines.
Question 7
A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary
hormones can cause immediate hemodynamic instability and has a risk of death. Which is
the most critical hormone deficiency to rule out?
A. Prolactin
B. TSH
C. ACTH
D. FSH/LH
Answer: C
Rationale: ACTH deficiency causes adrenal insufficiency (Addisonian crisis) with
hypotension, hemodynamic instability, and risk of death. Prolactin, TSH, and FSH/LH
deficiencies do not cause immediate life-threatening hemodynamic instability.
Question 8
A patient is having increased thirst and urination. You have ruled out diabetes mellitus.
After a complete history and physical you suspect diabetes insipidus. Your initial lab tests
should include?
A. Plasma sodium, 24-hour urine osmolality and volume
B. Recording Intake and output
C. Plasma sodium and renal US
D. Renal US and 24-hour urine for volume
Answer: A
Rationale: Diabetes insipidus is evaluated with plasma sodium (often elevated), 24-hour
urine osmolality (low), and volume (high). A water deprivation test may follow. Renal
ultrasound is not the initial test.
3
, Question 9
29-year-old male presents with severe abdominal pain, he has a history of alcohol abuse,
and recurrent pancreatitis. Patient's Lipase is elevated, and he has nausea and vomiting as
well. Abdominal CT shows inflammatory changes around the pancreas. What is the most
important intervention to consider in the acute phase?
A. Admit to the hospital for fluid resuscitation to avoid hypovolemic state, and reduce risk
of developing further complications
B. Amitriptyline (Elavil) 25 mg oral once daily
Answer: A
Rationale: Acute pancreatitis management prioritizes aggressive fluid resuscitation to
prevent hypovolemia, shock, and organ failure. Pain control and bowel rest are also
important. Amitriptyline is for chronic pain, not acute management.
Question 10
Your 24-year-old male patient has been admitted post-motor vehicle collision at a high rate
of speed. A CT head is performed revealing a pyramidal fracture involving the lateral walls
of the maxillary sinuses and inferior orbital rim. Which classification of fracture is this?
A. Le Fort II
B. Le Fort III
C. Le Fort I
D. Le Fort IV
Answer: A
Rationale: Le Fort II fracture involves the pyramidal fracture through the maxilla,
including the lateral walls of the maxillary sinuses and inferior orbital rim. Le Fort I is a
horizontal fracture above the teeth. Le Fort III is craniofacial separation. Le Fort IV is not a
standard classification.
Question 11
Adult patient with left lower quadrant abdominal pain dx with diverticulitis. No allergies.
Following is tx of choice:
A. Keflex
B. Prednisone
C. Medrol
D. Bactrim
Answer: A
Rationale: Keflex (cephalexin) is a first-generation cephalosporin used for uncomplicated
4
