NURS 5433 Family 2 FNP FINAL EXAM
QUESTION AND ANSWER FALL 2025/26 -
THE UNIVERSITY OF TEXAS AT
ARLINGTON
Section 1: Pharmacology & Medication Management
1. A patient is prescribed a medication eliminated primarily by the kidneys. Which
change would most likely require a dosage adjustment?
A) Increased age
B) History of heavy alcohol use
C) Elevated liver enzymes
D) Presence of a urinary tract infection
Answer: A
Rationale: Kidney function declines with age. For drugs eliminated renally, decreased
clearance in older patients requires a dosage adjustment to prevent toxicity. Liver
function and alcohol history are not primary concerns for renally eliminated drugs, and a
UTI does not typically alter systemic drug clearance.
2. Which is the primary mechanism of action for Penicillins?
A) Inhibiting bacterial protein synthesis
B) Inhibiting bacterial DNA synthesis
C) Inhibiting bacterial cell wall synthesis
D) Disrupting bacterial cell membrane integrity
Answer: C
Rationale: Penicillins inhibit bacterial cell wall synthesis by binding to and activating
,enzymes essential for cell wall function. This makes them particularly effective against
gram-positive bacteria.
3. The most serious adverse effect of ACE inhibitors requiring immediate
discontinuation is:
A) Dry cough
B) Angioedema
C) Hypotension
D) Hyperkalemia
Answer: B
Rationale: Angioedema is a potentially life-threatening reaction to ACE inhibitors
involving rapid swelling of deep dermal, subcutaneous, or mucosal tissue. While a dry
cough is a common side effect, it does not necessitate immediate discontinuation unless
severe.
4. A patient presents with a suspected UTI. Which first-line antibiotic is most
appropriate for an uncomplicated UTI in a non-pregnant female?
A) Ciprofloxacin
B) Nitrofurantoin
C) Azithromycin
D) Cephalexin
Answer: B
Rationale: According to IDSA guidelines, nitrofurantoin is a first-line agent for
uncomplicated cystitis due to its narrow spectrum and low resistance rates.
Fluoroquinolones are reserved for more complicated cases.
5. A patient newly prescribed warfarin should be warned about increasing intake
of which food?
A) Grapefruit juice
B) Dark green, leafy vegetables
C) Dairy products
D) Complex carbohydrates
,Answer: B
Rationale: Dark green vegetables are high in Vitamin K, which directly antagonizes the
effects of warfarin. Patients should maintain a consistent intake to keep the INR stable.
6. Which medication class is most appropriate as first-line therapy for a patient
with persistent asthma?
A) Inhaled corticosteroids (ICS)
B) Short-acting beta-agonists (SABA)
C) Leukotriene receptor antagonists
D) Oral corticosteroids
Answer: A
Rationale: Inhaled corticosteroids are the most effective long-term control medication
for persistent asthma. SABAs are used for quick relief, and oral corticosteroids are
reserved for exacerbations.
7. A patient with type 2 diabetes and a BMI of 32 is started on metformin. What is
the primary goal of this therapy?
A) Increase insulin secretion
B) Decrease hepatic glucose production
C) Increase glucose absorption in the gut
D) Slow carbohydrate digestion
Answer: B
Rationale: Metformin works primarily by decreasing hepatic glucose production and
improving insulin sensitivity. It does not directly stimulate insulin secretion.
8. Which laboratory value should be monitored closely in a patient taking an
SGLT2 inhibitor?
A) Potassium
B) Serum creatinine
C) INR
D) Platelet count
Answer: B
, Rationale: SGLT2 inhibitors can cause a temporary decline in renal function. Monitoring
serum creatinine and eGFR is recommended, especially after initiation.
9. A patient on levothyroxine reports fatigue and weight gain. Which instruction is
most important to reinforce?
A) Take the medication with food
B) Take the medication at bedtime
C) Take the medication on an empty stomach
D) Double the dose if a dose is missed
Answer: C
Rationale: Levothyroxine absorption is enhanced when taken on an empty stomach, 30-
60 minutes before breakfast. Taking it with food can significantly reduce absorption.
10. Which adverse effect is most characteristic of long-term corticosteroid use?
A) Weight loss
B) Hypotension
C) Osteoporosis
D) Bradycardia
Answer: C
Rationale: Long-term corticosteroid use is associated with decreased bone density and
osteoporosis, along with other effects like weight gain, hypertension, and
hyperglycemia.
11. A patient with heart failure is prescribed furosemide. Which electrolyte
imbalance is of greatest concern?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Answer: B
Rationale: Loop diuretics like furosemide cause significant potassium loss, leading to
hypokalemia, which can increase the risk of arrhythmias in heart failure patients.
QUESTION AND ANSWER FALL 2025/26 -
THE UNIVERSITY OF TEXAS AT
ARLINGTON
Section 1: Pharmacology & Medication Management
1. A patient is prescribed a medication eliminated primarily by the kidneys. Which
change would most likely require a dosage adjustment?
A) Increased age
B) History of heavy alcohol use
C) Elevated liver enzymes
D) Presence of a urinary tract infection
Answer: A
Rationale: Kidney function declines with age. For drugs eliminated renally, decreased
clearance in older patients requires a dosage adjustment to prevent toxicity. Liver
function and alcohol history are not primary concerns for renally eliminated drugs, and a
UTI does not typically alter systemic drug clearance.
2. Which is the primary mechanism of action for Penicillins?
A) Inhibiting bacterial protein synthesis
B) Inhibiting bacterial DNA synthesis
C) Inhibiting bacterial cell wall synthesis
D) Disrupting bacterial cell membrane integrity
Answer: C
Rationale: Penicillins inhibit bacterial cell wall synthesis by binding to and activating
,enzymes essential for cell wall function. This makes them particularly effective against
gram-positive bacteria.
3. The most serious adverse effect of ACE inhibitors requiring immediate
discontinuation is:
A) Dry cough
B) Angioedema
C) Hypotension
D) Hyperkalemia
Answer: B
Rationale: Angioedema is a potentially life-threatening reaction to ACE inhibitors
involving rapid swelling of deep dermal, subcutaneous, or mucosal tissue. While a dry
cough is a common side effect, it does not necessitate immediate discontinuation unless
severe.
4. A patient presents with a suspected UTI. Which first-line antibiotic is most
appropriate for an uncomplicated UTI in a non-pregnant female?
A) Ciprofloxacin
B) Nitrofurantoin
C) Azithromycin
D) Cephalexin
Answer: B
Rationale: According to IDSA guidelines, nitrofurantoin is a first-line agent for
uncomplicated cystitis due to its narrow spectrum and low resistance rates.
Fluoroquinolones are reserved for more complicated cases.
5. A patient newly prescribed warfarin should be warned about increasing intake
of which food?
A) Grapefruit juice
B) Dark green, leafy vegetables
C) Dairy products
D) Complex carbohydrates
,Answer: B
Rationale: Dark green vegetables are high in Vitamin K, which directly antagonizes the
effects of warfarin. Patients should maintain a consistent intake to keep the INR stable.
6. Which medication class is most appropriate as first-line therapy for a patient
with persistent asthma?
A) Inhaled corticosteroids (ICS)
B) Short-acting beta-agonists (SABA)
C) Leukotriene receptor antagonists
D) Oral corticosteroids
Answer: A
Rationale: Inhaled corticosteroids are the most effective long-term control medication
for persistent asthma. SABAs are used for quick relief, and oral corticosteroids are
reserved for exacerbations.
7. A patient with type 2 diabetes and a BMI of 32 is started on metformin. What is
the primary goal of this therapy?
A) Increase insulin secretion
B) Decrease hepatic glucose production
C) Increase glucose absorption in the gut
D) Slow carbohydrate digestion
Answer: B
Rationale: Metformin works primarily by decreasing hepatic glucose production and
improving insulin sensitivity. It does not directly stimulate insulin secretion.
8. Which laboratory value should be monitored closely in a patient taking an
SGLT2 inhibitor?
A) Potassium
B) Serum creatinine
C) INR
D) Platelet count
Answer: B
, Rationale: SGLT2 inhibitors can cause a temporary decline in renal function. Monitoring
serum creatinine and eGFR is recommended, especially after initiation.
9. A patient on levothyroxine reports fatigue and weight gain. Which instruction is
most important to reinforce?
A) Take the medication with food
B) Take the medication at bedtime
C) Take the medication on an empty stomach
D) Double the dose if a dose is missed
Answer: C
Rationale: Levothyroxine absorption is enhanced when taken on an empty stomach, 30-
60 minutes before breakfast. Taking it with food can significantly reduce absorption.
10. Which adverse effect is most characteristic of long-term corticosteroid use?
A) Weight loss
B) Hypotension
C) Osteoporosis
D) Bradycardia
Answer: C
Rationale: Long-term corticosteroid use is associated with decreased bone density and
osteoporosis, along with other effects like weight gain, hypertension, and
hyperglycemia.
11. A patient with heart failure is prescribed furosemide. Which electrolyte
imbalance is of greatest concern?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Answer: B
Rationale: Loop diuretics like furosemide cause significant potassium loss, leading to
hypokalemia, which can increase the risk of arrhythmias in heart failure patients.
