CMN 574 ADVANCED CLINICAL
MANAGEMENT FINAL EXAM 2026/2027
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A 62-year-old patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently
taking Lisinopril and Metoprolol Succinate. Despite therapy, the patient remains NYHA Class
II. What is the most appropriate next step according to the latest clinical guidelines?
A. Increase the dose of Metoprolol Succinate to maximum tolerance
B. Initiate Ivabradine
C. Add Digoxin for symptom management
D. Switch Lisinopril to Sacubitril/Valsartan (ARNI)
Answer: D
Conceptual Explanation: Current guidelines recommend switching an ACE inhibitor or
ARB to an ARNI in patients with symptomatic HFrEF to further reduce morbidity and
mortality.
2. A 4-year-old child presents with a sudden onset of a barking cough, inspiratory stridor at
rest, and mild intercostal retractions. What is the immediate priority in management?
A. Administer nebulized Albuterol and monitor for 2 hours
,B. Administer oral Dexamethasone and discharge home
C. Administer nebulized Racemic Epinephrine and Dexamethasone
D. Perform an immediate chest X-ray to rule out foreign body aspiration
Answer: C
Conceptual Explanation: Stridor at rest indicates moderate to severe croup, requiring
both nebulized racemic epinephrine for rapid airway diameter improvement and
dexamethasone for long-term inflammation reduction.
3. In a patient with Type 2 Diabetes and established Atherosclerotic Cardiovascular Disease
(ASCVD), which class of medications is preferred after Metformin for glycemic control and
cardiovascular benefit?
A. DPP-4 inhibitors
B. Sulfonylureas
C. SGLT2 inhibitors or GLP-1 receptor agonists
D. TZDs (Thiazolidinediones)
Answer: C
Conceptual Explanation: SGLT2 inhibitors and GLP-1 receptor agonists have proven
benefits in reducing major adverse cardiovascular events in patients with established
ASCVD.
, 4. A 68-year-old male presents with sudden onset unilateral vision loss described as a ‘curtain
coming down.’ He has a history of giant cell arteritis. What is the most likely diagnosis?
A. Retinal detachment
B. Amaurosis fugax
C. Central retinal artery occlusion
D. Acute angle-closure glaucoma
Answer: C
Conceptual Explanation: In the context of giant cell arteritis, sudden painless vision loss is
highly suggestive of central retinal artery occlusion due to ophthalmic artery involvement.
5. According to the GINA guidelines, what is the preferred controller treatment for adults
with Step 1 asthma?
A. SABA as needed only
B. Daily low-dose ICS plus SABA as needed
C. Daily leukotriene receptor antagonist
D. As-needed low-dose ICS-formoterol
Answer: D
Conceptual Explanation: The Global Initiative for Asthma (GINA) now recommends as-
needed low-dose ICS-formoterol as the preferred therapy for Step 1 to reduce the risk of
severe exacerbations.
MANAGEMENT FINAL EXAM 2026/2027
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A 62-year-old patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently
taking Lisinopril and Metoprolol Succinate. Despite therapy, the patient remains NYHA Class
II. What is the most appropriate next step according to the latest clinical guidelines?
A. Increase the dose of Metoprolol Succinate to maximum tolerance
B. Initiate Ivabradine
C. Add Digoxin for symptom management
D. Switch Lisinopril to Sacubitril/Valsartan (ARNI)
Answer: D
Conceptual Explanation: Current guidelines recommend switching an ACE inhibitor or
ARB to an ARNI in patients with symptomatic HFrEF to further reduce morbidity and
mortality.
2. A 4-year-old child presents with a sudden onset of a barking cough, inspiratory stridor at
rest, and mild intercostal retractions. What is the immediate priority in management?
A. Administer nebulized Albuterol and monitor for 2 hours
,B. Administer oral Dexamethasone and discharge home
C. Administer nebulized Racemic Epinephrine and Dexamethasone
D. Perform an immediate chest X-ray to rule out foreign body aspiration
Answer: C
Conceptual Explanation: Stridor at rest indicates moderate to severe croup, requiring
both nebulized racemic epinephrine for rapid airway diameter improvement and
dexamethasone for long-term inflammation reduction.
3. In a patient with Type 2 Diabetes and established Atherosclerotic Cardiovascular Disease
(ASCVD), which class of medications is preferred after Metformin for glycemic control and
cardiovascular benefit?
A. DPP-4 inhibitors
B. Sulfonylureas
C. SGLT2 inhibitors or GLP-1 receptor agonists
D. TZDs (Thiazolidinediones)
Answer: C
Conceptual Explanation: SGLT2 inhibitors and GLP-1 receptor agonists have proven
benefits in reducing major adverse cardiovascular events in patients with established
ASCVD.
, 4. A 68-year-old male presents with sudden onset unilateral vision loss described as a ‘curtain
coming down.’ He has a history of giant cell arteritis. What is the most likely diagnosis?
A. Retinal detachment
B. Amaurosis fugax
C. Central retinal artery occlusion
D. Acute angle-closure glaucoma
Answer: C
Conceptual Explanation: In the context of giant cell arteritis, sudden painless vision loss is
highly suggestive of central retinal artery occlusion due to ophthalmic artery involvement.
5. According to the GINA guidelines, what is the preferred controller treatment for adults
with Step 1 asthma?
A. SABA as needed only
B. Daily low-dose ICS plus SABA as needed
C. Daily leukotriene receptor antagonist
D. As-needed low-dose ICS-formoterol
Answer: D
Conceptual Explanation: The Global Initiative for Asthma (GINA) now recommends as-
needed low-dose ICS-formoterol as the preferred therapy for Step 1 to reduce the risk of
severe exacerbations.
