NR 667 FNP CAPSTONE
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 68-year-old male with a history of HFrEF and CKD Stage 3 has a blood pressure of 150/92
mmHg. Which medication is the preferred first-line agent for blood pressure control in this
patient?
A. Amlodipine
B. Lisinopril
C. Hydrochlorothiazide
D. Metoprolol Succinate
Answer: B
Conceptual Explanation: ACE inhibitors such as Lisinopril are first-line for patients with
CKD and Heart Failure with reduced Ejection Fraction due to renal protective effects and
mortality benefits.
2. According to the GINA guidelines, what is the preferred reliever therapy for a patient with
mild asthma?
A. Short-acting beta-agonist (SABA) alone
,B. Salmeterol used as needed
C. Oral corticosteroids for 5 days
D. Low-dose inhaled corticosteroid (ICS) plus formoterol as needed
Answer: D
Conceptual Explanation: Current GINA guidelines emphasize that low-dose ICS-
formoterol is the preferred reliever to reduce the risk of severe exacerbations compared to
SABA alone.
3. A 52-year-old female presents with a TSH of 7.2 mIU/L and a normal free T4 level. She
reports mild fatigue but no other symptoms. What is the most appropriate next step?
A. Immediately start Levothyroxine 50 mcg daily
B. Repeat TSH and Free T4 in 3 to 6 months
C. Order a thyroid ultrasound
D. Refer to endocrinology for radioactive iodine uptake study
Answer: B
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH, normal T4) without
significant symptoms or cardiovascular risk often warrants observation and repeat testing
before initiating lifelong therapy.
, 4. A patient with Type 2 Diabetes and a history of myocardial infarction has an A1c of 8.2%
despite Metformin. Which class of medication should be added next for its proven
cardiovascular benefit?
A. DPP-4 Inhibitor
B. Sulfonylurea
C. Thiazolidinedione
D. GLP-1 Receptor Agonist
Answer: D
Conceptual Explanation: GLP-1 receptor agonists and SGLT2 inhibitors are recommended
for patients with established ASCVD due to their significant reduction in major adverse
cardiovascular events.
5. In the treatment of acute bacterial rhinosinusitis, which of the following is the first-line
antibiotic for an adult with no drug allergies?
A. Azithromycin
B. Amoxicillin-Clavulanate
C. Ciprofloxacin
D. Doxycycline
Answer: B
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 68-year-old male with a history of HFrEF and CKD Stage 3 has a blood pressure of 150/92
mmHg. Which medication is the preferred first-line agent for blood pressure control in this
patient?
A. Amlodipine
B. Lisinopril
C. Hydrochlorothiazide
D. Metoprolol Succinate
Answer: B
Conceptual Explanation: ACE inhibitors such as Lisinopril are first-line for patients with
CKD and Heart Failure with reduced Ejection Fraction due to renal protective effects and
mortality benefits.
2. According to the GINA guidelines, what is the preferred reliever therapy for a patient with
mild asthma?
A. Short-acting beta-agonist (SABA) alone
,B. Salmeterol used as needed
C. Oral corticosteroids for 5 days
D. Low-dose inhaled corticosteroid (ICS) plus formoterol as needed
Answer: D
Conceptual Explanation: Current GINA guidelines emphasize that low-dose ICS-
formoterol is the preferred reliever to reduce the risk of severe exacerbations compared to
SABA alone.
3. A 52-year-old female presents with a TSH of 7.2 mIU/L and a normal free T4 level. She
reports mild fatigue but no other symptoms. What is the most appropriate next step?
A. Immediately start Levothyroxine 50 mcg daily
B. Repeat TSH and Free T4 in 3 to 6 months
C. Order a thyroid ultrasound
D. Refer to endocrinology for radioactive iodine uptake study
Answer: B
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH, normal T4) without
significant symptoms or cardiovascular risk often warrants observation and repeat testing
before initiating lifelong therapy.
, 4. A patient with Type 2 Diabetes and a history of myocardial infarction has an A1c of 8.2%
despite Metformin. Which class of medication should be added next for its proven
cardiovascular benefit?
A. DPP-4 Inhibitor
B. Sulfonylurea
C. Thiazolidinedione
D. GLP-1 Receptor Agonist
Answer: D
Conceptual Explanation: GLP-1 receptor agonists and SGLT2 inhibitors are recommended
for patients with established ASCVD due to their significant reduction in major adverse
cardiovascular events.
5. In the treatment of acute bacterial rhinosinusitis, which of the following is the first-line
antibiotic for an adult with no drug allergies?
A. Azithromycin
B. Amoxicillin-Clavulanate
C. Ciprofloxacin
D. Doxycycline
Answer: B
