NR 667/NR667 FNP Capstone Week 1 Full
Length Practice Exam | Questions and
Answers | 2026/2027 Updated | 100%
Correct.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
149 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This full-length practice exam assesses advanced clinical reasoning, diagnostic interpretation, pharmacologic
management, and evidence-based practice across the lifespan for the family nurse practitioner. It integrates
primary care, health policy, and professional role competencies expected at the capstone level.
STUDY GUIDE
Recommended duration: 3 hours. Passing target: 80% (A+ = 97-100%).
HIGHP - Page 1 of 49
,1. A patient with type 2 diabetes and an eGFR of 42 mL/min/1.73 m² is being evaluated for
cardiovascular risk reduction. Which medication class offers the strongest evidence for
slowing CKD progression and reducing heart failure hospitalization in this population?
[ ] A. SGLT2 inhibitors
[ ] B. DPP-4 inhibitors
[ ] C. Sulfonylureas
[ ] D. Thiazolidinediones
CORRECT: A. SGLT2 inhibitors
SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin) have landmark trial evidence (EMPA-REG, DAPA-CKD)
for slowing CKD progression and reducing HF hospitalization. DPP-4 inhibitors are weight-neutral and lack
renal/CV outcome benefits, sulfonylureas increase hypoglycemia risk, and thiazolidinediones worsen fluid
retention and HF.
2. Which statement best reflects the role of the Consensus Model for APRN Regulation in
the current nurse practitioner scope of practice?
[ ] A. It mandates independent practice in all 50 states.
[ ] B. It provides a standardized framework for licensure, accreditation, certification, and education
(LACE).
[ ] C. It replaces state boards of nursing with a federal regulatory body.
[ ] D. It restricts NP prescribing to physician-supervised protocols.
CORRECT: B. It provides a standardized framework for licensure, accreditation, certification, and
education (LACE).
The Consensus Model establishes the LACE framework to standardize APRN regulation across states, but it
does not mandate independent practice (A), replace state boards (C), or restrict prescribing (D). It guides
consistency while leaving full practice authority to individual state legislation.
3. A patient presents with a 3-day history of unilateral burning pain and vesicular lesions
in a dermatomal distribution. Which treatment initiated within 72 hours of rash onset is
most appropriate?
[ ] A. Oral acyclovir 800 mg five times daily for 7 days
[ ] B. Topical hydrocortisone 2.5% twice daily
[ ] C. Oral fluconazole 150 mg single dose
[ ] D. Oral amoxicillin 500 mg three times daily
CORRECT: A. Oral acyclovir 800 mg five times daily for 7 days
This is herpes zoster (shingles). Oral acyclovir (or valacyclovir/famciclovir) within 72 hours reduces duration
and complications. Topical steroids, antifungals, and antibiotics are ineffective against varicella-zoster virus.
HIGHP - Page 2 of 49
,4. Which laboratory finding is most consistent with primary hyperparathyroidism in an
otherwise asymptomatic patient?
[ ] A. Elevated calcium with elevated PTH
[ ] B. Elevated calcium with low PTH
[ ] C. Low calcium with elevated PTH
[ ] D. Normal calcium with low PTH
CORRECT: A. Elevated calcium with elevated PTH
Primary hyperparathyroidism is characterized by hypercalcemia with inappropriately normal or elevated PTH.
Elevated calcium with low PTH suggests malignancy or granulomatous disease. Low calcium with high PTH
indicates secondary hyperparathyroidism.
5. A patient with major depressive disorder has not responded to two adequate trials of
SSRIs. According to STAR*D findings, which strategy is most evidence-based?
[ ] A. Switch to a different SSRI
[ ] B. Augment with an atypical antipsychotic or switch to an SNRI
[ ] C. Add a benzodiazepine
[ ] D. Initiate a monoamine oxidase inhibitor immediately
CORRECT: B. Augment with an atypical antipsychotic or switch to an SNRI
STAR*D showed that after two failed SSRI trials, switching to an SNRI or augmenting with an atypical
antipsychotic (e.g., aripiprazole) improves remission rates. Adding benzodiazepines does not treat
depression, and MAOIs are later-line due to dietary restrictions and interactions.
6. Which screening recommendation is current for cervical cancer in an average-risk
patient aged 30-65?
[ ] A. Cytology alone every 3 years
[ ] B. Primary HPV testing every 5 years or co-testing every 5 years
[ ] C. Annual cytology
[ ] D. No screening needed if HPV vaccinated
CORRECT: B. Primary HPV testing every 5 years or co-testing every 5 years
The USPSTF and ACS recommend primary HPV testing every 5 years or co-testing every 5 years for ages
30-65. Cytology alone every 3 years is acceptable but less sensitive. Annual cytology is outdated, and
vaccination does not eliminate screening.
7. A patient with asthma uses a short-acting beta-agonist more than twice weekly. Which
step-up therapy is most appropriate according to current GINA guidelines?
[ ] A. Add a long-acting beta-agonist alone
[ ] B. Initiate or increase inhaled corticosteroid
HIGHP - Page 3 of 49
, [ ] C. Start oral prednisone daily
[ ] D. Add a leukotriene receptor antagonist as monotherapy
CORRECT: B. Initiate or increase inhaled corticosteroid
GINA recommends ICS-containing therapy as the cornerstone. Increasing ICS or initiating low-dose
ICS-formoterol is preferred. LABA monotherapy is contraindicated in asthma, daily oral steroids are for
severe cases, and LTRA monotherapy is less effective.
8. Which finding on a 12-lead ECG is most consistent with hyperkalemia?
[ ] A. Prolonged QT interval
[ ] B. Peaked T waves and widened QRS
[ ] C. ST elevation in contiguous leads
[ ] D. U waves and flattened T waves
CORRECT: B. Peaked T waves and widened QRS
Hyperkalemia causes tall, peaked T waves, widened QRS, and eventually sine wave patterns. Prolonged QT
is seen with hypocalcemia, ST elevation with ischemia, and U waves with hypokalemia.
9. A patient with newly diagnosed hypertension and no comorbidities has a blood
pressure of 148/92 mmHg. According to the 2017 ACC/AHA guidelines, what is the
recommended initial management?
[ ] A. Lifestyle modification alone for 6 months
[ ] B. Initiate antihypertensive medication plus lifestyle modification
[ ] C. Initiate two antihypertensive agents
[ ] D. Refer immediately to cardiology
CORRECT: B. Initiate antihypertensive medication plus lifestyle modification
Stage 2 hypertension (140/90) warrants initiation of medication along with lifestyle changes. Lifestyle alone is
for stage 1 without high risk. Two agents are for BP >20/10 above goal, and cardiology referral is not
indicated initially.
10. A family nurse practitioner is reviewing the diagnostic criteria for metabolic syndrome
in an adult patient. Which combination of findings best confirms the diagnosis according
to the most current harmonized guidelines?
[ ] A. Fasting glucose 100 mg/dL, blood pressure 130/85 mm Hg, and waist circumference 40 inches in
men
[ ] B. Triglycerides 150 mg/dL, HDL <40 mg/dL in men, and blood pressure 130/85 mm Hg
[ ] C. Three or more of: elevated waist circumference, triglycerides 150 mg/dL, HDL <40 mg/dL (men) or
<50 mg/dL (women), BP 130/85 mm Hg, fasting glucose 100 mg/dL
[ ] D. Two or more of: BMI 30 kg/m², HbA1c 6.5%, and LDL 160 mg/dL
HIGHP - Page 4 of 49
Length Practice Exam | Questions and
Answers | 2026/2027 Updated | 100%
Correct.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
149 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This full-length practice exam assesses advanced clinical reasoning, diagnostic interpretation, pharmacologic
management, and evidence-based practice across the lifespan for the family nurse practitioner. It integrates
primary care, health policy, and professional role competencies expected at the capstone level.
STUDY GUIDE
Recommended duration: 3 hours. Passing target: 80% (A+ = 97-100%).
HIGHP - Page 1 of 49
,1. A patient with type 2 diabetes and an eGFR of 42 mL/min/1.73 m² is being evaluated for
cardiovascular risk reduction. Which medication class offers the strongest evidence for
slowing CKD progression and reducing heart failure hospitalization in this population?
[ ] A. SGLT2 inhibitors
[ ] B. DPP-4 inhibitors
[ ] C. Sulfonylureas
[ ] D. Thiazolidinediones
CORRECT: A. SGLT2 inhibitors
SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin) have landmark trial evidence (EMPA-REG, DAPA-CKD)
for slowing CKD progression and reducing HF hospitalization. DPP-4 inhibitors are weight-neutral and lack
renal/CV outcome benefits, sulfonylureas increase hypoglycemia risk, and thiazolidinediones worsen fluid
retention and HF.
2. Which statement best reflects the role of the Consensus Model for APRN Regulation in
the current nurse practitioner scope of practice?
[ ] A. It mandates independent practice in all 50 states.
[ ] B. It provides a standardized framework for licensure, accreditation, certification, and education
(LACE).
[ ] C. It replaces state boards of nursing with a federal regulatory body.
[ ] D. It restricts NP prescribing to physician-supervised protocols.
CORRECT: B. It provides a standardized framework for licensure, accreditation, certification, and
education (LACE).
The Consensus Model establishes the LACE framework to standardize APRN regulation across states, but it
does not mandate independent practice (A), replace state boards (C), or restrict prescribing (D). It guides
consistency while leaving full practice authority to individual state legislation.
3. A patient presents with a 3-day history of unilateral burning pain and vesicular lesions
in a dermatomal distribution. Which treatment initiated within 72 hours of rash onset is
most appropriate?
[ ] A. Oral acyclovir 800 mg five times daily for 7 days
[ ] B. Topical hydrocortisone 2.5% twice daily
[ ] C. Oral fluconazole 150 mg single dose
[ ] D. Oral amoxicillin 500 mg three times daily
CORRECT: A. Oral acyclovir 800 mg five times daily for 7 days
This is herpes zoster (shingles). Oral acyclovir (or valacyclovir/famciclovir) within 72 hours reduces duration
and complications. Topical steroids, antifungals, and antibiotics are ineffective against varicella-zoster virus.
HIGHP - Page 2 of 49
,4. Which laboratory finding is most consistent with primary hyperparathyroidism in an
otherwise asymptomatic patient?
[ ] A. Elevated calcium with elevated PTH
[ ] B. Elevated calcium with low PTH
[ ] C. Low calcium with elevated PTH
[ ] D. Normal calcium with low PTH
CORRECT: A. Elevated calcium with elevated PTH
Primary hyperparathyroidism is characterized by hypercalcemia with inappropriately normal or elevated PTH.
Elevated calcium with low PTH suggests malignancy or granulomatous disease. Low calcium with high PTH
indicates secondary hyperparathyroidism.
5. A patient with major depressive disorder has not responded to two adequate trials of
SSRIs. According to STAR*D findings, which strategy is most evidence-based?
[ ] A. Switch to a different SSRI
[ ] B. Augment with an atypical antipsychotic or switch to an SNRI
[ ] C. Add a benzodiazepine
[ ] D. Initiate a monoamine oxidase inhibitor immediately
CORRECT: B. Augment with an atypical antipsychotic or switch to an SNRI
STAR*D showed that after two failed SSRI trials, switching to an SNRI or augmenting with an atypical
antipsychotic (e.g., aripiprazole) improves remission rates. Adding benzodiazepines does not treat
depression, and MAOIs are later-line due to dietary restrictions and interactions.
6. Which screening recommendation is current for cervical cancer in an average-risk
patient aged 30-65?
[ ] A. Cytology alone every 3 years
[ ] B. Primary HPV testing every 5 years or co-testing every 5 years
[ ] C. Annual cytology
[ ] D. No screening needed if HPV vaccinated
CORRECT: B. Primary HPV testing every 5 years or co-testing every 5 years
The USPSTF and ACS recommend primary HPV testing every 5 years or co-testing every 5 years for ages
30-65. Cytology alone every 3 years is acceptable but less sensitive. Annual cytology is outdated, and
vaccination does not eliminate screening.
7. A patient with asthma uses a short-acting beta-agonist more than twice weekly. Which
step-up therapy is most appropriate according to current GINA guidelines?
[ ] A. Add a long-acting beta-agonist alone
[ ] B. Initiate or increase inhaled corticosteroid
HIGHP - Page 3 of 49
, [ ] C. Start oral prednisone daily
[ ] D. Add a leukotriene receptor antagonist as monotherapy
CORRECT: B. Initiate or increase inhaled corticosteroid
GINA recommends ICS-containing therapy as the cornerstone. Increasing ICS or initiating low-dose
ICS-formoterol is preferred. LABA monotherapy is contraindicated in asthma, daily oral steroids are for
severe cases, and LTRA monotherapy is less effective.
8. Which finding on a 12-lead ECG is most consistent with hyperkalemia?
[ ] A. Prolonged QT interval
[ ] B. Peaked T waves and widened QRS
[ ] C. ST elevation in contiguous leads
[ ] D. U waves and flattened T waves
CORRECT: B. Peaked T waves and widened QRS
Hyperkalemia causes tall, peaked T waves, widened QRS, and eventually sine wave patterns. Prolonged QT
is seen with hypocalcemia, ST elevation with ischemia, and U waves with hypokalemia.
9. A patient with newly diagnosed hypertension and no comorbidities has a blood
pressure of 148/92 mmHg. According to the 2017 ACC/AHA guidelines, what is the
recommended initial management?
[ ] A. Lifestyle modification alone for 6 months
[ ] B. Initiate antihypertensive medication plus lifestyle modification
[ ] C. Initiate two antihypertensive agents
[ ] D. Refer immediately to cardiology
CORRECT: B. Initiate antihypertensive medication plus lifestyle modification
Stage 2 hypertension (140/90) warrants initiation of medication along with lifestyle changes. Lifestyle alone is
for stage 1 without high risk. Two agents are for BP >20/10 above goal, and cardiology referral is not
indicated initially.
10. A family nurse practitioner is reviewing the diagnostic criteria for metabolic syndrome
in an adult patient. Which combination of findings best confirms the diagnosis according
to the most current harmonized guidelines?
[ ] A. Fasting glucose 100 mg/dL, blood pressure 130/85 mm Hg, and waist circumference 40 inches in
men
[ ] B. Triglycerides 150 mg/dL, HDL <40 mg/dL in men, and blood pressure 130/85 mm Hg
[ ] C. Three or more of: elevated waist circumference, triglycerides 150 mg/dL, HDL <40 mg/dL (men) or
<50 mg/dL (women), BP 130/85 mm Hg, fasting glucose 100 mg/dL
[ ] D. Two or more of: BMI 30 kg/m², HbA1c 6.5%, and LDL 160 mg/dL
HIGHP - Page 4 of 49
