NURS 5434 Family III Final + Practice
Exam – 200Original Board-Style Questions
with Answers & Rationales (FNP III /
UTA-Style) Latest Update This Year Instant
Download Pdf
Coverage:
This exam is designed for NURS 5434 (Family Nurse Practitioner III / Family Health III) final
exam preparation, aligned with UTA-style FNP III content. It covers advanced adult primary
care including cardiometabolic disease (HTN, CAD, HF, diabetes, lipids, obesity),
behavioral health (depression, anxiety, bipolar, schizophrenia, ADHD), complex chronic
disease management, geriatrics, and advanced pharmacotherapeutics. Each question
includes a clear answer and a concise rationale to reinforce clinical reasoning and
guideline-based care. Ideal for FNP students preparing for the NURS 5434 final exam or
seeking to strengthen their family practice knowledge.
Q1. A 58-year-old patient with established ASCVD and LDL 110 mg/dL is on
moderate-intensity statin therapy. Which intensification strategy is most
appropriate?*
Answer: Switch to high-intensity statin therapy (e.g., atorvastatin 40–80 mg or
rosuvastatin 20–40 mg).
Explanation: Secondary prevention in ASCVD requires high-intensity statin to achieve
≥50% LDL reduction.
Q2. A 62-year-old patient with hypertension has BP 158/96 mmHg on lisinopril 40 mg
daily. Which medication addition is most appropriate?*
,Answer: Add a thiazide diuretic (e.g., HCTZ) or a CCB.
Explanation: For uncontrolled HTN on ACEi, add a complementary first-line agent.
Q3. A 45-year-old patient with type 2 diabetes and A1c 8.4% has established CKD
with eGFR 45 mL/min. Which medication class is most beneficial?*
Answer: SGLT2 inhibitor (e.g., empagliflozin) is most beneficial.
Explanation: SGLT2i reduce CKD progression and CV events in T2DM with CKD.
Q4. A 50-year-old patient with obesity (BMI 34) and hypertension wants help with
weight loss. Which medication is most appropriate for weight and cardiometabolic
risk?*
Answer: GLP-1 receptor agonist (e.g., semaglutide 2.4 mg) is most appropriate.
Explanation: GLP-1 RAs promote weight loss and improve cardiometabolic
parameters.
Q5. A 67-year-old patient with HFrEF (EF 30%) is on ACEi, beta-blocker, and MRA.
Which add-on therapy is most appropriate?*
Answer: Add an SGLT2 inhibitor (e.g., dapagliflozin).
Explanation: SGLT2i improve outcomes in HFrEF regardless of diabetes status.
Q6. A 55-year-old patient with angina and normal coronary angiography has
microvascular dysfunction. Which medication class is most beneficial?*
,Answer: Beta-blockers or CCBs are most beneficial.
Explanation: They reduce myocardial oxygen demand and microvascular angina
symptoms.
Q7. A 40-year-old patient with severe depression and suicidal ideation requires
urgent treatment. Which intervention is most appropriate?*
Answer: Immediate psychiatric evaluation and possible hospitalization are most
appropriate.
Explanation: Safety is priority; urgent assessment determines need for inpatient care.
Q8. A 32-year-old patient with generalized anxiety disorder has not responded to
SSRI monotherapy. Which augmentation strategy is most appropriate?*
Answer: Add cognitive behavioral therapy (CBT) or consider buspirone.
Explanation: CBT enhances SSRI effect; buspirone is an anxiolytic option.
Q9. A 28-year-old patient with bipolar I disorder is stable on lithium. Which lab
monitoring is most important?*
Answer: Serum lithium level, creatinine, and TSH are most important.
Explanation: Lithium affects renal and thyroid function; therapeutic drug monitoring is
essential.
, Q10. A 48-year-old patient with schizophrenia is on a second-generation
antipsychotic and has gained 15 lbs. Which metabolic monitoring is most
important?*
Answer: Weight, BMI, fasting glucose/A1c, and lipids are most important.
Explanation: SGAs increase risk of metabolic syndrome; regular monitoring is required.
Q11. A 60-year-old patient with type 2 diabetes has A1c 9.2% and symptomatic
hyperglycemia. Which treatment intensification is most appropriate?*
Answer: Initiate basal insulin or GLP-1 RA is most appropriate.
Explanation: A1c >9% with symptoms often requires insulin; GLP-1 RA is an
alternative.
Q12. A 70-year-old patient with osteoarthritis and CKD stage 3 needs pain control.
Which analgesic is most appropriate?*
Answer: Acetaminophen and topical NSAIDs are most appropriate.
Explanation: Systemic NSAIDs increase renal risk; acetaminophen and topicals are
safer.
Q13. A 55-year-old patient with gout and frequent flares is on allopurinol 300 mg
daily. Serum uric acid is 7.8 mg/dL. Which adjustment is most appropriate?*
Answer: Titrate allopurinol to achieve urate <6 mg/dL.
Explanation: Dose should be adjusted to target serum urate, not fixed dose.
Exam – 200Original Board-Style Questions
with Answers & Rationales (FNP III /
UTA-Style) Latest Update This Year Instant
Download Pdf
Coverage:
This exam is designed for NURS 5434 (Family Nurse Practitioner III / Family Health III) final
exam preparation, aligned with UTA-style FNP III content. It covers advanced adult primary
care including cardiometabolic disease (HTN, CAD, HF, diabetes, lipids, obesity),
behavioral health (depression, anxiety, bipolar, schizophrenia, ADHD), complex chronic
disease management, geriatrics, and advanced pharmacotherapeutics. Each question
includes a clear answer and a concise rationale to reinforce clinical reasoning and
guideline-based care. Ideal for FNP students preparing for the NURS 5434 final exam or
seeking to strengthen their family practice knowledge.
Q1. A 58-year-old patient with established ASCVD and LDL 110 mg/dL is on
moderate-intensity statin therapy. Which intensification strategy is most
appropriate?*
Answer: Switch to high-intensity statin therapy (e.g., atorvastatin 40–80 mg or
rosuvastatin 20–40 mg).
Explanation: Secondary prevention in ASCVD requires high-intensity statin to achieve
≥50% LDL reduction.
Q2. A 62-year-old patient with hypertension has BP 158/96 mmHg on lisinopril 40 mg
daily. Which medication addition is most appropriate?*
,Answer: Add a thiazide diuretic (e.g., HCTZ) or a CCB.
Explanation: For uncontrolled HTN on ACEi, add a complementary first-line agent.
Q3. A 45-year-old patient with type 2 diabetes and A1c 8.4% has established CKD
with eGFR 45 mL/min. Which medication class is most beneficial?*
Answer: SGLT2 inhibitor (e.g., empagliflozin) is most beneficial.
Explanation: SGLT2i reduce CKD progression and CV events in T2DM with CKD.
Q4. A 50-year-old patient with obesity (BMI 34) and hypertension wants help with
weight loss. Which medication is most appropriate for weight and cardiometabolic
risk?*
Answer: GLP-1 receptor agonist (e.g., semaglutide 2.4 mg) is most appropriate.
Explanation: GLP-1 RAs promote weight loss and improve cardiometabolic
parameters.
Q5. A 67-year-old patient with HFrEF (EF 30%) is on ACEi, beta-blocker, and MRA.
Which add-on therapy is most appropriate?*
Answer: Add an SGLT2 inhibitor (e.g., dapagliflozin).
Explanation: SGLT2i improve outcomes in HFrEF regardless of diabetes status.
Q6. A 55-year-old patient with angina and normal coronary angiography has
microvascular dysfunction. Which medication class is most beneficial?*
,Answer: Beta-blockers or CCBs are most beneficial.
Explanation: They reduce myocardial oxygen demand and microvascular angina
symptoms.
Q7. A 40-year-old patient with severe depression and suicidal ideation requires
urgent treatment. Which intervention is most appropriate?*
Answer: Immediate psychiatric evaluation and possible hospitalization are most
appropriate.
Explanation: Safety is priority; urgent assessment determines need for inpatient care.
Q8. A 32-year-old patient with generalized anxiety disorder has not responded to
SSRI monotherapy. Which augmentation strategy is most appropriate?*
Answer: Add cognitive behavioral therapy (CBT) or consider buspirone.
Explanation: CBT enhances SSRI effect; buspirone is an anxiolytic option.
Q9. A 28-year-old patient with bipolar I disorder is stable on lithium. Which lab
monitoring is most important?*
Answer: Serum lithium level, creatinine, and TSH are most important.
Explanation: Lithium affects renal and thyroid function; therapeutic drug monitoring is
essential.
, Q10. A 48-year-old patient with schizophrenia is on a second-generation
antipsychotic and has gained 15 lbs. Which metabolic monitoring is most
important?*
Answer: Weight, BMI, fasting glucose/A1c, and lipids are most important.
Explanation: SGAs increase risk of metabolic syndrome; regular monitoring is required.
Q11. A 60-year-old patient with type 2 diabetes has A1c 9.2% and symptomatic
hyperglycemia. Which treatment intensification is most appropriate?*
Answer: Initiate basal insulin or GLP-1 RA is most appropriate.
Explanation: A1c >9% with symptoms often requires insulin; GLP-1 RA is an
alternative.
Q12. A 70-year-old patient with osteoarthritis and CKD stage 3 needs pain control.
Which analgesic is most appropriate?*
Answer: Acetaminophen and topical NSAIDs are most appropriate.
Explanation: Systemic NSAIDs increase renal risk; acetaminophen and topicals are
safer.
Q13. A 55-year-old patient with gout and frequent flares is on allopurinol 300 mg
daily. Serum uric acid is 7.8 mg/dL. Which adjustment is most appropriate?*
Answer: Titrate allopurinol to achieve urate <6 mg/dL.
Explanation: Dose should be adjusted to target serum urate, not fixed dose.
