NR 667 FNP CAPSTONE PRACTICUM AND INTENSIVE FINAL
EXAM STUDY GUIDE 2026/2027 UPDATE. 100% VERIFIED
1. A 58-year-old male with Type 2 Diabetes, HbA1c of 8.2%, and
established ASCVD is currently on Metformin. Which medication should
be added to reduce cardiovascular risk?
A. Glipizide
B. Empagliflozin
C. Pioglitazone
D. Sitagliptin
Answer: B
Rationale: SGLT2 inhibitors like empagliflozin have proven
cardiovascular benefits in patients with Type 2 Diabetes and ASCVD.
They reduce the risk of major adverse cardiovascular events, heart
failure, and renal progression.
2. A 26-year-old female presents with purulent cervical discharge,
dysuria, and lower abdominal pain. She is diagnosed with Pelvic
Inflammatory Disease (PID). Which of the following is the
recommended outpatient antibiotic regimen?
A. Azithromycin 1g orally once
B. Ceftriaxone 500mg IM plus Doxycycline 100mg BID for 14 days plus
Metronidazole 500mg BID for 14 days
C. Amoxicillin 500mg TID for 7 days
D. Levofloxacin 500mg daily for 7 days
Answer: B
Rationale: The CDC recommends a combination regimen for PID to
cover N. gonorrhoeae, C. trachomatis, and anaerobic bacteria. The
,standard outpatient regimen is Ceftriaxone, Doxycycline, and
Metronidazole.
3. A 68-year-old male with heart failure with reduced ejection fraction
(HFrEF) and an EF of 25% is on a beta-blocker and ACE inhibitor. Which
additional medication class is now considered standard guideline-
directed medical therapy to reduce mortality?
A. Calcium channel blocker
B. Loop diuretic
C. Mineralocorticoid receptor antagonist (MRA)
D. Digoxin
Answer: C
Rationale: MRAs (like spironolactone or eplerenone) are a cornerstone
of GDMT for HFrEF, significantly reducing mortality and hospitalizations.
SGLT2 inhibitors and ARNIs are also part of GDMT.
4. A 4-year-old child presents with a sudden onset of fever, barking
cough, and inspiratory stridor. The child is otherwise healthy and has no
history of foreign body aspiration. What is the most appropriate first-
line pharmacologic treatment?
A. Albuterol nebulizer
B. Dexamethasone
C. Amoxicillin
D. Diphenhydramine
Answer: B
Rationale: The presentation is classic for croup
(laryngotracheobronchitis). A single dose of oral, IM, or IV
dexamethasone is the standard first-line treatment to reduce airway
inflammation and edema.
,5. A 30-year-old female presents with a 3-week history of depressed
mood, anhedonia, insomnia, and fatigue. She has no suicidal ideation
and no history of mania. What is the most appropriate first-line
pharmacologic therapy?
A. Fluoxetine
B. Lithium
C. Alprazolam
D. Quetiapine
Answer: A
Rationale: SSRIs like fluoxetine are considered first-line treatment for
Major Depressive Disorder due to their efficacy and favorable safety
profile. Lithium is for bipolar disorder, and benzodiazepines are not first-
line for depression.
6. A 45-year-old male presents with a 3-month history of heartburn,
regurgitation, and a sour taste in his mouth, especially after eating large
meals. What is the most appropriate initial management?
A. Immediate referral for endoscopy
B. Lifestyle modifications and a proton pump inhibitor (PPI) trial
C. H2 blocker as needed
D. Antibiotic therapy for H. pylori
Answer: B
Rationale: For typical GERD symptoms without alarm features (e.g.,
dysphagia, weight loss, anemia), the initial approach is lifestyle
modification and an 8-week trial of a PPI.
7. A 65-year-old female presents with chronic knee pain that worsens
with activity and improves with rest. She has morning stiffness lasting
less than 30 minutes. X-rays show joint space narrowing and
osteophytes. What is the most appropriate initial management?
, A. Methotrexate
B. Acetaminophen and physical therapy
C. Intra-articular corticosteroid injection
D. Colchicine
Answer: B
Rationale: The presentation is consistent with osteoarthritis. First-line
management includes acetaminophen or NSAIDs, along with physical
therapy, weight loss, and exercise. Methotrexate is for RA, and
colchicine is for gout.
8. A 52-year-old postmenopausal female presents with severe hot
flashes and night sweats that disrupt her sleep. She has no history of
breast cancer or thromboembolic disease. What is the most effective
treatment?
A. SSRI
B. Systemic estrogen therapy
C. Gabapentin
D. Clonidine
Answer: B
Rationale: Systemic estrogen therapy is the most effective treatment for
vasomotor symptoms in postmenopausal women without
contraindications. SSRIs, gabapentin, and clonidine are non-hormonal
alternatives.
9. A 72-year-old male presents with sudden onset of right-sided
weakness and aphasia. His symptoms started 45 minutes ago. What is
the most appropriate immediate action?
A. Administer aspirin 325mg orally
B. Obtain a non-contrast CT scan of the head
C. Administer IV tissue plasminogen activator (tPA)
EXAM STUDY GUIDE 2026/2027 UPDATE. 100% VERIFIED
1. A 58-year-old male with Type 2 Diabetes, HbA1c of 8.2%, and
established ASCVD is currently on Metformin. Which medication should
be added to reduce cardiovascular risk?
A. Glipizide
B. Empagliflozin
C. Pioglitazone
D. Sitagliptin
Answer: B
Rationale: SGLT2 inhibitors like empagliflozin have proven
cardiovascular benefits in patients with Type 2 Diabetes and ASCVD.
They reduce the risk of major adverse cardiovascular events, heart
failure, and renal progression.
2. A 26-year-old female presents with purulent cervical discharge,
dysuria, and lower abdominal pain. She is diagnosed with Pelvic
Inflammatory Disease (PID). Which of the following is the
recommended outpatient antibiotic regimen?
A. Azithromycin 1g orally once
B. Ceftriaxone 500mg IM plus Doxycycline 100mg BID for 14 days plus
Metronidazole 500mg BID for 14 days
C. Amoxicillin 500mg TID for 7 days
D. Levofloxacin 500mg daily for 7 days
Answer: B
Rationale: The CDC recommends a combination regimen for PID to
cover N. gonorrhoeae, C. trachomatis, and anaerobic bacteria. The
,standard outpatient regimen is Ceftriaxone, Doxycycline, and
Metronidazole.
3. A 68-year-old male with heart failure with reduced ejection fraction
(HFrEF) and an EF of 25% is on a beta-blocker and ACE inhibitor. Which
additional medication class is now considered standard guideline-
directed medical therapy to reduce mortality?
A. Calcium channel blocker
B. Loop diuretic
C. Mineralocorticoid receptor antagonist (MRA)
D. Digoxin
Answer: C
Rationale: MRAs (like spironolactone or eplerenone) are a cornerstone
of GDMT for HFrEF, significantly reducing mortality and hospitalizations.
SGLT2 inhibitors and ARNIs are also part of GDMT.
4. A 4-year-old child presents with a sudden onset of fever, barking
cough, and inspiratory stridor. The child is otherwise healthy and has no
history of foreign body aspiration. What is the most appropriate first-
line pharmacologic treatment?
A. Albuterol nebulizer
B. Dexamethasone
C. Amoxicillin
D. Diphenhydramine
Answer: B
Rationale: The presentation is classic for croup
(laryngotracheobronchitis). A single dose of oral, IM, or IV
dexamethasone is the standard first-line treatment to reduce airway
inflammation and edema.
,5. A 30-year-old female presents with a 3-week history of depressed
mood, anhedonia, insomnia, and fatigue. She has no suicidal ideation
and no history of mania. What is the most appropriate first-line
pharmacologic therapy?
A. Fluoxetine
B. Lithium
C. Alprazolam
D. Quetiapine
Answer: A
Rationale: SSRIs like fluoxetine are considered first-line treatment for
Major Depressive Disorder due to their efficacy and favorable safety
profile. Lithium is for bipolar disorder, and benzodiazepines are not first-
line for depression.
6. A 45-year-old male presents with a 3-month history of heartburn,
regurgitation, and a sour taste in his mouth, especially after eating large
meals. What is the most appropriate initial management?
A. Immediate referral for endoscopy
B. Lifestyle modifications and a proton pump inhibitor (PPI) trial
C. H2 blocker as needed
D. Antibiotic therapy for H. pylori
Answer: B
Rationale: For typical GERD symptoms without alarm features (e.g.,
dysphagia, weight loss, anemia), the initial approach is lifestyle
modification and an 8-week trial of a PPI.
7. A 65-year-old female presents with chronic knee pain that worsens
with activity and improves with rest. She has morning stiffness lasting
less than 30 minutes. X-rays show joint space narrowing and
osteophytes. What is the most appropriate initial management?
, A. Methotrexate
B. Acetaminophen and physical therapy
C. Intra-articular corticosteroid injection
D. Colchicine
Answer: B
Rationale: The presentation is consistent with osteoarthritis. First-line
management includes acetaminophen or NSAIDs, along with physical
therapy, weight loss, and exercise. Methotrexate is for RA, and
colchicine is for gout.
8. A 52-year-old postmenopausal female presents with severe hot
flashes and night sweats that disrupt her sleep. She has no history of
breast cancer or thromboembolic disease. What is the most effective
treatment?
A. SSRI
B. Systemic estrogen therapy
C. Gabapentin
D. Clonidine
Answer: B
Rationale: Systemic estrogen therapy is the most effective treatment for
vasomotor symptoms in postmenopausal women without
contraindications. SSRIs, gabapentin, and clonidine are non-hormonal
alternatives.
9. A 72-year-old male presents with sudden onset of right-sided
weakness and aphasia. His symptoms started 45 minutes ago. What is
the most appropriate immediate action?
A. Administer aspirin 325mg orally
B. Obtain a non-contrast CT scan of the head
C. Administer IV tissue plasminogen activator (tPA)
