NURS 5433 Family II (FNP) 2026/2027 — Original Practice
FAMILY NURSE PRACTITIONER — FAMILY II
NURS 5433 / NURS5433 Final Exam
Family II (FNP 2) Review • UTA • 2026/2027
Original practice questions for advanced primary-care family practice
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ Cardiovascular Conditions
■ Endocrine Disorders
■ Respiratory Conditions
■ Women's Health & Reproductive Care
■ Geriatrics & Complex Primary Care
NOTICE: This is an original practice examination created for study purposes. It is not an official University of Texas at Arlington, College of Nursing, or board
examination. All questions and rationales are newly written and aligned to common Family II / FNP primary-care competencies. Passing score on this set: 80%.
STUVIAACTUALEXAM
STUVIAACTUALEXAM Page 1
, NURS 5433 Family II (FNP) 2026/2027 — Original Practice
DOMAIN: CARDIOVASCULAR CONDITIONS
Q1. A 58-year-old man with stage 2 hypertension returns for follow-up. He is currently taking lisinopril 20 mg daily. Blood pressure today is
148/92 mm Hg. He reports a persistent dry cough that began after starting the ACE inhibitor. The most appropriate next step is to:
A. Increase lisinopril to 40 mg daily and recheck in 4 weeks.
B. Discontinue lisinopril and initiate an angiotensin-receptor blocker such as losartan, then reassess blood pressure and cough.
C. Add hydrochlorothiazide and continue the current lisinopril dose.
D. Switch to a non-dihydropyridine calcium-channel blocker as monotherapy.
Correct Answer: A
Rationale: ACE-inhibitor–induced cough is common and resolves after discontinuation. An ARB provides similar renin-angiotensin blockade without the cough
side effect and is an appropriate substitution.
Q2. A 67-year-old woman with HFrEF (EF 30%) is on carvedilol, sacubitril/valsartan, and spironolactone. She presents with progressive
dyspnea and 3+ bilateral edema. Serum potassium is 4.8 mEq/L and eGFR is 55 mL/min. The most evidence-based addition is:
A. Start digoxin primarily for symptom relief and rate control.
B. Initiate an SGLT2 inhibitor such as dapagliflozin, which has proven benefit in HFrEF independent of diabetes status.
C. Add verapamil for additional afterload reduction.
D. Discontinue spironolactone because of the borderline potassium.
Correct Answer: B
Rationale: SGLT2 inhibitors reduce heart-failure hospitalizations and cardiovascular death in HFrEF and are now foundational therapy. Her renal function and
potassium permit continuation of the MRA.
Q3. A 72-year-old man with atrial fibrillation (CHA2DS2-VASc score 4) is rate-controlled on metoprolol. He has normal renal function and no
history of GI bleeding. The preferred oral anticoagulant for stroke prevention is:
A. Aspirin 325 mg daily alone.
B. A direct oral anticoagulant (e.g., apixaban or rivaroxaban) rather than warfarin in the absence of moderate-to-severe mitral stenosis or
mechanical valve.
C. Warfarin with a target INR of 3.5–4.0.
D. No anticoagulation because he is already on a beta-blocker.
Correct Answer: C
Rationale: DOACs are preferred over warfarin for non-valvular AF in most patients because of lower intracranial hemorrhage risk and fewer monitoring
requirements. Aspirin alone is insufficient for a CHA2DS2-VASc of 4.
Q4. A 55-year-old woman with LDL-C of 165 mg/dL and a 10-year ASCVD risk of 12% is started on atorvastatin 20 mg. Six weeks later her
LDL-C is 118 mg/dL and she reports mild myalgias without CK elevation. The most appropriate action is:
A. Immediately discontinue the statin permanently.
B. Continue the statin, counsel on symptom monitoring, and consider dose adjustment or alternative statin if myalgias persist or worsen.
C. Switch to a high-intensity PCSK9 inhibitor as first-line therapy.
D. Add gemfibrozil to further lower LDL-C.
Correct Answer: D
Rationale: Mild myalgias without CK elevation are common and often manageable. Continuing or adjusting statin therapy is preferred over abandonment of
proven ASCVD risk reduction.
Q5. A 60-year-old man with stable ischemic heart disease is on aspirin, metoprolol, and atorvastatin. He develops intermittent claudication.
Ankle-brachial index is 0.75. In addition to supervised exercise and risk-factor control, the next pharmacologic consideration is:
A. Start cilostazol if no heart-failure contraindication exists, and ensure antiplatelet therapy is optimized.
B. Add warfarin for all patients with PAD.
C. Discontinue the beta-blocker because it worsens claudication in every case.
D. Initiate high-dose niacin as primary therapy.
Correct Answer: A
Rationale: Cilostazol improves walking distance in PAD and is appropriate when heart failure is absent. Antiplatelet therapy and intensive risk-factor
modification remain foundational.
Q6. A 48-year-old woman presents with sudden severe tearing chest pain radiating to the back. Blood pressure is 190/110 mm Hg in the right
arm and 160/95 mm Hg in the left arm. The most critical immediate action is:
A. Administer sublingual nitroglycerin and observe for 30 minutes.
B. Activate emergency transport for suspected acute aortic syndrome and arrange urgent imaging and blood-pressure control in an acute-care
setting.
C. Schedule an outpatient CT angiogram for the following week.
D. Start oral metoprolol and discharge with close follow-up.
Correct Answer: B
Rationale: Sudden severe tearing pain with pulse or blood-pressure differentials raises concern for acute aortic dissection. Immediate transfer to an
emergency facility is required.
STUVIAACTUALEXAM Page 2
FAMILY NURSE PRACTITIONER — FAMILY II
NURS 5433 / NURS5433 Final Exam
Family II (FNP 2) Review • UTA • 2026/2027
Original practice questions for advanced primary-care family practice
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ Cardiovascular Conditions
■ Endocrine Disorders
■ Respiratory Conditions
■ Women's Health & Reproductive Care
■ Geriatrics & Complex Primary Care
NOTICE: This is an original practice examination created for study purposes. It is not an official University of Texas at Arlington, College of Nursing, or board
examination. All questions and rationales are newly written and aligned to common Family II / FNP primary-care competencies. Passing score on this set: 80%.
STUVIAACTUALEXAM
STUVIAACTUALEXAM Page 1
, NURS 5433 Family II (FNP) 2026/2027 — Original Practice
DOMAIN: CARDIOVASCULAR CONDITIONS
Q1. A 58-year-old man with stage 2 hypertension returns for follow-up. He is currently taking lisinopril 20 mg daily. Blood pressure today is
148/92 mm Hg. He reports a persistent dry cough that began after starting the ACE inhibitor. The most appropriate next step is to:
A. Increase lisinopril to 40 mg daily and recheck in 4 weeks.
B. Discontinue lisinopril and initiate an angiotensin-receptor blocker such as losartan, then reassess blood pressure and cough.
C. Add hydrochlorothiazide and continue the current lisinopril dose.
D. Switch to a non-dihydropyridine calcium-channel blocker as monotherapy.
Correct Answer: A
Rationale: ACE-inhibitor–induced cough is common and resolves after discontinuation. An ARB provides similar renin-angiotensin blockade without the cough
side effect and is an appropriate substitution.
Q2. A 67-year-old woman with HFrEF (EF 30%) is on carvedilol, sacubitril/valsartan, and spironolactone. She presents with progressive
dyspnea and 3+ bilateral edema. Serum potassium is 4.8 mEq/L and eGFR is 55 mL/min. The most evidence-based addition is:
A. Start digoxin primarily for symptom relief and rate control.
B. Initiate an SGLT2 inhibitor such as dapagliflozin, which has proven benefit in HFrEF independent of diabetes status.
C. Add verapamil for additional afterload reduction.
D. Discontinue spironolactone because of the borderline potassium.
Correct Answer: B
Rationale: SGLT2 inhibitors reduce heart-failure hospitalizations and cardiovascular death in HFrEF and are now foundational therapy. Her renal function and
potassium permit continuation of the MRA.
Q3. A 72-year-old man with atrial fibrillation (CHA2DS2-VASc score 4) is rate-controlled on metoprolol. He has normal renal function and no
history of GI bleeding. The preferred oral anticoagulant for stroke prevention is:
A. Aspirin 325 mg daily alone.
B. A direct oral anticoagulant (e.g., apixaban or rivaroxaban) rather than warfarin in the absence of moderate-to-severe mitral stenosis or
mechanical valve.
C. Warfarin with a target INR of 3.5–4.0.
D. No anticoagulation because he is already on a beta-blocker.
Correct Answer: C
Rationale: DOACs are preferred over warfarin for non-valvular AF in most patients because of lower intracranial hemorrhage risk and fewer monitoring
requirements. Aspirin alone is insufficient for a CHA2DS2-VASc of 4.
Q4. A 55-year-old woman with LDL-C of 165 mg/dL and a 10-year ASCVD risk of 12% is started on atorvastatin 20 mg. Six weeks later her
LDL-C is 118 mg/dL and she reports mild myalgias without CK elevation. The most appropriate action is:
A. Immediately discontinue the statin permanently.
B. Continue the statin, counsel on symptom monitoring, and consider dose adjustment or alternative statin if myalgias persist or worsen.
C. Switch to a high-intensity PCSK9 inhibitor as first-line therapy.
D. Add gemfibrozil to further lower LDL-C.
Correct Answer: D
Rationale: Mild myalgias without CK elevation are common and often manageable. Continuing or adjusting statin therapy is preferred over abandonment of
proven ASCVD risk reduction.
Q5. A 60-year-old man with stable ischemic heart disease is on aspirin, metoprolol, and atorvastatin. He develops intermittent claudication.
Ankle-brachial index is 0.75. In addition to supervised exercise and risk-factor control, the next pharmacologic consideration is:
A. Start cilostazol if no heart-failure contraindication exists, and ensure antiplatelet therapy is optimized.
B. Add warfarin for all patients with PAD.
C. Discontinue the beta-blocker because it worsens claudication in every case.
D. Initiate high-dose niacin as primary therapy.
Correct Answer: A
Rationale: Cilostazol improves walking distance in PAD and is appropriate when heart failure is absent. Antiplatelet therapy and intensive risk-factor
modification remain foundational.
Q6. A 48-year-old woman presents with sudden severe tearing chest pain radiating to the back. Blood pressure is 190/110 mm Hg in the right
arm and 160/95 mm Hg in the left arm. The most critical immediate action is:
A. Administer sublingual nitroglycerin and observe for 30 minutes.
B. Activate emergency transport for suspected acute aortic syndrome and arrange urgent imaging and blood-pressure control in an acute-care
setting.
C. Schedule an outpatient CT angiogram for the following week.
D. Start oral metoprolol and discharge with close follow-up.
Correct Answer: B
Rationale: Sudden severe tearing pain with pulse or blood-pressure differentials raises concern for acute aortic dissection. Immediate transfer to an
emergency facility is required.
STUVIAACTUALEXAM Page 2
