NR667 - FNP Capstone Week 1 Full Length Practice Exam/150 Questions and Answers 100% Correct

NR667 - FNP Capstone Week 1 Full Length Practice
Exam/150 Questions and Answers 100% Correct




NR667 - FNP Capstone Week 1 Full Length Practice Exam
150 Most Tested & Most Difficult Questions with Answers


Question 1
Effective long-term treatment of systolic heart failure with reduced ejection
fraction should include which of the following?
A. Prescribing 500 ml fluid bolus for hypotension
B. Auscultating lung sounds for rhonchi
C. Prescribing valsartan/sacubitril (Entresto) unless contraindicated on discharge
D. Prescribing midazolam to aid with air hunger
Answer =: C. Prescribing valsartan/sacubitril (Entresto) unless contraindicated
on discharge
Rationale: Angiotensin Receptor and Neprilysin Inhibition is considered goal-
directed therapy for patients with reduced systolic heart function as evidenced by
the PARAGON-HF Trial. Auscultation is an assessment item, not a treatment.
Midazolam does not have any long-term benefit for heart failure. Fluid bolus in a
patient with likely fluid overload from systolic heart failure would only worsen
their presenting symptoms.


Question 2
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis,

,and shortness of breath. His ECG shows ST-segment elevation. What is the initial
management response?
A. Administer nitroglycerin sublingually
B. Start intravenous heparin
C. Perform immediate coronary angiography
D. Administer aspirin and call for emergency medical services
Answer =: D. Administer aspirin and call for emergency medical services


Question 3
An 80-year-old man with a history of atrial fibrillation presents with sudden-onset
unilateral leg pain and pallor. What is the most likely diagnosis?
A. Deep vein thrombosis
B. Acute arterial occlusion
C. Cellulitis
D. Peripheral artery disease
Answer =: B. Acute arterial occlusion


Question 4
An older adult female presents for her annual examination. She has been on
antihypertensive medications for over 20 years, with good control. Laboratory
values are within normal ranges. The nurse practitioner is concerned about the
patient's cardiac health risks due to her weight and her waist circumference.
According to the AHA guidelines, which of the following goals is expected for this
patient?
A. Physical activity for 60 minutes daily, 7 days a week
B. Physical activity for 30 minutes daily, 7 days a week
C. Physical activity for 30 minutes daily, for a minimum of 5 days a week
D. Physical activity for 60 minutes daily, for a minimum of 6 days a week
Answer =: C. Physical activity for 30 minutes daily, for a minimum of 5 days a
week

,Question 5
Recommendation for lipid check in adolescent with type 1 DM?
A. 10 years
B. 5 years
C. 2 years
D. 1 year
Answer =: D. 1 year
Rationale: Remember that with pediatric patients with diabetes, the easiest way
to remember the evaluation schedule is to perform lipid checks with annual
physicals.


Question 6
An adult patient must maintain an International Normalized Ratio (INR) between
2.0 and 3.0. The patient goes to a clinic for INR determination, and the result is
1.4. Which of the following would be likely to decrease the effects of warfarin
(Coumadin)?
A. Red Wine
B. Red meat
C. Broccoli
D. Grapefruit
Answer =: C. Broccoli
Rationale: It's important to remember with warfarin (Coumadin) therapy that it is
a vitamin K antagonist, and therefore it can be counteracted by a patient who is
eating a dietary intake of vitamin K. Leafy green vegetables such as broccoli and
spinach are notorious for increasing vitamin K levels, and therefore inhibiting the
anticoagulation effect of warfarin. It's also important to remember that with the
direct oral anticoagulants category, vitamin K is not affected, and therefore no
dietary restrictions are required for this class of medications such as apixaban,
rivaroxaban, and edoxaban, which is a distinct benefit over warfarin as noted
above. Also, with warfarin it is important to remember that the effects are based

, on the free drug, not the protein bound drug level, so patients who have
considerable protein stores will require more warfarin than those who are
emaciated or have low protein levels chronically. With respect to this particular
question, red wine and grapefruit do not have an effect of lowering the INR; in
fact, they will raise it by their unique mechanisms. Grapefruit specifically causes
warfarin levels to rise through the CYP 450 system, and red wine causes the INR to
increase by thinning the blood. Red meat is not likely to have a considerable
impact, although it might have some impact if the protein stores are otherwise
low prior to initiating the red meat in the diet. Broccoli is the only option that has
vitamin K.


Question 7
A patient has been complaining of palpitations for the past week and presents to
you at an urgent care clinic for evaluation. You perform a 12 lead EKG and identify
atrial fibrillation with a heart rate of 122 beats per minute. What is your next
order?
A. Administer 5mg of warfarin
B. Apply a Holter monitor
C. Administer 150mg of amiodarone IV bolus
D. Order a stat transthoracic (2D) echocardiogram and prepare the patient for
transport to the closest appropriate hospital for inpatient evaluation
Answer =: D. Order a stat transthoracic (2D) echocardiogram and prepare the
patient for transport to the closest appropriate hospital for inpatient evaluation
Rationale: A wearable monitor does not provide you with actionable information
until it is read, and the patient is already identified as being in atrial fibrillation.
Warfarin without bridging will take several days to achieve a therapeutic INR and
without bridging (as it is not mentioned) would potentially increase prothrombotic
state for first few days due to inhibition of protein C and S. Amiodarone is a
rhythm conversion medication and should not be given unless first identifying any
evidence of clot burden with an echocardiogram.