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NURS5433 Family II FNP 2 Midterm Exam 2026/2027
Actual Exam - Complete Questions with Detailed
Rationales | 100% Verified Graded A+ Pass Guaranteed
- A+ Graded
Exam Overview
• Course: NURS5433 – Family II (FNP 2)
• Institution: University of Texas at Arlington
• Exam Type: Midterm (actual exam)
• Focus Areas: Advanced primary care, family nursing, differential diagnosis, pharmacology,
pathophysiology, and evidence-based interventions across the lifespan
• Question Format: Multiple-choice, select-all-that-apply, and clinical case scenarios
• Success Strategy: Master the 3Ps (Pathophysiology, Pharmacology, Physical Assessment) and
apply them to family-centered care.
100 Exam-Style Questions & Answers with Rationales
✅ Pathophysiology & Cellular Adaptation
1. A patient’s lung biopsy shows disorganized, atypical cells with variations in size, shape, and nuclear
appearance. Which type of cellular adaptation is most concerning?
A) Metaplasia
B) Hypertrophy
C) Dysplasia
D) Hyperplasia
Rationale: Dysplasia is characterized by disordered growth and is considered a pre-malignant change. It
is the most concerning adaptation among the options.
2. Which statement about hypertrophy is correct?
A) Hypertrophy decreases cell size
B) Hypertrophy is always pathologic
,2
C) Hypertrophy involves an increase in cell size
D) Hypertrophy leads to a decrease in organ size
Rationale: Hypertrophy refers to an increase in the size of cells, which increases the overall size of the
organ.
3. A patient with left-sided heart failure is expected to exhibit which clinical manifestation?
A) Jugular venous distention
B) Peripheral edema
C) Crackles in the lungs
D) Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in crackles, cough, and
dyspnea. Right-sided failure produces systemic congestion (JVD, edema, hepatomegaly).
4. The pathogenesis of pneumonia includes inhalation of microbial agents and which of the following?
A) Inflammation, formation of exudates, and lung consolidation
B) Bronchospasm and mucus hypersecretion
C) Alveolar fibrosis and honeycombing
D) Pulmonary hypertension
Rationale: Pneumonia triggers an inflammatory response, exudate formation, and consolidation of lung
tissue, impairing gas exchange.
5. Which cells originate from the myeloid lineage?
A) Lymphocytes and plasma cells
B) Monocytes, granulocytes, and platelets
C) Natural killer cells and T-cells
D) Erythrocytes and mast cells
Rationale: Myeloid lineage produces monocytes, granulocytes (neutrophils, eosinophils, basophils), and
platelets. Lymphocytes arise from the lymphoid lineage.
✅ Pharmacology & Medication Management
6. A patient with heart failure is prescribed furosemide. Which finding indicates the medication is
effective?
A) Increased jugular venous distention
B) Weight loss of 1-2 kg in 24 hours
C) 3+ pitting edema
D) Crackles in the lung bases
,3
Rationale: Weight loss indicates diuresis and reduction of fluid overload, confirming effective treatment.
7. A patient with type 2 diabetes is started on metformin. Which instruction is correct?
A) Take with food to reduce gastrointestinal side effects
B) Take on an empty stomach for better absorption
C) Expect weight gain as a common side effect
D) Discontinue if blood glucose is normal
Rationale: Metformin should be taken with meals to minimize GI upset. It is weight-neutral and does
not cause hypoglycemia alone.
8. A patient with hypertension is prescribed lisinopril. Which adverse effect is specific to ACE inhibitors?
A) Hyperkalemia
B) Dry cough
C) Hypoglycemia
D) Weight gain
Rationale: ACE inhibitors cause a dry cough due to bradykinin accumulation. ARBs do not cause cough.
9. A patient with atrial fibrillation is prescribed warfarin. The INR is 4.5. The patient is not bleeding.
What is the priority action?
A) Administer vitamin K
B) Hold the next dose of warfarin and notify the provider
C) Increase the warfarin dose
D) Give fresh frozen plasma
Rationale: An INR of 4.5 is supratherapeutic. Hold warfarin and notify the provider; vitamin K is reserved
for INR >10 or bleeding.
10. A patient with heart failure is prescribed carvedilol. The nurse should monitor for which adverse
effect?
A) Tachycardia
B) Bradycardia
C) Hypertension
D) Hypoglycemia
Rationale: Carvedilol is a beta-blocker that can cause bradycardia and hypotension.
✅ Physical Assessment & Diagnostic Reasoning
, 4
11. During a respiratory assessment, you auscultate fine, late-inspiratory crackles at the lung bases. This
finding is most consistent with:
A) Pulmonary fibrosis or heart failure
B) Asthma
C) COPD
D) Pneumothorax
Rationale: Fine, late-inspiratory crackles are characteristic of interstitial lung disease or pulmonary
edema.
12. A patient with COPD has an oxygen saturation of 88% on room air. The nurse applies oxygen at 2
L/min via nasal cannula. Which finding indicates an adverse effect?
A) Oxygen saturation increases to 92%
B) Decreased respiratory rate from 22 to 10 breaths/min
C) Patient reports less shortness of breath
D) Patient is able to ambulate
Rationale: In COPD, high oxygen can suppress the hypoxic drive, causing hypoventilation and CO₂
retention.
13. A patient with a history of alcohol use disorder is admitted with confusion, ataxia, and nystagmus.
Which medication should the nurse prepare to administer?
A) Lorazepam
B) Thiamine
C) Naloxone
D) Folic acid
Rationale: Wernicke’s encephalopathy is caused by thiamine deficiency and requires urgent thiamine
replacement.
14. A patient with a new colostomy asks how to prevent skin breakdown around the stoma. Which
instruction is correct?
A) "Use adhesive remover to remove the pouch."
B) "Cut the pouch opening to fit snugly around the stoma."
C) "Apply lotion to the peristomal skin daily."
D) "Change the pouch every day."
Rationale: A correctly fitted opening prevents leakage and skin irritation.
15. A patient with a central venous catheter (CVC) has redness, fever, chills, and a positive blood culture.
This indicates:
A) Phlebitis
NURS5433 Family II FNP 2 Midterm Exam 2026/2027
Actual Exam - Complete Questions with Detailed
Rationales | 100% Verified Graded A+ Pass Guaranteed
- A+ Graded
Exam Overview
• Course: NURS5433 – Family II (FNP 2)
• Institution: University of Texas at Arlington
• Exam Type: Midterm (actual exam)
• Focus Areas: Advanced primary care, family nursing, differential diagnosis, pharmacology,
pathophysiology, and evidence-based interventions across the lifespan
• Question Format: Multiple-choice, select-all-that-apply, and clinical case scenarios
• Success Strategy: Master the 3Ps (Pathophysiology, Pharmacology, Physical Assessment) and
apply them to family-centered care.
100 Exam-Style Questions & Answers with Rationales
✅ Pathophysiology & Cellular Adaptation
1. A patient’s lung biopsy shows disorganized, atypical cells with variations in size, shape, and nuclear
appearance. Which type of cellular adaptation is most concerning?
A) Metaplasia
B) Hypertrophy
C) Dysplasia
D) Hyperplasia
Rationale: Dysplasia is characterized by disordered growth and is considered a pre-malignant change. It
is the most concerning adaptation among the options.
2. Which statement about hypertrophy is correct?
A) Hypertrophy decreases cell size
B) Hypertrophy is always pathologic
,2
C) Hypertrophy involves an increase in cell size
D) Hypertrophy leads to a decrease in organ size
Rationale: Hypertrophy refers to an increase in the size of cells, which increases the overall size of the
organ.
3. A patient with left-sided heart failure is expected to exhibit which clinical manifestation?
A) Jugular venous distention
B) Peripheral edema
C) Crackles in the lungs
D) Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in crackles, cough, and
dyspnea. Right-sided failure produces systemic congestion (JVD, edema, hepatomegaly).
4. The pathogenesis of pneumonia includes inhalation of microbial agents and which of the following?
A) Inflammation, formation of exudates, and lung consolidation
B) Bronchospasm and mucus hypersecretion
C) Alveolar fibrosis and honeycombing
D) Pulmonary hypertension
Rationale: Pneumonia triggers an inflammatory response, exudate formation, and consolidation of lung
tissue, impairing gas exchange.
5. Which cells originate from the myeloid lineage?
A) Lymphocytes and plasma cells
B) Monocytes, granulocytes, and platelets
C) Natural killer cells and T-cells
D) Erythrocytes and mast cells
Rationale: Myeloid lineage produces monocytes, granulocytes (neutrophils, eosinophils, basophils), and
platelets. Lymphocytes arise from the lymphoid lineage.
✅ Pharmacology & Medication Management
6. A patient with heart failure is prescribed furosemide. Which finding indicates the medication is
effective?
A) Increased jugular venous distention
B) Weight loss of 1-2 kg in 24 hours
C) 3+ pitting edema
D) Crackles in the lung bases
,3
Rationale: Weight loss indicates diuresis and reduction of fluid overload, confirming effective treatment.
7. A patient with type 2 diabetes is started on metformin. Which instruction is correct?
A) Take with food to reduce gastrointestinal side effects
B) Take on an empty stomach for better absorption
C) Expect weight gain as a common side effect
D) Discontinue if blood glucose is normal
Rationale: Metformin should be taken with meals to minimize GI upset. It is weight-neutral and does
not cause hypoglycemia alone.
8. A patient with hypertension is prescribed lisinopril. Which adverse effect is specific to ACE inhibitors?
A) Hyperkalemia
B) Dry cough
C) Hypoglycemia
D) Weight gain
Rationale: ACE inhibitors cause a dry cough due to bradykinin accumulation. ARBs do not cause cough.
9. A patient with atrial fibrillation is prescribed warfarin. The INR is 4.5. The patient is not bleeding.
What is the priority action?
A) Administer vitamin K
B) Hold the next dose of warfarin and notify the provider
C) Increase the warfarin dose
D) Give fresh frozen plasma
Rationale: An INR of 4.5 is supratherapeutic. Hold warfarin and notify the provider; vitamin K is reserved
for INR >10 or bleeding.
10. A patient with heart failure is prescribed carvedilol. The nurse should monitor for which adverse
effect?
A) Tachycardia
B) Bradycardia
C) Hypertension
D) Hypoglycemia
Rationale: Carvedilol is a beta-blocker that can cause bradycardia and hypotension.
✅ Physical Assessment & Diagnostic Reasoning
, 4
11. During a respiratory assessment, you auscultate fine, late-inspiratory crackles at the lung bases. This
finding is most consistent with:
A) Pulmonary fibrosis or heart failure
B) Asthma
C) COPD
D) Pneumothorax
Rationale: Fine, late-inspiratory crackles are characteristic of interstitial lung disease or pulmonary
edema.
12. A patient with COPD has an oxygen saturation of 88% on room air. The nurse applies oxygen at 2
L/min via nasal cannula. Which finding indicates an adverse effect?
A) Oxygen saturation increases to 92%
B) Decreased respiratory rate from 22 to 10 breaths/min
C) Patient reports less shortness of breath
D) Patient is able to ambulate
Rationale: In COPD, high oxygen can suppress the hypoxic drive, causing hypoventilation and CO₂
retention.
13. A patient with a history of alcohol use disorder is admitted with confusion, ataxia, and nystagmus.
Which medication should the nurse prepare to administer?
A) Lorazepam
B) Thiamine
C) Naloxone
D) Folic acid
Rationale: Wernicke’s encephalopathy is caused by thiamine deficiency and requires urgent thiamine
replacement.
14. A patient with a new colostomy asks how to prevent skin breakdown around the stoma. Which
instruction is correct?
A) "Use adhesive remover to remove the pouch."
B) "Cut the pouch opening to fit snugly around the stoma."
C) "Apply lotion to the peristomal skin daily."
D) "Change the pouch every day."
Rationale: A correctly fitted opening prevents leakage and skin irritation.
15. A patient with a central venous catheter (CVC) has redness, fever, chills, and a positive blood culture.
This indicates:
A) Phlebitis
