NURS 5433 FNP II Final Exam (PDF) | (2026)
Family Nurse Practitioner Questions | FNP
1. A 58-year-old male with hypertension presents with
sudden onset of tearing chest pain radiating to the back.
BP is 160/100 in right arm, 110/70 in left arm. What is
the most appropriate next step?
A) Order a stat chest X-ray
B) Administer thrombolytics
C) Obtain a stat CT angiography
D) Start nitroglycerin drip
1
,Answer: C
Rationale: Differences in BP between arms with tearing
pain suggest aortic dissection. CT angiography is the
definitive diagnostic test. Thrombolytics are
contraindicated.
2. Which beta-blocker is preferred in heart failure with
reduced ejection fraction (HFrEF)?
A) Atenolol
B) Metoprolol succinate
C) Propranolol
D) Esmolol
2
,Answer: B
Rationale: Metoprolol succinate (extended release),
carvedilol, and bisoprolol are evidence-based for HFrEF.
Atenolol and propranolol are not indicated.
3. A 72-year-old with hypertension and DM type 2 has a
BP of 148/90. What is the first-line medication?
A) HCTZ
B) Amlodipine
C) Lisinopril
D) Metoprolol
3
, Answer: C
Rationale: ACE inhibitors (lisinopril) are first-line in
patients with DM and hypertension due to renoprotective
effects.
4. An ECG shows a regular narrow-complex tachycardia
at 180 bpm without visible P waves. The patient is
hemodynamically stable. Next step?
A) Adenosine 6 mg IV push
B) Synchronized cardioversion
C) Amiodarone 150 mg IV
4
Family Nurse Practitioner Questions | FNP
1. A 58-year-old male with hypertension presents with
sudden onset of tearing chest pain radiating to the back.
BP is 160/100 in right arm, 110/70 in left arm. What is
the most appropriate next step?
A) Order a stat chest X-ray
B) Administer thrombolytics
C) Obtain a stat CT angiography
D) Start nitroglycerin drip
1
,Answer: C
Rationale: Differences in BP between arms with tearing
pain suggest aortic dissection. CT angiography is the
definitive diagnostic test. Thrombolytics are
contraindicated.
2. Which beta-blocker is preferred in heart failure with
reduced ejection fraction (HFrEF)?
A) Atenolol
B) Metoprolol succinate
C) Propranolol
D) Esmolol
2
,Answer: B
Rationale: Metoprolol succinate (extended release),
carvedilol, and bisoprolol are evidence-based for HFrEF.
Atenolol and propranolol are not indicated.
3. A 72-year-old with hypertension and DM type 2 has a
BP of 148/90. What is the first-line medication?
A) HCTZ
B) Amlodipine
C) Lisinopril
D) Metoprolol
3
, Answer: C
Rationale: ACE inhibitors (lisinopril) are first-line in
patients with DM and hypertension due to renoprotective
effects.
4. An ECG shows a regular narrow-complex tachycardia
at 180 bpm without visible P waves. The patient is
hemodynamically stable. Next step?
A) Adenosine 6 mg IV push
B) Synchronized cardioversion
C) Amiodarone 150 mg IV
4
