NR667 Week 3 Actual Exam Style V1 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 58-year-old African American male presents with a blood pressure of 152/94 mmHg on
two separate occasions. According to JNC 8 guidelines, which of the following is the most
appropriate initial treatment?
A. Lisinopril
B. Losartan
C. Metoprolol
D. Amlodipine
Answer: D
Rationale: For African American patients with hypertension without chronic kidney
disease, initial therapy should include a thiazide-type diuretic or a calcium channel blocker.
Amlodipine is a calcium channel blocker and is preferred in this population due to higher
efficacy in lowering blood pressure. This differs from non-black patients where ACE
inhibitors or ARBs might be the first line of treatment.
2. Which of the following laboratory findings is the most sensitive indicator for diagnosing
iron deficiency anemia?
A. Serum Iron
,B. Total Iron Binding Capacity (TIBC)
C. Hemoglobin level
D. Serum Ferritin
Answer: D
Rationale: Serum ferritin reflects the total body iron stores and is the most sensitive test
for iron deficiency. A low ferritin level is almost always diagnostic of iron deficiency, even
before the hemoglobin drops. TIBC is usually elevated in iron deficiency, but it is less
specific than ferritin.
3. A 65-year-old male presents with urinary frequency, urgency, and a weak stream. His PSA
is 2.4 ng/mL and his digital rectal exam (DRE) reveals a smooth, enlarged prostate. What is
the most likely diagnosis?
A. Benign Prostatic Hyperplasia (BPH)
B. Acute Prostatitis
C. Prostate Cancer
D. Urinary Tract Infection
Answer: A
Rationale: Benign Prostatic Hyperplasia (BPH) commonly presents with lower urinary
tract symptoms in aging men. The smooth enlargement found on DRE and a PSA within the
normal range for his age support this diagnosis over malignancy. Initial management
, usually involves alpha-blockers or 5-alpha-reductase inhibitors depending on the prostate
size and symptom severity.
4. In the treatment of a patient with newly diagnosed Type 2 Diabetes and an A1C of 7.8%,
what is the recommended first-line pharmacological therapy according to the ADA?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Sitagliptin
Answer: A
Rationale: Metformin is the gold standard for initial pharmacological treatment of Type 2
Diabetes unless contraindicated. It works primarily by decreasing hepatic glucose
production and improving insulin sensitivity. Metformin is preferred due to its efficacy, low
risk of hypoglycemia, and weight neutrality.
5. A 24-year-old female presents with a malodorous vaginal discharge. Physical exam reveals
a thin, grayish-white discharge and a positive ‘whiff test’ with KOH. What is the treatment of
choice?
A. Fluconazole 150 mg PO once
B. Ceftriaxone 500 mg IM once
C. Metronidazole 500 mg PO BID for 7 days
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 58-year-old African American male presents with a blood pressure of 152/94 mmHg on
two separate occasions. According to JNC 8 guidelines, which of the following is the most
appropriate initial treatment?
A. Lisinopril
B. Losartan
C. Metoprolol
D. Amlodipine
Answer: D
Rationale: For African American patients with hypertension without chronic kidney
disease, initial therapy should include a thiazide-type diuretic or a calcium channel blocker.
Amlodipine is a calcium channel blocker and is preferred in this population due to higher
efficacy in lowering blood pressure. This differs from non-black patients where ACE
inhibitors or ARBs might be the first line of treatment.
2. Which of the following laboratory findings is the most sensitive indicator for diagnosing
iron deficiency anemia?
A. Serum Iron
,B. Total Iron Binding Capacity (TIBC)
C. Hemoglobin level
D. Serum Ferritin
Answer: D
Rationale: Serum ferritin reflects the total body iron stores and is the most sensitive test
for iron deficiency. A low ferritin level is almost always diagnostic of iron deficiency, even
before the hemoglobin drops. TIBC is usually elevated in iron deficiency, but it is less
specific than ferritin.
3. A 65-year-old male presents with urinary frequency, urgency, and a weak stream. His PSA
is 2.4 ng/mL and his digital rectal exam (DRE) reveals a smooth, enlarged prostate. What is
the most likely diagnosis?
A. Benign Prostatic Hyperplasia (BPH)
B. Acute Prostatitis
C. Prostate Cancer
D. Urinary Tract Infection
Answer: A
Rationale: Benign Prostatic Hyperplasia (BPH) commonly presents with lower urinary
tract symptoms in aging men. The smooth enlargement found on DRE and a PSA within the
normal range for his age support this diagnosis over malignancy. Initial management
, usually involves alpha-blockers or 5-alpha-reductase inhibitors depending on the prostate
size and symptom severity.
4. In the treatment of a patient with newly diagnosed Type 2 Diabetes and an A1C of 7.8%,
what is the recommended first-line pharmacological therapy according to the ADA?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Sitagliptin
Answer: A
Rationale: Metformin is the gold standard for initial pharmacological treatment of Type 2
Diabetes unless contraindicated. It works primarily by decreasing hepatic glucose
production and improving insulin sensitivity. Metformin is preferred due to its efficacy, low
risk of hypoglycemia, and weight neutrality.
5. A 24-year-old female presents with a malodorous vaginal discharge. Physical exam reveals
a thin, grayish-white discharge and a positive ‘whiff test’ with KOH. What is the treatment of
choice?
A. Fluconazole 150 mg PO once
B. Ceftriaxone 500 mg IM once
C. Metronidazole 500 mg PO BID for 7 days
