NR667 Week 4 Actual Exam Style V2 NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 65-year-old male presents with a cough and progressive shortness of breath. His
FEV1/FVC ratio is 0.65, and his FEV1 is 70% of predicted. According to the GOLD criteria,
which category of COPD does this patient fall into?
A. Mild COPD (GOLD 1)
B. Very Severe COPD (GOLD 4)
C. Severe COPD (GOLD 3)
D. Moderate COPD (GOLD 2)
Answer: D
Rationale: The GOLD criteria define moderate COPD (GOLD 2) as an FEV1 between 50%
and 80% of predicted. Since the patient’s FEV1 is 70%, he fits into this category. The
FEV1/FVC ratio of less than 0.70 confirms the presence of persistent airflow limitation.
2. Which of the following is the most appropriate initial treatment for a patient newly
diagnosed with Stage 1 Hypertension and an ASCVD risk of 12%?
A. Lifestyle modifications only for 6 months
B. Metoprolol 25 mg daily
C. Lisinopril 10 mg daily
,D. Spironolactone 25 mg daily
Answer: C
Rationale: According to the ACC/AHA guidelines, patients with Stage 1 Hypertension and
an ASCVD risk greater than 10% should be started on pharmacological therapy. ACE
inhibitors like Lisinopril are considered first-line agents for most patients. Lifestyle
modifications should always accompany medication rather than being the sole treatment in
high-risk individuals.
3. An 18-month-old child is brought in for a well-child visit. Which developmental milestone
should the nurse practitioner expect the child to have achieved?
A. Speaking in 4- to 5-word sentences
B. Running well without falling
C. Walking up and down stairs alone
D. Walking while holding onto furniture
Answer: B
Rationale: By 18 months of age, children are typically able to run well and walk
independently. Walking while holding onto furniture is a milestone more typical of a 10- to
12-month-old. Complex sentences are not expected until approximately 3 to 4 years of age.
4. A patient presents with a TSH level of 8.2 mIU/L and a normal Free T4 level. The patient
reports mild fatigue but no other symptoms. What is the most likely diagnosis?
A. Primary Hyperthyroidism
, B. Secondary Hypothyroidism
C. Subclinical Hypothyroidism
D. Euthyroid Sick Syndrome
Answer: C
Rationale: Subclinical hypothyroidism is characterized by an elevated TSH level in the
presence of a normal Free T4 level. Treatment is typically considered if the TSH exceeds 10
mIU/L or if the patient is symptomatic. Monitoring is often recommended before initiating
levothyroxine in mild cases.
5. Which physical exam maneuver is most sensitive for detecting an anterior cruciate
ligament (ACL) tear?
A. McMurray test
B. Lachman test
C. Posterior drawer test
D. Valgus stress test
Answer: B
Rationale: The Lachman test is widely recognized as the most sensitive physical
examination maneuver for diagnosing an ACL injury. It involves stabilizing the femur and
pulling the tibia anteriorly at a 20- to 30-degree angle. The McMurray test is used for
meniscus tears, while the posterior drawer test assesses the PCL.
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 65-year-old male presents with a cough and progressive shortness of breath. His
FEV1/FVC ratio is 0.65, and his FEV1 is 70% of predicted. According to the GOLD criteria,
which category of COPD does this patient fall into?
A. Mild COPD (GOLD 1)
B. Very Severe COPD (GOLD 4)
C. Severe COPD (GOLD 3)
D. Moderate COPD (GOLD 2)
Answer: D
Rationale: The GOLD criteria define moderate COPD (GOLD 2) as an FEV1 between 50%
and 80% of predicted. Since the patient’s FEV1 is 70%, he fits into this category. The
FEV1/FVC ratio of less than 0.70 confirms the presence of persistent airflow limitation.
2. Which of the following is the most appropriate initial treatment for a patient newly
diagnosed with Stage 1 Hypertension and an ASCVD risk of 12%?
A. Lifestyle modifications only for 6 months
B. Metoprolol 25 mg daily
C. Lisinopril 10 mg daily
,D. Spironolactone 25 mg daily
Answer: C
Rationale: According to the ACC/AHA guidelines, patients with Stage 1 Hypertension and
an ASCVD risk greater than 10% should be started on pharmacological therapy. ACE
inhibitors like Lisinopril are considered first-line agents for most patients. Lifestyle
modifications should always accompany medication rather than being the sole treatment in
high-risk individuals.
3. An 18-month-old child is brought in for a well-child visit. Which developmental milestone
should the nurse practitioner expect the child to have achieved?
A. Speaking in 4- to 5-word sentences
B. Running well without falling
C. Walking up and down stairs alone
D. Walking while holding onto furniture
Answer: B
Rationale: By 18 months of age, children are typically able to run well and walk
independently. Walking while holding onto furniture is a milestone more typical of a 10- to
12-month-old. Complex sentences are not expected until approximately 3 to 4 years of age.
4. A patient presents with a TSH level of 8.2 mIU/L and a normal Free T4 level. The patient
reports mild fatigue but no other symptoms. What is the most likely diagnosis?
A. Primary Hyperthyroidism
, B. Secondary Hypothyroidism
C. Subclinical Hypothyroidism
D. Euthyroid Sick Syndrome
Answer: C
Rationale: Subclinical hypothyroidism is characterized by an elevated TSH level in the
presence of a normal Free T4 level. Treatment is typically considered if the TSH exceeds 10
mIU/L or if the patient is symptomatic. Monitoring is often recommended before initiating
levothyroxine in mild cases.
5. Which physical exam maneuver is most sensitive for detecting an anterior cruciate
ligament (ACL) tear?
A. McMurray test
B. Lachman test
C. Posterior drawer test
D. Valgus stress test
Answer: B
Rationale: The Lachman test is widely recognized as the most sensitive physical
examination maneuver for diagnosing an ACL injury. It involves stabilizing the femur and
pulling the tibia anteriorly at a 20- to 30-degree angle. The McMurray test is used for
meniscus tears, while the posterior drawer test assesses the PCL.
