NR667 Week 2 Actual Exam Style V1 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 45-year-old African American male presents with a blood pressure of 152/94 mmHg.
According to JNC 8 guidelines, which of the following is the most appropriate initial
treatment?
A. Lisinopril
B. Amlodipine
C. Losartan
D. Metoprolol
Answer: B
Rationale: According to JNC 8, initial antihypertensive treatment in the general black
population should include a thiazide-type diuretic or calcium channel blocker. Amlodipine
is a calcium channel blocker that is highly effective in this demographic. ACE inhibitors and
ARBs are generally less effective as monotherapy for black patients without chronic kidney
disease.
2. A 62-year-old female patient presents with a T-score of -2.6 on a DXA scan of the hip.
Which of the following is the most appropriate diagnosis?
A. Osteopenia
,B. Osteoporosis
C. Osteoarthritis
D. Normal bone density
Answer: B
Rationale: A T-score of -2.5 or lower is the diagnostic threshold for osteoporosis according
to the World Health Organization. Osteopenia is defined as a T-score between -1.0 and -2.5.
This patient’s score indicates a significant loss of bone density that requires clinical
intervention and education on fracture prevention.
3. A 24-year-old female presents for a routine physical. Her last Pap smear was 3 years ago
and was normal. What is the current recommendation for cervical cancer screening for this
patient?
A. Screen today with cytology alone.
B. Screen today with HPV testing alone.
C. No screening is needed until age 30.
D. Screen today with co-testing (cytology and HPV).
Answer: A
Rationale: The USPSTF recommends screening for cervical cancer every 3 years with
cervical cytology alone in women aged 21 to 29 years. Co-testing or HPV testing alone is
, not recommended as the primary screening method for women under age 30. Since her last
test was 3 years ago, she is due for a new cytology screening now.
4. A 55-year-old male with a history of COPD presents with increased shortness of breath and
productive cough. His FEV1/FVC ratio is 0.65. Which of the following confirms the diagnosis of
COPD?
A. Total Lung Capacity < 80% predicted
B. FEV1/FVC ratio > 0.80 pre-bronchodilator
C. FEV1/FVC ratio < 0.70 post-bronchodilator
D. Reversibility of FEV1 by more than 12%
Answer: C
Rationale: The GOLD criteria state that a post-bronchodilator FEV1/FVC ratio of less than
0.70 confirms the presence of persistent airflow limitation. This measurement is the gold
standard for diagnosing chronic obstructive pulmonary disease. Significant reversibility,
mentioned in option D, is more indicative of asthma than COPD.
5. A patient with Type 2 Diabetes has an A1C of 8.2% despite taking Metformin 1000mg BID.
She has a history of heart failure with reduced ejection fraction. Which medication should be
added next?
A. Empagliflozin
B. Pioglitazone
C. Glipizide
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 45-year-old African American male presents with a blood pressure of 152/94 mmHg.
According to JNC 8 guidelines, which of the following is the most appropriate initial
treatment?
A. Lisinopril
B. Amlodipine
C. Losartan
D. Metoprolol
Answer: B
Rationale: According to JNC 8, initial antihypertensive treatment in the general black
population should include a thiazide-type diuretic or calcium channel blocker. Amlodipine
is a calcium channel blocker that is highly effective in this demographic. ACE inhibitors and
ARBs are generally less effective as monotherapy for black patients without chronic kidney
disease.
2. A 62-year-old female patient presents with a T-score of -2.6 on a DXA scan of the hip.
Which of the following is the most appropriate diagnosis?
A. Osteopenia
,B. Osteoporosis
C. Osteoarthritis
D. Normal bone density
Answer: B
Rationale: A T-score of -2.5 or lower is the diagnostic threshold for osteoporosis according
to the World Health Organization. Osteopenia is defined as a T-score between -1.0 and -2.5.
This patient’s score indicates a significant loss of bone density that requires clinical
intervention and education on fracture prevention.
3. A 24-year-old female presents for a routine physical. Her last Pap smear was 3 years ago
and was normal. What is the current recommendation for cervical cancer screening for this
patient?
A. Screen today with cytology alone.
B. Screen today with HPV testing alone.
C. No screening is needed until age 30.
D. Screen today with co-testing (cytology and HPV).
Answer: A
Rationale: The USPSTF recommends screening for cervical cancer every 3 years with
cervical cytology alone in women aged 21 to 29 years. Co-testing or HPV testing alone is
, not recommended as the primary screening method for women under age 30. Since her last
test was 3 years ago, she is due for a new cytology screening now.
4. A 55-year-old male with a history of COPD presents with increased shortness of breath and
productive cough. His FEV1/FVC ratio is 0.65. Which of the following confirms the diagnosis of
COPD?
A. Total Lung Capacity < 80% predicted
B. FEV1/FVC ratio > 0.80 pre-bronchodilator
C. FEV1/FVC ratio < 0.70 post-bronchodilator
D. Reversibility of FEV1 by more than 12%
Answer: C
Rationale: The GOLD criteria state that a post-bronchodilator FEV1/FVC ratio of less than
0.70 confirms the presence of persistent airflow limitation. This measurement is the gold
standard for diagnosing chronic obstructive pulmonary disease. Significant reversibility,
mentioned in option D, is more indicative of asthma than COPD.
5. A patient with Type 2 Diabetes has an A1C of 8.2% despite taking Metformin 1000mg BID.
She has a history of heart failure with reduced ejection fraction. Which medication should be
added next?
A. Empagliflozin
B. Pioglitazone
C. Glipizide
