NR667 Week 9 Actual Exam Style V1 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 55-year-old male presents for a follow-up visit with a blood pressure of 152/94 mmHg.
This is the third consecutive visit with elevated readings. Which of the following is the most
appropriate initial pharmacological intervention for this non-Black patient?
A. Metoprolol 25 mg daily
B. Clonidine 0.1 mg twice daily
C. Lisinopril 10 mg daily
D. Furosemide 20 mg daily
Answer: C
Rationale: The patient meets the criteria for Stage 2 Hypertension according to current
guidelines. First-line agents for non-Black patients include ACE inhibitors, ARBs, CCBs, or
thiazide diuretics. Lisinopril is an ACE inhibitor and is appropriate for initial monotherapy
in this clinical scenario.
2. Which of the following lab values is most characteristic of primary hypothyroidism?
A. Low TSH and Low Free T4
B. High TSH and Low Free T4
C. High TSH and High Free T4
,D. Low TSH and High Free T4
Answer: B
Rationale: Primary hypothyroidism occurs when the thyroid gland cannot produce enough
hormone despite stimulation. This results in a compensatory elevation of Thyroid
Stimulating Hormone (TSH) from the pituitary gland. Low levels of circulating Free T4
confirm the diagnosis of clinical hypothyroidism.
3. A 68-year-old female with a history of COPD presents with increased sputum production
and dyspnea. Her FEV1 is 60% of predicted. Which classification of COPD severity does this
patient fall under based on GOLD criteria?
A. GOLD 1 (Mild)
B. GOLD 4 (Very Severe)
C. GOLD 3 (Severe)
D. GOLD 2 (Moderate)
Answer: D
Rationale: GOLD 2 (Moderate) severity is defined by an FEV1 between 50% and 79% of
predicted. GOLD 1 is greater than or equal to 80%, while GOLD 3 is between 30% and 49%.
Clinical management for this stage typically involves the addition of long-acting
bronchodilators.
, 4. When screening for Diabetes Mellitus, what is the minimum Hemoglobin A1c percentage
required for a formal diagnosis?
A. 5.7%
B. 6.0%
C. 6.5%
D. 7.0%
Answer: C
Rationale: An A1c level of 6.5% or higher is diagnostic for Diabetes Mellitus according to
the American Diabetes Association. Levels between 5.7% and 6.4% are considered pre-
diabetic. The test should be repeated for confirmation unless the patient is symptomatic
with clear hyperglycemia.
5. Which heart murmur is best heard at the apex of the heart and radiates to the left axilla?
A. Aortic Stenosis
B. Aortic Regurgitation
C. Mitral Regurgitation
D. Mitral Stenosis
Answer: C
Rationale: Mitral regurgitation is a holosystolic murmur heard best at the apex with the
diaphragm of the stethoscope. It classically radiates to the left axilla and may be associated
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 55-year-old male presents for a follow-up visit with a blood pressure of 152/94 mmHg.
This is the third consecutive visit with elevated readings. Which of the following is the most
appropriate initial pharmacological intervention for this non-Black patient?
A. Metoprolol 25 mg daily
B. Clonidine 0.1 mg twice daily
C. Lisinopril 10 mg daily
D. Furosemide 20 mg daily
Answer: C
Rationale: The patient meets the criteria for Stage 2 Hypertension according to current
guidelines. First-line agents for non-Black patients include ACE inhibitors, ARBs, CCBs, or
thiazide diuretics. Lisinopril is an ACE inhibitor and is appropriate for initial monotherapy
in this clinical scenario.
2. Which of the following lab values is most characteristic of primary hypothyroidism?
A. Low TSH and Low Free T4
B. High TSH and Low Free T4
C. High TSH and High Free T4
,D. Low TSH and High Free T4
Answer: B
Rationale: Primary hypothyroidism occurs when the thyroid gland cannot produce enough
hormone despite stimulation. This results in a compensatory elevation of Thyroid
Stimulating Hormone (TSH) from the pituitary gland. Low levels of circulating Free T4
confirm the diagnosis of clinical hypothyroidism.
3. A 68-year-old female with a history of COPD presents with increased sputum production
and dyspnea. Her FEV1 is 60% of predicted. Which classification of COPD severity does this
patient fall under based on GOLD criteria?
A. GOLD 1 (Mild)
B. GOLD 4 (Very Severe)
C. GOLD 3 (Severe)
D. GOLD 2 (Moderate)
Answer: D
Rationale: GOLD 2 (Moderate) severity is defined by an FEV1 between 50% and 79% of
predicted. GOLD 1 is greater than or equal to 80%, while GOLD 3 is between 30% and 49%.
Clinical management for this stage typically involves the addition of long-acting
bronchodilators.
, 4. When screening for Diabetes Mellitus, what is the minimum Hemoglobin A1c percentage
required for a formal diagnosis?
A. 5.7%
B. 6.0%
C. 6.5%
D. 7.0%
Answer: C
Rationale: An A1c level of 6.5% or higher is diagnostic for Diabetes Mellitus according to
the American Diabetes Association. Levels between 5.7% and 6.4% are considered pre-
diabetic. The test should be repeated for confirmation unless the patient is symptomatic
with clear hyperglycemia.
5. Which heart murmur is best heard at the apex of the heart and radiates to the left axilla?
A. Aortic Stenosis
B. Aortic Regurgitation
C. Mitral Regurgitation
D. Mitral Stenosis
Answer: C
Rationale: Mitral regurgitation is a holosystolic murmur heard best at the apex with the
diaphragm of the stethoscope. It classically radiates to the left axilla and may be associated
