NR667 Week 6 Actual Exam Style V1 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 55-year-old African American male presents with a blood pressure of 152/94 mmHg.
According to JNC 8 guidelines, which class of medication is preferred for initial therapy?
A. ACE Inhibitors
B. Beta-Blockers
C. Calcium Channel Blockers
D. Loop Diuretics
Answer: C
Rationale: According to JNC 8 guidelines, African American patients without chronic
kidney disease should be started on either a thiazide-type diuretic or a calcium channel
blocker. This population generally responds better to these classes than to ACE inhibitors
or beta-blockers. Starting with a calcium channel blocker like amlodipine helps reduce
cardiovascular risk effectively in this demographic.
2. Which of the following findings is most diagnostic for iron deficiency anemia?
A. Increased Ferritin
B. Decreased Total Iron Binding Capacity (TIBC)
C. Low Serum Ferritin
,D. Macrocytic RBCs
Answer: C
Rationale: Low serum ferritin is the most specific and sensitive marker for iron deficiency
anemia as it reflects total body iron stores. In this condition, TIBC typically increases as the
body attempts to bind more iron, and RBCs are microcytic, not macrocytic. A ferritin level
below 30 ng/mL is highly suggestive of iron depletion in most clinical scenarios.
3. A 65-year-old patient with a history of COPD presents with increased sputum production
and dyspnea. Which antibiotic is typically first-line for an acute exacerbation?
A. Azithromycin
B. Ciprofloxacin
C. Vancomycin
D. Nitrofurantoin
Answer: A
Rationale: Azithromycin or doxycycline are commonly used first-line agents for mild to
moderate COPD exacerbations to cover typical and atypical pathogens. These agents target
common bacteria such as Streptococcus pneumoniae and Haemophilus influenzae.
Nitrofurantoin is used for urinary tract infections and is not appropriate for respiratory
infections.
4. What is the gold standard for diagnosing a pulmonary embolism in a stable patient?
A. Chest X-ray
, B. D-dimer assay
C. CT Angiography (CTPA)
D. Venous Doppler of the legs
Answer: C
Rationale: CT Pulmonary Angiography (CTPA) is the preferred imaging modality for
diagnosing pulmonary embolism due to its high sensitivity and specificity. While a D-dimer
can rule out PE in low-risk patients, it cannot confirm the diagnosis. Chest X-rays are often
normal or show non-specific findings in patients with a PE.
5. A patient presents with a ‘curtain-like’ loss of vision in one eye. This symptom is most
characteristic of:
A. Cataracts
B. Glaucoma
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Rationale: Retinal detachment often presents as a sudden, painless loss of vision described
as a ‘curtain’ being pulled over the visual field. This is a medical emergency requiring
immediate referral to an ophthalmologist to prevent permanent vision loss. Glaucoma and
cataracts usually involve a much slower, more chronic progression of visual changes.
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 55-year-old African American male presents with a blood pressure of 152/94 mmHg.
According to JNC 8 guidelines, which class of medication is preferred for initial therapy?
A. ACE Inhibitors
B. Beta-Blockers
C. Calcium Channel Blockers
D. Loop Diuretics
Answer: C
Rationale: According to JNC 8 guidelines, African American patients without chronic
kidney disease should be started on either a thiazide-type diuretic or a calcium channel
blocker. This population generally responds better to these classes than to ACE inhibitors
or beta-blockers. Starting with a calcium channel blocker like amlodipine helps reduce
cardiovascular risk effectively in this demographic.
2. Which of the following findings is most diagnostic for iron deficiency anemia?
A. Increased Ferritin
B. Decreased Total Iron Binding Capacity (TIBC)
C. Low Serum Ferritin
,D. Macrocytic RBCs
Answer: C
Rationale: Low serum ferritin is the most specific and sensitive marker for iron deficiency
anemia as it reflects total body iron stores. In this condition, TIBC typically increases as the
body attempts to bind more iron, and RBCs are microcytic, not macrocytic. A ferritin level
below 30 ng/mL is highly suggestive of iron depletion in most clinical scenarios.
3. A 65-year-old patient with a history of COPD presents with increased sputum production
and dyspnea. Which antibiotic is typically first-line for an acute exacerbation?
A. Azithromycin
B. Ciprofloxacin
C. Vancomycin
D. Nitrofurantoin
Answer: A
Rationale: Azithromycin or doxycycline are commonly used first-line agents for mild to
moderate COPD exacerbations to cover typical and atypical pathogens. These agents target
common bacteria such as Streptococcus pneumoniae and Haemophilus influenzae.
Nitrofurantoin is used for urinary tract infections and is not appropriate for respiratory
infections.
4. What is the gold standard for diagnosing a pulmonary embolism in a stable patient?
A. Chest X-ray
, B. D-dimer assay
C. CT Angiography (CTPA)
D. Venous Doppler of the legs
Answer: C
Rationale: CT Pulmonary Angiography (CTPA) is the preferred imaging modality for
diagnosing pulmonary embolism due to its high sensitivity and specificity. While a D-dimer
can rule out PE in low-risk patients, it cannot confirm the diagnosis. Chest X-rays are often
normal or show non-specific findings in patients with a PE.
5. A patient presents with a ‘curtain-like’ loss of vision in one eye. This symptom is most
characteristic of:
A. Cataracts
B. Glaucoma
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Rationale: Retinal detachment often presents as a sudden, painless loss of vision described
as a ‘curtain’ being pulled over the visual field. This is a medical emergency requiring
immediate referral to an ophthalmologist to prevent permanent vision loss. Glaucoma and
cataracts usually involve a much slower, more chronic progression of visual changes.
