NR667 Week 10 Actual Exam Style V1 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 55-year-old male presents for a routine check-up. His blood pressure is 152/94 mmHg
today and was 148/92 mmHg at his last visit. According to JNC 8 guidelines, what is the most
appropriate initial management?
A. Immediate initiation of a beta-blocker.
B. Strict lifestyle modifications for 6 months before re-evaluating.
C. Initiation of a thiazide-type diuretic or ACE inhibitor.
D. Referral to a cardiologist for emergency hypertension management.
Answer: C
Rationale: The patient’s blood pressure is consistently above 140/90 mmHg, classifying
him with Stage 2 hypertension. According to JNC 8, pharmacotherapy should be initiated
for patients with these readings. Initial choices include thiazide diuretics, ACE inhibitors,
ARBs, or CCBs for non-black patients.
2. A 65-year-old female with Type 2 Diabetes has an A1C of 8.2% despite being on Metformin
1000mg twice daily. Which of the following is a contraindication for adding a SGLT2 inhibitor?
A. History of frequent urinary tract infections.
B. Documented history of cardiovascular disease.
,C. Body Mass Index (BMI) greater than 35.
D. Glomerular filtration rate (GFR) less than 30 mL/min/1.73 m2.
Answer: D
Rationale: SGLT2 inhibitors depend on renal function to effectively lower blood glucose
levels. A GFR below 30 mL/min/1.73 m2 is generally a contraindication due to decreased
efficacy and safety concerns. Clinicians should monitor renal function closely when
prescribing this class of medication.
3. A mother brings her 12-month-old infant for a well-child visit. Which developmental
milestone is most characteristic of this age?
A. Running and climbing on furniture.
B. Speaking in 4-5 word sentences.
C. Using a spoon and fork perfectly.
D. Standing alone and taking a few steps.
Answer: D
Rationale: At 12 months, infants typically reach the milestone of standing alone and
beginning to walk. Fine motor skills usually include a pincer grasp to pick up small objects.
Socially, they may start to show separation anxiety or fear of strangers.
, 4. A 30-year-old female presents with fatigue and heavy menstrual periods. Lab results show
Hemoglobin 10.5 g/dL, MCV 72 fL, and Ferritin 10 ng/mL. What is the most likely diagnosis?
A. Folate deficiency anemia.
B. Anemia of chronic disease.
C. Vitamin B12 deficiency.
D. Iron deficiency anemia.
Answer: D
Rationale: The laboratory findings show a microcytic anemia characterized by a low MCV
and low ferritin. Low ferritin is the most sensitive marker for depleted iron stores. Heavy
menses is a common cause of iron deficiency in premenopausal women.
5. Which physical examination finding is most specific for acute cholecystitis?
A. Rovsing’s sign.
B. Murphy’s sign.
C. McBurney’s point tenderness.
D. Psoas sign.
Answer: B
Rationale: Murphy’s sign involves cessation of inspiration during deep palpation of the
right upper quadrant. It is highly suggestive of gallbladder inflammation or cholecystitis. In
contrast, Rovsing’s and Psoas signs are associated with appendicitis.
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. A 55-year-old male presents for a routine check-up. His blood pressure is 152/94 mmHg
today and was 148/92 mmHg at his last visit. According to JNC 8 guidelines, what is the most
appropriate initial management?
A. Immediate initiation of a beta-blocker.
B. Strict lifestyle modifications for 6 months before re-evaluating.
C. Initiation of a thiazide-type diuretic or ACE inhibitor.
D. Referral to a cardiologist for emergency hypertension management.
Answer: C
Rationale: The patient’s blood pressure is consistently above 140/90 mmHg, classifying
him with Stage 2 hypertension. According to JNC 8, pharmacotherapy should be initiated
for patients with these readings. Initial choices include thiazide diuretics, ACE inhibitors,
ARBs, or CCBs for non-black patients.
2. A 65-year-old female with Type 2 Diabetes has an A1C of 8.2% despite being on Metformin
1000mg twice daily. Which of the following is a contraindication for adding a SGLT2 inhibitor?
A. History of frequent urinary tract infections.
B. Documented history of cardiovascular disease.
,C. Body Mass Index (BMI) greater than 35.
D. Glomerular filtration rate (GFR) less than 30 mL/min/1.73 m2.
Answer: D
Rationale: SGLT2 inhibitors depend on renal function to effectively lower blood glucose
levels. A GFR below 30 mL/min/1.73 m2 is generally a contraindication due to decreased
efficacy and safety concerns. Clinicians should monitor renal function closely when
prescribing this class of medication.
3. A mother brings her 12-month-old infant for a well-child visit. Which developmental
milestone is most characteristic of this age?
A. Running and climbing on furniture.
B. Speaking in 4-5 word sentences.
C. Using a spoon and fork perfectly.
D. Standing alone and taking a few steps.
Answer: D
Rationale: At 12 months, infants typically reach the milestone of standing alone and
beginning to walk. Fine motor skills usually include a pincer grasp to pick up small objects.
Socially, they may start to show separation anxiety or fear of strangers.
, 4. A 30-year-old female presents with fatigue and heavy menstrual periods. Lab results show
Hemoglobin 10.5 g/dL, MCV 72 fL, and Ferritin 10 ng/mL. What is the most likely diagnosis?
A. Folate deficiency anemia.
B. Anemia of chronic disease.
C. Vitamin B12 deficiency.
D. Iron deficiency anemia.
Answer: D
Rationale: The laboratory findings show a microcytic anemia characterized by a low MCV
and low ferritin. Low ferritin is the most sensitive marker for depleted iron stores. Heavy
menses is a common cause of iron deficiency in premenopausal women.
5. Which physical examination finding is most specific for acute cholecystitis?
A. Rovsing’s sign.
B. Murphy’s sign.
C. McBurney’s point tenderness.
D. Psoas sign.
Answer: B
Rationale: Murphy’s sign involves cessation of inspiration during deep palpation of the
right upper quadrant. It is highly suggestive of gallbladder inflammation or cholecystitis. In
contrast, Rovsing’s and Psoas signs are associated with appendicitis.
