CMN 568 FINAL EXAM – FAMILY NURSE
PRACTITIONER (FNP) COMPREHENSIVE
ASSESSMENT – 2026/2027] ACTUAL QUESTIONS
AND CORRECT ANSWERS (LATEST 2026/2027
UPDATE) | COMPLETE Q&A WITH VERIFIED
ANSWERS AND DETAILED RATIONALES | OBJECTIVE
ASSESSMENT PREP | A+
CMN 568 FINAL EXAM – FAMILY NURSE PRACTITIONER (FNP) COMPREHENSIVE
ASSESSMENT
COMPLETE PRACTICE EXAMINATION
SECTION I: CARDIOVASCULAR SYSTEM
Question 1: A 68-year-old male with a history of hypertension and hyperlipidemia
presents with substernal chest pressure that occurs with exertion and resolves with
rest. The pain is described as "heavy" and radiates to his left arm. He is able to
walk 2 blocks before symptoms develop. His ECG shows no acute changes. What is
the most appropriate initial diagnostic test?
A) Exercise stress test
B) Coronary angiography
,C) CT coronary angiography
D) Resting echocardiogram
Answer: A) Exercise stress test
Rationale: This patient has stable angina (exertional chest pain relieved by rest).
Exercise stress testing is the initial diagnostic test of choice for patients with
suspected stable angina who can exercise. Coronary angiography (B) is reserved
for patients with high-risk features or positive stress test. CT coronary angiography
(C) is an alternative for patients who cannot exercise. Resting echocardiogram (D)
does not evaluate for ischemia.
Question 2: A 72-year-old female with heart failure with reduced ejection fraction
(HFrEF) is on optimal medical therapy including sacubitril/valsartan, carvedilol,
and spironolactone. She presents with worsening dyspnea, fatigue, and a 6-pound
weight gain over 3 days. Which is the most appropriate intervention?
A) Increase sacubitril/valsartan dose
B) Increase carvedilol dose
C) Add furosemide 40 mg daily
D) Refer for heart transplant evaluation
Answer: C) Add furosemide 40 mg daily
Rationale: This patient is experiencing volume overload (weight gain, worsening
dyspnea) despite being on guideline-directed medical therapy. Adding a loop
diuretic (furosemide) is the most appropriate intervention to manage fluid
overload. Increasing sacubitril/valsartan (A) or carvedilol (B) would not address
the acute volume overload. Heart transplant evaluation (D) is for end-stage
disease.
Question 3: A 55-year-old male with hypertension is started on lisinopril 10 mg
daily. He returns 2 weeks later with a new dry cough. What is the most
appropriate next step?
,A) Continue lisinopril and add a cough suppressant
B) Switch to losartan 50 mg daily
C) Increase lisinopril to 20 mg daily
D) Add hydrochlorothiazide 12.5 mg daily
Answer: B) Switch to losartan 50 mg daily
Rationale: Lisinopril is an ACE inhibitor known to cause a dry, persistent cough in
approximately 10-20% of patients. The cough is not dose-dependent and typically
resolves within 1-4 weeks of discontinuing the drug. Switching to an ARB (losartan)
is appropriate as ARBs do not cause cough due to no effect on bradykinin
metabolism. Continuing the drug (A) is not appropriate as the cough will likely
persist. Increasing the dose (C) will not improve symptoms. Adding HCTZ (D)
addresses blood pressure but not the cough.
Question 4: A 48-year-old female presents with palpitations, anxiety, heat
intolerance, and weight loss over the past 3 months. Her heart rate is 110 bpm,
and she has a fine tremor. TSH is <0.01 mIU/L (normal 0.4-4.5) and free T4 is 3.2
ng/dL (normal 0.8-1.8). Which is the most appropriate initial treatment?
A) Methimazole 10-15 mg daily
B) Levothyroxine 50 mcg daily
C) Radioactive iodine ablation
D) Propylthiouracil 100 mg TID
Answer: A) Methimazole 10-15 mg daily
Rationale: This patient has Graves' disease or hyperthyroidism. Methimazole is the
preferred thioamide for initial treatment of hyperthyroidism due to fewer adverse
effects and once-daily dosing compared to PTU (D). Radioactive iodine ablation (C)
is an alternative for patients who fail medical therapy or have contraindications.
Levothyroxine (B) would exacerbate symptoms.
, Question 5: A 65-year-old male with a history of paroxysmal atrial fibrillation is
started on apixaban for stroke prevention. Which of the following is the most
important teaching point for this patient?
A) Take with food to improve absorption
B) Monitor INR weekly
C) Do not stop abruptly without consulting provider
D) Monitor blood pressure daily
Answer: C) Do not stop abruptly without consulting provider
Rationale: DOACs like apixaban should not be stopped abruptly due to the risk of
thrombotic events. Unlike warfarin, INR monitoring (B) is not required. Apixaban
does not require food for absorption (A). Blood pressure monitoring (D) is
important but not specific to apixaban therapy.
Question 6: A 75-year-old male presents with syncope while walking his dog. He
has a history of hypertension and coronary artery disease. His ECG shows a heart
rate of 38 bpm with a regular rhythm and no P waves. What is the most likely
diagnosis?
A) Atrial fibrillation with slow ventricular response
B) Complete heart block
C) Sick sinus syndrome
D) Ventricular tachycardia
Answer: B) Complete heart block
Rationale: Complete heart block (third-degree AV block) presents with bradycardia
(heart rate often 30-40 bpm), regular rhythm, and no relationship between P
waves and QRS complexes. It can cause syncope (Stokes-Adams attacks) due to
inadequate cerebral perfusion. Atrial fibrillation (A) would have an irregular
rhythm. Sick sinus syndrome (C) typically has variable rates. Ventricular
tachycardia (D) has a rate >100 bpm.
PRACTITIONER (FNP) COMPREHENSIVE
ASSESSMENT – 2026/2027] ACTUAL QUESTIONS
AND CORRECT ANSWERS (LATEST 2026/2027
UPDATE) | COMPLETE Q&A WITH VERIFIED
ANSWERS AND DETAILED RATIONALES | OBJECTIVE
ASSESSMENT PREP | A+
CMN 568 FINAL EXAM – FAMILY NURSE PRACTITIONER (FNP) COMPREHENSIVE
ASSESSMENT
COMPLETE PRACTICE EXAMINATION
SECTION I: CARDIOVASCULAR SYSTEM
Question 1: A 68-year-old male with a history of hypertension and hyperlipidemia
presents with substernal chest pressure that occurs with exertion and resolves with
rest. The pain is described as "heavy" and radiates to his left arm. He is able to
walk 2 blocks before symptoms develop. His ECG shows no acute changes. What is
the most appropriate initial diagnostic test?
A) Exercise stress test
B) Coronary angiography
,C) CT coronary angiography
D) Resting echocardiogram
Answer: A) Exercise stress test
Rationale: This patient has stable angina (exertional chest pain relieved by rest).
Exercise stress testing is the initial diagnostic test of choice for patients with
suspected stable angina who can exercise. Coronary angiography (B) is reserved
for patients with high-risk features or positive stress test. CT coronary angiography
(C) is an alternative for patients who cannot exercise. Resting echocardiogram (D)
does not evaluate for ischemia.
Question 2: A 72-year-old female with heart failure with reduced ejection fraction
(HFrEF) is on optimal medical therapy including sacubitril/valsartan, carvedilol,
and spironolactone. She presents with worsening dyspnea, fatigue, and a 6-pound
weight gain over 3 days. Which is the most appropriate intervention?
A) Increase sacubitril/valsartan dose
B) Increase carvedilol dose
C) Add furosemide 40 mg daily
D) Refer for heart transplant evaluation
Answer: C) Add furosemide 40 mg daily
Rationale: This patient is experiencing volume overload (weight gain, worsening
dyspnea) despite being on guideline-directed medical therapy. Adding a loop
diuretic (furosemide) is the most appropriate intervention to manage fluid
overload. Increasing sacubitril/valsartan (A) or carvedilol (B) would not address
the acute volume overload. Heart transplant evaluation (D) is for end-stage
disease.
Question 3: A 55-year-old male with hypertension is started on lisinopril 10 mg
daily. He returns 2 weeks later with a new dry cough. What is the most
appropriate next step?
,A) Continue lisinopril and add a cough suppressant
B) Switch to losartan 50 mg daily
C) Increase lisinopril to 20 mg daily
D) Add hydrochlorothiazide 12.5 mg daily
Answer: B) Switch to losartan 50 mg daily
Rationale: Lisinopril is an ACE inhibitor known to cause a dry, persistent cough in
approximately 10-20% of patients. The cough is not dose-dependent and typically
resolves within 1-4 weeks of discontinuing the drug. Switching to an ARB (losartan)
is appropriate as ARBs do not cause cough due to no effect on bradykinin
metabolism. Continuing the drug (A) is not appropriate as the cough will likely
persist. Increasing the dose (C) will not improve symptoms. Adding HCTZ (D)
addresses blood pressure but not the cough.
Question 4: A 48-year-old female presents with palpitations, anxiety, heat
intolerance, and weight loss over the past 3 months. Her heart rate is 110 bpm,
and she has a fine tremor. TSH is <0.01 mIU/L (normal 0.4-4.5) and free T4 is 3.2
ng/dL (normal 0.8-1.8). Which is the most appropriate initial treatment?
A) Methimazole 10-15 mg daily
B) Levothyroxine 50 mcg daily
C) Radioactive iodine ablation
D) Propylthiouracil 100 mg TID
Answer: A) Methimazole 10-15 mg daily
Rationale: This patient has Graves' disease or hyperthyroidism. Methimazole is the
preferred thioamide for initial treatment of hyperthyroidism due to fewer adverse
effects and once-daily dosing compared to PTU (D). Radioactive iodine ablation (C)
is an alternative for patients who fail medical therapy or have contraindications.
Levothyroxine (B) would exacerbate symptoms.
, Question 5: A 65-year-old male with a history of paroxysmal atrial fibrillation is
started on apixaban for stroke prevention. Which of the following is the most
important teaching point for this patient?
A) Take with food to improve absorption
B) Monitor INR weekly
C) Do not stop abruptly without consulting provider
D) Monitor blood pressure daily
Answer: C) Do not stop abruptly without consulting provider
Rationale: DOACs like apixaban should not be stopped abruptly due to the risk of
thrombotic events. Unlike warfarin, INR monitoring (B) is not required. Apixaban
does not require food for absorption (A). Blood pressure monitoring (D) is
important but not specific to apixaban therapy.
Question 6: A 75-year-old male presents with syncope while walking his dog. He
has a history of hypertension and coronary artery disease. His ECG shows a heart
rate of 38 bpm with a regular rhythm and no P waves. What is the most likely
diagnosis?
A) Atrial fibrillation with slow ventricular response
B) Complete heart block
C) Sick sinus syndrome
D) Ventricular tachycardia
Answer: B) Complete heart block
Rationale: Complete heart block (third-degree AV block) presents with bradycardia
(heart rate often 30-40 bpm), regular rhythm, and no relationship between P
waves and QRS complexes. It can cause syncope (Stokes-Adams attacks) due to
inadequate cerebral perfusion. Atrial fibrillation (A) would have an irregular
rhythm. Sick sinus syndrome (C) typically has variable rates. Ventricular
tachycardia (D) has a rate >100 bpm.
