NURS 5432 Final Exam V1 | NURS 5432
Family I (FNP 1) | Actual Q&A with
Rationale (NURS5432 Final Exam) | The
University of Texas at Arlington
1. A 55-year-old African American male presents for a follow-up visit regarding his
hypertension. His blood pressure today is 152/94 mmHg. He has no history of diabetes or
chronic kidney disease. According to JNC 8 guidelines, which of the following is the most
appropriate initial pharmacological treatment?
A. Lisinopril
B. Metoprolol
C. Losartan
D. Chlorthalidone
Answer: D
Rationale: According to JNC 8 guidelines, initial antihypertensive treatment for the general
Black population, including those with diabetes, should include a thiazide-type diuretic or a
calcium channel blocker. This recommendation is based on clinical trials showing these
agents are more effective in blood pressure reduction and stroke prevention in this
demographic. The patient should be reassessed in four weeks to ensure blood pressure
goals are met and electrolytes are stable.
,2. A 42-year-old female presents with symptoms of polyuria and polydipsia. A fasting plasma
glucose (FPG) is 132 mg/dL. What is the most appropriate next step to confirm the diagnosis
of Diabetes Mellitus?
A. Repeat the fasting plasma glucose test on a different day.
B. Initiate Metformin 500mg daily immediately.
C. Perform a random blood glucose test.
D. Order a 24-hour urine collection for glucose.
Answer: A
Rationale: Diagnosis of Diabetes Mellitus requires two abnormal test results from the
same sample or in two separate test samples. A fasting plasma glucose of 126 mg/dL or
higher is diagnostic for diabetes if confirmed on a repeat test. Clinicians must ensure the
patient has fasted for at least 8 hours prior to the second test for accurate results.
3. A 30-year-old patient with a history of mild intermittent asthma presents with increased
symptoms of wheezing. According to the current GINA guidelines, what is the preferred
rescue medication?
A. Low-dose inhaled corticosteroid (ICS)-formoterol as needed.
B. Albuterol (SABA) alone as needed.
C. Salmeterol (LABA) alone as needed.
D. Oral Prednisone for 5 days.
,Answer: A
Rationale: Recent GINA guidelines now recommend low-dose ICS-formoterol as the
preferred reliever for all asthma severities to reduce the risk of severe exacerbations. This
approach addresses the underlying inflammation even when symptoms are mild or
infrequent. Relying solely on SABA is no longer recommended as it does not protect against
inflammation-driven airway remodeling.
4. A 68-year-old male with a 40-pack-year smoking history presents with chronic cough and
shortness of breath. Spirometry reveals a post-bronchodilator FEV1/FVC ratio of 0.62. How is
this finding interpreted according to GOLD guidelines?
A. Normal lung function for his age.
B. Restrictive lung disease.
C. Confirmed persistent airflow limitation (COPD).
D. Reversible airway obstruction suggestive of asthma.
Answer: C
Rationale: The GOLD criteria define COPD as a post-bronchodilator FEV1/FVC ratio of less
than 0.70. This fixed ratio confirms the presence of persistent airflow limitation which is
characteristic of chronic obstructive pulmonary disease. Further staging should be
conducted using the FEV1 percentage of predicted and assessment of symptom burden
using the CAT or mMRC scales.
, 5. A 45-year-old patient is evaluated for dyslipidemia. According to the ACC/AHA guidelines,
which of the following patients should be started on high-intensity statin therapy?
A. A 50-year-old with an LDL-C of 130 mg/dL and no other risks.
B. A 45-year-old with a history of clinical atherosclerotic cardiovascular disease (ASCVD).
C. A 40-year-old with diabetes and an LDL-C of 100 mg/dL.
D. A 60-year-old with a 10-year ASCVD risk score of 5%.
Answer: B
Rationale: High-intensity statin therapy is recommended for all individuals with clinical
ASCVD to achieve a 50% or greater reduction in LDL-C. Clinical ASCVD includes conditions
such as myocardial infarction, stable or unstable angina, and stroke or TIA. This
pharmacological intervention is a cornerstone of secondary prevention aimed at reducing
future cardiovascular events.
6. A 24-year-old male presents with a sore throat, fever of 102°F, and tender anterior cervical
lymphadenopathy. He denies cough. What is the most appropriate management according to
Centor criteria?
A. Perform a Rapid Antigen Detection Test (RADT) for Strep.
B. Reassurance and salt water gargles only.
C. Treat with Amoxicillin immediately.
D. Order a chest X-ray to rule out pneumonia.
Family I (FNP 1) | Actual Q&A with
Rationale (NURS5432 Final Exam) | The
University of Texas at Arlington
1. A 55-year-old African American male presents for a follow-up visit regarding his
hypertension. His blood pressure today is 152/94 mmHg. He has no history of diabetes or
chronic kidney disease. According to JNC 8 guidelines, which of the following is the most
appropriate initial pharmacological treatment?
A. Lisinopril
B. Metoprolol
C. Losartan
D. Chlorthalidone
Answer: D
Rationale: According to JNC 8 guidelines, initial antihypertensive treatment for the general
Black population, including those with diabetes, should include a thiazide-type diuretic or a
calcium channel blocker. This recommendation is based on clinical trials showing these
agents are more effective in blood pressure reduction and stroke prevention in this
demographic. The patient should be reassessed in four weeks to ensure blood pressure
goals are met and electrolytes are stable.
,2. A 42-year-old female presents with symptoms of polyuria and polydipsia. A fasting plasma
glucose (FPG) is 132 mg/dL. What is the most appropriate next step to confirm the diagnosis
of Diabetes Mellitus?
A. Repeat the fasting plasma glucose test on a different day.
B. Initiate Metformin 500mg daily immediately.
C. Perform a random blood glucose test.
D. Order a 24-hour urine collection for glucose.
Answer: A
Rationale: Diagnosis of Diabetes Mellitus requires two abnormal test results from the
same sample or in two separate test samples. A fasting plasma glucose of 126 mg/dL or
higher is diagnostic for diabetes if confirmed on a repeat test. Clinicians must ensure the
patient has fasted for at least 8 hours prior to the second test for accurate results.
3. A 30-year-old patient with a history of mild intermittent asthma presents with increased
symptoms of wheezing. According to the current GINA guidelines, what is the preferred
rescue medication?
A. Low-dose inhaled corticosteroid (ICS)-formoterol as needed.
B. Albuterol (SABA) alone as needed.
C. Salmeterol (LABA) alone as needed.
D. Oral Prednisone for 5 days.
,Answer: A
Rationale: Recent GINA guidelines now recommend low-dose ICS-formoterol as the
preferred reliever for all asthma severities to reduce the risk of severe exacerbations. This
approach addresses the underlying inflammation even when symptoms are mild or
infrequent. Relying solely on SABA is no longer recommended as it does not protect against
inflammation-driven airway remodeling.
4. A 68-year-old male with a 40-pack-year smoking history presents with chronic cough and
shortness of breath. Spirometry reveals a post-bronchodilator FEV1/FVC ratio of 0.62. How is
this finding interpreted according to GOLD guidelines?
A. Normal lung function for his age.
B. Restrictive lung disease.
C. Confirmed persistent airflow limitation (COPD).
D. Reversible airway obstruction suggestive of asthma.
Answer: C
Rationale: The GOLD criteria define COPD as a post-bronchodilator FEV1/FVC ratio of less
than 0.70. This fixed ratio confirms the presence of persistent airflow limitation which is
characteristic of chronic obstructive pulmonary disease. Further staging should be
conducted using the FEV1 percentage of predicted and assessment of symptom burden
using the CAT or mMRC scales.
, 5. A 45-year-old patient is evaluated for dyslipidemia. According to the ACC/AHA guidelines,
which of the following patients should be started on high-intensity statin therapy?
A. A 50-year-old with an LDL-C of 130 mg/dL and no other risks.
B. A 45-year-old with a history of clinical atherosclerotic cardiovascular disease (ASCVD).
C. A 40-year-old with diabetes and an LDL-C of 100 mg/dL.
D. A 60-year-old with a 10-year ASCVD risk score of 5%.
Answer: B
Rationale: High-intensity statin therapy is recommended for all individuals with clinical
ASCVD to achieve a 50% or greater reduction in LDL-C. Clinical ASCVD includes conditions
such as myocardial infarction, stable or unstable angina, and stroke or TIA. This
pharmacological intervention is a cornerstone of secondary prevention aimed at reducing
future cardiovascular events.
6. A 24-year-old male presents with a sore throat, fever of 102°F, and tender anterior cervical
lymphadenopathy. He denies cough. What is the most appropriate management according to
Centor criteria?
A. Perform a Rapid Antigen Detection Test (RADT) for Strep.
B. Reassurance and salt water gargles only.
C. Treat with Amoxicillin immediately.
D. Order a chest X-ray to rule out pneumonia.
