NR 667 Final Exam – FNP Capstone Practicum
(Chamberlain) – Complete Exam 8 with Verified
Answers (2026 Edition)
Question 1: A family nurse practitioner (FNP) is assessing a 45-year-old male client with a history of
hypertension who presents with complaints of chest pain, shortness of breath, and diaphoresis that
began 30 minutes ago. Which action should the FNP take first?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead electrocardiogram (ECG)
C) Administer aspirin 324 mg chewed
D) Call 911 for emergency transport
Answer: D) Call 911 for emergency transport
Rationale: The client is presenting with signs and symptoms of acute myocardial infarction (chest pain,
shortness of breath, diaphoresis). The first priority is to activate emergency medical services (call 911) for
immediate transport to the emergency department. While ECG, aspirin, and nitroglycerin are important
interventions, they should not delay emergency transport. The FNP should also consider administering
aspirin and nitroglycerin while awaiting transport.
Question 2: An FNP is evaluating a 55-year-old female client with type 2 diabetes mellitus. The client's
hemoglobin A1c is 9.2%. Which intervention should the FNP prioritize?
A) Initiate insulin therapy immediately
B) Refer to a diabetes educator for lifestyle modification education
C) Increase the dose of oral hypoglycemic agents
D) Order a fasting blood glucose and repeat the hemoglobin A1c in 3 months
Answer: B) Refer to a diabetes educator for lifestyle modification education
Rationale: A hemoglobin A1c of 9.2% indicates poor glycemic control. The FNP should prioritize a
multidisciplinary approach, including referral to a diabetes educator for lifestyle modification education
and dietary counseling. While medication adjustment may be needed, education is a critical component
of diabetes management. Insulin therapy may be needed but is not the first step. Repeating the A1c in 3
months is appropriate after interventions have been implemented.
Question 3: An FNP is performing a well-child examination on a 2-year-old child. Which developmental
milestone should the child have achieved by this age?
A) Standing on one foot for 3 seconds
B) Kicking a ball forward
,C) Using 2-3 word phrases
D) Riding a tricycle
Answer: C) Using 2-3 word phrases
Rationale: By age 2, a child should be able to use 2-3 word phrases and have a vocabulary of about 50
words. Standing on one foot for 3 seconds is a 3-4 year milestone. Kicking a ball forward is a 2-3 year
milestone. Riding a tricycle is a 3-4 year milestone. The FNP should assess developmental milestones at
each well-child visit to identify any delays.
Question 4: An FNP is managing a 65-year-old male client with hypertension and hyperlipidemia. The
client's blood pressure is 148/90 mmHg on lisinopril 20 mg daily. Which action should the FNP take?
A) Increase lisinopril to 40 mg daily
B) Add amlodipine 5 mg daily
C) Add hydrochlorothiazide 12.5 mg daily
D) Refer to a cardiologist
Answer: C) Add hydrochlorothiazide 12.5 mg daily
Rationale: The client's blood pressure is not at goal (<130/80 mmHg). The FNP should consider adding a
low-dose thiazide diuretic (hydrochlorothiazide) to the existing ACE inhibitor. This is consistent with the
JNC-8 and ACC/AHA guidelines for hypertension management. Increasing lisinopril to 40 mg may not be
as effective as combination therapy. Adding amlodipine (CCB) is also an option but should be considered
after thiazide diuretics. Referral to a cardiologist is appropriate for resistant hypertension but should not
be the first step.
Question 5: An FNP is assessing a 25-year-old female client who reports a 3-week history of fatigue,
weight gain, and cold intolerance. Which laboratory test should the FNP order first?
A) Complete blood count (CBC)
B) Thyroid-stimulating hormone (TSH)
C) Basic metabolic panel (BMP)
D) Urinalysis
Answer: B) Thyroid-stimulating hormone (TSH)
Rationale: The client's symptoms (fatigue, weight gain, cold intolerance) are classic signs of
hypothyroidism. TSH is the most sensitive screening test for thyroid dysfunction. A low TSH indicates
hyperthyroidism, and a high TSH indicates hypothyroidism. The FNP should order TSH as the first-line
diagnostic test. CBC, BMP, and urinalysis may be helpful but are not the most specific for the presenting
symptoms.
, Question 6: An FNP is evaluating a 60-year-old male client with benign prostatic hyperplasia (BPH). The
client reports difficulty initiating urination, weak stream, and nocturia. Which medication should the
FNP consider as first-line treatment?
A) Tamsulosin
B) Finasteride
C) Terazosin
D) Dutasteride
Answer: A) Tamsulosin
Rationale: Tamsulosin is an alpha-1 blocker that relaxes smooth muscle in the prostate and bladder neck,
improving urinary flow and reducing symptoms of BPH. It is a first-line treatment for BPH. Finasteride
and dutasteride are 5-alpha-reductase inhibitors that reduce prostate size and are effective but have a
slower onset of action (6-12 months). Terazosin is an alpha-1 blocker but has more side effects than
tamsulosin, especially orthostatic hypotension.
Question 7: An FNP is performing a physical examination on a 15-year-old male athlete who reports
knee pain. The pain is localized to the anterior knee and worsens with squatting, climbing stairs, and
kneeling. Which finding is most consistent with Osgood-Schlatter disease?
A) Tenderness at the tibial tuberosity
B) Tenderness at the patellar tendon
C) Swelling of the knee joint
D) Positive Lachman test
Answer: A) Tenderness at the tibial tuberosity
Rationale: Osgood-Schlatter disease is a traction apophysitis of the tibial tuberosity, commonly seen in
adolescent athletes during growth spurts. It presents with anterior knee pain that worsens with activity
and tenderness at the tibial tuberosity. Patellar tendon tenderness, joint swelling, and positive Lachman
test are associated with other knee conditions (patellar tendinopathy, joint effusion, and ACL injury,
respectively).
Question 8: An FNP is managing a 50-year-old female client with osteoporosis. The client's DEXA scan
shows a T-score of -3.0 at the lumbar spine. Which medication should the FNP consider as first-line
treatment?
A) Alendronate
B) Raloxifene
C) Calcitonin
D) Teriparatide
Answer: A) Alendronate
(Chamberlain) – Complete Exam 8 with Verified
Answers (2026 Edition)
Question 1: A family nurse practitioner (FNP) is assessing a 45-year-old male client with a history of
hypertension who presents with complaints of chest pain, shortness of breath, and diaphoresis that
began 30 minutes ago. Which action should the FNP take first?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead electrocardiogram (ECG)
C) Administer aspirin 324 mg chewed
D) Call 911 for emergency transport
Answer: D) Call 911 for emergency transport
Rationale: The client is presenting with signs and symptoms of acute myocardial infarction (chest pain,
shortness of breath, diaphoresis). The first priority is to activate emergency medical services (call 911) for
immediate transport to the emergency department. While ECG, aspirin, and nitroglycerin are important
interventions, they should not delay emergency transport. The FNP should also consider administering
aspirin and nitroglycerin while awaiting transport.
Question 2: An FNP is evaluating a 55-year-old female client with type 2 diabetes mellitus. The client's
hemoglobin A1c is 9.2%. Which intervention should the FNP prioritize?
A) Initiate insulin therapy immediately
B) Refer to a diabetes educator for lifestyle modification education
C) Increase the dose of oral hypoglycemic agents
D) Order a fasting blood glucose and repeat the hemoglobin A1c in 3 months
Answer: B) Refer to a diabetes educator for lifestyle modification education
Rationale: A hemoglobin A1c of 9.2% indicates poor glycemic control. The FNP should prioritize a
multidisciplinary approach, including referral to a diabetes educator for lifestyle modification education
and dietary counseling. While medication adjustment may be needed, education is a critical component
of diabetes management. Insulin therapy may be needed but is not the first step. Repeating the A1c in 3
months is appropriate after interventions have been implemented.
Question 3: An FNP is performing a well-child examination on a 2-year-old child. Which developmental
milestone should the child have achieved by this age?
A) Standing on one foot for 3 seconds
B) Kicking a ball forward
,C) Using 2-3 word phrases
D) Riding a tricycle
Answer: C) Using 2-3 word phrases
Rationale: By age 2, a child should be able to use 2-3 word phrases and have a vocabulary of about 50
words. Standing on one foot for 3 seconds is a 3-4 year milestone. Kicking a ball forward is a 2-3 year
milestone. Riding a tricycle is a 3-4 year milestone. The FNP should assess developmental milestones at
each well-child visit to identify any delays.
Question 4: An FNP is managing a 65-year-old male client with hypertension and hyperlipidemia. The
client's blood pressure is 148/90 mmHg on lisinopril 20 mg daily. Which action should the FNP take?
A) Increase lisinopril to 40 mg daily
B) Add amlodipine 5 mg daily
C) Add hydrochlorothiazide 12.5 mg daily
D) Refer to a cardiologist
Answer: C) Add hydrochlorothiazide 12.5 mg daily
Rationale: The client's blood pressure is not at goal (<130/80 mmHg). The FNP should consider adding a
low-dose thiazide diuretic (hydrochlorothiazide) to the existing ACE inhibitor. This is consistent with the
JNC-8 and ACC/AHA guidelines for hypertension management. Increasing lisinopril to 40 mg may not be
as effective as combination therapy. Adding amlodipine (CCB) is also an option but should be considered
after thiazide diuretics. Referral to a cardiologist is appropriate for resistant hypertension but should not
be the first step.
Question 5: An FNP is assessing a 25-year-old female client who reports a 3-week history of fatigue,
weight gain, and cold intolerance. Which laboratory test should the FNP order first?
A) Complete blood count (CBC)
B) Thyroid-stimulating hormone (TSH)
C) Basic metabolic panel (BMP)
D) Urinalysis
Answer: B) Thyroid-stimulating hormone (TSH)
Rationale: The client's symptoms (fatigue, weight gain, cold intolerance) are classic signs of
hypothyroidism. TSH is the most sensitive screening test for thyroid dysfunction. A low TSH indicates
hyperthyroidism, and a high TSH indicates hypothyroidism. The FNP should order TSH as the first-line
diagnostic test. CBC, BMP, and urinalysis may be helpful but are not the most specific for the presenting
symptoms.
, Question 6: An FNP is evaluating a 60-year-old male client with benign prostatic hyperplasia (BPH). The
client reports difficulty initiating urination, weak stream, and nocturia. Which medication should the
FNP consider as first-line treatment?
A) Tamsulosin
B) Finasteride
C) Terazosin
D) Dutasteride
Answer: A) Tamsulosin
Rationale: Tamsulosin is an alpha-1 blocker that relaxes smooth muscle in the prostate and bladder neck,
improving urinary flow and reducing symptoms of BPH. It is a first-line treatment for BPH. Finasteride
and dutasteride are 5-alpha-reductase inhibitors that reduce prostate size and are effective but have a
slower onset of action (6-12 months). Terazosin is an alpha-1 blocker but has more side effects than
tamsulosin, especially orthostatic hypotension.
Question 7: An FNP is performing a physical examination on a 15-year-old male athlete who reports
knee pain. The pain is localized to the anterior knee and worsens with squatting, climbing stairs, and
kneeling. Which finding is most consistent with Osgood-Schlatter disease?
A) Tenderness at the tibial tuberosity
B) Tenderness at the patellar tendon
C) Swelling of the knee joint
D) Positive Lachman test
Answer: A) Tenderness at the tibial tuberosity
Rationale: Osgood-Schlatter disease is a traction apophysitis of the tibial tuberosity, commonly seen in
adolescent athletes during growth spurts. It presents with anterior knee pain that worsens with activity
and tenderness at the tibial tuberosity. Patellar tendon tenderness, joint swelling, and positive Lachman
test are associated with other knee conditions (patellar tendinopathy, joint effusion, and ACL injury,
respectively).
Question 8: An FNP is managing a 50-year-old female client with osteoporosis. The client's DEXA scan
shows a T-score of -3.0 at the lumbar spine. Which medication should the FNP consider as first-line
treatment?
A) Alendronate
B) Raloxifene
C) Calcitonin
D) Teriparatide
Answer: A) Alendronate
