1
, NRNP 6531 Midterm Exam Prep | (2026) High-
Yield Questions | FNP Study (PDF)
Question 1
A 55-year-old obese male with hypertension presents
with acute-onset sharp chest pain that worsens when lying
flat and improves when sitting forward. ECG shows
diffuse ST elevations. What is the most likely diagnosis?
A) Unstable angina
B) Acute pericarditis
C) Inferior STEMI
D) Pulmonary embolism
Correct Answer: B
Rationale: Pericarditis classically causes pleuritic chest
pain relieved by sitting forward, with diffuse ST
elevations on ECG.
Question 2
2
,A 68-year-old woman with heart failure with reduced
ejection fraction (HFrEF) is on carvedilol, lisinopril, and
furosemide. Her EF is 30%. She remains symptomatic with
dyspnea on minimal exertion. Which medication should be
added next?
A) Digoxin
B) Spironolactone
C) Hydralazine
D) Amlodipine
Correct Answer: B
Rationale: Spironolactone (mineralocorticoid receptor
antagonist) is guideline-directed therapy for HFrEF to
reduce mortality and hospitalizations.
Question 3
Which ECG finding is most specific for acute pericarditis?
A) ST elevation in leads V1–V4
B) PR segment depression
3
, C) Pathologic Q waves
D) T wave inversion in limb leads
Correct Answer: B
Rationale: PR segment depression is an early, specific
finding in acute pericarditis due to subepicardial
inflammation.
Question 4
A 62-year-old with diabetes and hypertension has BP
148/90 mmHg while taking lisinopril 40 mg daily. Her
creatinine is 1.0 mg/dL. What is the best next step?
A) Increase lisinopril to 80 mg daily
B) Add amlodipine 5 mg daily
C) Add hydrochlorothiazide 12.5 mg daily
D) Add carvedilol 6.25 mg twice daily
Correct Answer: C
Rationale: Adding a low-dose thiazide diuretic is
4
, NRNP 6531 Midterm Exam Prep | (2026) High-
Yield Questions | FNP Study (PDF)
Question 1
A 55-year-old obese male with hypertension presents
with acute-onset sharp chest pain that worsens when lying
flat and improves when sitting forward. ECG shows
diffuse ST elevations. What is the most likely diagnosis?
A) Unstable angina
B) Acute pericarditis
C) Inferior STEMI
D) Pulmonary embolism
Correct Answer: B
Rationale: Pericarditis classically causes pleuritic chest
pain relieved by sitting forward, with diffuse ST
elevations on ECG.
Question 2
2
,A 68-year-old woman with heart failure with reduced
ejection fraction (HFrEF) is on carvedilol, lisinopril, and
furosemide. Her EF is 30%. She remains symptomatic with
dyspnea on minimal exertion. Which medication should be
added next?
A) Digoxin
B) Spironolactone
C) Hydralazine
D) Amlodipine
Correct Answer: B
Rationale: Spironolactone (mineralocorticoid receptor
antagonist) is guideline-directed therapy for HFrEF to
reduce mortality and hospitalizations.
Question 3
Which ECG finding is most specific for acute pericarditis?
A) ST elevation in leads V1–V4
B) PR segment depression
3
, C) Pathologic Q waves
D) T wave inversion in limb leads
Correct Answer: B
Rationale: PR segment depression is an early, specific
finding in acute pericarditis due to subepicardial
inflammation.
Question 4
A 62-year-old with diabetes and hypertension has BP
148/90 mmHg while taking lisinopril 40 mg daily. Her
creatinine is 1.0 mg/dL. What is the best next step?
A) Increase lisinopril to 80 mg daily
B) Add amlodipine 5 mg daily
C) Add hydrochlorothiazide 12.5 mg daily
D) Add carvedilol 6.25 mg twice daily
Correct Answer: C
Rationale: Adding a low-dose thiazide diuretic is
4
