NR 667 CEA FINAL EXAM | (2026) QUESTIONS | FNP CAPSTONE QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse practitioner is assessing a patient who experienced a sudden onset of severe pain, swelling, and
erythema in the first metatarsophalangeal joint. Which finding would confirm the diagnosis?
A. Elevated serum uric acid level
B. Positive response to indomethacin
C. Synovial fluid analysis revealing monosodium urate crystals
D. Patient history of hypertension and diabetes
🟢 Correct Answer:
C. Synovial fluid analysis revealing monosodium urate crystals
🔴 RATIONALE:
While hyperuricemia and a positive response to NSAIDs support the diagnosis of gout, the most specific test is
synovial fluid analysis demonstrating negatively birefringent monosodium urate crystals. This confirms the
diagnosis and rules out other causes of monoarticular arthritis such as pseudogout or septic arthritis .
Question 2
A 72-year-old female presents with a new onset of unilateral headache, scalp tenderness, and jaw claudication.
Her erythrocyte sedimentation rate (ESR) is significantly elevated. What is the most appropriate initial
,management?
A. Order a temporal artery biopsy
B. Begin high-dose corticosteroids
C. Prescribe a triptan for migraine
D. Recommend over-the-counter NSAIDs
🟢 Correct Answer:
B. Begin high-dose corticosteroids
🔴 RATIONALE:
This presentation is classic for giant cell arteritis (temporal arteritis). To prevent the risk of blindness, immediate
treatment with high-dose corticosteroids should be initiated as soon as the diagnosis is suspected, even before
a temporal artery biopsy is performed. The biopsy can be scheduled and performed within days without
compromising diagnostic accuracy .
Question 3
A 78-year-old male with a history of rectal adenocarcinoma who completed chemoradiation earlier this year
presents with chronic fatigue, bruising, and recurrent infections. His CBC shows pancytopenia with dysplasia on
peripheral smear. What additional workup should the NP anticipate?
A. Bone marrow biopsy and flow cytometry
B. Colonoscopy to rule out recurrence
C. Repeat CBC in 8 weeks
D. Serum vitamin B12 and folate levels
,🟢 Correct Answer:
A. Bone marrow biopsy and flow cytometry
🔴 RATIONALE:
This patient's presentation of pancytopenia with dysplasia following chemotherapy is concerning for therapy-
related myelodysplastic syndrome (MDS), which carries a risk of progression to acute myeloid leukemia (AML). A
bone marrow biopsy with flow cytometry is the definitive diagnostic test to confirm MDS and evaluate for
leukemic transformation .
Question 4
A 45-year-old male with a history of benign prostatic hyperplasia (BPH) presents with worsening nocturia and a
weak urinary stream. What is the most appropriate initial pharmacological treatment?
A. Finasteride
B. Tamsulosin
C. Antibiotics
D. Anticholinergics
🟢 Correct Answer:
B. Tamsulosin
🔴 RATIONALE:
Alpha-blockers such as tamsulosin are the first-line pharmacologic treatment for symptomatic BPH. They work
by relaxing the smooth muscle of the prostate and bladder neck, improving urine flow and reducing obstructive
symptoms. 5-alpha-reductase inhibitors like finasteride are used for larger prostates and take longer to work .
, Question 5
A 35-year-old woman with allergic rhinitis reports persistent nasal congestion, sneezing, and itchy eyes despite
over-the-counter antihistamine use. What is the most appropriate next step in management?
A. Add an oral decongestant
B. Initiate intranasal corticosteroids
C. Recommend nasal saline irrigation only
D. Refer to an allergist for immunotherapy
🟢 Correct Answer:
B. Initiate intranasal corticosteroids
🔴 RATIONALE:
Intranasal corticosteroids are the most effective pharmacologic treatment for moderate to severe allergic
rhinitis. They are superior to oral antihistamines alone and address multiple symptoms including nasal
congestion, which is poorly controlled by oral antihistamines .
Question 6
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by bladder emptying. She
has been evaluated by urology and urogynecology with negative urinalyses, cultures, STD panels, and an
unremarkable cystoscopy. What is an appropriate plan of care?
A. Referral to psychiatry
B. Daily nitrofurantoin prophylaxis
GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
The nurse practitioner is assessing a patient who experienced a sudden onset of severe pain, swelling, and
erythema in the first metatarsophalangeal joint. Which finding would confirm the diagnosis?
A. Elevated serum uric acid level
B. Positive response to indomethacin
C. Synovial fluid analysis revealing monosodium urate crystals
D. Patient history of hypertension and diabetes
🟢 Correct Answer:
C. Synovial fluid analysis revealing monosodium urate crystals
🔴 RATIONALE:
While hyperuricemia and a positive response to NSAIDs support the diagnosis of gout, the most specific test is
synovial fluid analysis demonstrating negatively birefringent monosodium urate crystals. This confirms the
diagnosis and rules out other causes of monoarticular arthritis such as pseudogout or septic arthritis .
Question 2
A 72-year-old female presents with a new onset of unilateral headache, scalp tenderness, and jaw claudication.
Her erythrocyte sedimentation rate (ESR) is significantly elevated. What is the most appropriate initial
,management?
A. Order a temporal artery biopsy
B. Begin high-dose corticosteroids
C. Prescribe a triptan for migraine
D. Recommend over-the-counter NSAIDs
🟢 Correct Answer:
B. Begin high-dose corticosteroids
🔴 RATIONALE:
This presentation is classic for giant cell arteritis (temporal arteritis). To prevent the risk of blindness, immediate
treatment with high-dose corticosteroids should be initiated as soon as the diagnosis is suspected, even before
a temporal artery biopsy is performed. The biopsy can be scheduled and performed within days without
compromising diagnostic accuracy .
Question 3
A 78-year-old male with a history of rectal adenocarcinoma who completed chemoradiation earlier this year
presents with chronic fatigue, bruising, and recurrent infections. His CBC shows pancytopenia with dysplasia on
peripheral smear. What additional workup should the NP anticipate?
A. Bone marrow biopsy and flow cytometry
B. Colonoscopy to rule out recurrence
C. Repeat CBC in 8 weeks
D. Serum vitamin B12 and folate levels
,🟢 Correct Answer:
A. Bone marrow biopsy and flow cytometry
🔴 RATIONALE:
This patient's presentation of pancytopenia with dysplasia following chemotherapy is concerning for therapy-
related myelodysplastic syndrome (MDS), which carries a risk of progression to acute myeloid leukemia (AML). A
bone marrow biopsy with flow cytometry is the definitive diagnostic test to confirm MDS and evaluate for
leukemic transformation .
Question 4
A 45-year-old male with a history of benign prostatic hyperplasia (BPH) presents with worsening nocturia and a
weak urinary stream. What is the most appropriate initial pharmacological treatment?
A. Finasteride
B. Tamsulosin
C. Antibiotics
D. Anticholinergics
🟢 Correct Answer:
B. Tamsulosin
🔴 RATIONALE:
Alpha-blockers such as tamsulosin are the first-line pharmacologic treatment for symptomatic BPH. They work
by relaxing the smooth muscle of the prostate and bladder neck, improving urine flow and reducing obstructive
symptoms. 5-alpha-reductase inhibitors like finasteride are used for larger prostates and take longer to work .
, Question 5
A 35-year-old woman with allergic rhinitis reports persistent nasal congestion, sneezing, and itchy eyes despite
over-the-counter antihistamine use. What is the most appropriate next step in management?
A. Add an oral decongestant
B. Initiate intranasal corticosteroids
C. Recommend nasal saline irrigation only
D. Refer to an allergist for immunotherapy
🟢 Correct Answer:
B. Initiate intranasal corticosteroids
🔴 RATIONALE:
Intranasal corticosteroids are the most effective pharmacologic treatment for moderate to severe allergic
rhinitis. They are superior to oral antihistamines alone and address multiple symptoms including nasal
congestion, which is poorly controlled by oral antihistamines .
Question 6
A 24-year-old female reports urinary urgency with suprapubic tenderness relieved by bladder emptying. She
has been evaluated by urology and urogynecology with negative urinalyses, cultures, STD panels, and an
unremarkable cystoscopy. What is an appropriate plan of care?
A. Referral to psychiatry
B. Daily nitrofurantoin prophylaxis
