NURS 5432 FAMILY NURSING
PRACTICE COMPREHENSIVE FINAL
EXAM QUESTIONS AND ANSWERS
1. A 62-year-old male with a history of Type 2 Diabetes and Stage 3 Chronic Kidney Disease
(GFR 44) presents with a BP of 155/92. Which medication is first-line for blood pressure
management?
A. Metoprolol
B. Lisinopril
C. Hydrochlorothiazide
D. Amlodipine
Answer: B
Conceptual Explanation: ACE inhibitors such as Lisinopril are first-line for patients with
diabetes and CKD because they provide renal protection by reducing intraglomerular
pressure and albuminuria.
,2. According to the ADA guidelines, what is the diagnostic threshold for Hemoglobin A1c to
confirm Diabetes Mellitus?
A. 5.7% or higher
B. 6.0% or higher
C. 7.0% or higher
D. 6.5% or higher
Answer: D
Conceptual Explanation: An A1c level of 6.5% or higher, confirmed by a second test
unless symptoms are present, is diagnostic for Diabetes Mellitus.
3. A 45-year-old female presents with fatigue, cold intolerance, and weight gain. Her TSH is
12.4 mIU/L and Free T4 is low. What is the most likely diagnosis?
A. Primary Hypothyroidism
B. Secondary Hypothyroidism
C. Subclinical Hypothyroidism
D. Hashimoto’s Encephalopathy
Answer: A
Conceptual Explanation: An elevated TSH combined with a low Free T4 indicates Primary
Hypothyroidism, most commonly caused by Hashimoto’s thyroiditis.
, 4. A 12-month-old infant is brought in for a well-child visit. Which developmental milestone
should the nurse practitioner expect the child to have achieved?
A. Copying a circle and a square
B. Running well and jumping in place
C. Standing alone and taking a few steps
D. Pedaling a tricycle
Answer: C
Conceptual Explanation: At 12 months, infants typically can stand alone, walk while
holding onto furniture (cruising), and may take a few independent steps.
5. A patient with intermittent asthma reports symptoms twice a week but no nocturnal
awakenings. Which treatment step is appropriate?
A. Medium-dose ICS only
B. Low-dose Inhaled Corticosteroid (ICS) plus SABA as needed
C. SABA as needed only
D. LABA as needed only
Answer: B
Conceptual Explanation: Current GINA and NHLBI guidelines suggest that even for mild
asthma, a low-dose ICS should be considered alongside a SABA to reduce the risk of
exacerbations, or a PRN ICS-formoterol combination.
PRACTICE COMPREHENSIVE FINAL
EXAM QUESTIONS AND ANSWERS
1. A 62-year-old male with a history of Type 2 Diabetes and Stage 3 Chronic Kidney Disease
(GFR 44) presents with a BP of 155/92. Which medication is first-line for blood pressure
management?
A. Metoprolol
B. Lisinopril
C. Hydrochlorothiazide
D. Amlodipine
Answer: B
Conceptual Explanation: ACE inhibitors such as Lisinopril are first-line for patients with
diabetes and CKD because they provide renal protection by reducing intraglomerular
pressure and albuminuria.
,2. According to the ADA guidelines, what is the diagnostic threshold for Hemoglobin A1c to
confirm Diabetes Mellitus?
A. 5.7% or higher
B. 6.0% or higher
C. 7.0% or higher
D. 6.5% or higher
Answer: D
Conceptual Explanation: An A1c level of 6.5% or higher, confirmed by a second test
unless symptoms are present, is diagnostic for Diabetes Mellitus.
3. A 45-year-old female presents with fatigue, cold intolerance, and weight gain. Her TSH is
12.4 mIU/L and Free T4 is low. What is the most likely diagnosis?
A. Primary Hypothyroidism
B. Secondary Hypothyroidism
C. Subclinical Hypothyroidism
D. Hashimoto’s Encephalopathy
Answer: A
Conceptual Explanation: An elevated TSH combined with a low Free T4 indicates Primary
Hypothyroidism, most commonly caused by Hashimoto’s thyroiditis.
, 4. A 12-month-old infant is brought in for a well-child visit. Which developmental milestone
should the nurse practitioner expect the child to have achieved?
A. Copying a circle and a square
B. Running well and jumping in place
C. Standing alone and taking a few steps
D. Pedaling a tricycle
Answer: C
Conceptual Explanation: At 12 months, infants typically can stand alone, walk while
holding onto furniture (cruising), and may take a few independent steps.
5. A patient with intermittent asthma reports symptoms twice a week but no nocturnal
awakenings. Which treatment step is appropriate?
A. Medium-dose ICS only
B. Low-dose Inhaled Corticosteroid (ICS) plus SABA as needed
C. SABA as needed only
D. LABA as needed only
Answer: B
Conceptual Explanation: Current GINA and NHLBI guidelines suggest that even for mild
asthma, a low-dose ICS should be considered alongside a SABA to reduce the risk of
exacerbations, or a PRN ICS-formoterol combination.
