UNIVERSITY OF TEXAS AT ARLINGTON (UTA) – NURS 5434-
FAMILY NURSE PRACTITIONER 3 EXAM | ALL 200+ QUESTIONS
AND ANSWERS 2026/2027 | VERIFIED ANSWERS PLUS
RATIONALES | GRADED Q&A COMPREHENSIVE STUDY GUIDE
|VERIFIED LATEST 2027
1. A 52-year-old patient with hypertension has an office blood pressure of 154/92 mm Hg.
The patient reports taking lisinopril daily but frequently forgets doses on weekends. What
is the most appropriate initial action?
A. Add a thiazide diuretic immediately
B. Increase the lisinopril dose
C. Assess and address medication adherence
D. Refer the patient to cardiology
Answer: C
The first step is to determine whether uncontrolled blood pressure results from inadequate
adherence before escalating therapy. Addressing barriers to adherence may improve control
without unnecessary medication changes.
2. A 46-year-old woman reports fatigue, constipation, dry skin, and weight gain.
Laboratory testing shows an elevated TSH and low free T4. Which diagnosis is most
consistent with these findings?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: A
An elevated TSH with a low free T4 indicates primary hypothyroidism because the thyroid
gland is failing despite increased pituitary stimulation.
3. A patient with type 2 diabetes has an A1C of 9.4% despite adherence to metformin and
lifestyle recommendations. The patient has no contraindication to additional
pharmacotherapy. Which consideration is most important when selecting the next
medication?
A. Hair color
B. Cardiovascular and renal comorbidities
C. Fasting alone for 24 hours
D. Discontinuing all current therapy
Answer: B
,Modern diabetes treatment selection should consider cardiovascular disease, heart failure,
chronic kidney disease, hypoglycemia risk, weight effects, cost, and patient preferences.
4. A 67-year-old patient taking warfarin develops melena and dizziness. Blood pressure is
88/54 mm Hg. What is the priority?
A. Schedule routine follow-up in one week
B. Recommend increased dietary vitamin K
C. Hold only the next dose and reassess tomorrow
D. Arrange immediate emergency evaluation
Answer: D
Melena, hypotension, and dizziness suggest potentially significant gastrointestinal bleeding.
Hemodynamic instability requires immediate emergency evaluation and stabilization.
5. A 28-year-old woman presents with dysuria and urinary frequency without vaginal
discharge, fever, flank pain, or pregnancy. Which diagnosis is most likely?
A. Acute uncomplicated cystitis
B. Pyelonephritis
C. Bacterial vaginosis
D. Pelvic inflammatory disease
Answer: A
Dysuria and frequency without systemic symptoms or vaginal findings are classic for acute
uncomplicated cystitis.
6. A 71-year-old patient develops sudden unilateral weakness, facial droop, and difficulty
speaking 45 minutes before arrival. What is the most appropriate action?
A. Arrange routine outpatient MRI
B. Activate emergency stroke evaluation
C. Administer oral antibiotics
D. Schedule a neurology visit next month
Answer: B
Sudden focal neurologic deficits indicate a possible acute stroke. Rapid emergency evaluation
is essential because time-sensitive reperfusion therapies may be available.
7. A patient with asthma uses a rescue inhaler four days each week and wakes with cough
twice monthly. What does this pattern suggest?
A. Well-controlled asthma
B. Excessive medication adherence
C. Inadequately controlled asthma
D. A contraindication to inhaled corticosteroids
,Answer: C
Frequent rescue-inhaler use and nighttime symptoms indicate inadequate asthma control and
warrant reassessment of adherence, technique, triggers, and controller therapy.
8. A 59-year-old smoker reports painless gross hematuria occurring twice in the past
month. What is the most appropriate approach?
A. Reassure the patient that this is common with aging
B. Treat empirically for cystitis without further evaluation
C. Repeat urinalysis in one year
D. Initiate evaluation for a possible urinary tract malignancy
Answer: D
Painless gross hematuria, particularly in an older smoker, is a red flag for urinary tract
malignancy and requires appropriate diagnostic evaluation.
9. A 35-year-old patient has recurrent episodes of palpitations accompanied by
tremulousness and sweating. Which additional finding would most strongly support
hyperthyroidism?
A. Heat intolerance and weight loss
B. Cold intolerance and constipation
C. Bradycardia and dry skin
D. Weight gain and slowed reflexes
Answer: A
Heat intolerance, weight loss, tremor, palpitations, and sweating are characteristic
manifestations of increased thyroid hormone activity.
10. A patient with chronic kidney disease has persistent hypertension and albuminuria.
Which medication class is particularly useful for reducing intraglomerular pressure and
albuminuria when clinically appropriate?
A. Short-acting nitrates
B. ACE inhibitors or ARBs
C. Anticholinergics
D. Proton pump inhibitors
Answer: B
Renin-angiotensin system blockade with an ACE inhibitor or ARB can reduce albuminuria and
slow kidney disease progression in appropriate patients, while renal function and potassium
are monitored.
11. A 62-year-old patient presents with crushing substernal chest pressure radiating to the
left arm and diaphoresis. What is the priority?
, A. Obtain an immediate emergency cardiac evaluation
B. Schedule an exercise program
C. Treat for gastroesophageal reflux first
D. Reassure the patient because the pain is not pleuritic
Answer: A
The symptom pattern is highly concerning for acute coronary syndrome. Immediate
emergency assessment, including ECG and appropriate cardiac testing, is required.
12. A 40-year-old patient has a BMI of 34 kg/m² and newly diagnosed hypertension. Which
counseling approach is most appropriate?
A. Recommend eliminating all carbohydrates permanently
B. Focus only on medication and avoid lifestyle discussion
C. Establish achievable nutrition, physical activity, and weight-management goals
D. Recommend fasting as the sole treatment
Answer: C
Sustainable lifestyle modification should address nutrition, physical activity, weight
management, sleep, and other cardiovascular risk factors alongside pharmacologic treatment
when indicated.
13. A patient taking a statin reports new severe generalized muscle pain and weakness.
What is the most appropriate next step?
A. Ignore the symptoms because statins never cause muscle effects
B. Assess for statin-associated muscle injury and obtain appropriate laboratory testing
C. Double the statin dose
D. Start an antibiotic
Answer: B
Significant muscle symptoms warrant assessment for statin-associated myopathy, including
evaluation for severe complications such as rhabdomyolysis when clinically indicated.
14. A 24-year-old patient presents with a painful vesicular rash clustered along the right
thoracic dermatome. Which diagnosis is most likely?
A. Impetigo
B. Tinea corporis
C. Herpes zoster
D. Contact dermatitis
Answer: C
Grouped painful vesicles following a unilateral dermatome are characteristic of herpes zoster
caused by reactivation of varicella-zoster virus.
FAMILY NURSE PRACTITIONER 3 EXAM | ALL 200+ QUESTIONS
AND ANSWERS 2026/2027 | VERIFIED ANSWERS PLUS
RATIONALES | GRADED Q&A COMPREHENSIVE STUDY GUIDE
|VERIFIED LATEST 2027
1. A 52-year-old patient with hypertension has an office blood pressure of 154/92 mm Hg.
The patient reports taking lisinopril daily but frequently forgets doses on weekends. What
is the most appropriate initial action?
A. Add a thiazide diuretic immediately
B. Increase the lisinopril dose
C. Assess and address medication adherence
D. Refer the patient to cardiology
Answer: C
The first step is to determine whether uncontrolled blood pressure results from inadequate
adherence before escalating therapy. Addressing barriers to adherence may improve control
without unnecessary medication changes.
2. A 46-year-old woman reports fatigue, constipation, dry skin, and weight gain.
Laboratory testing shows an elevated TSH and low free T4. Which diagnosis is most
consistent with these findings?
A. Primary hypothyroidism
B. Secondary hypothyroidism
C. Hyperthyroidism
D. Euthyroid sick syndrome
Answer: A
An elevated TSH with a low free T4 indicates primary hypothyroidism because the thyroid
gland is failing despite increased pituitary stimulation.
3. A patient with type 2 diabetes has an A1C of 9.4% despite adherence to metformin and
lifestyle recommendations. The patient has no contraindication to additional
pharmacotherapy. Which consideration is most important when selecting the next
medication?
A. Hair color
B. Cardiovascular and renal comorbidities
C. Fasting alone for 24 hours
D. Discontinuing all current therapy
Answer: B
,Modern diabetes treatment selection should consider cardiovascular disease, heart failure,
chronic kidney disease, hypoglycemia risk, weight effects, cost, and patient preferences.
4. A 67-year-old patient taking warfarin develops melena and dizziness. Blood pressure is
88/54 mm Hg. What is the priority?
A. Schedule routine follow-up in one week
B. Recommend increased dietary vitamin K
C. Hold only the next dose and reassess tomorrow
D. Arrange immediate emergency evaluation
Answer: D
Melena, hypotension, and dizziness suggest potentially significant gastrointestinal bleeding.
Hemodynamic instability requires immediate emergency evaluation and stabilization.
5. A 28-year-old woman presents with dysuria and urinary frequency without vaginal
discharge, fever, flank pain, or pregnancy. Which diagnosis is most likely?
A. Acute uncomplicated cystitis
B. Pyelonephritis
C. Bacterial vaginosis
D. Pelvic inflammatory disease
Answer: A
Dysuria and frequency without systemic symptoms or vaginal findings are classic for acute
uncomplicated cystitis.
6. A 71-year-old patient develops sudden unilateral weakness, facial droop, and difficulty
speaking 45 minutes before arrival. What is the most appropriate action?
A. Arrange routine outpatient MRI
B. Activate emergency stroke evaluation
C. Administer oral antibiotics
D. Schedule a neurology visit next month
Answer: B
Sudden focal neurologic deficits indicate a possible acute stroke. Rapid emergency evaluation
is essential because time-sensitive reperfusion therapies may be available.
7. A patient with asthma uses a rescue inhaler four days each week and wakes with cough
twice monthly. What does this pattern suggest?
A. Well-controlled asthma
B. Excessive medication adherence
C. Inadequately controlled asthma
D. A contraindication to inhaled corticosteroids
,Answer: C
Frequent rescue-inhaler use and nighttime symptoms indicate inadequate asthma control and
warrant reassessment of adherence, technique, triggers, and controller therapy.
8. A 59-year-old smoker reports painless gross hematuria occurring twice in the past
month. What is the most appropriate approach?
A. Reassure the patient that this is common with aging
B. Treat empirically for cystitis without further evaluation
C. Repeat urinalysis in one year
D. Initiate evaluation for a possible urinary tract malignancy
Answer: D
Painless gross hematuria, particularly in an older smoker, is a red flag for urinary tract
malignancy and requires appropriate diagnostic evaluation.
9. A 35-year-old patient has recurrent episodes of palpitations accompanied by
tremulousness and sweating. Which additional finding would most strongly support
hyperthyroidism?
A. Heat intolerance and weight loss
B. Cold intolerance and constipation
C. Bradycardia and dry skin
D. Weight gain and slowed reflexes
Answer: A
Heat intolerance, weight loss, tremor, palpitations, and sweating are characteristic
manifestations of increased thyroid hormone activity.
10. A patient with chronic kidney disease has persistent hypertension and albuminuria.
Which medication class is particularly useful for reducing intraglomerular pressure and
albuminuria when clinically appropriate?
A. Short-acting nitrates
B. ACE inhibitors or ARBs
C. Anticholinergics
D. Proton pump inhibitors
Answer: B
Renin-angiotensin system blockade with an ACE inhibitor or ARB can reduce albuminuria and
slow kidney disease progression in appropriate patients, while renal function and potassium
are monitored.
11. A 62-year-old patient presents with crushing substernal chest pressure radiating to the
left arm and diaphoresis. What is the priority?
, A. Obtain an immediate emergency cardiac evaluation
B. Schedule an exercise program
C. Treat for gastroesophageal reflux first
D. Reassure the patient because the pain is not pleuritic
Answer: A
The symptom pattern is highly concerning for acute coronary syndrome. Immediate
emergency assessment, including ECG and appropriate cardiac testing, is required.
12. A 40-year-old patient has a BMI of 34 kg/m² and newly diagnosed hypertension. Which
counseling approach is most appropriate?
A. Recommend eliminating all carbohydrates permanently
B. Focus only on medication and avoid lifestyle discussion
C. Establish achievable nutrition, physical activity, and weight-management goals
D. Recommend fasting as the sole treatment
Answer: C
Sustainable lifestyle modification should address nutrition, physical activity, weight
management, sleep, and other cardiovascular risk factors alongside pharmacologic treatment
when indicated.
13. A patient taking a statin reports new severe generalized muscle pain and weakness.
What is the most appropriate next step?
A. Ignore the symptoms because statins never cause muscle effects
B. Assess for statin-associated muscle injury and obtain appropriate laboratory testing
C. Double the statin dose
D. Start an antibiotic
Answer: B
Significant muscle symptoms warrant assessment for statin-associated myopathy, including
evaluation for severe complications such as rhabdomyolysis when clinically indicated.
14. A 24-year-old patient presents with a painful vesicular rash clustered along the right
thoracic dermatome. Which diagnosis is most likely?
A. Impetigo
B. Tinea corporis
C. Herpes zoster
D. Contact dermatitis
Answer: C
Grouped painful vesicles following a unilateral dermatome are characteristic of herpes zoster
caused by reactivation of varicella-zoster virus.
