• NUR 509 09/07/2026
NUR 509 - FNP ADULTS FINAL EXAM PREP
NEWEST 2026/2027 ACTUAL EXAM COMPLETE
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALE
A 42-year-old G2P1 arrives at clinic for a routine prenatal visit late in her third trimester. On exam, the physician
notes a subtle murmur; on further auscultation, it becomes apparent that the murmur occurs during the
diastolic phase. The patient has minimal complaints but does reveal that she has had swelling in her feet and
shortness of breath. Because these symptoms have been only slightly more severe than during her last
pregnancy, she assumed this was normal for pregnancy. Which of the following is true about her presentation?
a. Diastolic murmurs during pregnancy may be due to anemia.
b. A diastolic murmur during pregnancy is known as a venous hum.
P 1
, • NUR 509 09/07/2026
c. A diastolic murmur during pregnancy is likely pathological and should always be investigated.
d. Cardiomyopathy is very rare during and after pregnancy due to protective effects of estrogen and
progesterone; it does not need to be considered on this patient's di –
Correct Answer :c. A diastolic murmur during pregnancy is likely pathological and should always be investigated.
Rationale: Diastolic murmurs are rarely benign and should always be investigated, especially during pregnancy.
A 17-year-old G1P0 presents at a routine prenatal check. By last menstrual period (LMP), her gestational age at
this visit is 36 weeks, 2 days. A first-trimester ultrasound confirmed her estimated delivery date. On exam, her
fundus measures 31 centimeters. Ultrasound imaging might reveal which of the following anatomical findings
that would explain this size?
a. Normal size, organs, and amniotic fluid for the gestational age
b. Uterine leiomyomata that restrict fetal development
c. Extra amniotic fluid
d. Renal agenesis of the fetus resulting in intrauterine growth retardation
e. Twin pregnancy –
Correct Answer :d. Renal agenesis of the fetus resulting in intrauterine growth retardation
Rationale: After 20 weeks' gestational age, the fundal height as measured from the pubic symphysis should
equal the number of weeks in the gestational age (e.g., 34 cm at 34 weeks' gestational age). Although these
measurements are not exact, deviations >4 cm deserve evaluation for the cause of the abnormally large or small
fundal height. The fetal kidneys produce urine that becomes amniotic fluid; without normal development of the
kidneys (i.e., renal agenesis), fluid levels can be very low, resulting in small-for-dates measurements on exam;
bilateral renal agenesis is not usually compatible with life. There are many other potential reasons a fetus may be
small for dates—such as fetal anomaly or missed abortion—but none of the other explanations listed here are
likely explanations.
A 26-year-old G0P0 is interested in becoming pregnant and presents for prepregnancy counseling. She was not
vaccinated as a child and unsure if she wishes to be vaccinated now. She asks if she can change her mind during
pregnancy and receive vaccinations during that time. What should she be told?
a. If a pregnant woman does not show sufficient titers to rubella, measles/mumps/rubella (MMR) vaccination
should be given postpartum to protect future pregnancies from the effects of congenital rubella.
b. Hepatitis B, measles/mumps/rubella (MMR), and influenza vaccines are safe during pregnancy.
c. Polio and influenza vaccinations are not safe during pregnancy and should never be utilized.
P 2
, • NUR 509 09/07/2026
d. RhoGAM is a vaccine specific to pregnancy that should be given to all pregnant women.
e. No vaccines are safe during pregnancy, and the risks of vaccination outweigh the benefits of immunity to
infectious diseases. –
Correct Answer :a. If a pregnant woman does not show sufficient titers to rubella, measles/mumps/rubella
(MMR) vaccination should be given postpartum to protect future pregnancies from the effects of congenital
rubella.
Rationale: If a pregnant woman does not show sufficient titers to rubella, MMR vaccination should be given
postpartum to protect future pregnancies from the effects of congenital rubella.
A 31-year-old marathon runner presents for prenatal care with her first pregnancy. She is in her second trimester
and is experiencing some fatigue and muscle aches. Her prepregnancy body mass index (BMI) was noted at 19.2.
How should she be counseled on exercise and nutrition during pregnancy?
a. She should gain at least 40 pounds during the pregnancy to account for being underweight at the time of
conception.
b. Immersion in hot water is a safe and effective nonmedicinal way of coping with musculoskeletal complaints
during pregnancy.
c. She should increase her calorie intake to 300 calories per day or more from her prepregnancy baseline.
d. She should avoid unpasteurized dairy products and delicatessen meats due to the risk of mycobacteria,
shigellosis, and brucellosis.
e. She should switch from running to weight-lifting (e.g., bench press) to maintain muscle mass while avoiding
the stressors of running on the fetus –
Correct Answer :c. She should increase her calorie intake to 300 calories per day or more from her
prepregnancy baseline.
Rationale: As the patient's BMI was low-normal to begin with, she may need more than the usual 300 calorie
increase to account for the growing fetus.
A 29-year-old G2P1 presents to the clinic after a positive home pregnancy test. She confides at the appointment
that her male partner has become increasingly abusive lately and once struck her while she was holding her older
child. How should she be counseled?
a. Ask that she bring the partner to all appointments so that he can be included in decisions and thus feel less
threatened and less likely to harm the patient again.
b. Reassure her that no matter what she reveals, all information she discloses will be kept strictly confidential.
P 3
, • NUR 509 09/07/2026
c. Ask open-ended questions, allow her to make decisions that she feels are best for herself given the
circumstance, and provide immediate or long-term referrals to domestic violence resources.
d. Reassure her that she is safe as very few pregnant women are hurt or murdered by their partners, who
generally become less violent during the vulnerable period of pregnancy.
e. Demand that s –
Correct Answer :c. Ask open-ended questions, allow her to make decisions that she feels are best for herself
given the circumstance, and provide immediate or long-term referrals to domestic violence resources.
Rationale: The approach of asking open-ended questions, allowing her to make decisions that she feels are best
for herself given the circumstance, and providing immediate or long-term referrals to domestic violence
resources is most likely to build trust and provide the resource needed for the patient to care for herself and her
children.
A 34-year-old G3P2 at 27 weeks' gestation is referred to the clinic upon discharge from a correctional institution
where she has been incarcerated for 25 days for a drug offense. She denies any further substance abuse, but her
behavior is concerning for intoxication, and she smells of alcohol and cigarettes. The clinician inquires about her
drug use with open-ended questions and counsels her that which of the following is true?
a. Pregnant women are not routinely screened for hepatitis C, but this test should be added to the panel of
prenatal blood tests for patients with a history of intravenous drug use.
b. Cigarettes are a rare cause of low birth weight in the growing fetus.
c. Women can safely drink one alcoholic drink per day without risk of fetal alcohol syndrome.
d. If a pregnant patient does not intend to quit tobacco, she should not bother to cut down as there is no
benefit to the pregnancy from decreased us –
Correct Answer :a. Pregnant women are not routinely screened for hepatitis C, but this test should be added to
the panel of prenatal blood tests for patients with a history of intravenous drug use.
Rationale: The U.S. Preventive Services Task Force currently does not recommend routine screening of pregnant
women for hepatitis C but does recommend screening of individuals at elevated risk of the disease.
A 78-year-old woman presents to clinic with her two daughters, who are concerned about her continued ability
to live independently. She has thus far been highly self-reliant and is opposed to the idea of leaving of her home
of 30 years. The clinician performs a complete history and physical exam (including mental status and memory
testing) as well as orders laboratory tests before providing the patient and her family the finding that she has
P 4
NUR 509 - FNP ADULTS FINAL EXAM PREP
NEWEST 2026/2027 ACTUAL EXAM COMPLETE
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALE
A 42-year-old G2P1 arrives at clinic for a routine prenatal visit late in her third trimester. On exam, the physician
notes a subtle murmur; on further auscultation, it becomes apparent that the murmur occurs during the
diastolic phase. The patient has minimal complaints but does reveal that she has had swelling in her feet and
shortness of breath. Because these symptoms have been only slightly more severe than during her last
pregnancy, she assumed this was normal for pregnancy. Which of the following is true about her presentation?
a. Diastolic murmurs during pregnancy may be due to anemia.
b. A diastolic murmur during pregnancy is known as a venous hum.
P 1
, • NUR 509 09/07/2026
c. A diastolic murmur during pregnancy is likely pathological and should always be investigated.
d. Cardiomyopathy is very rare during and after pregnancy due to protective effects of estrogen and
progesterone; it does not need to be considered on this patient's di –
Correct Answer :c. A diastolic murmur during pregnancy is likely pathological and should always be investigated.
Rationale: Diastolic murmurs are rarely benign and should always be investigated, especially during pregnancy.
A 17-year-old G1P0 presents at a routine prenatal check. By last menstrual period (LMP), her gestational age at
this visit is 36 weeks, 2 days. A first-trimester ultrasound confirmed her estimated delivery date. On exam, her
fundus measures 31 centimeters. Ultrasound imaging might reveal which of the following anatomical findings
that would explain this size?
a. Normal size, organs, and amniotic fluid for the gestational age
b. Uterine leiomyomata that restrict fetal development
c. Extra amniotic fluid
d. Renal agenesis of the fetus resulting in intrauterine growth retardation
e. Twin pregnancy –
Correct Answer :d. Renal agenesis of the fetus resulting in intrauterine growth retardation
Rationale: After 20 weeks' gestational age, the fundal height as measured from the pubic symphysis should
equal the number of weeks in the gestational age (e.g., 34 cm at 34 weeks' gestational age). Although these
measurements are not exact, deviations >4 cm deserve evaluation for the cause of the abnormally large or small
fundal height. The fetal kidneys produce urine that becomes amniotic fluid; without normal development of the
kidneys (i.e., renal agenesis), fluid levels can be very low, resulting in small-for-dates measurements on exam;
bilateral renal agenesis is not usually compatible with life. There are many other potential reasons a fetus may be
small for dates—such as fetal anomaly or missed abortion—but none of the other explanations listed here are
likely explanations.
A 26-year-old G0P0 is interested in becoming pregnant and presents for prepregnancy counseling. She was not
vaccinated as a child and unsure if she wishes to be vaccinated now. She asks if she can change her mind during
pregnancy and receive vaccinations during that time. What should she be told?
a. If a pregnant woman does not show sufficient titers to rubella, measles/mumps/rubella (MMR) vaccination
should be given postpartum to protect future pregnancies from the effects of congenital rubella.
b. Hepatitis B, measles/mumps/rubella (MMR), and influenza vaccines are safe during pregnancy.
c. Polio and influenza vaccinations are not safe during pregnancy and should never be utilized.
P 2
, • NUR 509 09/07/2026
d. RhoGAM is a vaccine specific to pregnancy that should be given to all pregnant women.
e. No vaccines are safe during pregnancy, and the risks of vaccination outweigh the benefits of immunity to
infectious diseases. –
Correct Answer :a. If a pregnant woman does not show sufficient titers to rubella, measles/mumps/rubella
(MMR) vaccination should be given postpartum to protect future pregnancies from the effects of congenital
rubella.
Rationale: If a pregnant woman does not show sufficient titers to rubella, MMR vaccination should be given
postpartum to protect future pregnancies from the effects of congenital rubella.
A 31-year-old marathon runner presents for prenatal care with her first pregnancy. She is in her second trimester
and is experiencing some fatigue and muscle aches. Her prepregnancy body mass index (BMI) was noted at 19.2.
How should she be counseled on exercise and nutrition during pregnancy?
a. She should gain at least 40 pounds during the pregnancy to account for being underweight at the time of
conception.
b. Immersion in hot water is a safe and effective nonmedicinal way of coping with musculoskeletal complaints
during pregnancy.
c. She should increase her calorie intake to 300 calories per day or more from her prepregnancy baseline.
d. She should avoid unpasteurized dairy products and delicatessen meats due to the risk of mycobacteria,
shigellosis, and brucellosis.
e. She should switch from running to weight-lifting (e.g., bench press) to maintain muscle mass while avoiding
the stressors of running on the fetus –
Correct Answer :c. She should increase her calorie intake to 300 calories per day or more from her
prepregnancy baseline.
Rationale: As the patient's BMI was low-normal to begin with, she may need more than the usual 300 calorie
increase to account for the growing fetus.
A 29-year-old G2P1 presents to the clinic after a positive home pregnancy test. She confides at the appointment
that her male partner has become increasingly abusive lately and once struck her while she was holding her older
child. How should she be counseled?
a. Ask that she bring the partner to all appointments so that he can be included in decisions and thus feel less
threatened and less likely to harm the patient again.
b. Reassure her that no matter what she reveals, all information she discloses will be kept strictly confidential.
P 3
, • NUR 509 09/07/2026
c. Ask open-ended questions, allow her to make decisions that she feels are best for herself given the
circumstance, and provide immediate or long-term referrals to domestic violence resources.
d. Reassure her that she is safe as very few pregnant women are hurt or murdered by their partners, who
generally become less violent during the vulnerable period of pregnancy.
e. Demand that s –
Correct Answer :c. Ask open-ended questions, allow her to make decisions that she feels are best for herself
given the circumstance, and provide immediate or long-term referrals to domestic violence resources.
Rationale: The approach of asking open-ended questions, allowing her to make decisions that she feels are best
for herself given the circumstance, and providing immediate or long-term referrals to domestic violence
resources is most likely to build trust and provide the resource needed for the patient to care for herself and her
children.
A 34-year-old G3P2 at 27 weeks' gestation is referred to the clinic upon discharge from a correctional institution
where she has been incarcerated for 25 days for a drug offense. She denies any further substance abuse, but her
behavior is concerning for intoxication, and she smells of alcohol and cigarettes. The clinician inquires about her
drug use with open-ended questions and counsels her that which of the following is true?
a. Pregnant women are not routinely screened for hepatitis C, but this test should be added to the panel of
prenatal blood tests for patients with a history of intravenous drug use.
b. Cigarettes are a rare cause of low birth weight in the growing fetus.
c. Women can safely drink one alcoholic drink per day without risk of fetal alcohol syndrome.
d. If a pregnant patient does not intend to quit tobacco, she should not bother to cut down as there is no
benefit to the pregnancy from decreased us –
Correct Answer :a. Pregnant women are not routinely screened for hepatitis C, but this test should be added to
the panel of prenatal blood tests for patients with a history of intravenous drug use.
Rationale: The U.S. Preventive Services Task Force currently does not recommend routine screening of pregnant
women for hepatitis C but does recommend screening of individuals at elevated risk of the disease.
A 78-year-old woman presents to clinic with her two daughters, who are concerned about her continued ability
to live independently. She has thus far been highly self-reliant and is opposed to the idea of leaving of her home
of 30 years. The clinician performs a complete history and physical exam (including mental status and memory
testing) as well as orders laboratory tests before providing the patient and her family the finding that she has
P 4
