NR667 FNP Exam 2 — Comprehensive Practice
Question Bank (Verified Update)
Format: Question → Answer → Detailed Rationale |
Complete Verified Questions | Graded A+
SECTION 1: CARDIOVASCULAR (Questions)
1. A 55-year-old male presents with a blood pressure
of 158/96 mmHg on two separate office visits. Per
current guidelines, this is classified as:
A) Elevated blood pressure
B) Stage 1 hypertension
C) Stage 2 hypertension
D) Normal blood pressure
Correct Answer: C
Rationale: A BP of 158/96 mmHg meets criteria for Stage
2 hypertension (≥140/90 mmHg) per current ACC/AHA
guidelines, confirmed on repeated measurement.
2. Which first-line antihypertensive class is generally
preferred for a Black patient with hypertension and no
other compelling comorbidities?
A) ACE inhibitor as first-line monotherapy
,B) Thiazide diuretic or calcium channel blocker
C) Beta-blocker as first-line monotherapy
D) Alpha-1 blocker as first-line monotherapy
Correct Answer: B
Rationale: Current guidelines recommend thiazide
diuretics or calcium channel blockers as preferred first-line
agents for Black patients with hypertension without
compelling comorbidities.
3. A patient with hypertension and comorbid diabetic
nephropathy with proteinuria should be prescribed
which first-line antihypertensive class?
A) ACE inhibitor or ARB
B) Beta-blocker as first-line
C) Thiazide diuretic as first-line
D) Alpha-1 blocker as first-line
Correct Answer: A
Rationale: ACE inhibitors/ARBs provide renoprotective
effects beyond blood pressure control in patients with
diabetic nephropathy and proteinuria.
4. A 62-year-old patient presents with new-onset
exertional chest pressure relieved by rest, occurring for
the past 2 months. The FNP suspects:
A) Unstable angina
B) Stable angina
,C) Acute myocardial infarction
D) Pericarditis
Correct Answer: B
Rationale: Stable angina presents with predictable,
exertion-triggered chest discomfort that is relieved by rest
or nitroglycerin.
5. Which finding would prompt immediate referral to
the emergency department rather than outpatient
management for suspected angina?
A) Chest pain only with strenuous exertion that resolves
with rest
B) Chest pain at rest, unrelieved by nitroglycerin, lasting
more than 15–20 minutes
C) Chest pain reproducible with palpation of the chest wall
D) Occasional chest pain relieved by antacids
Correct Answer: B
Rationale: Chest pain at rest, unrelieved by nitroglycerin,
lasting >15–20 minutes suggests unstable angina or acute
coronary syndrome requiring emergency evaluation.
6. A patient presents with a new onset rapid heart rate
that is irregularly irregular, heart rate 100, BP 120/74,
respirations 16 non-labored, SpO2 99%. They state this
has been going on for a week intermittently, but for
the past four days straight it hasn't stopped. Your first
priority intervention is:
, A) Immediate synchronized cardioversion
B) Maintain rate control and anticoagulation prior to
rhythm conversion
C) Administer adenosine 6 mg IV push
D) Start amiodarone infusion
Correct Answer: B
Rationale: For atrial fibrillation lasting >48 hours, rate
control and anticoagulation are priorities prior to rhythm
conversion to prevent thromboembolic events.
7. A patient with COPD has increased sputum
production and purulence. What antibiotic class is
preferred?
A) Fluoroquinolones
B) Macrolides (e.g., azithromycin)
C) Penicillins
D) Cephalosporins
Correct Answer: B
Rationale: Macrolides are preferred for COPD
exacerbations with increased sputum purulence.
8. Which cardiac biomarker rises earliest after
myocardial infarction?
A) CK-MB
B) Troponin I
C) Myoglobin
D) LDH
Question Bank (Verified Update)
Format: Question → Answer → Detailed Rationale |
Complete Verified Questions | Graded A+
SECTION 1: CARDIOVASCULAR (Questions)
1. A 55-year-old male presents with a blood pressure
of 158/96 mmHg on two separate office visits. Per
current guidelines, this is classified as:
A) Elevated blood pressure
B) Stage 1 hypertension
C) Stage 2 hypertension
D) Normal blood pressure
Correct Answer: C
Rationale: A BP of 158/96 mmHg meets criteria for Stage
2 hypertension (≥140/90 mmHg) per current ACC/AHA
guidelines, confirmed on repeated measurement.
2. Which first-line antihypertensive class is generally
preferred for a Black patient with hypertension and no
other compelling comorbidities?
A) ACE inhibitor as first-line monotherapy
,B) Thiazide diuretic or calcium channel blocker
C) Beta-blocker as first-line monotherapy
D) Alpha-1 blocker as first-line monotherapy
Correct Answer: B
Rationale: Current guidelines recommend thiazide
diuretics or calcium channel blockers as preferred first-line
agents for Black patients with hypertension without
compelling comorbidities.
3. A patient with hypertension and comorbid diabetic
nephropathy with proteinuria should be prescribed
which first-line antihypertensive class?
A) ACE inhibitor or ARB
B) Beta-blocker as first-line
C) Thiazide diuretic as first-line
D) Alpha-1 blocker as first-line
Correct Answer: A
Rationale: ACE inhibitors/ARBs provide renoprotective
effects beyond blood pressure control in patients with
diabetic nephropathy and proteinuria.
4. A 62-year-old patient presents with new-onset
exertional chest pressure relieved by rest, occurring for
the past 2 months. The FNP suspects:
A) Unstable angina
B) Stable angina
,C) Acute myocardial infarction
D) Pericarditis
Correct Answer: B
Rationale: Stable angina presents with predictable,
exertion-triggered chest discomfort that is relieved by rest
or nitroglycerin.
5. Which finding would prompt immediate referral to
the emergency department rather than outpatient
management for suspected angina?
A) Chest pain only with strenuous exertion that resolves
with rest
B) Chest pain at rest, unrelieved by nitroglycerin, lasting
more than 15–20 minutes
C) Chest pain reproducible with palpation of the chest wall
D) Occasional chest pain relieved by antacids
Correct Answer: B
Rationale: Chest pain at rest, unrelieved by nitroglycerin,
lasting >15–20 minutes suggests unstable angina or acute
coronary syndrome requiring emergency evaluation.
6. A patient presents with a new onset rapid heart rate
that is irregularly irregular, heart rate 100, BP 120/74,
respirations 16 non-labored, SpO2 99%. They state this
has been going on for a week intermittently, but for
the past four days straight it hasn't stopped. Your first
priority intervention is:
, A) Immediate synchronized cardioversion
B) Maintain rate control and anticoagulation prior to
rhythm conversion
C) Administer adenosine 6 mg IV push
D) Start amiodarone infusion
Correct Answer: B
Rationale: For atrial fibrillation lasting >48 hours, rate
control and anticoagulation are priorities prior to rhythm
conversion to prevent thromboembolic events.
7. A patient with COPD has increased sputum
production and purulence. What antibiotic class is
preferred?
A) Fluoroquinolones
B) Macrolides (e.g., azithromycin)
C) Penicillins
D) Cephalosporins
Correct Answer: B
Rationale: Macrolides are preferred for COPD
exacerbations with increased sputum purulence.
8. Which cardiac biomarker rises earliest after
myocardial infarction?
A) CK-MB
B) Troponin I
C) Myoglobin
D) LDH
