NR 667 CEA FINAL EXAM FNP / ACTUAL EXAM
CHAMBERLAIN UNIVERSITY | QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES
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<LATEST VERSION>
Question 1
A 68-year-old man with ischemic cardiomyopathy presents for follow-up. His
LVEF is 30%. Current medications include furosemide 40 mg daily and lisinopril
20 mg daily. He remains euvolemic but reports exertional fatigue. Blood pressure
is 124/72 mm Hg, heart rate 78/min, serum potassium 4.4 mEq/L, and eGFR 68
mL/min/1.73 m². Which medication would most directly add one of the major
evidence-based disease-modifying therapies for his heart failure with reduced
ejection fraction?
A. Dapagliflozin
B. Digoxin
C. Diltiazem
D. Hydrochlorothiazide
Answer: A
Rationale: Sodium-glucose cotransporter-2 inhibitors are one of the four major
guideline-directed medication classes for HFrEF and provide benefit regardless of
whether the patient has diabetes.
,Question 2
During a routine examination, a 74-year-old woman reports intermittent
palpitations and reduced exercise tolerance. Her pulse varies between 88 and
118/min with no discernible pattern. The ECG shows narrow QRS complexes
occurring at irregularly irregular intervals with no consistent P waves. Which
rhythm is most likely?
A. Atrial flutter with fixed conduction
B. Atrial fibrillation
C. Multifocal atrial tachycardia
D. Sinus arrhythmia
Answer: B
Rationale: Atrial fibrillation classically produces an irregularly irregular
ventricular rhythm with absent organized P waves because atrial electrical activity
is disorganized.
Question 3
A 59-year-old man with chronic kidney disease presents to urgent care for
weakness. His medications include lisinopril and spironolactone. Laboratory
testing shows a potassium level of 7.0 mEq/L. ECG demonstrates tall, peaked T
waves and widening of the QRS complex. Which intervention is used immediately
to stabilize the cardiac membrane while definitive potassium-lowering therapy is
initiated?
A. Intravenous calcium gluconate
B. Oral sodium polystyrene sulfonate
C. Intravenous furosemide alone
D. Oral sodium bicarbonate
Answer: A
Rationale: Hyperkalemia with ECG abnormalities requires immediate cardiac
membrane stabilization with intravenous calcium while other measures lower
serum potassium. Peaked T waves are a classic early ECG manifestation of
,hyperkalemia, which can progress to conduction abnormalities and life-threatening
arrhythmias.
Question 4
A 46-year-old woman reports fatigue, constipation, dry skin, and a 10-lb weight
gain over 6 months. Laboratory results show:
TSH: 14.8 mIU/L
Free T4: 0.5 ng/dL
Which interpretation is most appropriate?
A. Central hypothyroidism
B. Subclinical hypothyroidism
C. Primary hypothyroidism
D. Thyroid hormone resistance
Answer: C
Rationale: An elevated TSH accompanied by a low free T4 indicates primary
hypothyroidism. Standard treatment is thyroid hormone replacement with
levothyroxine.
Question 5
A 31-year-old woman with symptomatic Graves disease is starting methimazole.
Which instructions should the nurse practitioner include? Select all that apply.
A. Report fever or severe sore throat promptly.
B. Report jaundice or dark urine.
C. Stop the medication whenever symptoms improve.
D. Routine thyroid laboratory monitoring is needed during treatment.
E. Double the next dose if one dose is missed.
F. Expect the medication to provide immediate normalization of thyroid hormone
levels within hours.
Answer: A, B, D
, Rationale: Methimazole can cause serious adverse effects, including
agranulocytosis and hepatic injury, so fever, sore throat, jaundice, or dark urine
warrant prompt evaluation. Thyroid function must be monitored during therapy
because biochemical improvement occurs over time rather than immediately.
Question 6
A 65-year-old former smoker has progressive exertional dyspnea and chronic
morning cough. Spirometry after administration of a bronchodilator demonstrates
an FEV₁/FVC ratio of 0.62. Which finding most strongly supports a diagnosis of
COPD?
A. Pre-bronchodilator FEV₁/FVC of 0.82
B. Post-bronchodilator FEV₁/FVC below 0.70
C. Increased total lung capacity with normal airflow
D. Isolated reduction in diffusing capacity with normal spirometry
Answer: B
Rationale: Persistent airflow obstruction demonstrated by a post-bronchodilator
FEV₁/FVC ratio below 0.70 is the classic spirometric criterion used to establish
COPD in the appropriate clinical setting. GOLD identifies spirometry as essential
for confirming the diagnosis.
Question 7
A 22-year-old college student has asthma symptoms approximately twice per
month. She has normal lung function between episodes and has been using an
albuterol inhaler as her only medication. She asks whether she can continue this
strategy. Which regimen is most consistent with current preferred adult asthma
management?
A. Continue albuterol alone as needed
B. Begin daily oral prednisone
C. Use low-dose inhaled corticosteroid-formoterol as needed
D. Begin daily tiotropium monotherapy
CHAMBERLAIN UNIVERSITY | QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A 68-year-old man with ischemic cardiomyopathy presents for follow-up. His
LVEF is 30%. Current medications include furosemide 40 mg daily and lisinopril
20 mg daily. He remains euvolemic but reports exertional fatigue. Blood pressure
is 124/72 mm Hg, heart rate 78/min, serum potassium 4.4 mEq/L, and eGFR 68
mL/min/1.73 m². Which medication would most directly add one of the major
evidence-based disease-modifying therapies for his heart failure with reduced
ejection fraction?
A. Dapagliflozin
B. Digoxin
C. Diltiazem
D. Hydrochlorothiazide
Answer: A
Rationale: Sodium-glucose cotransporter-2 inhibitors are one of the four major
guideline-directed medication classes for HFrEF and provide benefit regardless of
whether the patient has diabetes.
,Question 2
During a routine examination, a 74-year-old woman reports intermittent
palpitations and reduced exercise tolerance. Her pulse varies between 88 and
118/min with no discernible pattern. The ECG shows narrow QRS complexes
occurring at irregularly irregular intervals with no consistent P waves. Which
rhythm is most likely?
A. Atrial flutter with fixed conduction
B. Atrial fibrillation
C. Multifocal atrial tachycardia
D. Sinus arrhythmia
Answer: B
Rationale: Atrial fibrillation classically produces an irregularly irregular
ventricular rhythm with absent organized P waves because atrial electrical activity
is disorganized.
Question 3
A 59-year-old man with chronic kidney disease presents to urgent care for
weakness. His medications include lisinopril and spironolactone. Laboratory
testing shows a potassium level of 7.0 mEq/L. ECG demonstrates tall, peaked T
waves and widening of the QRS complex. Which intervention is used immediately
to stabilize the cardiac membrane while definitive potassium-lowering therapy is
initiated?
A. Intravenous calcium gluconate
B. Oral sodium polystyrene sulfonate
C. Intravenous furosemide alone
D. Oral sodium bicarbonate
Answer: A
Rationale: Hyperkalemia with ECG abnormalities requires immediate cardiac
membrane stabilization with intravenous calcium while other measures lower
serum potassium. Peaked T waves are a classic early ECG manifestation of
,hyperkalemia, which can progress to conduction abnormalities and life-threatening
arrhythmias.
Question 4
A 46-year-old woman reports fatigue, constipation, dry skin, and a 10-lb weight
gain over 6 months. Laboratory results show:
TSH: 14.8 mIU/L
Free T4: 0.5 ng/dL
Which interpretation is most appropriate?
A. Central hypothyroidism
B. Subclinical hypothyroidism
C. Primary hypothyroidism
D. Thyroid hormone resistance
Answer: C
Rationale: An elevated TSH accompanied by a low free T4 indicates primary
hypothyroidism. Standard treatment is thyroid hormone replacement with
levothyroxine.
Question 5
A 31-year-old woman with symptomatic Graves disease is starting methimazole.
Which instructions should the nurse practitioner include? Select all that apply.
A. Report fever or severe sore throat promptly.
B. Report jaundice or dark urine.
C. Stop the medication whenever symptoms improve.
D. Routine thyroid laboratory monitoring is needed during treatment.
E. Double the next dose if one dose is missed.
F. Expect the medication to provide immediate normalization of thyroid hormone
levels within hours.
Answer: A, B, D
, Rationale: Methimazole can cause serious adverse effects, including
agranulocytosis and hepatic injury, so fever, sore throat, jaundice, or dark urine
warrant prompt evaluation. Thyroid function must be monitored during therapy
because biochemical improvement occurs over time rather than immediately.
Question 6
A 65-year-old former smoker has progressive exertional dyspnea and chronic
morning cough. Spirometry after administration of a bronchodilator demonstrates
an FEV₁/FVC ratio of 0.62. Which finding most strongly supports a diagnosis of
COPD?
A. Pre-bronchodilator FEV₁/FVC of 0.82
B. Post-bronchodilator FEV₁/FVC below 0.70
C. Increased total lung capacity with normal airflow
D. Isolated reduction in diffusing capacity with normal spirometry
Answer: B
Rationale: Persistent airflow obstruction demonstrated by a post-bronchodilator
FEV₁/FVC ratio below 0.70 is the classic spirometric criterion used to establish
COPD in the appropriate clinical setting. GOLD identifies spirometry as essential
for confirming the diagnosis.
Question 7
A 22-year-old college student has asthma symptoms approximately twice per
month. She has normal lung function between episodes and has been using an
albuterol inhaler as her only medication. She asks whether she can continue this
strategy. Which regimen is most consistent with current preferred adult asthma
management?
A. Continue albuterol alone as needed
B. Begin daily oral prednisone
C. Use low-dose inhaled corticosteroid-formoterol as needed
D. Begin daily tiotropium monotherapy
