NR 667 FNP CAPSTONE PRACTICUM
FINAL EXAM QUESTIONS AND
ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 65-year-old male with a history of Heart Failure with reduced Ejection Fraction (HFrEF) is
currently taking Lisinopril and Carvedilol. His blood pressure is 128/76 and heart rate is 68.
Which medication should be added next to improve survival based on current guidelines?
A. Amlodipine
B. Digoxin
C. Furosemide
D. Spironolactone
Answer: D
Conceptual Explanation: Mineralocorticoid receptor antagonists (MRAs) like
spironolactone are indicated for patients with HFrEF already on ACE inhibitors and beta-
blockers to further reduce mortality and hospitalization.
2. According to the JNC-8 guidelines, what is the blood pressure goal for a 62-year-old patient
with Type 2 Diabetes?
A. < 120/80
,B. < 130/80
C. < 140/90
D. < 150/90
Answer: C
Conceptual Explanation: JNC-8 recommends a goal of <140/90 mmHg for adults aged 18
years or older with diabetes, though newer ACC/AHA guidelines suggest <130/80.
3. A 24-year-old female presents with a 3-day history of dysuria and frequency. She is 12
weeks pregnant. Which of the following is the best antibiotic choice?
A. Ciprofloxacin
B. Nitrofurantoin
C. Doxycycline
D. Trimethoprim-sulfamethoxazole
Answer: B
Conceptual Explanation: Nitrofurantoin is generally considered safe in the first and
second trimesters of pregnancy. Fluoroquinolones and Tetracyclines are contraindicated.
4. A patient presents with a TSH level of 8.2 mIU/L and a normal Free T4 level. They complain
of fatigue and mild weight gain. What is the most appropriate management?
A. Repeat labs in 3-6 months to confirm subclinical hypothyroidism
B. Start Levothyroxine 1.6 mcg/kg/day
, C. Diagnose primary hypothyroidism and start therapy
D. Refer to surgery for possible thyroidectomy
Answer: A
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH, normal T4) should
usually be monitored and retested before initiating therapy unless TSH is >10 or the
patient is symptomatic/trying to conceive.
5. In the evaluation of a murmur, you hear a harsh systolic crescendo-decrescendo murmur at
the right upper sternal border that radiates to the carotids. This is most likely:
A. Mitral Regurgitation
B. Aortic Regurgitation
C. Mitral Stenosis
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur heard best
at the RUSB radiating to the neck.
6. Which of the following is an example of ‘Incident To’ billing in the primary care setting?
A. The NP sees a new patient for a new problem while the physician is in the office suite.
B. The NP performs a procedure the physician has never performed.
C. The NP sees a patient at the hospital for an initial consult.
FINAL EXAM QUESTIONS AND
ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 65-year-old male with a history of Heart Failure with reduced Ejection Fraction (HFrEF) is
currently taking Lisinopril and Carvedilol. His blood pressure is 128/76 and heart rate is 68.
Which medication should be added next to improve survival based on current guidelines?
A. Amlodipine
B. Digoxin
C. Furosemide
D. Spironolactone
Answer: D
Conceptual Explanation: Mineralocorticoid receptor antagonists (MRAs) like
spironolactone are indicated for patients with HFrEF already on ACE inhibitors and beta-
blockers to further reduce mortality and hospitalization.
2. According to the JNC-8 guidelines, what is the blood pressure goal for a 62-year-old patient
with Type 2 Diabetes?
A. < 120/80
,B. < 130/80
C. < 140/90
D. < 150/90
Answer: C
Conceptual Explanation: JNC-8 recommends a goal of <140/90 mmHg for adults aged 18
years or older with diabetes, though newer ACC/AHA guidelines suggest <130/80.
3. A 24-year-old female presents with a 3-day history of dysuria and frequency. She is 12
weeks pregnant. Which of the following is the best antibiotic choice?
A. Ciprofloxacin
B. Nitrofurantoin
C. Doxycycline
D. Trimethoprim-sulfamethoxazole
Answer: B
Conceptual Explanation: Nitrofurantoin is generally considered safe in the first and
second trimesters of pregnancy. Fluoroquinolones and Tetracyclines are contraindicated.
4. A patient presents with a TSH level of 8.2 mIU/L and a normal Free T4 level. They complain
of fatigue and mild weight gain. What is the most appropriate management?
A. Repeat labs in 3-6 months to confirm subclinical hypothyroidism
B. Start Levothyroxine 1.6 mcg/kg/day
, C. Diagnose primary hypothyroidism and start therapy
D. Refer to surgery for possible thyroidectomy
Answer: A
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH, normal T4) should
usually be monitored and retested before initiating therapy unless TSH is >10 or the
patient is symptomatic/trying to conceive.
5. In the evaluation of a murmur, you hear a harsh systolic crescendo-decrescendo murmur at
the right upper sternal border that radiates to the carotids. This is most likely:
A. Mitral Regurgitation
B. Aortic Regurgitation
C. Mitral Stenosis
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis is characterized by a systolic murmur heard best
at the RUSB radiating to the neck.
6. Which of the following is an example of ‘Incident To’ billing in the primary care setting?
A. The NP sees a new patient for a new problem while the physician is in the office suite.
B. The NP performs a procedure the physician has never performed.
C. The NP sees a patient at the hospital for an initial consult.
