NR 667 FAMILY NURSE PRACTITIONER
MIDTERM EXAM QUESTIONS AND
ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 55-year-old male with a history of hypertension presents with a new onset of a ‘tearing’
chest pain radiating to the back. His BP is 190/110 mmHg. What is the most likely diagnosis?
A. Myocardial Infarction
B. Aortic Dissection
C. Pulmonary Embolism
D. Pneumothorax
Answer: B
Conceptual Explanation: Aortic dissection is classically described as a ‘tearing’ or ‘ripping’
pain that radiates to the back between the scapulae, often associated with severe
hypertension.
2. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old patient
with no history of diabetes or chronic kidney disease?
A. < 130/80 mmHg
B. < 140/90 mmHg
,C. < 120/70 mmHg
D. < 150/90 mmHg
Answer: D
Conceptual Explanation: JNC 8 recommends a target BP of < 150/90 mmHg for
individuals aged 60 years or older without DM or CKD.
3. A patient presents with a TSH of 0.1 mIU/L and a high Free T4. Which clinical finding is
most consistent with this lab result?
A. Weight gain and bradycardia
B. Constipation and fatigue
C. Coarse hair and cold intolerance
D. Pretibial myxedema and exophthalmos
Answer: D
Conceptual Explanation: Low TSH and high Free T4 indicate hyperthyroidism. Pretibial
myxedema and exophthalmos are specific signs of Graves’ disease.
4. Which of the following is considered the first-line treatment for a 30-year-old pregnant
woman diagnosed with a Urinary Tract Infection (UTI)?
A. Nitrofurantoin
B. Doxycycline
C. Ciprofloxacin
, D. Trimethoprim-Sulfamethoxazole
Answer: A
Conceptual Explanation: Nitrofurantoin (Macrobid) is generally considered safe in the
first and second trimesters of pregnancy for UTIs, unlike Fluoroquinolones or
Tetracyclines.
5. A 12-month-old infant is brought in for a well-child check. Which vaccine should the NP
prepare to administer?
A. Rotavirus
B. MMR and Varicella
C. HPV
D. Meningococcal
Answer: B
Conceptual Explanation: The first doses of Measles, Mumps, Rubella (MMR) and Varicella
are typically administered between 12-15 months of age.
6. A patient with Type 2 Diabetes has an A1C of 8.5% despite being on Metformin 1000mg
BID. What is the next appropriate step in management?
A. Add a second agent such as a GLP-1 receptor agonist or SGLT2 inhibitor
B. Switch Metformin to Glyburide
C. Increase Metformin to 3000mg daily
MIDTERM EXAM QUESTIONS AND
ANSWERS 2026/2027 UPDATE. 100%
VERIFIED
1. A 55-year-old male with a history of hypertension presents with a new onset of a ‘tearing’
chest pain radiating to the back. His BP is 190/110 mmHg. What is the most likely diagnosis?
A. Myocardial Infarction
B. Aortic Dissection
C. Pulmonary Embolism
D. Pneumothorax
Answer: B
Conceptual Explanation: Aortic dissection is classically described as a ‘tearing’ or ‘ripping’
pain that radiates to the back between the scapulae, often associated with severe
hypertension.
2. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-year-old patient
with no history of diabetes or chronic kidney disease?
A. < 130/80 mmHg
B. < 140/90 mmHg
,C. < 120/70 mmHg
D. < 150/90 mmHg
Answer: D
Conceptual Explanation: JNC 8 recommends a target BP of < 150/90 mmHg for
individuals aged 60 years or older without DM or CKD.
3. A patient presents with a TSH of 0.1 mIU/L and a high Free T4. Which clinical finding is
most consistent with this lab result?
A. Weight gain and bradycardia
B. Constipation and fatigue
C. Coarse hair and cold intolerance
D. Pretibial myxedema and exophthalmos
Answer: D
Conceptual Explanation: Low TSH and high Free T4 indicate hyperthyroidism. Pretibial
myxedema and exophthalmos are specific signs of Graves’ disease.
4. Which of the following is considered the first-line treatment for a 30-year-old pregnant
woman diagnosed with a Urinary Tract Infection (UTI)?
A. Nitrofurantoin
B. Doxycycline
C. Ciprofloxacin
, D. Trimethoprim-Sulfamethoxazole
Answer: A
Conceptual Explanation: Nitrofurantoin (Macrobid) is generally considered safe in the
first and second trimesters of pregnancy for UTIs, unlike Fluoroquinolones or
Tetracyclines.
5. A 12-month-old infant is brought in for a well-child check. Which vaccine should the NP
prepare to administer?
A. Rotavirus
B. MMR and Varicella
C. HPV
D. Meningococcal
Answer: B
Conceptual Explanation: The first doses of Measles, Mumps, Rubella (MMR) and Varicella
are typically administered between 12-15 months of age.
6. A patient with Type 2 Diabetes has an A1C of 8.5% despite being on Metformin 1000mg
BID. What is the next appropriate step in management?
A. Add a second agent such as a GLP-1 receptor agonist or SGLT2 inhibitor
B. Switch Metformin to Glyburide
C. Increase Metformin to 3000mg daily
