NR 667 - FNP Capstone Week 2 Full Length Practice Exam
Questions and Answers|2025 Update|100%
NR 667 - FNP Capstone Week 2 Full Length Practice Exam
Table of Contents
Section Topic Questions
I Cardiovascular Assessment & Management 1–15
II Respiratory & Infectious Disease 16–30
III Endocrine & Metabolic Disorders 31–45
IV Hematology & Oncology 46–58
V Dermatology & Musculoskeletal 59–72
VI Neurologic & Psychiatric 73–85
VII Clinical Decision-Making & Professional Practice 86–100
— Complete Answer Key —
— High-Yield Review —
Section I: Cardiovascular Assessment & Management
Questions 1–15
Question 1
A 58-year-old male presents with sudden onset of severe, tearing chest pain radiating to his
,back. He has a history of hypertension and smokes one pack per day. His blood pressure is
180/100 mmHg in the right arm and 150/90 mmHg in the left arm. Which finding is most
concerning for aortic dissection?
A) Equal blood pressures in both arms
B) Interarm blood pressure differential
C) Pain relieved by nitroglycerin
D) ST elevation on ECG
Correct Answer: B) Interarm blood pressure differential
Rationale: A significant interarm blood pressure differential (>20 mmHg) is a classic
finding in aortic dissection due to compromised flow in the subclavian artery. This requires
emergent imaging and surgical consultation. Equal blood pressures (A) would argue against
dissection. Pain relieved by nitroglycerin (C) suggests angina. ST elevation (D) suggests
myocardial infarction.
Question 2
A patient presents with a new onset rapid heart rate that is irregularly irregular, heart rate 100,
BP 120/74, respiration 16 non-labored, and SpO2 99%. They state this has been going on
intermittently for a week but for the past four days straight it hasn't stopped. Your first priority
intervention for this patient is to do which of the following?
A) Maintain rate control and anticoagulation prior to rhythm conversion
B) Immediate synchronized cardioversion
C) Administer adenosine 6 mg IV push
D) Start amiodarone infusion
Correct Answer: A) Maintain rate control and anticoagulation prior to rhythm
conversion
Rationale: This patient has atrial fibrillation with rapid ventricular response. The priority
is rate control and anticoagulation before any rhythm conversion attempt, as cardioversion
without adequate anticoagulation increases stroke risk. Immediate cardioversion (B) is reserved
for hemodynamically unstable patients. Adenosine (C) is for SVT, not atrial fibrillation.
Amiodarone (D) is not first-line for rate control.
Question 3
A 54-year-old male with heart failure with reduced ejection fraction (HFrEF), EF of 30%, known
,coronary artery disease, and normal renal function. Which of the following medications is NOT
considered part of optimal medical therapy?
A) Aspirin
B) Carvedilol (Coreg)
C) Diltiazem (Cardizem)
D) Lisinopril
Correct Answer: C) Diltiazem (Cardizem)
Rationale: Non-dihydropyridine calcium channel blockers like diltiazem are generally
avoided in HFrEF because they have negative inotropic effects and can worsen heart failure.
Aspirin (A) is appropriate for CAD. Carvedilol (B) is a guideline-directed beta-blocker for HFrEF.
Lisinopril (D) is an ACE inhibitor, first-line for HFrEF.
Question 4
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps were
worst when walking to the supermarket. If she stops to rest, the pain subsides. The nurse
practitioner knows that this patient needs a workup for:
A) Popliteal aneurysm
B) Deep vein thrombosis
C) Benign nocturnal leg cramps
D) Intermittent claudication
Correct Answer: D) Intermittent claudication
Rationale: Intermittent claudication is characterized by muscle pain (cramping) with
exercise that resolves with rest, due to peripheral arterial disease. Popliteal aneurysm (A) may
be asymptomatic or present with pulsatile mass. DVT (B) presents with unilateral swelling and
pain. Nocturnal leg cramps (C) occur at rest, not with exercise.
Question 5
A patient with hypertension asks about lifestyle changes. Which recommendation is most
appropriate?
A) Increase sodium intake
B) Reduce physical activity
, C) Adopt a DASH-style diet
D) Avoid all fruits and vegetables
Correct Answer: C) Adopt a DASH-style diet
Rationale: The DASH diet helps lower blood pressure through reduced sodium and
increased nutrient-dense foods. Increasing sodium (A) raises blood pressure. Reducing physical
activity (B) is counterproductive. Avoiding fruits and vegetables (D) is harmful.
Question 6
What is the key long-term benefit of using carvedilol for patients with coronary artery disease
and heart failure with reduced ejection fraction (HFrEF)?
A) Baseline reduction of blood pressure
B) Increase in libido
C) Potential increase in ejection fraction
D) Reduction in cardiac output
Correct Answer: C) Potential increase in ejection fraction
Rationale: Carvedilol is a beta-blocker with alpha-blocking properties that has been
shown to improve ejection fraction and reduce mortality in HFrEF. Blood pressure reduction (A)
is a secondary effect. Increased libido (B) is not a known effect. Reduction in cardiac output (D)
would be detrimental.
Question 7
Which finding on physical examination would most suggest malignancy in a breast lump?
A) Mobile, smooth, well-circumscribed mass
B) Firm, irregular, fixed mass with skin dimpling
C) Soft, tender mass that varies with menstrual cycle
D) Bilateral diffuse nodularity
Correct Answer: B) Firm, irregular, fixed mass with skin dimpling
Rationale: Malignant breast masses are typically firm, irregular, fixed, and may cause
skin dimpling or nipple retraction. Mobile, smooth masses (A) suggest fibroadenoma. Tender,
cyclical masses (C) suggest fibrocystic changes. Bilateral diffuse nodularity (D) is common in
fibrocystic disease.
Questions and Answers|2025 Update|100%
NR 667 - FNP Capstone Week 2 Full Length Practice Exam
Table of Contents
Section Topic Questions
I Cardiovascular Assessment & Management 1–15
II Respiratory & Infectious Disease 16–30
III Endocrine & Metabolic Disorders 31–45
IV Hematology & Oncology 46–58
V Dermatology & Musculoskeletal 59–72
VI Neurologic & Psychiatric 73–85
VII Clinical Decision-Making & Professional Practice 86–100
— Complete Answer Key —
— High-Yield Review —
Section I: Cardiovascular Assessment & Management
Questions 1–15
Question 1
A 58-year-old male presents with sudden onset of severe, tearing chest pain radiating to his
,back. He has a history of hypertension and smokes one pack per day. His blood pressure is
180/100 mmHg in the right arm and 150/90 mmHg in the left arm. Which finding is most
concerning for aortic dissection?
A) Equal blood pressures in both arms
B) Interarm blood pressure differential
C) Pain relieved by nitroglycerin
D) ST elevation on ECG
Correct Answer: B) Interarm blood pressure differential
Rationale: A significant interarm blood pressure differential (>20 mmHg) is a classic
finding in aortic dissection due to compromised flow in the subclavian artery. This requires
emergent imaging and surgical consultation. Equal blood pressures (A) would argue against
dissection. Pain relieved by nitroglycerin (C) suggests angina. ST elevation (D) suggests
myocardial infarction.
Question 2
A patient presents with a new onset rapid heart rate that is irregularly irregular, heart rate 100,
BP 120/74, respiration 16 non-labored, and SpO2 99%. They state this has been going on
intermittently for a week but for the past four days straight it hasn't stopped. Your first priority
intervention for this patient is to do which of the following?
A) Maintain rate control and anticoagulation prior to rhythm conversion
B) Immediate synchronized cardioversion
C) Administer adenosine 6 mg IV push
D) Start amiodarone infusion
Correct Answer: A) Maintain rate control and anticoagulation prior to rhythm
conversion
Rationale: This patient has atrial fibrillation with rapid ventricular response. The priority
is rate control and anticoagulation before any rhythm conversion attempt, as cardioversion
without adequate anticoagulation increases stroke risk. Immediate cardioversion (B) is reserved
for hemodynamically unstable patients. Adenosine (C) is for SVT, not atrial fibrillation.
Amiodarone (D) is not first-line for rate control.
Question 3
A 54-year-old male with heart failure with reduced ejection fraction (HFrEF), EF of 30%, known
,coronary artery disease, and normal renal function. Which of the following medications is NOT
considered part of optimal medical therapy?
A) Aspirin
B) Carvedilol (Coreg)
C) Diltiazem (Cardizem)
D) Lisinopril
Correct Answer: C) Diltiazem (Cardizem)
Rationale: Non-dihydropyridine calcium channel blockers like diltiazem are generally
avoided in HFrEF because they have negative inotropic effects and can worsen heart failure.
Aspirin (A) is appropriate for CAD. Carvedilol (B) is a guideline-directed beta-blocker for HFrEF.
Lisinopril (D) is an ACE inhibitor, first-line for HFrEF.
Question 4
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps were
worst when walking to the supermarket. If she stops to rest, the pain subsides. The nurse
practitioner knows that this patient needs a workup for:
A) Popliteal aneurysm
B) Deep vein thrombosis
C) Benign nocturnal leg cramps
D) Intermittent claudication
Correct Answer: D) Intermittent claudication
Rationale: Intermittent claudication is characterized by muscle pain (cramping) with
exercise that resolves with rest, due to peripheral arterial disease. Popliteal aneurysm (A) may
be asymptomatic or present with pulsatile mass. DVT (B) presents with unilateral swelling and
pain. Nocturnal leg cramps (C) occur at rest, not with exercise.
Question 5
A patient with hypertension asks about lifestyle changes. Which recommendation is most
appropriate?
A) Increase sodium intake
B) Reduce physical activity
, C) Adopt a DASH-style diet
D) Avoid all fruits and vegetables
Correct Answer: C) Adopt a DASH-style diet
Rationale: The DASH diet helps lower blood pressure through reduced sodium and
increased nutrient-dense foods. Increasing sodium (A) raises blood pressure. Reducing physical
activity (B) is counterproductive. Avoiding fruits and vegetables (D) is harmful.
Question 6
What is the key long-term benefit of using carvedilol for patients with coronary artery disease
and heart failure with reduced ejection fraction (HFrEF)?
A) Baseline reduction of blood pressure
B) Increase in libido
C) Potential increase in ejection fraction
D) Reduction in cardiac output
Correct Answer: C) Potential increase in ejection fraction
Rationale: Carvedilol is a beta-blocker with alpha-blocking properties that has been
shown to improve ejection fraction and reduce mortality in HFrEF. Blood pressure reduction (A)
is a secondary effect. Increased libido (B) is not a known effect. Reduction in cardiac output (D)
would be detrimental.
Question 7
Which finding on physical examination would most suggest malignancy in a breast lump?
A) Mobile, smooth, well-circumscribed mass
B) Firm, irregular, fixed mass with skin dimpling
C) Soft, tender mass that varies with menstrual cycle
D) Bilateral diffuse nodularity
Correct Answer: B) Firm, irregular, fixed mass with skin dimpling
Rationale: Malignant breast masses are typically firm, irregular, fixed, and may cause
skin dimpling or nipple retraction. Mobile, smooth masses (A) suggest fibroadenoma. Tender,
cyclical masses (C) suggest fibrocystic changes. Bilateral diffuse nodularity (D) is common in
fibrocystic disease.