MN 566 Unit 5 Midterm Exam Advanced Primary Care FNP Actual Exam 2026/2027
– Complete 75 Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Section A: Advanced Health Assessment & Diagnostic Reasoning
(Questions 1–12)
Q1: A 28-year-old healthy adult presents with a 3-day history of sore throat and
low-grade fever. Which assessment approach is MOST appropriate?
A. A comprehensive head-to-toe assessment covering every body system
B. A focused assessment of the head, neck, throat, lymph nodes, and associated
symptoms [CORRECT]
C. A complete psychological and developmental assessment only
D. Defer assessment entirely until laboratory results are available
Correct Answer: B
Rationale: A focused assessment targets the presenting problem and related systems,
which is appropriate for an acute complaint in an otherwise healthy adult.
Comprehensive assessments are reserved for new patients, annual visits, or complex
presentations.
Q2: A 58-year-old male presents with substernal chest pressure radiating to the jaw,
diaphoresis, and nausea that began 45 minutes ago. Which differential diagnosis is the
MOST urgent to rule out first?
A. Gastroesophageal reflux disease
B. Costochondritis
C. Anxiety-related chest pain
D. Acute coronary syndrome [CORRECT]
Correct Answer: D
Rationale: The classic presentation of pressure radiating to the jaw with diaphoresis
strongly suggests ACS, which is life-threatening and requires immediate ECG and
emergency activation. GERD, costochondritis, and anxiety are diagnoses of exclusion
once ACS is ruled out.
Q3: Which of the following is NOT one of the four steps of Tanner's Model of Clinical
Judgment?
,A. Noticing
B. Interpreting
C. Diagnosing [CORRECT]
D. Reflecting
Correct Answer: C
Rationale: Tanner's model consists of Noticing, Interpreting, Responding, and Reflecting
(reflection-in-action and reflection-on-action). "Diagnosing" belongs to the nursing
process framework, not Tanner's model.
Q4: In SBAR communication, the letter "R" stands for:
A. Recommendation [CORRECT]
B. Response
C. Referral
D. Review of systems
Correct Answer: A
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation,
in which the clinician states what is needed or proposed. The other options are not
components of the SBAR framework.
Q5: What is the CORRECT sequence for performing an abdominal assessment?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation [CORRECT]
C. Auscultation, inspection, palpation, percussion
D. Palpation, percussion, auscultation, inspection
Correct Answer: B
Rationale: Bowel sounds are auscultated before percussion and palpation because
manipulating the abdomen can alter bowel sounds and create false findings. Inspection
always comes first, and palpation is performed last.
Q6: On cardiac auscultation, a grade 3/6 holosystolic murmur heard loudest at the
cardiac apex and radiating to the left axilla is MOST consistent with:
A. Aortic stenosis
B. Pulmonic regurgitation
C. Mitral regurgitation [CORRECT]
D. Tricuspid stenosis
Correct Answer: C
Rationale: A holosystolic murmur at the apex radiating to the axilla is the classic finding
of mitral regurgitation. Aortic stenosis is systolic at the right upper sternal border
radiating to the neck, and tricuspid/pulmonic lesions localize to the lower left sternal
border.
, Q7: A 3-year-old presents with fever, irritability, and ear tugging. Otoscopy reveals a
bulging, erythematous tympanic membrane with reduced mobility on pneumatic
otoscopy. These findings establish the diagnosis of:
A. Acute otitis media [CORRECT]
B. Otitis externa
C. Serous otitis media without infection
D. Tympanic membrane perforation
Correct Answer: A
Rationale: Bulging, erythema, and decreased tympanic membrane mobility with fever
define acute otitis media. Otitis externa involves the ear canal with pain on tragus
manipulation, and perforation would show a visible defect with loss of landmarks.
Q8: A 78-year-old female presents with new-onset fatigue, mild dyspnea, and confusion
but denies chest pain. Which action by the NP BEST demonstrates sound diagnostic
reasoning?
A. Reassure the patient that fatigue is normal at her age
B. Treat for depression without further workup
C. Diagnose a urinary tract infection based on confusion alone
D. Maintain a high index of suspicion for acute coronary syndrome and obtain an ECG
[CORRECT]
Correct Answer: D
Rationale: Older adults frequently present with atypical or silent myocardial infarction
symptoms such as fatigue, dyspnea, and confusion, so an ECG and cardiac workup are
essential. Dismissing symptoms or anchoring on a single diagnosis exemplifies
premature closure.
Q9: A clean-catch urinalysis from a symptomatic woman shows positive leukocyte
esterase, positive nitrites, and 20 WBC/hpf. These findings MOST strongly support:
A. Nephrolithiasis
B. Urinary tract infection [CORRECT]
C. Glomerulonephritis
D. Normal findings
Correct Answer: B
Rationale: Positive leukocyte esterase and nitrites with pyuria indicate bacteriuria
consistent with UTI. Stones typically present with hematuria and colicky pain,
glomerulonephritis shows protein and casts, and these results are clearly abnormal.
Q10: A 42-year-old presents with the sudden onset of "the worst headache of my life"
during weightlifting. What is the NP's MOST appropriate action?
– Complete 75 Questions with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Section A: Advanced Health Assessment & Diagnostic Reasoning
(Questions 1–12)
Q1: A 28-year-old healthy adult presents with a 3-day history of sore throat and
low-grade fever. Which assessment approach is MOST appropriate?
A. A comprehensive head-to-toe assessment covering every body system
B. A focused assessment of the head, neck, throat, lymph nodes, and associated
symptoms [CORRECT]
C. A complete psychological and developmental assessment only
D. Defer assessment entirely until laboratory results are available
Correct Answer: B
Rationale: A focused assessment targets the presenting problem and related systems,
which is appropriate for an acute complaint in an otherwise healthy adult.
Comprehensive assessments are reserved for new patients, annual visits, or complex
presentations.
Q2: A 58-year-old male presents with substernal chest pressure radiating to the jaw,
diaphoresis, and nausea that began 45 minutes ago. Which differential diagnosis is the
MOST urgent to rule out first?
A. Gastroesophageal reflux disease
B. Costochondritis
C. Anxiety-related chest pain
D. Acute coronary syndrome [CORRECT]
Correct Answer: D
Rationale: The classic presentation of pressure radiating to the jaw with diaphoresis
strongly suggests ACS, which is life-threatening and requires immediate ECG and
emergency activation. GERD, costochondritis, and anxiety are diagnoses of exclusion
once ACS is ruled out.
Q3: Which of the following is NOT one of the four steps of Tanner's Model of Clinical
Judgment?
,A. Noticing
B. Interpreting
C. Diagnosing [CORRECT]
D. Reflecting
Correct Answer: C
Rationale: Tanner's model consists of Noticing, Interpreting, Responding, and Reflecting
(reflection-in-action and reflection-on-action). "Diagnosing" belongs to the nursing
process framework, not Tanner's model.
Q4: In SBAR communication, the letter "R" stands for:
A. Recommendation [CORRECT]
B. Response
C. Referral
D. Review of systems
Correct Answer: A
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation,
in which the clinician states what is needed or proposed. The other options are not
components of the SBAR framework.
Q5: What is the CORRECT sequence for performing an abdominal assessment?
A. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation [CORRECT]
C. Auscultation, inspection, palpation, percussion
D. Palpation, percussion, auscultation, inspection
Correct Answer: B
Rationale: Bowel sounds are auscultated before percussion and palpation because
manipulating the abdomen can alter bowel sounds and create false findings. Inspection
always comes first, and palpation is performed last.
Q6: On cardiac auscultation, a grade 3/6 holosystolic murmur heard loudest at the
cardiac apex and radiating to the left axilla is MOST consistent with:
A. Aortic stenosis
B. Pulmonic regurgitation
C. Mitral regurgitation [CORRECT]
D. Tricuspid stenosis
Correct Answer: C
Rationale: A holosystolic murmur at the apex radiating to the axilla is the classic finding
of mitral regurgitation. Aortic stenosis is systolic at the right upper sternal border
radiating to the neck, and tricuspid/pulmonic lesions localize to the lower left sternal
border.
, Q7: A 3-year-old presents with fever, irritability, and ear tugging. Otoscopy reveals a
bulging, erythematous tympanic membrane with reduced mobility on pneumatic
otoscopy. These findings establish the diagnosis of:
A. Acute otitis media [CORRECT]
B. Otitis externa
C. Serous otitis media without infection
D. Tympanic membrane perforation
Correct Answer: A
Rationale: Bulging, erythema, and decreased tympanic membrane mobility with fever
define acute otitis media. Otitis externa involves the ear canal with pain on tragus
manipulation, and perforation would show a visible defect with loss of landmarks.
Q8: A 78-year-old female presents with new-onset fatigue, mild dyspnea, and confusion
but denies chest pain. Which action by the NP BEST demonstrates sound diagnostic
reasoning?
A. Reassure the patient that fatigue is normal at her age
B. Treat for depression without further workup
C. Diagnose a urinary tract infection based on confusion alone
D. Maintain a high index of suspicion for acute coronary syndrome and obtain an ECG
[CORRECT]
Correct Answer: D
Rationale: Older adults frequently present with atypical or silent myocardial infarction
symptoms such as fatigue, dyspnea, and confusion, so an ECG and cardiac workup are
essential. Dismissing symptoms or anchoring on a single diagnosis exemplifies
premature closure.
Q9: A clean-catch urinalysis from a symptomatic woman shows positive leukocyte
esterase, positive nitrites, and 20 WBC/hpf. These findings MOST strongly support:
A. Nephrolithiasis
B. Urinary tract infection [CORRECT]
C. Glomerulonephritis
D. Normal findings
Correct Answer: B
Rationale: Positive leukocyte esterase and nitrites with pyuria indicate bacteriuria
consistent with UTI. Stones typically present with hematuria and colicky pain,
glomerulonephritis shows protein and casts, and these results are clearly abnormal.
Q10: A 42-year-old presents with the sudden onset of "the worst headache of my life"
during weightlifting. What is the NP's MOST appropriate action?
