FNP REVIEW QUESTIONS LATEST 2025/2026 REVISED
EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED COMPLETE SOLUTION)
ALREADY GRADED A+
According to the National Heart, Lung and Blood Institute, which characteristic listed below is a coronary
heart disease (CHD) risk equivalent; that is, which risk factor places the patient at similar risk for CHD as
a history of CHD?
a. Hypertension
b. Cigarette smoking
c. Male age > 45 years
d. Diabetes mellitus - correct answer✨✔✔,,d. Diabetes mellitus
Rationale:
In determining whether a patient should be treated for hyperlipidemia, a patient's risk factors must be
determined. After assessing fasting lipids, specifically LDLs, CHD equivalents must be identified. These
are diabetes, symptomatic carotid artery disease, peripheral artery disease, abnormal aortic aneurysm,
and multiple risk factors that confer a 10 year risk of CHD > 20%. Major CHD risk factors are elevated LDL
cholesterol, cigarette smoking, hypertension, low HDL cholesterol, family history of premature CHD [in
male first degree relatives (FDR) < 55years; female FDR, 65 years] , and age (men ≥ 45 years, women ≥
55 years). Patients with 2 or more risk factors should have a 10 risk assessment performed and treated
accordingly.
A patient will be screened for hyperlipidemia via a serum specimen. He should be told:
a. to fast for 12 to 14 hours
b. to fast for 6 to 8 hours
c. that black coffee is allowed
d. a non-fasting state will not affect the results - correct answer✨✔✔,a. to fast for 12 to 14 hours
Rationale:
Serum total and HDL cholesterol can be measured in fasting or non-fasting individuals. There are very
small and clinically insignificant differences in these values when fasting or not. The primary effect of
eating on a patient's lipid values is on the triglyceride levels. The maximum effect of eating on
,triglyceride levels occurs at 3 to 4 hours after eating, but there may be several peaks during a 12-hour
period. Therefore, the most accurate triglyceride levels will be obtained following a 12-hour fast.
A 65-year-old male patient has the following lipid levels:
Total cholesterol = 240 mg/dL
LDL = 140 mg/dL
HDL = 35 mg/dL
Triglycerides = 129 mg/dL
What class of medications is preferred to normalize his lipid levels and reduce his risk of a cardiac event?
a. Niacin
b. Fibric acids
c. HMG Co-A reductase inhibitors
d. Bile acid sequestrants - correct answer✨✔✔,c. HMG Co-A reductase inhibitors
Rationale:
The only medication class that reduces elevated lipid levels and has proven efficacy in reducing risk of
cardiac events, even for primary prevention, is a HMG Co-A reductase inhibitor, a statin. Statin therapy
has been shown to reduce overall mortality due to cardiovascular deaths. The statin should significantly
reduce his total cholesterol and LDL levels.
Which test listed below may be used to exclude a secondary cause of hyperlipidemia in a patient with
elevated lipids?
a. CBC
b. TSH
c. Urine culture and sensitivity
d. Sedimentation rate - correct answer✨✔✔,b. TSH
Rationale:
, Patients who have dyslipidemia should be screened for diabetes, renal disease, and hypothyroidism.
Nephrotic syndrome can produce remarkably elevated cholesterol levels. Therefore, measurements of
glucose, creatinine, and thyroid stimulating hormone should be performed when elevating dyslipidemia.
Sedimentation rate is a measurement of non-specific inflammation and so it is not helpful in this
situation. Specifically, hypothyroidism can produce marked lipid abnormalities.
In order to reduce lipid levels, statins are most beneficial when taken:
a. once daily in the AM
b. always with food
c. with an aspirin in the evening
d. in conjunction with diet and exercise - correct answer✨✔✔,d. in conjunction with diet and
exercise
Rationale:
Statins are used to reduce elevated level of lipids in conjunction with modifications in diet and exercise.
The timing of statin dosing and and indication with food (or not) is different for each statin. Most
patients who take statins are also candidates for aspirin therapy as primary or secondary prevention,
but aspirin does not improve statin tolerance. Statins are correctly taken once daily.
A patient is taking atorvastatin for newly diagnosed dyslipidemia complains of muscle aches in his upper
and lower legs for the past 3-weeks. It has not improved with rest. How should this be evaluated?
a. Stop the atorvastatin immediately.
b. Check liver enzymes first.
c. Order a CPK level
d. Ask about nighttime muscle cramps. - correct answer✨✔✔,c. Order a CPK level
Rationale:
This patient has a complaint of myalgias that could be associated with statin use. This patient should be
assessed for rhabdomyolysis. This is done by measuring a CPK level. If this level is elevated, atorvastatin
should be stopped immediately. Liver enzymes would not assess for the etiology of myalgias. They
assess tolerance of statins in the liver. Nighttime muscle cramps are not associated with statin use.
EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED COMPLETE SOLUTION)
ALREADY GRADED A+
According to the National Heart, Lung and Blood Institute, which characteristic listed below is a coronary
heart disease (CHD) risk equivalent; that is, which risk factor places the patient at similar risk for CHD as
a history of CHD?
a. Hypertension
b. Cigarette smoking
c. Male age > 45 years
d. Diabetes mellitus - correct answer✨✔✔,,d. Diabetes mellitus
Rationale:
In determining whether a patient should be treated for hyperlipidemia, a patient's risk factors must be
determined. After assessing fasting lipids, specifically LDLs, CHD equivalents must be identified. These
are diabetes, symptomatic carotid artery disease, peripheral artery disease, abnormal aortic aneurysm,
and multiple risk factors that confer a 10 year risk of CHD > 20%. Major CHD risk factors are elevated LDL
cholesterol, cigarette smoking, hypertension, low HDL cholesterol, family history of premature CHD [in
male first degree relatives (FDR) < 55years; female FDR, 65 years] , and age (men ≥ 45 years, women ≥
55 years). Patients with 2 or more risk factors should have a 10 risk assessment performed and treated
accordingly.
A patient will be screened for hyperlipidemia via a serum specimen. He should be told:
a. to fast for 12 to 14 hours
b. to fast for 6 to 8 hours
c. that black coffee is allowed
d. a non-fasting state will not affect the results - correct answer✨✔✔,a. to fast for 12 to 14 hours
Rationale:
Serum total and HDL cholesterol can be measured in fasting or non-fasting individuals. There are very
small and clinically insignificant differences in these values when fasting or not. The primary effect of
eating on a patient's lipid values is on the triglyceride levels. The maximum effect of eating on
,triglyceride levels occurs at 3 to 4 hours after eating, but there may be several peaks during a 12-hour
period. Therefore, the most accurate triglyceride levels will be obtained following a 12-hour fast.
A 65-year-old male patient has the following lipid levels:
Total cholesterol = 240 mg/dL
LDL = 140 mg/dL
HDL = 35 mg/dL
Triglycerides = 129 mg/dL
What class of medications is preferred to normalize his lipid levels and reduce his risk of a cardiac event?
a. Niacin
b. Fibric acids
c. HMG Co-A reductase inhibitors
d. Bile acid sequestrants - correct answer✨✔✔,c. HMG Co-A reductase inhibitors
Rationale:
The only medication class that reduces elevated lipid levels and has proven efficacy in reducing risk of
cardiac events, even for primary prevention, is a HMG Co-A reductase inhibitor, a statin. Statin therapy
has been shown to reduce overall mortality due to cardiovascular deaths. The statin should significantly
reduce his total cholesterol and LDL levels.
Which test listed below may be used to exclude a secondary cause of hyperlipidemia in a patient with
elevated lipids?
a. CBC
b. TSH
c. Urine culture and sensitivity
d. Sedimentation rate - correct answer✨✔✔,b. TSH
Rationale:
, Patients who have dyslipidemia should be screened for diabetes, renal disease, and hypothyroidism.
Nephrotic syndrome can produce remarkably elevated cholesterol levels. Therefore, measurements of
glucose, creatinine, and thyroid stimulating hormone should be performed when elevating dyslipidemia.
Sedimentation rate is a measurement of non-specific inflammation and so it is not helpful in this
situation. Specifically, hypothyroidism can produce marked lipid abnormalities.
In order to reduce lipid levels, statins are most beneficial when taken:
a. once daily in the AM
b. always with food
c. with an aspirin in the evening
d. in conjunction with diet and exercise - correct answer✨✔✔,d. in conjunction with diet and
exercise
Rationale:
Statins are used to reduce elevated level of lipids in conjunction with modifications in diet and exercise.
The timing of statin dosing and and indication with food (or not) is different for each statin. Most
patients who take statins are also candidates for aspirin therapy as primary or secondary prevention,
but aspirin does not improve statin tolerance. Statins are correctly taken once daily.
A patient is taking atorvastatin for newly diagnosed dyslipidemia complains of muscle aches in his upper
and lower legs for the past 3-weeks. It has not improved with rest. How should this be evaluated?
a. Stop the atorvastatin immediately.
b. Check liver enzymes first.
c. Order a CPK level
d. Ask about nighttime muscle cramps. - correct answer✨✔✔,c. Order a CPK level
Rationale:
This patient has a complaint of myalgias that could be associated with statin use. This patient should be
assessed for rhabdomyolysis. This is done by measuring a CPK level. If this level is elevated, atorvastatin
should be stopped immediately. Liver enzymes would not assess for the etiology of myalgias. They
assess tolerance of statins in the liver. Nighttime muscle cramps are not associated with statin use.
