1
FNP 652 / FNP 6552 Midterm Exam
2026/2027 | GCU Family Primary Care
I | Questions with Verified Answers |
100% Correct | Complete Exam Guide
Q001: A 28-year-old woman presents with 3 weeks of fatigue, weight gain, and
cold intolerance. TSH is 6.8 mIU/L (normal 0.4–4.0) and free T4 is low. She is not
pregnant. Which is the preferred initial treatment and counselling?
Options:
A. Start levothyroxine 25 µg daily and recheck TSH in 6 weeks
B. Start levothyroxine 1.6 µg/kg/day and take 30–60 min before breakfast -
CORRECT
C. Repeat TSH in 3 months; begin therapy only if TSH >10
D. Prescribe liothyronine 5 µg BID for faster symptom relief
ANSWER: B
Q002: A 42-year-old man with COPD (FEV₁ 55%) reports increased dyspnea and
purulent sputum for 48 h. He is afebrile and SpO₂ 89% on room air. Which initial
outpatient management is guideline-concordant?
Options:
A. Increase inhaled corticosteroid dose only
B. Oral prednisolone 40 mg daily × 5 days and amoxicillin-clavulanate -
CORRECT
C. High-flow oxygen to maintain SpO₂ >94%
D. Immediate referral for hospital admission
ANSWER: B
Q003: A 24-year-old woman requests contraception. She has migraine with aura
and BMI 31 kg/m², BP 118/76 mmHg. She smokes 5 cigarettes/day. Which method
is safest today?
, 2
Options:
A. Combined oral contraceptive 20 µg ethinyl estradiol
B. Depot medroxyprogesterone 150 mg q12 weeks - CORRECT
C. Copper IUD—contraindicated in nullipara
D. Combined vaginal ring to reduce systemic estrogen
ANSWER: B
Q004: A 36-year-old woman with PCOS (BMI 30) has irregular menses and
hirsutism; LH:FSH >2 and testosterone mildly elevated. She wishes to conceive.
Which first-line fertility intervention is evidence-based?
Options:
A. Immediate referral for IVF
B. Letrozole 2.5 mg cycle days 3–7 with timed intercourse - CORRECT
C. Metformin 1500 mg daily until conception
D. Combined OCP for 6 months then reassess
ANSWER: B
Q005: A 50-year-old man with HTN and 30 pack-year history reports 3 weeks of
morning headaches and visual floaters. BP 180/110 mmHg; fundoscopy shows
arteriolar narrowing. Which work-up is most urgent today?
Options:
A. Head CT to rule out mass
B. BMP, ECG, urinalysis; start amlodipine 5 mg daily - CORRECT
C. Carotid duplex for bruit
D. MRI brain with contrast for vasculitis
ANSWER: B
Q006: A 19-year-old college student has 10 days of fatigue, pharyngitis, and
cervical nodes. Monospot is positive; liver enzymes mildly elevated. Which return-
to-class advice is correct?
Options:
A. Immediate return if afebrile 24 h
B. No contact sports for 3 weeks and gradual return when fever-free - CORRECT
C. Isolate for 6 weeks to prevent transmission
D. Amoxicillin for 7 days to shorten course
ANSWER: B
, 3
Q007: A 31-year-old woman has 2 days of dysuria and meatal itching. UA: 15
WBC/hpf, no bacteria on Gram stain. No fever or flank pain. Which management
is most appropriate today?
Options:
A. Empiric ciprofloxacin for possible UTI
B. Doxycycline 100 mg BID × 7 days and test for GC/Chlamydia - CORRECT
C. Increase fluids only; no antibiotics
D. IM ceftriaxone and azithromycin 1 g for GC
ANSWER: B
Q008: A 40-year-old man with T2DM (HbA1c 9.2%) has burning feet and hands at
night; monofilament shows decreased sensation. Strength is 5/5. Which
intervention is best today?
Options:
A. Gabapentin 300 mg TID after renal function confirmed
B. Start duloxetine 30 mg daily and optimise glycaemic control - CORRECT
C. MRI lumbar spine for radiculopathy
D. EMG before any medication
ANSWER: B
Q009: A 45-year-old woman has 4 months of bilateral hand pain and stiffness >1 h;
MCP/PIP swelling. RF 42 IU/mL and anti-CCP positive. X-rays normal. Which
initial DMARD is preferred?
Options:
A. Methotrexate 15 mg weekly with folic acid - CORRECT
B. Prednisone 20 mg daily bridge
C. Hydroxychloroquine 400 mg daily
D. NSAID only; rheumatology in 6 months
ANSWER: A
Q010: A 26-year-old woman has 1 week of severe pelvic pain, mucopurulent
discharge, and GC/Chlamydia NAAT positive. She has no allergies. Which CDC-
recommended regimen is best?
Options:
A. Cefixime 400 mg PO and doxycycline × 7 days
B. Ceftriaxone 500 mg IM and azithromycin 1 g PO × 1 - CORRECT
FNP 652 / FNP 6552 Midterm Exam
2026/2027 | GCU Family Primary Care
I | Questions with Verified Answers |
100% Correct | Complete Exam Guide
Q001: A 28-year-old woman presents with 3 weeks of fatigue, weight gain, and
cold intolerance. TSH is 6.8 mIU/L (normal 0.4–4.0) and free T4 is low. She is not
pregnant. Which is the preferred initial treatment and counselling?
Options:
A. Start levothyroxine 25 µg daily and recheck TSH in 6 weeks
B. Start levothyroxine 1.6 µg/kg/day and take 30–60 min before breakfast -
CORRECT
C. Repeat TSH in 3 months; begin therapy only if TSH >10
D. Prescribe liothyronine 5 µg BID for faster symptom relief
ANSWER: B
Q002: A 42-year-old man with COPD (FEV₁ 55%) reports increased dyspnea and
purulent sputum for 48 h. He is afebrile and SpO₂ 89% on room air. Which initial
outpatient management is guideline-concordant?
Options:
A. Increase inhaled corticosteroid dose only
B. Oral prednisolone 40 mg daily × 5 days and amoxicillin-clavulanate -
CORRECT
C. High-flow oxygen to maintain SpO₂ >94%
D. Immediate referral for hospital admission
ANSWER: B
Q003: A 24-year-old woman requests contraception. She has migraine with aura
and BMI 31 kg/m², BP 118/76 mmHg. She smokes 5 cigarettes/day. Which method
is safest today?
, 2
Options:
A. Combined oral contraceptive 20 µg ethinyl estradiol
B. Depot medroxyprogesterone 150 mg q12 weeks - CORRECT
C. Copper IUD—contraindicated in nullipara
D. Combined vaginal ring to reduce systemic estrogen
ANSWER: B
Q004: A 36-year-old woman with PCOS (BMI 30) has irregular menses and
hirsutism; LH:FSH >2 and testosterone mildly elevated. She wishes to conceive.
Which first-line fertility intervention is evidence-based?
Options:
A. Immediate referral for IVF
B. Letrozole 2.5 mg cycle days 3–7 with timed intercourse - CORRECT
C. Metformin 1500 mg daily until conception
D. Combined OCP for 6 months then reassess
ANSWER: B
Q005: A 50-year-old man with HTN and 30 pack-year history reports 3 weeks of
morning headaches and visual floaters. BP 180/110 mmHg; fundoscopy shows
arteriolar narrowing. Which work-up is most urgent today?
Options:
A. Head CT to rule out mass
B. BMP, ECG, urinalysis; start amlodipine 5 mg daily - CORRECT
C. Carotid duplex for bruit
D. MRI brain with contrast for vasculitis
ANSWER: B
Q006: A 19-year-old college student has 10 days of fatigue, pharyngitis, and
cervical nodes. Monospot is positive; liver enzymes mildly elevated. Which return-
to-class advice is correct?
Options:
A. Immediate return if afebrile 24 h
B. No contact sports for 3 weeks and gradual return when fever-free - CORRECT
C. Isolate for 6 weeks to prevent transmission
D. Amoxicillin for 7 days to shorten course
ANSWER: B
, 3
Q007: A 31-year-old woman has 2 days of dysuria and meatal itching. UA: 15
WBC/hpf, no bacteria on Gram stain. No fever or flank pain. Which management
is most appropriate today?
Options:
A. Empiric ciprofloxacin for possible UTI
B. Doxycycline 100 mg BID × 7 days and test for GC/Chlamydia - CORRECT
C. Increase fluids only; no antibiotics
D. IM ceftriaxone and azithromycin 1 g for GC
ANSWER: B
Q008: A 40-year-old man with T2DM (HbA1c 9.2%) has burning feet and hands at
night; monofilament shows decreased sensation. Strength is 5/5. Which
intervention is best today?
Options:
A. Gabapentin 300 mg TID after renal function confirmed
B. Start duloxetine 30 mg daily and optimise glycaemic control - CORRECT
C. MRI lumbar spine for radiculopathy
D. EMG before any medication
ANSWER: B
Q009: A 45-year-old woman has 4 months of bilateral hand pain and stiffness >1 h;
MCP/PIP swelling. RF 42 IU/mL and anti-CCP positive. X-rays normal. Which
initial DMARD is preferred?
Options:
A. Methotrexate 15 mg weekly with folic acid - CORRECT
B. Prednisone 20 mg daily bridge
C. Hydroxychloroquine 400 mg daily
D. NSAID only; rheumatology in 6 months
ANSWER: A
Q010: A 26-year-old woman has 1 week of severe pelvic pain, mucopurulent
discharge, and GC/Chlamydia NAAT positive. She has no allergies. Which CDC-
recommended regimen is best?
Options:
A. Cefixime 400 mg PO and doxycycline × 7 days
B. Ceftriaxone 500 mg IM and azithromycin 1 g PO × 1 - CORRECT
